1.The nurse encourages a client with an immunologic disorder to eat a nutritionally balanced diet to promote optimal immunologic function. Autoimmunity has been linked to excessive ingestion of A) protein B) fat C) vitamin A D) Zinc ANSWER: B 2.A client with a history of asthma presents in the physician's office with complaints of difficulty breathing. While performing the initial assessment,the nurse become concerned that the client's respiratory status has worsened based on which of the following? A) Wheezing throughout the lung fields B) Noticeably diminished breath Sounds C) Loud wheezing only on expiration D) Mild wheezing on inspiration ANSWER: B 3.The nurse assesses a college age client complaining of shortness of breath after joggin and tightness in his chest. Upon further questioning, the client denies a sore throat, fever or productive cough.The nurse notifies the physician that this client's clinical manifestations are most likely related to A) pneumonia B) bronchitis C) pneumoconiosis D) asthma ANSWER: D 4.A patient has acne, easy bruising, thin extremities, and truncal obesity. These clinical manifestations are indicative of which endocrine disorder? A) Hyperthyroidism B) Hypoaldosteronism C) Diabetes insipidus D) Cushing disease ANSWER: D 5.When assessing a 40 year old client with Cushing's syndrome, the nurse should expect the client to demonstrate: A) Lability of mood, hyperglycemia and excessive facial hair B) Ectomorphism, moon face and hypoglycemia C) Decreased facial hair D) Increased resistance to bruising and bleeding ANSWER: A 6.What is the first lab test that indicates a patient with type 1 diabetes is developing nephropathy? A) Dipstick test for urine ketones B) Increase in serum creatinine and blood urea nitrogen [BUN] C) Protein in the urinalysis D) Cloudy urine on the urinalysis ANSWER: C 7.Which clinical finding occurs first in metabolic acidosis of the patient with type 1 diabetes mellitus? A) Ketones in the urine B) Palpitations, anxiety, and confusion C) Hyperlipidemia D) Kussmaul respirations ANSWER: A 8.A patient with diabetes mellitus type 1 experiences hunger, lightheadedness, tachycardia, pallor, headache, and confusion. What is the most probable cause of these symptoms? A) Hyperglycemia caused by incorrect insulin administration B) Dawn phenomenon from eating a snack before bed time C) Hypoglycemia caused by increased exercise D) Somogyi effect from insulin sensitivity ANSWER: C 9.A client complains of cold clammy skin, hunger, dizziness and irritability. He has been diagnosed with insulin –dependent diabetes mellitus for several years now. Based on these symptoms, the nurse should suspect that the client's serum glucose levels (in mg/dl) is A) More than 300 B) Between 150 and 200 C) Approximately 80 to 100 D) Below 50 ANSWER: D 10.When a client experiences hypoglycemia, the nurse should initially administer A) Insulin B) Metformin C) Glass of orange juice D) Toblerone chocolate bar ANSWER: C 11.Which of the following should be included in the assessment of a client with diabetes mellitus who is experiencing a hypoglycemic reaction? A) Tremors B) Extreme thirst C) Flushed skin D) Constricted pupils ANSWER: A 12.The client with diabetes mellitus asks the nurse which blood sugar test is most significant in determining one is diabetiC) The best response of the nurse would be A) When you have two consecutive fasting blood sugars of 126 or more in a short period of time B) Whenever you have a blood sugar taken and it is 150 or more C) When your blood sugar is in the range of 150 and 190 a couple of hours after you drink a special glucose solution D) When your blood sugar is 175 or more an hour after you have taken a meal ANSWER: A 13.A client complains of cold clammy skin, hunger, dizziness and irritability. He has been diagnosed with insulin –dependent diabetes mellitus for several years now. Based on these symptoms, the nurse should suspect that the client's serum glucose levels (in mg/dl) is A) More than 300 B,Between 150 and 200 C) Approximately 80 to 100 D) Below 50 ANSWER: D 14. The nurse should instruct a client with diabetes mellitus and the client's family the clinical manifestations of diabetic ketoacidosis before discharge. Which of the following should be included? A) Dehydration B) Shallow labored respirations C) Tremors D) Cold, clammy skin ANSWER: A 15.Which of the following should the nurse include in the instructions given to a client with diabetes mellitus on how to prevent hypoglycemia? A) Eat a meal or snack every four to five hours while awake B) have a family member learn to inject insulin if symptoms appear C) Increase insulin if moderate exercise is planned D) Ingest complex carbohydrates if symptoms appear ANSWER: A 16. The nurse instructs a client with Diabetes mellitus that the priority self-care activity for preventing the complications of diabetes is A) Learn to administer insulin properly and know the signs of hyperglycemia and hypoglycemia B) Follow the prescribed diabetic diet closely unless medical condition changes C) Keep the blood glucose levels controlled at or near normal levels D) Report to the physician immediately any kidney, vascular or neurologic changes ANSWER: C 17.What are clinical manifestations of hypothyroidism? A) Intolerance to heat, tachycardia, and weight loss B) Oligomenorrhea, fatigue, and warm skin C) Restlessness, increased appetite, and metrorrhagia D) Constipation, decreased heat rate, and lethargy ANSWER: D 18.Which lab value would be expected for the patient with hypothyroidism? A) Increased triiodothyronine [T3] B) Increased thyroxine [T4] C) Increased thyroid stimulating hormone [TSH] D) Increased calcitonin ANSWER: C 19.The nurse is caring for a client with myxedema. Which of the following would indicate to the nurse that the client's condition is deteriorating? A) An increase in pulse rate and respirations B) Cold skin and episodes of chills C) Difficulty in arousing the client for medications D) Client complains of palpitations ANSWER: C 20.The nurse implements which of the following interventions in the plan of care for a client with hypothyroidism? A) Applying lotion for skin care B) Providing a cool temperature in the room C) Scheduling periods of rest D) Administering prn medications for diarrhea ANSWER: A 21.The nurse should report which of the following client assessments as not consistent with a diagnosis of Grave's disease? Select all that apply A) Lethargy B) Exopthalmus C) Heat intolerance D) Weight loss ANSWER: A 22.A client with Cushing's disease was admitted for adrenalectomy. As a result of the surgery he developed Addison's disease. Which of the following goals of care is the priority for him? A) Decreasing the blood pressure B) Preventing infection C) Promoting the client's safety D) Monitor the vital signs ANSWER: D 23.Which nursing diagnosis is of the highest priority of a client with Addison's disease? A) Fluid and electrolyte balance B) Risk for infection C) Fluid volume excess D) Altered cardiac output ANSWER: A 24.Which of the following nursing interventions should be included in a plan of care for a client with Addison's disease? A) Administer the prescribed diuretics B) Give diet instructions for a low carbohydrate, low protein diet C) Monitor for signs of [Na+] and [K+] imbalances D) self-care activities ANSWER: C 25.Which initial etiological factor establishes a nursing diagnosis of fluid volume deficit in a client with Addison's disease? A) Glucocorticoid excess B) Mineralocorticoid deficiency C,Melanocyte stimulating hormone excess D) Melanocyte stimulating hormone deficit ANSWER: B 26.The nurse is discharging a client with rheumatoid arthritis who complains of morning stiffness.Which of the following measures should the nurse include in the discharge instructions? A) Encourage the client to sleep with pillows under the knees B) Instruct the client to apply ice packs to the joints before getting out of bed C) Instruct the client to take a warm shower in the morning when getting up D) Teach the client to perform all household chores at one time ANSWER: C 27.The client with rheumatoid arthritis reports GI irritation after taking peroxicam.To prevent GI upset, the nurse should provide which instruction? A) Space the administration every 4 hours B) Take peroxicam with food or antacid C) Use the peroxicam for a short time only D) Decrease the peroxicam dosage ANSWER: B 28.A client with rheumatoid arthritis is about to begin aspirin therapy to reduce inflammation.When teaching the client about aspirin, the nurse discusses adverse reactions to prolonged aspirin therapy.These include A) weight gain B) fine motor tremors C) respiratory acidosis D) bilateral hearing loss ANSWER: D 29.During a routine check up,the nurse evaluates a client with rheumatoid arthritis.To assess for the most obvious disease manifestations, first the nurse checks for A) muscle weakness B) joint abnormalities C) painful subcutaneous nodules D) gait disturbances ANSWER: B 30.For a client with an exacerbation of rheumatoid arthritis,the physician prescribes the corticosteroid prednisone.When caring for this client,the nurse should monitor for which adverse reaction? A) Increased weight,hypertension,and insomnia B) Vaginal bleeding,jaundice,and inflammation C) Stupor,breast lumps and pain D) Dyspnea,numbness and headache ANSWER: A 31.A client takes prednisone as prescribed for rheumatoid arthritis. During follow up visits, the nurse should assess the client for common adverse reactions to this drug such as A) tetany and tremors B) anorexia and weight loss C) fluid retention and weight gain D) abdominal cramps and diarrhea ANSWER: C 32. A client with rheumatoid arthritis is being discharged with a prescription of aspirin 600 mg every 6 hours. The nurse should instruct the client to notify the physician if which adverse reaction occurs? A) Dysuria B) Tinnitus C) Leg cramps D) Constipation ANSWER: B 33.A client is diagnosed with rheumatoid arthritis,an autoimmune disorder.When teaching the client and family about auto immune disorders, the nurse should provide which information? A) Clients with autoimmune disorders may have false negative but not false positive serologic tests B) Advanced medical intervention can cure most autoimmune disorders C) Autoimmune disorders include connective tissue[collagen] disorders. D) Autoimmune disorders are distinctive,aiding differential diagnosis ANSWER: C 34.The nurse is admitting a client for possible systemic lupus erythematosus. When assessing this client, the nurse understands that the most significant clinical manifestation present in SLE is A) petechiae on the abdomen B) low grade afternoon fever C) discoid rash over the face and upper chest D) multiple ecchymoses over the body ANSWER: C 35.A client with systemic lupus erythematosus is admitted to a nursing unit.Which of the following would indicate to the nurse that the client's condition is deteriorating? A) A serum sodium of 145 milliequivalents of solute per litre B) A serum potassium of 5.5 milliequivalents of solute per litre C) Large amounts of glucose in the urine D) Large amounts of protein in the urine ANSWER: D 36.The nurse is preparing a client with systemic lupus erythematosus for discharge.Which instruction to include in the teaching plan? A) Exposure to sunlight will help control skin rashes B) There are no activity limitations between flare ups C) Monitor body temperature D) Corticosteroids may be stopped when symptoms are relieved ANSWER: C 37.A client diagnosed with systemic lupus erythematosus comes to the emergency department with severe back pain.She reports that she first felt pain after manually opening her garage door and she is taking prednisone daily.What adverse effect of long term corticosteroid therapy is most likely responsible for the pain? A) Hypertension B) Osteoporosis C) Muscle wasting D) Truncal obesity ANSWER: B 38.A client is admitted to the facility with an exacerbation of her chronic systemic lupus erythematosus. She gets angry when her call bell isn't ANSWER: ed immediately.The most appropriate response to her would be A) You seem angry, would you like to talk about it? B) Calm down.You know that stress will make your symptoms worse C) Would you like to talk about the problem with the nursing supervisor D) I can see you're angry.I'll come back when you calm down ANSWER: A 39.The nurse practitioner assesses a client in the physician's office.Which assessment findings a suspicion of systemic lupus erythematosus? A) facial erythema,profuse hematurai,pruritus, fever and weight loss B) pericarditis, photosensitivity,polyarthralgia and painful mucous membrane ulcers C) weight gain,hypervigilance,hypothermia and edema of the legs D) hypothermia,weight gain,lethargy,with edema of the arms ANSWER: A 40.After an extensive diagnostic workshop,a client is diagnosed with systemic lupus erythematosus.Which statement about the incidence of SLE is true? A) SLE is most common in between the ages 45 and 60 B) SLE affects more whites than blacks C) SLE tends to occur in families D) SLE is more common in underweight than overweight persons ANSWER: C 41.A client is admitted to an acute care facility with a myocardial infarction.During the admission history,the nurse learns that the client also has hypertension and progressive systemic sclerosis.For a client with this disease, the nurse is most likely to formulate which nursing diagnosis? A) Risk for impaired skin integrity B) Constipation C) Ineffective thermoregulation D) Altered nutrition.Risk for more than body requirements ANSWER: A 42.A clinical nurse specialist is orienting a new graduate registered nurse to an oncology unit where blood product transfusions are frequently administered in discussing ABO compatibility,the CNS presents several hypothetical scenarios.A well informed a new graduate wouldknow the greatest of an acute hemolytic would occur when giving A) A- positive blood to an A negative client B) O-negative blood to a O positive client C) O-positive blood to an A Positive client D) B-positive blood to an AB positive client ANSWER: A 43.When administering a blood transfusion to a client with multiple traumatic injuries,the nurse monitors closely for evidence of a transfusion reaction.Shortly after the transfusion begins,the client complains of chest pains,nausea and itching.When urticaria,tachycardia and hypotension develop,the nurse stops the transfusion and notifies the physician.The nurse suspects which type of hypersensitivity reaction? A) Type 1 [immediate,anaphylactic] hypersensitivity reaction B) Type 11 [cytolytic,cytotoxic] hypersensitivity reaction C) Type 111[Immune complex] hypersensitivity reaction D) Type 1V [cell mediated,delayed] hypersensitivity reaction ANSWER: B 44.Which of the following blood types would the nurse identify as the rarest A) A B) B C) AB D) O ANSWER: C 45.A client is receiving a blood transfusion. If this client experiences an acute hemolytic reaction which nursing intervention is most important? A) Immediately stop the transfusion,infuse the dextrose 5% in water(D5W) and call the physician B) Slow the transfusion and monitor the client closely C) Stop the transfusionmnotify the blood bank and administer antihistamine D) Immediately stop the transfusion,infuse normal saline solution,notify the blood bank,and call the physician ANSWER: D 46.Which immunologlobulin is specific to an allergic response? A) IgA B) IgB C) IgE D) IgG ANSWER: C 47.A client with allergic rhinitis is prescribed loratdine.On a follow up visit,the client tells the nurse,I take one 10 mg tablet of loratadine with one glass of water two times daily.The nurse concludes that the client requires additional about the medication because A) loratadine is not available in 10 mg tablet B) loratadine should be taken in an empty stomach C) Loratadine should be taken once daily for allergic rhinitis D) Claritin is not the trade name for loratadine ANSWER: C 48.Which white blood cells are involved in releasing histamine during an allergic reaction? A) Basophils B) Eosinophils C) Monocytes D) Neutrophils ANSWER: A 49.While obtaining a health history the nurse learns that the client is allergic to bee stings.When obtaining this client's medication history,the nurse should determine if the client keeps which medication on hand? A) diphenhydramine hydrochloride B) pseudoephedrine hydrochloride C) guiafenesine D) loperamide ANSWER: A 50.After receiving a dose of penicillin, a client develops dyspnea and hypotension.The nurse suspects,the client is experiencing anaphylactic shock.What should the nurse do first? A) Page an anesthesiologist immediately and prepare to intubate the client B) Administer epinephrine,as prescribed and prepare to intubate the client if necessary C) Administer the antidote to penicillin as prescribe and continue to monitor the client's vital signs D) Insert an indwelling urinary catheter and begin to infuse IV fluids as ordered ANSWER: B 52.A client with an endstage acquired immunodeficiency syndrome has profound manifestations of cryptosporidium infection caused by the protozoA) In planning the client's care,the nurse should focus on his need for A) pain management B) fluid replacement C) antiretroviral therapy D) high caloric nutrition ANSWER: B 53.The nurse is working in a support for clients with acquired immunodeficiency syndrome. Which point is most important for the nurse to stress? A) Avoiding the use of recreational drugs and alcohol B) Refraining from telling anyone about the diagnosis C) Following safer-sex practices D) Telling potential sex partners about the diagnosis,as required by law ANSWER: C 54.A client human immunodeficiency virus undergoes intradermal anergy testing using candida and mumps antigen.During the 3 days following the test,there is no induration or evidence of reaction at the intradermal injection site.The most accurate the nurse can make is A) the client has no previous exposure to the antigens injected B) the results demonstrate the client has antibodies to the antigen C) the client is immunodeficient and wont have a skin response D) the client isn't allergic to the antigens and therefore doesn't react ANSWER: C 55.The nurse is assigned to a client with acquired immunodeficiency syndrome.When handing the client's blood and body fluids.the nurse uses standard precautions which include A) wearing globes to empty a bedpan B) wearing a gown, gloves, and protective eyewear when obtaining a urine specimen via a catheter. C) disposing of needles uncapped D) wearing gloves when applying eye drops ANSWER: C 57.The physician prescribes didanosine 200 mg P.O. every 12 hours for a client with acquired immunodeficiency syndrome who is intolerant to Ziduvudine,AZT.Which condition in the client's history warrants cautious use of this drug? A) Peripheral neuropathy B) Diabetes mellitus C) Hypertension D) Asthma ANSWER: A 58.A female client with human immunodeficiency virus receives family planning counseling. Which statement about safer sex practices for persons with HIV is accurate? A) If the client and her sexual partners are HIV positive unprotected sex is permitted B) A latex condom with spermicide provides the best protection against HIV transmission during sexual intercourse C) Contraceptive methods like birth control,pills, implants,and injections are recommended for HIV injections D) The intrauterine device is recommended for a client with HIV ANSWER: B 59.A nurse is teaching high school students about transmission of the human immunodeficiency virus. Which comment by the student warrants clarification by the nurse? A) A man should wear a latex condom during intimate sexual contact B) Ive heard about people who got AIDS from blood transfusion C) I won't donate blood because I don”t want to get AIDS D) IV drug users can get HIV from sharing needles ANSWER: C 60. A client is diagnosed with human immunodeficiency virus. After recovering from the initial shock of the diagnosis, the client expresses the desire to learn as much as possible about HIV and acquired immunodeficiency syndrome,When teaching the client about the immune system, the nurse states that adaptive immunity is provided by which type of white blood cell? A) Neutrophil B) Basophil C) Monocyte D) Lymphocyte ANSWER: D 61.A client in a late stage of acquired immunodeficiency syndrome shows signs of AIDS related dementiA) Which nursing diagnosis takes highest priority? A) Bathing-hygiene self care deficit B) Altered special tissue perfusion C) Dysfunctional grieving D) risk injury ANSWER: A 62.In teaching a client who is HIV positive about pregnancy,the nurse would know more teaching is necessary when the client says A) The baby can get the virus from my placenta B) Im planning on starting on birth control pills C) Not everybody who has the virus will give birth to a baby who has the virus D) The need to have a section if I become pregnant and have a baby ANSWER: D 63.When preparing a client with acquired immunodeficiency syndrome for discharge to the home,the nurse should be sure to include which instructions? A) Put on disposable gloves before bathing B) Sterilize all plates and utensils on boiling water C) Avoid sharing such articles as toothbrushes and razors D) Avoid eating foods from serving dishes shared by other family members ANSWER: C 65. The nurse is caring for a client with acquired immunodeficiency syndrome, the nurse should A) maintain strict isolation B) keep the client in a private room if possible C) wear gloves when providing mouth care D) wear a gown when delivering the client's food tray ANSWER: C 66 A client seeks medical evaluation for fatigue,night sweats and a 20 lb weight loss in 6 weeks.To confirm that the client has been infected with the human immunodeficiency virus, the nurse expect the physician to order A) E-rosette immunoflorescence B) quantification of T lymphocytes C) enzyme- linked immunoabsorbent assay [ELISA] D) Western Blot test with ELISA ANSWER: D 67 A client with acquired immunodeficiency syndrome is receiving Ziduvudine.To check for adverse effects, the nurse should monitor which laboratory test? A) RBC count B) Fasting blood glucose C) Serum Calcium D) Platelet Count ANSWER: A 68.in an individual with Sjogren's syndrome,nursing care should focus on A) moisture replacement B) electrolyte balance C) nutritional supplentation D) arrhytmia management ANSWER: A 69.The nurse assesses a client shortly after kidney transplant surgery.Which postoperative finding must the nurse report to the physician immediately? A) Serum potassium level of 4.9 milliequivalents of solute per litre B) Serum sodium level of 135 milliequivalents of solute per litre C) Temperature of 37.3oC D) Urine output of 20 ml per hour ANSWER: D 70.A client who agreed to become an organ donor is pronounced dead. What is the most important factor in selecting a transplant recipient? A) Blood relationship B) Sex and size C) Compatble blood and tissue types D) Need ANSWER: C 71.Twenty after undergoing kidney transplantation.A client develops a superacute rejection.To correct this problem, the nurse should prepare the client A) removal of the transplanted kidney B) high dose IV cyclosporine therapy C) bone marrow transplant D) intra-abdominal instillation of methylprednisolone sodium succinate ANSWER: A 72.A client with autoimmune thrombocytopenia and a platelet count of 8000 develops epistaxis and melenA) Treatment corticosteroid and immunoglobulin has been unsuccessful and the physician recommends spleenectomy.The client states,I dont need surgery.this will go away on its own.In considering her response to the client, the nurse must depend on the ethical principle A) beneficence B) autonomy C) advocacy D) justice ANSWER: B 73.A client with idiopathic thrombocytopenic purpura,an autoimmune disorder is admitted to an acute care facility.Concerned about the hemorrhage, the nurse monitors the client's platelet count and observe closely for signs and symptoms of bleeding. The client is at greatest risk for cerebral hemorrhage when the platelet count falls below A) 135,000 B) 75,000 C) 20,000 D) 500 ANSWER: D 74 A child with impetigo is to be discharged from the hospital. The nurses's plan of care should include which of the following measures? A) Providing high protein meals for the child B) Teaching the child and family members about good hand-washing technique C) Instructing the child and family members about decreasing playground activity D) Providing sun lamp treatments for the child ANSWER: B 75 Which of the follwing statements, if made by the parent of an eight-year-old child undergoing treatment of impetigo, indicates an accurate understanding of the treatment plan? A) I have been draining the lesions as they develop. B) I wash the lesions every day using a freshly laundered cloth. C) I keep the lesions covered with a gauze dressing. D) I remind my child several times each day not to touch the lesions. ANSWER: D 76 A patient who has human immunodeficiency virus (HIV) positive is admitted to an isolation unit for treatment of mycobacterium avium complex disease (or infection) and tuberculosis. The nurse observes that the patient has difficulty following instructions, short-term memory loss, and difficulty concentrating. The nurse should be aware that these behaviors A) Will disappear when isolation is no longer requireD) B) are symptomatic of AIDS dementia complex. C) Are normal for the early stage of HIV infection. D) are a result of mycobacterium infection. ANSWER: B 78 A patient who has acquired immune deficiency syndrome (AIDS) develops Pneumocystis carinii pneumonia (PCP). The patient asks the nurse How did I get pneumonia? The nurses response should be based on which of these statements about PCP? A) It occurs in immunosupressed persons from proliferation of organisms that are normally present in the body. B) It is transmitted from close contact with an infected individual who has a supressed immune system. C) It results from exposure to a carrier of the organism who has not yet taken appropriate precautions. D) It is most often acquired from unprotected sex with an infected individual. ANSWER: A 79 An HIV-positive patient is prescribed zidovudine (AZT) and ganciclovir (Cytovene). The nurse should be aware that both drugs have which of the following side effects? A) Peripheral neuropathy B) Insomnia C) Anticholinergic effects D) Bone marrow suppression ANSWER: A 80.A patient who is human immunodeficiency virus [HIV] positive has a CD-4 count of 200. To which of the following measures should a nurse give priority in the patients plan of care? A) Implement reverse isolation. B) Limit the number of venipunctures. C) Institute regular position changes. D) Monitor intake and output ANSWER: A 81 When assessing a patient who has acquired immune deficiency syndrome (AIDS), which of the following signs and symptoms would be most indicative of AIDS dementia complex? A) Headaches B) Bronchial infection C) Unsteady gait D) Diarrhea ANSWER: C 82.Acquired Immune Deficiency Syndrome (AIDS) is caused by a specific virus which has recently been given a new name: HIV (Human Immunodeficiency Virus). This is a/an: A) Arbovirus B) Rhinovirus C) Adenovirus D) Retrovirus ANSWER: D 83.AIDS is transmitted by/through the following except: A) Sexual intercourse B) Blood and blood products contaminated with HIV C) Syringes and needles D) Casual contact ANSWER: D 84.Some afflictions which the damaged immune system cannot protect and which may become the direct cause of death are a rare form of pneumonia, aggressive KaposiÕs sarcoma, brain infections, persistent diarrhea and herpes infections. KarposiÕs sarcoma is: A) Cancer of the skin B) Cancer of the blood vessels C) Cancer of the reproductive organs D) Cancer of the brain ANSWER: A 85. Which of the following are life-threatening symptoms of AIDS?? A) Malaise, headache, sorethroat and fever B) Generalized lymph-adenopathy, oral thrush and shingles C) Night sweats, diarrhea, weight loss and fatigue D) Memory loss dementia, psychaitric symptoms, encephalitis, meningitis ANSWER: D 86 A nurse should recognize that an infant would receive which of the following vaccinations during the neonatal period? A) Haemophilus influenza B B) Rubella C) Hepatitis B D) Varicella ANSWER: C 87 Hepatitis A or infectious hepatitis is caused by viruses introduced by fecally contaminated food or water. Which of these is NOT a predisposing factor for infection? A) Crowding B) Poor sanitation C) Malnutrition D) Smoking ANSWER: D 88. Hepatitis A is more infectious during the occurence of one of the following: A) Presence of the virus in the liver B) Presence of the virus in the blood and stools C) Presence of the virus before the appearance of jaundice D) Presence of the virus after the appearance of jaundice ANSWER: B 89.When a woman receives a rubella vaccination after delivery, a nurse would give her which of the following instructions? A) Dont get pregnant for at least three months. B) Refrain from eating eggs and egg products for 48 hours. C) Limit contact with visitors for at least one week. D) Avoid breast-feeding the baby for at least 24 hours. ANSWER: A 90.A synonym for measles is: A) Rubeola B) Rubella C) Rosacea D) Ritters Disease ANSWER: A 90 Which of the following lymph glands are most affected and become enlarged in German measles? A) Tnguinal B) Axillary C) Suboccipital D) Hepatic ANSWER: C 91.Which of the following groups of symptoms characterize a case of typhoid fever?? A) Profuse, colorless diarrhea, vomiting, muscular cramps, and severe dehydration B) Anorexia, slow pulse, fever, rose spots on the trunk and diarrhea C) Diarrhea, fever, tenesmus, bloody and mucoid stools D) Abdominal pain, vomiting, pallor, weakness,excessive perspiration ANSWER: B 92 Which of the following symptoms best describes that of poliomyelitis?? A) Characterized systematically by high fever of a bizarre pattern, headaches, nausea, vomiting, abdominal pain; tremor, lethargy, stiff neck, convulsions B) Characterized by symptoms in 3 stages: invasion, involvement of the central nervous system, and paralysis. The stage of invasion starts with fever and symptoms referable to the GI tract C) High fever accompanied by frontal headaches, chills and vomiting; large blotchy eruptions on the skin; petechiae may be found in the conjunctive D) The first symptom is usually mental depression followed by headache, malaise, restlessness and fever; excitement, then to delirium and convulsion ANSWER: B 93.Malaria is transmitted by: A) An anopheles male mosquito B) An anopheles female mosquito C) An anopheles aegypti D) A housefly ANSWER: B 94. Which is a febrile disease caused by a virus transmitted by aedes aegypti characterized by sudden onset of high fever, headache, anorexia, abdominal pain, and vomiting? A) H-fever B) Dengue fever C) Malaria D) Infectious hepatitis ANSWER: A 95.Which is a febrile disease caused by a filtrable virus transmitted by aedes aegypti characterized by intense headaches, joint and muscle pain?? A) Philippine hemorrhagic fever B) Dengue fever C) Malaria D) Schistosomiasis ANSWER: A 96 Tetanus neonatorum can best be prevented by....? A) Conducting hilot classes B) Immunizing pregnant mothers C) Hospital delivery D) Delivery only by licensed wives and nurses\+ ANSWER: B 97. An acute infection caused by Neisserian bodies the nursing care and preventive measures of control of which are: Instruction on personal hygiene and prevention of transmission of infection to eyes Examination of all contacts. Exposure of all contaminated solid and moist articles to sunshine. This disease is.: A) Syphilis B) AIDS C) Gonorrhea D) Herpes ANSWER: C 98.Diphtheria is caused by: A) Kocks bacillus B) Streptococcus C) Klebs-Lofflers bacillus D) Staphylococcus ANSWER: C 99. The organism causing whooping cough is: A) Hemolytic streptococcus B) Hemophillus pertussis C) Streptococcus aureus D) Streptococcus albus ANSWER: rB 100 Hepatitis B is transmitted through: A) Air B) Blood or plasma transfusion C) Food and water D) Contaminated spoons, forks and plates ANSWER: B 101. A client sees a dermatologist for a skin problem. Later, the nurse reviews the client's chart and notes that the chief complaint was intertrigo. This term refers to which condition? A) Spontaneously occurring wheals B) A fungus that enters the skin's surface, causing infection C) Inflammation D) Irritation of opposing skin surfaces caused by friction. ANSWER: D 102. The nurse is providing home care instructions to a client who has recently had a skin graft. It's not important that the client remember to A) Use cosmetic camouflage techniques B) Protect the graft from direct sunlight C) Continued physical therapy D) Apply lubricating lotion to the graft site. ANSWER: B 103.A client is diagnosed with herpes simplex. Which statement about herpes simplex infection is true? A) During early pregnancy, herpes simplex infection may cause spontaneous abortion or premature delivery B) Genital herpes simplex lesions are painless, fluid- filled vesicles that are ulcerated and heal in 3-7 days C) Herpetic keratoconjunctivitis usually is bilateral and cause systemic symptoms D) A client with genital herpes lesions can have sexual contact but must use condoms. ANSWER: A 104. A client is diagnosed with genital herpes simplex. Concerned about spread of the virus to others, the nurse questions the client about recent sexual activity. What is the average incubation period for localized genital herpes simplex infection? A) 6 to 8 days B) 1 to 2 days C) 3 to 7 days D) 10 to 14 days ANSWER: C 105.The nurse is examining a client for evidence of lice. The nurse should pay particular attention to which part of the scalp? A) Temporal area B) Top of the head C) Behind the ears D) Middle ear ANSWER: C 109. The nurse discover scabies when assessing a client who has just been transferred to the medical surguical unit from the day surgery unit. To prevent scabies infections in other clients , the nurse should A) Wash hands, apply pediculocide in the client's scalp, and remove any observable mites B) Isolate the clients bed linens until the client is no longer infectious C) Notify the nurses in day surgery unit of a potent scabies outbreak D) Place the client in enteric precautions ANSWER: B 110. A client diagnosed with gonorrhea, when teaching this client about this disease, the nurse should include which instruction? A) Avoid sexual intercourse until you've completed treatment, which takes 14-21 days B) Wash your hands thoroughly to avoid transferring the infection to your eyes C) If yoy have intercourse before treatment ends, tell sexual partners of your status and have them wash well after intercourse D) If you don't get treatment, you may develop enengitis and suffer widespread central nervous system change ANSWER: B 112. While in a skilled nursing facility a client contracted scabies, which is diagnosed the day after discharge. The client is living at her daughters home where six other persons are living . During her visit to the clinic, she asks a staff nurse,What should my family do? The most accurate response from the nurse is A) All family members will need to be treated B) If someone develops symptoms tell him to see a physician right away. C) Just be careful not to share linens and towels with family members D) After you're treated, family members must be at risk for contracting scabies ANSWER: 113.A female client with genital herpes simplex is being treated in the outpatient department. The nurse teaches her about measures that may prevent herpes recurrences and emphasizes the need for prompt treatment of complications arise. Genital herpes simplex increases the risk. A) Cancer of the ovaries B) Cancer of the uterus C) cancer of the cervix D) Cancer of the vagina ANSWER: C 114. A client with atopic dermatitis is prescribed a potent topical corticosteroid , to be covered with an occlusive dressing. To address a potential client problem associated with treatment, the nurse formulates the nursing diagnosis of risk for injury. To complete the nursing diagnosis statement, the nurse should add which related to phrase? A) Related to potential interaction between the topical corticosteroids and other prescribed drugs B) Related to vasodilatory effects of the topical corticosteroid C) Related to percutaneous absorption of the topical corticosteroid D) Related to topical corticosteroid application to the surface, neck and intertrigonous site. ANSWER: C 115. A client is diagnosed with herpes simplex. Which statement about herpes simplex infection is true? A) During early pregnancy, herpes simplex infection may cause spontaneous abortion or premature delivery B) Genital herpes simplex lesions are painless, fluid- filled vesicles that are ulcerated and heal in 3-7 days C) Herpetic keratoconjunctivitis usually is bilateral and cause systemic symptoms D) A client with genital herpes lesions can have sexual contact but must use condoms. ANSWER: A 116.A client is diagnosed with primary herpes genitalis. Which instruction should the nurse provide? A) Apply one applicator of terconazole ultraviolet at bedtime for 7 days B) Apply one applicator if ticonazole intrvaginally at bedtime for 7 days C) Apply acyclovir ointment to the lesions every 3 hours, six times a day for 7 days D) Apply sulconazole nitrate twicw a day by massaging it gently into the lesions ANSWER: C 117. A client who was bitten by a wild animal is admitted to an acute care facility for treatment of rabies. Which type of isolation does this patient require? A) Strict isolation B) Contact isolation C) Respiratory isolation D) Enteric isolation ANSWER: B 1118. A client diagnosed with gonorrhea, when teaching this client about this disease, the nurse should include which instruction? A) Avoid sexual intercourse until you've completed treatment, which takes 14-21 days B) Wash your hands thoroughly to avoid transferring the infection to your eyes C) If you have intercourse before treatment ends, tell sexual partners of your status and have them wash well after intercourse D) If you don't get treatment, you may develop enengitis and suffer widespread central nervous system change ANSWER: B 119.A female client with genital herpes simplex is being treated in the outpatient department. The nurse teaches her about measures that may prevent herpes recurrences and emphasizes the need for prompt treatment of complications arise. Genital herpes simplex increases the risk. A) Cancer of the ovaries B) Cancer of the uterus C) cancer of the cervix D) Cancer of the vagina ANSWER: C 120. When caring for a client with severe impetigo, the nurse should include which intervention in the plan of care? A) Placing mitts in the client's hands B) Administering systemic antibiotics C) Applying topical antibiotics as prescribed D) Continuing to administer antibiotics for 21 days as prescribed ANSWER: B 121. The nurse is administering a purified protein derivative test to a homeless patient. Which of the following statements concerning PPD testing is true? A) A positive reaction indicates that the patient has active tuberculosis B) A positive reaction indicates that a patient has been exposed to the disease C) A negative reaction always excludes the diagnosis of TB D) The PPD can be read within 12 hours after injection ANSWER: B 122. After diagnosing a patient with pulmonary tuberculosis, the physician tells the family members that they must receive INH, as prophylaxis against tuberculosis. The patient's teenage daughter asks the nurse how long the drug must be taken. What is the normal duration of prophylactic INH therapy? A) 3 to 5 days B) 1 to 3 months C) 2 to 4 months D) 6 to 12 months ANSWER: D 123. A patient is prescribed refampicin 600 mg P.O. Which statement about refampicin is true? A) It's usually given alone B) Its exact mechanism of action is unknown C) It tubercolocidal, destrying the bacteria D) It acts primarily against resting bacteria ANSWER: C 124. The nurse recognizes that a patient with tuberculosis need further teaching when the patient states that A) I'll have to take these medications for 9-12 months B) It wont be necessary for the people I work with to take medications C) I'll need to have scheduled laboratory tests while on medication D) The people I have contact with should be checked regularly ANSWER: D 126. A patient undergoes a PPD test for tuberculosis. After injecting PPD, the nurse should plan to read the results after waiting. A) 12 hours B) 24 hours C) 36 hours D) 48 hours ANSWER: D 127. The physician determines that a patient has been exposed to someone with tuberculosis. The nurse expects the physician to order which of the following? A) Daily oral doses of INH and Rifampicin for 6 moths to 2 years B) Isolation until 24 hours after antituberculosis therapy C) Nothing until signs of active disease arise D) Daily doses of INH, 300 mg 6 moths to 1 year ANSWER: D 128. Before returning a child who is being treated for tuberculosis to his home, the community health nurse determines A) That the child has a private room B) That all family members have been tested C) Home school placement D) Proper room ventilation ANSWER: B 129. Staff nurses learn that a patient they have been caring for during the last few weeks has just been diagnosed with tuberculosis. When the nurses express concern about contracting tuberculosis themselves, the charge nurse's response should be based on which of the following statements? A) Tuberculosis is easily treated with a short course of antibiotics B) The Mantoux test is used to confirm diagnosis of tuberculosis C) Tuberculosis is not highly infectious when standard precautions are followed D) Vaccination with Bacille Calmette Guerin [BCG] will be used to immunize the nurses against infection ANSWER: C 130. Which of the following assessment findings should indicate to a nurse that a patient has an active case of tuberculosis? A) Reactive tuberculin skin test B) Productive cough C) Positive chest x ray D) Presence of night sweats ANSWER: C 131. A patient who is administered isoniazid and pyridoxine hydrochloride for treatment of tuberculosis asks a nurse why the Vitamin B6 is necessary. The nurse would respond that A) Vitamin B6 is necessary for absorption of INH B) Vitamin B6 activates the metabolism of INH C) INH leads to Vitamin B6 depletion, which causes neurotoxic effects D) INH can cause anorexia, which leads to Vitamin B6 deficiency ANSWER: C 132.A woman who has tuberculosis and is to be treated with Rifampcin is given medication instructions. The woman would show that she understood the instructions about Rifampicin if she were to make which of the following statements? A) I should avoid milk products while taking this medication B) I may need a laxative if I develop hard stools C) I should expect some burning on urination D) I may develop orange-colored urine ANSWER: D 133. A patient was hospitalized for treatment of acute bacterial pneumonia. Which outcome indicates improvement in the patient's condition? A) The patient has a partial arterial pressure value of 90 mmHg or higher B) The patient has a partial pressure of PaCO2 of 65 mmHg and higher C) The patient exhibits restlessness D) The patient exhibits bronchial breath sounds over the affected area ANSWER: A 134. A patient with pneumococcal pneumonia is admitted to a hospital. The patient in the next room is being treated for mycoplasma pneumonia. Despite the different causes of the various pneumonia, all of them have the same which feature? A) Inflamed lung tissue B) Sudden onset C) Responsiveness to penicillin D) Elevated white blood cell count ANSWER: A 135. In bacterial pneumonia A) Non-productive cough and normal temperature B) Sore throat and abdominal pain C) Hemoptysis and dyspnea D) Dyspnea and wheezing ANSWER: D