Question 1

The nurse should assess the patient undergoing plasmapheresis for which clinical manifestation?

Accepted Answer

A)  Shortness of breath
B)  High blood pressure
C)  Transfusion reaction
D)  Extremity numbness D

Question 2

A patient is admitted to the hospital with acute rejection of a kidney transplant. Which intervention will the nurse prepare for this patient?

Accepted Answer

A)  Testing for human leukocyte antigen (HL
A)   match
B)  Administration of immunosuppressant medications
C)  Insertion of an arteriovenous graft for hemodialysis
D)  Placement of the patient on the transplant waiting list B

Question 3

A patient is being evaluated for possible atopic dermatitis. The nurse expects elevation of which laboratory value?

Accepted Answer

A)  IgE
B)  IgA
C)  Basophils
D)  Neutrophils A

Question 4

A patient who is receiving an IV antibiotic develops wheezes and dyspnea. In which order should the nurse implement these prescribed actions? (Put a comma and a space between each answer choice [A,B,C,D,E]).

Accepted Answer

A)  Discontinue the antibiotic.
B)  Give diphenhydramine IV.
C)  Inject epinephrine IM or IV.
D)  Prepare an infusion of dopamine.
E)  Provide 100% oxygen using a nonrebreather mask.

Question 5

Immediately after the nurse administers an intracutaneous injection of an allergen on the forearm,the patient complains of itching at the site,weakness,and dizziness. What action should the nurse take first?

Accepted Answer

A)  Apply antiinflammatory cream.
B)  Place a tourniquet above the site.
C)  Administer subcutaneous epinephrine.
D)  Reschedule the patient's other allergen tests.

Question 6

A nurse has obtained donor tissue typing information about a patient who is waiting for a kidney transplant. Which results should be reported to the transplant surgeon?

Accepted Answer

A)  Patient is Rh positive and donor is Rh negative
B)  Six antigen matches are present in HLA typing
C)  Results of patient-donor crossmatching are positive
D)  Panel of reactive antibodies (PR
A)   percentage is low

Question 7

The charge nurse is assigning semiprivate rooms for new admissions. Which patient could safely be assigned as a roommate for a patient who has acute rejection of an organ transplant?

Accepted Answer

A)  A patient who has viral pneumonia
B)  A patient with second-degree burns
C)  A patient who is recovering from an anaphylactic reaction to a bee sting
D)  A patient with graft-versus-host disease after a recent bone marrow transplant

Question 8

An older adult patient has a prescription for cyclosporine following a kidney transplant. Which information in the patient's health history has implications for planning patient teaching about the medication at this time?

Accepted Answer

A)  The patient restricts salt to 2 grams per day.
B)  The patient eats green leafy vegetables daily.
C)  The patient drinks grapefruit juice every day.
D)  The patient drinks 3 to 4 quarts of fluid each day.

Question 9

A patient who is receiving immunotherapy has just received an allergen injection. Which assessment finding is most important to communicate to the health care provider?

Accepted Answer

A)  The patient's IgG level is increased.
B)  The injection site is red and swollen.
C)  The patient's symptoms did not improve in 2 months.
D)  There is a 2-cm wheal at the site of the allergen injection.

Question 10

Ten days after receiving a bone marrow transplant,a patient develops a skin rash. What would the nurse suspect is the cause of the rash?

Accepted Answer

A)  The donor T cells are attacking the patient's skin cells.
B)  The patient needs treatment to prevent hyperacute rejection.
C)  The patient's antibodies are rejecting the donor bone marrow.
D)  The patient is experiencing a delayed hypersensitivity reaction.

Question 11

Which patient should the nurse assess first?

Accepted Answer

A)  Patient with urticaria after receiving an IV antibiotic
B)  Patient who is sneezing after subcutaneous immunotherapy
C)  Patient who has graft-versus-host disease and severe diarrhea
D)  Patient with multiple chemical sensitivities who has muscle stiffness

Question 12

A patient is anxious and reports difficulty breathing after being stung by a wasp. What is the nurse's priority action?

Accepted Answer

A)  Provide high-flow oxygen.
B)  Administer antihistamines.
C)  Assess the patient's airway.
D)  Remove the stinger from the site.

Question 13

Which information about intradermal skin testing should the nurse teach to a patient with possible allergies?

Accepted Answer

A)  "Do not eat anything for about 6 hours before the testing."
B)  "Take an oral antihistamine about an hour before the testing."
C)  "Plan to wait in the clinic for 20 to 30 minutes after the testing."
D)  "Reaction to the testing will take about 48 to 72 hours to occur."

Question 14

A patient in the health care provider's office for allergen testing using the cutaneous scratch method develops itching and swelling at the skin site. Which action should the nurse take first?

Accepted Answer

A)  Monitor the patient's edema.
B)  Administer a dose of epinephrine.
C)  Provide a prescription for oral antihistamines
D)  Ask the patient about the use of new skin products.

Question 15

The nurse taking a health history learns that the patient,who has worked in rubber tire manufacturing,has allergic rhinitis and multiple food allergies. Which action by the nurse is correct?

Accepted Answer

A)  Recommend that the patient use latex gloves in preventing blood-borne pathogen contact.
B)  Document the patient's history and teach about clinical manifestations of a type I latex allergy.
C)  Encourage the patient to carry an epinephrine kit in case a type IV allergic reaction to latex develops.
D)  Advise the patient to use oil-based hand creams to decrease contact with natural proteins in latex gloves.

Question 16

The nurse teaches a patient about drug therapy after a kidney transplant. Which statement by the patient would indicate a need for further instructions?

Accepted Answer

A)  "I need to be monitored closely for development of malignant tumors."
B)  "After a couple of years I will be able to stop taking the cyclosporine."
C)  "If I develop acute rejection episode, I will need additional types of drugs."
D)  "The drugs are combined to inhibit different ways the kidney can be rejected."

Question 17

A patient who collects honey to earn supplemental income has developed a hypersensitivity to bee stings. Which statement,if made by the patient,would indicate a need for additional teaching?

Accepted Answer

A)  "I need to find a different way to earn extra money."
B)  "I will take oral antihistamines before going to work."
C)  "I will get a prescription for epinephrine and learn to self-inject it."
D)  "I should wear a Medic-Alert bracelet indicating my allergy to bee stings."

Question 18

An older adult patient who is having an annual check-up tells the nurse,"I feel fine,and I don't want to pay for all these unnecessary cancer screening tests!" Which information should the nurse plan to teach this patient?

Accepted Answer

A)  Consequences of aging on cell-mediated immunity
B)  Decrease in antibody production associated with aging
C)  Impact of poor nutrition on immune function in older people
D)  Incidence of cancer-associated infections in older individuals

Question 19

A patient seeks care in the emergency department after sharing needles for heroin injection with a friend who has hepatitis B. To provide immediate protection from infection,what medication will the nurse expect to administer?

Accepted Answer

A)  Corticosteroids
B)  Gamma globulin
C)  Hepatitis B vaccine
D)  Fresh frozen plasma

Question 20

Which example should the nurse use to explain an infant's "passive immunity" to a new mother?

Accepted Answer

A)  Vaccinations
B)  Breastfeeding
C)  Stem cells in peripheral blood
D)  Exposure to communicable diseases

Exam 13: Altered Immune Responses and Transplantation