Chapter 47 - practice questions with 100% correct answers /updated and verified/25, Exams of Nursing

Download Chapter 47 - practice questions with 100% correct answers /updated and verified/25 and more Exams Nursing in PDF only on Docsity! 1 / 10 Chapter 47 - practice questions with 100% correct answers /updated and verified/25 1. while providing care to a 5-month-old girl whose family has a history of food allergies, the nurse instructs the parents about foods to be avoided in the first year of life. which response by the parents indicates a need for further teaching? a. "she cannot have any cow's milk" b. "I should continue breastfeeding until at least 6 months" c. "peanuts in any form should be avoided" d. "any kind of fruit is acceptable": d. "any kind of fruit is acceptable" feedback: the nurse should caution the parents that kiwifruit should be avoided. other foods to avoid include cow's milk, eggs, peanuts, tree nuts, sesame seeds, fish, and shellfish. breastfeeding also is recommended for at least the first 6 months. 2. a nurse is caring for a 12-year-old girl with a severe peanut allergy. the girl's parents are upset because the school does not permit her to carry her EpiPen with her. it must remain in the school's office per school regulations. which response by the nurse would be most appropriate? a. "she is allowed by law to carry her EpiPen with her; I will talk to school authorities" b. "let's file an action plan and keep it in the school office in the event of anaphylaxis" c. "make sure she wears a medical alert bracelet so that school staff know she has allergies" d. "I will be happy to train school authorities and staff to recognize anaphlyax- is": a. "she is allowed by law to carry her EpiPen with her; I will talk to school authorities" feedback: public Law No. 108-377, the Asthmatic Schoolchildren's Treatment and Health Management Act of 2004, was passed by the U.S. Congress. this law is intended to ensure that students with severe allergies can carry prescribed med- ications such as an EpiPen with them at all times. the nurse must contact the school and inform them of this law so that the girl is allowed to carry her EpiPen on her person at all times. the school staff should be trained to recognize anaphylaxis, there should be an action plan on file, and the girl should wear a medical alert bracelet as well. however, the most important action is to notify school authorities of the law. 3. the nurse is caring for a newborn whose mother is HIV positive. the nurse would expect to administer a 6-week course of which medication? 2 / 10 a. lopinavir b. ritonavir c. neviarpine d. zidovudine: d. zidovudine feedback: children born to HIV-positive mothers should receive a 6-week course of zidovudine therapy. lopinovair, ritonavir, and nevirapine are medications used for treatment of HIV-1 infections as part of a three-drug regimen. 4. the nurse is caring for a child who is having an anaphylactic reaction with bronchospasm. the nurse would expect to administer what medication for bronchospasm as ordered? a. epinephrine b. corticosteroid c. albuterol d. diphenhydramine: c. albuterol feedback: the nurse would expect to administer bronchodilator inhalation treatment (albuterol) if bronchospasm is present. epinephrine, diphenhydramine, and/or corti- costeroids are administered to revere the allergic process. 5. the nurse is caring for a child undergoing highly active antiretroviral ther- apy (HAART) for HIV infection. the nurse is preparing to administer the pre- scribed medication. in addition to the nucleoside analog reverse transcrip- tase inhibitors (NRTIs) and the nonnucleoside analog reverse transcriptase inhibitors (NNRTIs), the nurse is cognizant that the child will be taking which additional medication as part of the three-drug regimen? a. protease inhibitors b. corticosteroids c. cytotoxic drugs d. disease-modifying antrirheumatic drugs (DMARDs): a. protease inhibitors feedback: the nurse understands that the child will be taking protease inhibitors as part of the three- drug regimen for HAART. corticosteroids, cytotoxic agents, and DMARDs are typically used for the treatment of juvenile idiopathic arthritis (JIA). 6. the nurse is providing home care instructions for a 13-year-old girl recently diagnosed with systemic lupus erythematosus. which response by the girl indicates a need for further teaching? 5 / 10 a. humoral immunity crosses the placenta b. cellular immunity involves the T lymphocytes c. cellular immunity recognizes antigens d. humoral immunity does not destroy the foreign cell: c. cellular immunity recognizes antigens feedback: humoral immunity recognizes antigens and cellular immunity does not. humoral immunity crosses the placenta in the form of IgG. cellular immunity involves the action of T lymphocytes, and humoral immunity does not destroy the foreign cell. 13. when teaching a group of new parents about newborn care and devel- opment, which immunoglobulin would the nurse explain as being primarily responsible for the passive immunity exhibited by newborns? a. IgA b. IgG c. IgM d. IgE: b. IgG feedback: IgG is acquired transplacentally, providing the newborn with passive immunity to antigens to which the mother had developed antibodies. IgA, IgD, IgE, and IgM do not cross the placenta and require an antigenic challenge for production. 14. which exercise would the nurse suggest as most helpful to maintain mo- bility in a child with juvenile idiopathic arthritis? a. jogging every other day b. using a treadmill c. swimming d. playing basketball: c. swimming feedback: swimming is a particularly useful exercise to maintain joint mobility without placing pressure on the joints. jogging, using a treadmill, and playing basketball would place pressure on the joints of the lower extremities. 15. a child is diagnosed with juvenile idiopathic arthritis and is receiving several different medications listed in the medication administration record. which agent would the nurse identify as being used to prevent disease pro- gression? a. aspirin 6 / 10 b. prednisone c. ibuprofen d. methotrexate: d. methotrexate feedback: disease-modifying antirheumatic drugs (DMARDs), such as methotrex- ate, are necessary to prevent disease progression. other agents, such as aspirin and ibuprofen, are helpful with pain relief. prednisone helps for relief of inflammation. 16. a group of nursing students are reviewing information about humoral and cellular immunity. the students demonstrate understanding of this material when they identify what as being involved in cellular immunity? a. B cells b. antibodies c. antigens d.T cells: d. T cells feedback: cellular immunity involves T cells, which do not recognize antigens. B cells, antibodies, and antigens are involved in humoral immunity. 17. a nurse is preparing a plan of care for a child with a primary immunodefi- ciency. which nursing diagnosis is the priority? a. imbalanced nutrition, less than body requirements related to poor appetite b. ineffective protection related to impaired humoral defenses c. acute pain related to inflammatory processes d. risk for delayed growth and development related to chronic illness: b. inef- fective protection related to impaired humoral defenses feedback: the child with a primary immunodeficiency lacks the necessary immune responses that provide protection from infection. therefore, the priority nursing diagnosis would be ineffective protection. imbalanced nutrition and risk for delayed growth and development may be appropriate, but these would not be the priority. acute pain would be more appropriate for a child with juvenile idiopathic arthritis. 18. a child with hypogammaglobulinemia is to receive intravenous im- munoglobulin (IVIG). what action would not be correct to take? a. shake the vial after reconstituing it b. premedicate the child with acetaminopehn c. obtain preinfusion vital signs d. check serim blood urea nitrogen and creatinine levels: a. shake the vial after 7 / 10 reconstituting it feedback: many IVIG products are packed as two vials, one the IVIG powder and one the sterile diluents. once reconstituted, the IVIG should not be shaken because this leads to foaming and may cause the immunoglobulin protein to degrade. the child can be premedicated with acetaminophen or diphenhydramine. baseline serum blood urea nitrogen and creatinine should be assessed because acute renal insufficiency may occur as a serious adverse reaction. 19. the nurse is reviewing the laboratory test results of a child who is sus- pected of having systemic lupus erythematosus (SLE). what would the nurse identify as supporting this diagnosis? select all that apply. a. positive antinuclear antibody (ANA) b. increased C3 levels c. thrombocytopenia d. decreased C4 levels e. increased hematocrit: a. positive antinuclear antibody (ANA) c. thrombocytopenia d. decreased C4 levels feedback: laboratory findings may include decreased hemoglobin and hematocrit, decreaed platelet count, and low white blood cell count. complement levels, C3 and C4, will also be decreased. though not specific to SLE, the ANA is usually positive in children with SLE. 20. a child is diagnosed with a food allergy to milk. when teaching the parents about this allergy, what would the nurse suggest as possible substitutions for milk? select all that apply. a. fruit juice b. rice milk c. yogurt d. nondairy creamers e. soy milk: a. fruit juice b. rice milk e. soy milk feedback: milk can be replaced with water, fruit juice, rice milk, or soy milk. yogurt contains milk and some nondairy products such as creamers may contain milk and should be avoided.