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A client sustained an injury in one eye during a basketball game after being hit with another player's elbow. The client reports now having difficulty with vision in the other eye too, although that eye was not hit by the elbow. What does the nurse understand this phenomenon to be known as?
- A. Cataracts
- B. Psychosomatic blindness
- C. Glaucoma
- D. Sympathetic uveitis
Correct Answer: D
Rationale: When a person experiences trauma followed by inflammation to the iris, ciliary body, and choroid layer of one eye, the vision in the untraumatized eye also becomes affected. The term for this phenomenon is sympathetic uveitis. Cataracts do not occur from trauma, they develop over time. Psychosomatic blindness does not relate to the client's visual disturbance because the client is not blind at this time. Glaucoma is an eye disorder that occurs over time and is not related to trauma to the eye.
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A client is scheduled to have a prick test to determine what specific allergens are creating problems for the client. What should the nurse inform the client is involved with the testing?
- A. A concentrated form of the substance is applied to the skin and covered with an occlusive dressing for 48 hours and then examined.
- B. A dilute solution of an antigen is injected intradermally and observed for a wheal.
- C. The skin will be scratched, a small amount of the liquid test antigen will be applied to the scratch, usually on the back.
- D. The client will taste several different possible antigens and observe for wheals.
Correct Answer: C
Rationale: The scratch or prick test involves scratching the skin and applying a small amount of the liquid test antigen to the scratch. The tester applies one allergen per scratch over the client's forearm, upper arm, or back. The back is more sensitive than the arm. Results of the test are identifiable in as little as 20 minutes. If a raised wheal with localized erythema appears, the tester measures its length and width in millimeters. The client does not taste in any of the skin tests.
A client presents to the clinic with reports of itching and hives after taking an aspirin this morning. What medication does the nurse anticipate administering that blocks histamine receptors?
- A. Diphenhydramine
- B. Flunisolide
- C. Beclomethasone dipropionate
- D. Pseudoephedrine hydrochloride
Correct Answer: A
Rationale: Diphenhydramine is an antihistamine used for allergic reactions. Flunisolide is a nasal decongestant agent and is used locally to the nasal mucosa. Beclomethasone dipropionate is a nasal steroid spray and inhalant. Pseudoephedrine hydrochloride only constricts nasal membranes.
A client received 2 units of packed red blood cells while in the hospital with rectal bleeding. Three days after discharge, the client experienced an allergic response and began to itch and break out with hives. What type of reaction does the nurse understand could be occurring?
- A. Delayed hypersensitivity response
- B. Anaphylactic reaction
- C. Sensitization
- D. An immediate hypersensitivity response
Correct Answer: A
Rationale: A delayed hypersensitivity response may develop over several hours or days, or it may reach maximum severity after repeated exposure. Examples of a delayed hypersensitivity response include a blood transfusion reaction that occurs days to weeks after blood administration, rejection of transplanted tissues, and reaction to a tuberculin skin test. Anaphylaxis is a rapid and profound type I hypersensitivity response. Sensitization is the process by which cellular and chemical events occur after a second or subsequent exposure to an allergen. An immediate hypersensitivity response is due to antibodies interacting with allergens and occurs rapidly.
A client comes to the clinic and reports having 'broken out in hives and itching since eating strawberries this morning.' The client states never having had problems with strawberries before. What is the best response by the nurse?
- A. It is probably not the strawberries that you are having an allergy to if you have eaten them before.'
- B. It is possible to develop an allergic reaction to something you have had prior exposure to previously.'
- C. Are you sure that you haven't had an allergic reaction before; this doesn't seem possible.'
- D. We will probably be admitting you to the hospital; this could cause respiratory arrest.'
Correct Answer: B
Rationale: Allergies can occur at any age, and the pattern of allergic response can vary in the same person at different points in life. For example, a person may suddenly develop an allergic reaction to a substance such as latex, despite having had multiple prior contacts with latex and no past problems. Although an allergic reaction may cause laryngeal swelling, this client does not exhibit any of the signs and symptoms of respiratory distress that would lead to respiratory arrest.
The nurse has four clients who are scheduled to see the physician for 'fatigue' and other general symptom complaints. Which client does the nurse determine is at most risk for having chronic fatigue syndrome?
- A. Male of Hispanic descent, age 28 years
- B. Female of Caucasian descent, age 47 years
- C. Female of African descent, age 42 years
- D. Female of Chinese descent, age 18 years
Correct Answer: B
Rationale: Estimates are that as many as 4 million people in the United States have symptoms corresponding with chronic fatigue syndrome, but fewer than 80% have been diagnosed by a medical provider. Most clients who seek treatment for their symptoms are Caucasian women 40 to 59 years of age. CFS also occurs at lower rates among children, adolescents, and men.