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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: Immunotherapy, also known as allergy shots, is a form of treatment that can help reduce symptoms for individuals with severe allergies to substances such as pollen, dust mites, or pet dander. This treatment involves exposing the patient to small, increasing doses of the allergen over time to help the immune system gradually build up a tolerance. Patients with severe allergies to grass and tree pollen would most likely benefit from immunotherapy as it can help reduce their allergy symptoms and improve their quality of life. On the other hand, individuals with anaphylactic reactions to insect stings (Choice A), allergies to eggs and dairy (Choice B), or a positive tuberculin skin test (Choice C) are not typically candidates for immunotherapy as their conditions are not related to the type of allergies that are commonly treated with this method.
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A nurse at an allergy clinic is providing education for a patient starting immunotherapy for the treatment of allergies. What education should the nurse prioritize?
- A. The importance of scheduling appointments for the same time each month
- B. The importance of keeping appointments for desensitization procedures
- C. The importance of avoiding antihistamines for the duration of treatment
- D. The importance of keeping a diary of reactions to the immunotherapy
Correct Answer: B
Rationale: The nurse should prioritize educating the patient on the importance of keeping appointments for desensitization procedures. Immunotherapy involves gradually increasing exposure to allergens to build tolerance and reduce allergic reactions. Missing desensitization appointments can lead to interruptions in treatment and potentially decrease the effectiveness of the therapy. It is crucial for the patient to adhere to the scheduled appointments as prescribed by the healthcare provider to ensure the success of the immunotherapy treatment.
A patient is on a full liquid diet. Which food item choice by the patient will cause the nurse to intervene?
- A. Custard
- B. Frozen yogurt
- C. Pureed vegetables
- D. Mashed potatoes and gravy
Correct Answer: D
Rationale: Mashed potatoes and gravy are not appropriate for a full liquid diet. A full liquid diet consists of foods that are liquid at room temperature or melt into liquid form at body temperature. Mashed potatoes and gravy are not in liquid form and therefore should not be consumed by a patient following a full liquid diet. The nurse should intervene and provide education about the correct food choices allowed on a full liquid diet, such as custard, frozen yogurt, and pureed vegetables.
The nurse is caring for a patient receiving total parenteral nutrition (TPN). Which action will the nurse take?
- A. Run lipids for no longer than 24 hours.
- B. Take down a running bag of TPN after 36 hours.
- C. Clean injection port with alcohol 5 seconds before and after use.
- D. Wear a sterile mask when changing the central venous catheter dressing.
Correct Answer: D
Rationale: When caring for a patient receiving total parenteral nutrition (TPN), it is crucial to maintain strict aseptic technique to prevent infection. Wearing a sterile mask when changing the central venous catheter dressing helps to reduce the risk of introducing pathogens into the catheter site, which can lead to serious bloodstream infections. It is essential to use sterile gloves, a sterile mask, and to assess the insertion site for any signs or symptoms of infection during central venous catheter dressing changes. Additionally, to prevent infection, TPN infusion tubing should be changed every 24 hours, and no single container of TPN should be hung for longer than 24 hours, with lipids not running for longer than 12 hours.
A patient comes to the clinic complaining of a tender, inflamed vulva. Testing does not reveal the presence of any known causative microorganism. What aspect of this patients current health status may account for the patients symptoms of vulvitis?
- A. The patient is morbidly obese.
- B. The patient has type 1 diabetes.
- C. The patient has chronic kidney disease.
- D. The patient has numerous allergies.
Correct Answer: A
Rationale: Morbid obesity is a risk factor for developing a condition known as intertrigo, which is inflammation of the skin folds. In this case, the skin folds of the vulva are affected, leading to vulvitis. The warm and moist environment between the skin folds in obese individuals can promote the growth of microorganisms and the development of inflammation. This can result in symptoms such as tenderness and redness in the vulva. Since testing did not reveal the presence of any known causative microorganism, the patient's morbid obesity may be the underlying factor contributing to the symptoms of vulvitis. Treating the intertrigo and addressing the underlying obesity may help alleviate the symptoms.
A nurse is teaching a patient about the largeintestine in elimination. In which order will the nurse list the structures, starting with the first portion?
- A. Cecum, ascending, transverse, descending, sigmoid, and rectum
- B. Ascending, transverse, descending, sigmoid, rectum, and cecum
- C. Cecum, sigmoid, ascending, transverse, descending, and rectum
- D. Ascending, transverse, descending, rectum, sigmoid, and cecum
Correct Answer: A
Rationale: The order in which the structures of the large intestine are listed starting with the first portion is as follows: cecum (the pouch where the large intestine begins), ascending colon (runs vertically up the right side of the abdomen), transverse colon (crosses horizontally from the right side of the abdomen to the left), descending colon (descends vertically down the left side of the abdomen), sigmoid colon (the S-shaped curve that leads into the rectum), and rectum (the final portion where feces are stored before being eliminated from the body). Therefore, option A provides the correct order of structures in the large intestine during elimination.