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Ati lpn advanced med Surg exam.
Ati lpn advanced med Surg exam.
Total Questions : 45
Showing 10 questions Sign up for moreThe nurse is educating a patient concerning use of an Epi-pen for a severe allergic reaction to peanuts.
Which of the following statements, made by the patient, allows the nurse to know that the education must be reinforced?
Explanation
"I need to carry the Epi-pen with me at all times": Individuals with severe allergies should always have an Epi-pen in case of exposure to allergens. No reinforcement needed.
"When my Epi-pen reaches its expiration date, I need to get a new one": Epi-pens have a limited shelf life, and using an expired pen may be ineffective. No reinforcement needed.
"Once I inject myself with my Epi-pen, I won't have to go to the hospital": Epinephrine provides temporary relief, but further medical evaluation is essential due to the risk of a biphasic reaction or persistent symptoms. Reinforcement needed.
"I need to avoid all foods that may have been exposed to peanuts": Strict avoidance of allergens is essential to prevent severe reactions. No reinforcement needed.
A nurse is collecting data from a client who has systemic lupus erythematosus (SLE). Which of the following findings should the nurse expect?
Explanation
- Iritis: This is associated more with autoimmune conditions like ankylosing spondylitis rather than SLE.
- Spinal deformity is not a typical feature of SLE. Spinal deformities are more commonly seen in conditions like rheumatoid arthritis.
- Facial rash: The characteristic "butterfly" rash over the cheeks and nose is a hallmark finding in SLE.
- Thickened skin: SLE typically presents with skin lesions or rashes rather than skin thickening.
A nurse is reviewing the medical record of a client who just returned to the unit following surgery and notes the client has a history of anaphylaxis in response to penicillin. The client's postoperative prescriptions include a dose of cephalexin. Which of the following actions should the nurse take?
Explanation
Request that the surgeon prescribe a different antibiotic: Cephalexin is a cephalosporin, and there is a risk of cross-reactivity in clients with a history of anaphylaxis to penicillin.
Ask the provider to prescribe diphenhydramine as a precaution: While antihistamines may alleviate mild allergic reactions, they are not a substitute for avoiding high-risk medications in clients with anaphylaxis history.
Confirm with the client that the reaction he had was truly anaphylaxis: The client's medical record already documents anaphylaxis, which should be taken seriously without further questioning.
Administer the medication: This action disregards the client's history of anaphylaxis to a related drug class.
The nurse knows that Type IV Hypersensitivity Reaction involves which of the following?
Explanation
Histamine release: Histamine release is characteristic of Type I hypersensitivity reactions (immediate hypersensitivity) rather than Type IV.
T-lymphocyte memory cells: Type IV hypersensitivity is a delayed response mediated by T-lymphocytes, not antibodies.
Immunosuppression: Immunosuppression is not directly related to hypersensitivity reactions.
Antigen/antibody interaction: This is characteristic of Types I, II, and III hypersensitivity reactions, not Type IV.
The nurse knows that pernicious anemia is caused by which of the following?
Explanation
A. Damage to kidneys, which cause a decrease in erythropoietin production: This describes anemia of chronic disease or kidney-related anemia, not pernicious anemia.
B. Destruction of gastric parietal cells, which decrease intrinsic factor production: Pernicious anemia results from the loss of intrinsic factor, essential for vitamin B12 absorption in the intestine.
C. Decrease in RBC in the bone marrow: This is more characteristic of aplastic anemia or bone marrow suppression rather than pernicious anemia.
D. Hemolysis of RBC: This describes hemolytic anemia rather than pernicious anemia.
The nurse would evaluate that the patient understands what triggers allergic rhinitis by which of the following patient responses?
Explanation
A. Topical creams and ointments: These are more likely to trigger contact dermatitis, not allergic rhinitis.
B. Airborne pollens and molds: Allergic rhinitis is often triggered by airborne allergens such as pollen, mold spores, and dust mites.
C. Ingested food and medications: These are typically triggers for food allergies or medication allergies, not allergic rhinitis.
D. Injected medications: Although injections can cause allergic reactions, they are not the typical trigger for allergic rhinitis.
The nurse knows the following are symptoms of anaphylaxis and they need to intervene quickly.
(Select All that Apply.)
Explanation
A. Hypotension: A rapid drop in blood pressure is a hallmark symptom of anaphylaxis.
B. Bradycardia: Bradycardia is not a common finding in anaphylaxis. Tachycardia (rapid heart rate) is more typical due to compensatory mechanisms.
C. Hypertension: Anaphylaxis usually causes hypotension due to vascular leakage and vasodilation.
D. Tachycardia: Tachycardia is commonly seen in anaphylaxis as the heart attempts to compensate for the drop in blood pressure.
E. Wheezing: Wheezing is a sign of bronchospasm and respiratory distress, which is a common feature of anaphylaxis.
The most common medication category used to treat allergic rhinitis is which of the following?
Explanation
A. Antihistamines: Antihistamines are the first-line treatment for allergic rhinitis as they block histamine, which is responsible for allergic symptoms such as sneezing, itching, and runny nose.
B. Antibiotics: Antibiotics are used for bacterial infections, not for allergic rhinitis, which is an allergic condition.
C. Antivirals: Antivirals are used for viral infections, not allergic rhinitis.
D. Bronchodilators: Bronchodilators are used for conditions like asthma, not for allergic rhinitis.
The nurse knows that it is very important when giving a patient blood to make sure it is the correct blood type to avoid which of the following conditions?
Explanation
A. Hemolytic transfusion reaction: Administering the wrong blood type can lead to a hemolytic transfusion reaction, where the immune system attacks the transfused red blood cells, causing serious complications.
B. Pernicious anemia: Pernicious anemia is related to a lack of intrinsic factor and vitamin B12 absorption, not blood transfusions.
C. Angioedema: Angioedema involves swelling of the skin or mucous membranes, typically due to allergic reactions, not blood transfusions.
D. Contact dermatitis: Contact dermatitis is a skin condition caused by direct contact with allergens, irritants, or chemicals, not by blood transfusions.
A nurse is collecting data from a client who has AIDS. When checking the client's mouth, the nurse notes a white, creamy covering on the tongue and buccal membranes. The nurse should recognize this is a manifestation of which of the following conditions?
Explanation
A. Gingivitis refers to inflammation of the gums, typically causing redness and bleeding, not a white, creamy coating.
B. Xerostomia (dry mouth) can occur in HIV/AIDS but does not typically cause a white, creamy coating.
C. Candidiasis; a white, creamy coating on the tongue and buccal membranes is characteristic of oral candidiasis (thrush), a common fungal infection in immunocompromised individuals, including those with AIDS.
D. Halitosis refers to bad breath and is not associated with a white coating on the tongue.
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