Nokea
The nurse encourages a new mother to breastfeed her infant, even for a short time, because colostrum will provide the infant with which of the following types of immunity?
- A. Innate
- B. Active
- C. Passive
- D. Cell-mediated
Correct Answer: C
Rationale: Colostrum provides passive immunity through antibodies from the mother; these antibodies protect the infant for a few months. However, memory cells are not retained, so the protection is not permanent. Innate immunity is present at birth and occurs without exposure to an antigen. Active immunity requires that the infant manufacture antibodies after exposure to an antigen. Cell-mediated immunity is acquired through T-lymphocytes and is a form of active immunity.
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To determine whether a patient's angioedema has responded to prescribed therapies, which of the following actions should the nurse take first?
- A. Ask about any clear nasal discharge.
- B. Obtain blood pressure and heart rate.
- C. Check for swelling of the lips and tongue.
- D. Assess extremities for wheal and flare lesions.
Correct Answer: C
Rationale: Angioedema is characterized by swelling of the eyelids, lips, and tongue. Wheal and flare lesions, clear nasal drainage, and hypotension and tachycardia are characteristics of other allergic reactions.
The nurse is obtaining a health history from a patient who works as a laboratory technician and learns that the patient has a history of allergic rhinitis, asthma, and multiple food allergies. Which of the following actions is most important for the nurse to implement?
- A. Encourage the patient to carry an epinephrine kit in case a type IV allergic reaction to latex develops.
- B. Advise the patient to use oil-based hand creams to decrease contact with natural proteins in latex gloves.
- C. Document the patient's allergy history and be alert for any clinical manifestations of a type I latex allergy.
- D. Recommend that the patient use vinyl gloves instead of latex gloves in preventing bloodborne pathogen contact.
Correct Answer: C
Rationale: The patient's allergy history and occupation indicate a risk for development of latex allergy, and the nurse should be prepared to manage any symptoms that occur. Epinephrine is not an appropriate treatment for contact dermatitis that is caused by a type IV allergic reaction to latex. Oil-based creams will increase the exposure to latex from latex gloves. Vinyl gloves are appropriate to use when exposure to body fluids is unlikely.
The nurse discusses the prevention and management of allergic reactions with a patient who is a beekeeper and has developed a hypersensitivity to bee sting. Which of the following patient statements indicates a need for additional teaching?
- A. I will plan to take oral antihistamines daily before going to work.'
- B. I will get a prescription for epinephrine and learn to self-inject it.'
- C. I should wear a Medic Alert bracelet indicating my allergy to bee stings.'
- D. I am going to need job retraining so that I can work in a different occupation.'
Correct Answer: A
Rationale: Since the patient is at risk for bee stings and the severity of allergic reactions tends to increase with added exposure to allergen, taking oral antihistamines will not adequately control the patient's hypersensitivity reaction. The other patient statements indicate a good understanding of management of the problem.
Which information about a patient who is receiving immunotherapy and has just received an allergen injection is most important to communicate to the health care provider?
- A. The patient's IgG level is increased.
- B. The injection site is red and swollen.
- C. The patient's allergy symptoms have not improved.
- D. There is a 3-cm wheal at the site of the allergen injection.
Correct Answer: D
Rationale: A local reaction larger than quarter size may indicate that a decrease in the allergen dose is needed. An increase in IgG indicates that the therapy is effective. Redness and swelling at the site are not unusual. Because immunotherapy usually takes 1-2 years to achieve an effect, an improvement in the patient's symptoms is not expected after a few months.
The nurse is admitting a patient to hospital who has acute rejection of an organ transplant. Which of the following patients is the most appropriate roommate?
- A. A patient who has viral pneumonia
- B. A patient with second-degree burns
- C. A patient who is recovering from an anaphylactic reaction to a bee sting
- D. A patient with graft-versus-host disease after a recent bone marrow transplant
Correct Answer: C
Rationale: Treatment for a patient with acute rejection includes administration of additional immunosuppressants, and the patient should not be exposed to increased risk for infection as would occur from patients with viral pneumonia, graft-versus-host disease, and burns. There is no increased exposure to infection from a patient with anaphylaxis.