Nokea
Immediately after the nurse administers an intradermal injection of a suspected antigen during allergy testing, the patient complains of itching at the site, weakness, and dizziness. Which action by the nurse is most appropriate initially?
- A. Elevate the arm above the shoulder.
- B. Administer subcutaneous epinephrine.
- C. Apply a warm compress to area.
- D. Apply a local antiinflammatory cream to the site.
Correct Answer: B
Rationale: Injection of subcutaneous epinephrine should be given at the first sign of allergy.
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Which person is most at risk for having a reduced number of T-cells?
- A. 26 year old receiving a second desensitization injection
- B. 35 year old starting back on birth control tablets
- C. The 52 year old started on a new series of Pyridium for cystitis
- D. The 84 year old receiving penicillin for an annually recurring respiratory infection
Correct Answer: D
Rationale: The 84 year old with the deteriorated immune system is at risk for having a reduced number of T-cells.
Which substance is released by the T cells that stimulates the lymphocytes to attack an inflammation?
- A. Lymphokine
- B. Epinephrine
- C. B cells
- D. Histamine
Correct Answer: A
Rationale: Lymphokines help attract macrophages to the site of the inflammation.
A patient who works in a plant nursery and has experienced an allergic reaction to a bee sting is stabilized and prepared for discharge from the clinic. During discussion of prevention and management of further allergic reactions, the nurse identifies a need for additional teaching based on which comment?
- A. I need to think about a change in my occupation.'
- B. I will learn to administer epinephrine so that I will be prepared if I am stung again.'
- C. I should wear a Medic-Alert bracelet indicating my allergy to insect stings.'
- D. I will need to take maintenance doses of corticosteroids to prevent reactions to further stings.'
Correct Answer: D
Rationale: The nurse?s responsibilities in patient education are as follows: Teach the patient preparation and administration of epinephrine subcutaneously. There is no need for the patient to take maintenance doses of corticosteroids because this was a short, rapid reaction.
The nurse recommends to the busy parent of three young children that the antihistamine fexofenadine would be more beneficial than diphenhydramine because fexofenadine has which quality?
- A. is inexpensive.
- B. contains a stimulant for an energy boost.
- C. does not dry out the mucous membranes.
- D. does not induce drowsiness.
Correct Answer: D
Rationale: Allegra does not induce drowsiness as does Benadryl.
Which advice will the nurse provide for a 94-year-old patient with deteriorated cell-mediated immunity?
- A. Avoiding the influenza vaccine
- B. Getting pneumonia vaccine
- C. Having skin tests for all antigens
- D. Taking large doses of β-carotene
Correct Answer: B
Rationale: As the older adult loses some of the cell-mediated immunity, especially against pneumonia and influenza, it is recommended that they acquire the immunization.