Systems of Care 3 Immune Dysfunction Med-Surg Practice Questions

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1. Which of the following statements made by the nurse is most appropriate in teaching patient interventions to minimize the effects of seasonal allergic rhinitis? A. B. C. D. You will need to get rid of your pets. You should sleep in an air-conditioned room. You would do best to stay indoors during the winter months. You will need to dust your house with a dry feather duster twice a week.

B: Seasonal allergic rhinitis is most commonly caused by pollens from trees, weeds, and grasses. Airborne allergies can be controlled by sleeping in an air-conditioned room, daily damp dusting, covering the mattress and pillows with hypoallergenic covers, and wearing a mask outdoors. 2. When caring for a patient with a known latex allergy, the nurse would monitor the patient closely for a cross-sensitivity to which of the following foods (select all that apply)? A. B. C. D. E. Grapes Oranges Bananas Potatoes Tomatoes

C: Because some proteins in rubber are similar to food proteins, some foods may cause an allergic reaction in people who are allergic to latex. The most common of these foods are bananas, avocados, chestnuts, kiwi fruit, tomatoes, water chestnuts, guava, hazelnuts, potatoes, peaches, grapes, and apricots. 3. Ten days after receiving a bone marrow transplant, a patient has developed a skin rash on his palms and soles, jaundice, and diarrhea. What is the most likely etiology of these clinical manifestations?

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A. B. C. D. The patient is experiencing a type I allergic reaction. An atopic reaction is causing the patients symptoms. The patient is experiencing rejection of the bone marrow. Cells in the transplanted bone marrow are rejecting the host tissue.

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D: The patients symptoms are characteristic of graft-versus-host-disease (GVHD) in which transplanted cells mount an immune response to the hosts tissue. GVHD is not a type I allergic response or an atopic reaction, and it differs from transplant rejection in that the graft rejects the host rather than the host rejecting the graft. 4. A patients low hemoglobin and hematocrit have necessitated a transfusion of packed red blood cells (PRBCs). Shortly after the first unit of PRBCs is hung, the patient develops signs and symptoms of a transfusion reaction. Which of the following hypersensitivity reactions has the patient experienced? A. B. C. D. Type I Type II Type III Type IV

B: Transfusion reactions are characterized as a type II (cytotoxic) reaction in which agglutination and cytolysis occur. 5. A patient has begun immunotherapy for the treatment of intractable environmental allergies. When administering the patients immunotherapy, which of the following is the nurses priority action? A. B. C. D. Monitoring the patients fluid balance Assessing the patients need for analgesia Assessing the patient for changes in level of consciousness Monitoring for signs and symptoms of an adverse reaction

D: When administering immunotherapy, it is imperative to closely monitor the patient for any signs of an adverse reaction. The high risk and significant consequence of an adverse

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reaction supersede the need to assess the patients fluid balance, whereas pain and changes in level of consciousness are not likely events when administering immunotherapy. 6. For which of the following individuals is genetic carrier screening indicated? A. B. C. D. A patient with a history of type 1 diabetes A patient with a family history of sickle cell disease A patient whose mother and sister died of breast cancer A patient who has a long-standing history of iron-deficiency anemia

B: Genetic carrier screening should be done in families with a history of sickle cell disease. Diabetes and iron-deficiency anemia are not amenable to any form of genetic testing, whereas a family history of breast cancer suggests the need for presymptomatic testing for estimating the patients risk of developing breast cancer.