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The nurse is providing health education to the parents of a toddler who has been diagnosed with food allergies. What should the nurse teach this family about the childs health problem?
- A. Food allergies are a life-long condition, but most families adjust quite well to the necessary lifestyle changes.
- B. Consistent use of over-the-counter antihistamines can often help a child overcome food allergies.
- C. Make sure that you carry a steroid inhaler with you at all times, especially when you eat in restaurants.
- D. Many children outgrow their food allergies in a few years if they avoid the offending foods.
Correct Answer: D
Rationale: Many food allergies disappear with time, particularly in children. About one-third of proven allergies disappear in 1 to 2 years if the patient carefully avoids the offending food. Antihistamines do not cure allergies and an EpiPen is carried, not a steroid inhaler.
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A nurse has asked the nurse educator if there is any way to predict the severity of a patients anaphylactic reaction. What would be the nurses best response?
- A. The faster the onset of symptoms, the more severe the reaction.
- B. The reaction will be about one-third more severe than the patients last reaction to the same antigen.
- C. There is no way to gauge the severity of a patients anaphylaxis, even if it has occurred repeatedly in the past.
- D. The reaction will generally be slightly less severe than the last reaction to the same antigen.
Correct Answer: A
Rationale: The time from exposure to the antigen to onset of symptoms is a good indicator of the severity of the reaction: the faster the onset, the more severe the reaction. None of the other statements is an accurate description of the course of anaphylactic reactions.
Which of the following individuals would be the most appropriate candidate for immunotherapy?
- A. A patient who had an anaphylactic reaction to an insect sting
- B. A child with allergies to eggs and dairy
- C. A patient who has had a positive tuberculin skin test
- D. A patient with severe allergies to grass and tree pollen
Correct Answer: D
Rationale: The benefit of immunotherapy has been fairly well established in instances of allergic rhinitis and bronchial asthma that are clearly due to sensitivity to one of the common pollens, molds, or household dust. Immunotherapy is not used to treat type I hypersensitivities. A positive tuberculin skin test is not an indication for immunotherapy.
A patient is receiving a transfusion of packed red blood cells. Shortly after initiation of the transfusion, the patient begins to exhibit signs and symptoms of a transfusion reaction. The patient is suffering from which type of hypersensitivity?
- A. Anaphylactic (type I)
- B. Cytotoxic (type II)
- C. Immune complex (type III)
- D. Delayed type (type IV)
Correct Answer: B
Rationale: A type II hypersensitivity reaction resulting in red blood cell destruction is associated with blood transfusions. This type of reaction does not result from types I, III, or IV reactions.
A nurse knows of several patients who have achieved adequate control of their allergy symptoms using over-the-counter antihistamines. Antihistamines would be contraindicated in the care of which patient?
- A. A patient who has previously been treated for tuberculosis
- B. A pregnant woman at 30 weeks gestation
- C. A patient who is on estrogen-replacement therapy
- D. A patient with a severe allergy to eggs
Correct Answer: B
Rationale: Antihistamines are contraindicated during the third trimester of pregnancy. Previous tuberculosis, hormone therapy, and food allergies do not contraindicate the use of antihistamines.
A child has been diagnosed with a severe walnut allergy after suffering an anaphylactic reaction. What is a priority for health education?
- A. The need to begin immunotherapy as soon as possible
- B. The need for the parents to carry an epinephrine pen
- C. The need to vigilantly maintain the childs immunization status
- D. The need for the child to avoid all foods that have a high potential for allergies
Correct Answer: B
Rationale: All patients with food allergies, especially seafood and nuts, should have an EpiPen device prescribed. The child does not necessarily need to avoid all common food allergens. Immunotherapy is not indicated in the treatment of childhood food allergies. Immunizations are important, but do not address food allergies.