Nokea
The client is highly allergic to insect venom and is prescribed venom immunotherapy. Which statement is the scientific rationale for this treatment?
- A. Immunotherapy is effective in preventing anaphylaxis following a future sting.
- B. Immunotherapy will prevent all future insect stings from harming the client.
- C. This therapy will cure the client from having any allergic reactions in the future.
- D. This therapy is experimental and should not be undertaken by the client.
Correct Answer: A
Rationale: Venom immunotherapy desensitizes the immune system, reducing anaphylaxis risk. It does not prevent stings, cure all allergies, or remain experimental.
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Which sign/symptom makes the nurse suspect the client has ankylosing spondylitis?
- A. Low back pain at night relieved by activity in the morning.
- B. Ascending paralysis of the lower extremities up to the spinal cord.
- C. A deep ache and stiffness in the hip joints radiating down the legs.
- D. Difficulty changing from lying to sitting position, especially at night.
Correct Answer: A
Rationale: Nighttime low back pain relieved by morning activity is classic for ankylosing spondylitis. Paralysis, hip pain, and positional difficulty suggest other conditions.
The client is experiencing an anaphylactic reaction to bee venom. Which interventions should the nurse implement? List in order of priority.
- A. Establish a patent airway.
- B. Administer epinephrine, an adrenergic agonist, IVP.
- C. Start an IV with 0.9% saline.
- D. Teach the client to carry an EpiPen when outside.
- E. Administer diphenhydramine (Benadryl), an antihistamine, IVP.
Correct Answer: A,B,C,E,D
Rationale: Priority: 1) Airway (ABCs); 2) Epinephrine (reverse anaphylaxis); 3) IV fluids (support hemodynamics); 4) Diphenhydramine (reduce histamine effects); 5) EpiPen teaching (prevention).
The 20-year-old female client diagnosed with advanced unremitting RA is being admitted to receive a regimen of immunosuppressive medications. Which question should the nurse ask during the admission process regarding the medications?
- A. Are you sexually active, and, if so, are you using birth control?
- B. Have you discussed taking these drugs with your parents?
- C. Which arm do you prefer to have an IV in for four (4) days?
- D. Have you signed an informed consent for investigational drugs?
Correct Answer: A
Rationale: Immunosuppressants are teratogenic, making contraception critical. Parental discussion, IV preference, and investigational consent are less relevant.
Which surgical procedure should the nurse anticipate the client with myasthenia gravis undergoing to help prevent the signs/symptoms of the disease process?
- A. There is no surgical option.
- B. A transsphenoidal hypophysectomy.
- C. A thymectomy.
- D. An adrenalectomy.
Correct Answer: C
Rationale: Thymectomy can reduce symptoms in myasthenia gravis by removing the thymus, often implicated in autoimmunity. Other surgeries are irrelevant.
The home health nurse is caring for the client newly diagnosed with multiple sclerosis. Which client issue is of most importance?
- A. The client refuses to have a gastrostomy feeding.
- B. The client wants to discuss if she should tell her fiancé.
- C. The client tells the nurse life is not worth living anymore.
- D. The client needs the flu and pneumonia vaccines.
Correct Answer: C
Rationale: Suicidal ideation indicates a mental health crisis, requiring immediate intervention. Gastrostomy refusal, disclosure to fiancé, and vaccines are less urgent.