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1. The nurse is instructing an unlicensed health care worker on the care of the client with HIV
who also has active genital herpes. Which statement by the health care worker indicates
effective teaching of standard precautions?
A) ''I need to know my HIV status, so I must get tested before caring for any clients."
B) ''Putting on a gown and gloves will cover up the itchy sores on my elbows.''
C) ''Washing my hands and putting on a gown and gloves is what I must do before starting
care.''
D) ''I will wash my hands before going into the room, and then put on gown and gloves only for
direct contact with the client's genitals."
2. Which statement made to the nurse by a health care worker assigned to care for the client
with HIV indicates a breach of confidentiality and requires further education by the nurse?
A) ''I told the family members they needed to wash their hands when they enter and leave the
room.''
B) ''The other health care worker and I were out in the hallway discussing how we were
concerned about getting HIV from our client, so no one could hear us in the client's room.''
C) ''Yes, I understand the reasons why I have to wear gloves when I bathe my client.''
D) ''The client's spouse told me she got HIV from a blood transfusion.''
3. When preparing the newly diagnosed client with HIV and significant other for discharge,
which explanation by the nurse accurately describes proper condom use?
B) ''Always position the condom with a space at the tip of an erect penis.''
4. The nurse presents a seminar on HIV testing to a group of seniors and their caregivers in an
assisted living facility. Which responses fit the Centers for Disease Control and Prevention's
(CDC's) recommendations for HIV testing? (Select all that apply.)
A) ''I am 78 years old and I was treated and cured of syphilis many years ago.''
D) ''I used to smoke marijuana 30 years ago, but I have not done any drugs since.''
E) ''I had sex with a man with a disreputable past from New York back in the late 1960s, but I
have been happily married since 1971.''
E) Write out all instructions and have the client read them over before performing a task.
G) Mark off the days of the calendar, leaving open the current date.
H) For continuity, the primary caregiver should be the only person reorienting the client.
6. The home health nurse is making an initial home visit to the client currently living with family
members after being hospitalized with pneumonia and newly diagnosed with AIDS. Which
statement by the nurse best acknowledges the client's fear of discovery by his family?
A) ''Do you think that I could post a sign on your bedroom door for everyone about the need to
wash their hands?''
C) ''I hope that all of your family members know about your disease and how you need to be
protected, since you have been so sick.''
D) ''It is your duty to protect your family members from getting AIDS.''
7. The nurse is caring for a patient newly diagnosed with HIV. The patient asks what would
determine the actual development of AIDS. The nurse's response is based on the knowledge
that what is a diagnostic criterion for AIDS?
8. When teaching a patient infected with HIV regarding transmission of the virus to others,
which statement made by the patient would indicate a need for further teaching?
A. "I will need to isolate any tissues I use so as not to infect my family."
B. "I will notify all of my sexual partners so they can get tested for HIV."
D. "I do not need to worry about spreading this virus to others by sweating at the gym."
9. The nurse is providing care for a patient who has been living with HIV for several years.
Which assessment finding most clearly indicates an acute exacerbation of the disease?
10. A pregnant woman who was tested and diagnosed with HIV infection is very upset. What
should the nurse teach this patient about her baby's risk of being born with HIV infection?
C. "Treatment with antiretroviral therapy will decrease the baby's chance of HIV infection."
D. "The duration and frequency of contact with the organism will determine if the baby gets HIV
infection.
11. A 25-year-old male patient has been diagnosed with HIV. The patient does not want to take
more than one antiretroviral drug. What reasons can the nurse tell the patient about for taking
more than one drug?
12. The woman is afraid she may get HIV from her bisexual husband. What should the nurse
include when teaching her about preexposure prophylaxis (select all that apply)?
13. The nurse was accidently stuck with a needle used on an HIV-positive patient. After
reporting this, what care should this nurse first receive?
14. The HIV-infected patient is taught health promotion activities including good nutrition;
avoiding alcohol, tobacco, drug use, and exposure to infectious agents; keeping up to date with
vaccines; getting adequate rest; and stress management. What is the rationale behind these
interventions that the nurse knows?
15. The patient is admitted to the ED with fever, swollen lymph glands, sore throat, headache,
malaise, joint pain, and diarrhea. What nursing measures will help identify the need for further
assessment of the cause of this patient's manifestations (select all that apply)?
16. Transmission of HIV from an infected individual to another most commonly occurs as a
result of
b. low levels of virus in the blood and high levels of CD4+ T cells.
c. transmission from mother to infant during labor and delivery and breastfeeding.
b. infection of monocytes may occur, but antibodies quickly destroy these cells.
d. a long period of dormancy develops during which HIV cannot be found in the blood and there
is little viral replication
18. Which statements accurately describe HIV infection (select all that apply)?
a. Untreated HIV infection has a predictable pattern of progression.
c. Untreated HIV infection can remain in the early chronic stage for a decade or more.
d. Untreated HIV infection usually remains in the early chronic stage for 1 year or less.
e. Opportunistic diseases occur more often when the CD4+ T cell count is high and the viral load
is low
23. Which statement about metabolic side effects of ART is true (select all that apply)?
b. ART-related body changes include central fat accumulation and peripheral wasting.
c. Lipid abnormalities include increases in triglycerides and decreases in high-density
cholesterol.
d. Insulin resistance and hyperlipidemia can be treated with drugs to control glucose and
cholesterol.
e. Compared to uninfected people, insulin resistance and hyperlipidemia are more difficult to
treat in HIV-infected patients
24. Which strategy can the nurse teach the patient to eliminate the risk of HIV transmission?
25. What is the most appropriate nursing intervention to help an HIV-infected patient adhere to
a treatment regimen?
b. Give the patient a video and a brochure to view and read at home.
c. Tell the patient that the side effects of the drugs are bad but that they go away after a while.
d. Assess the patient's routines and find adherence cues that fit into the patient's life
circumstances.
26. The nurse is providing postoperative care for a 30-year-old female patient after an
appendectomy. The patient has tested positive for human immunodeficiency virus (HIV). What
type of precautions should the nurse observe to prevent the transmission of this disease?
a. Droplet precautions
b. Contact precautions
c. Airborne precautions
d. Standard precautions
27. A 52-year-old female patient was exposed to human immunodeficiency virus (HIV) 2 weeks
ago through sharing needles with other substance users. What symptoms will the nurse teach
the patient to report that would indicate the patient has developed an acute HIV infection?
d. Flu-like symptoms such as fever, sore throat, swollen lymph glands, nausea, or diarrhea
28. The nurse is monitoring the effectiveness of antiretroviral therapy (ART) for a 56-year-old
man with acquired immunodeficiency syndrome (AIDS). What laboratory study result indicates
the medications have been effective?
29. A 62-year-old patient has acquired immunodeficiency syndrome (AIDS), and the viral load is
reported as undetectable. What patient teaching should be provided by the nurse related to
this laboratory study result?
a. The patient has the virus present and can transmit the infection to others.
b. The patient is not able to transmit the virus to others through sexual contact.
c. The patient will be prescribed lower doses of antiretroviral medications for 2 months.
d. The syndrome has been cured, and the patient will be able to discontinue all medications.
30. A patient who has vague symptoms of fatigue, headaches, and a positive test for human
immunodeficiency virus (HIV) antibodies using an enzyme immunoassay (EIA) test. What
instructions should the nurse give to this patient?
b. "A viral culture will be done to determine the progression of the disease."
c. "It will probably be 10 or more years before you develop acquired immunodeficiency
syndrome (AIDS)."
d. "The Western blot test will be done to determine whether acquired immunodeficiency
syndrome (AIDS) has developed."
31. A patient who has a positive test for human immunodeficiency virus (HIV) antibodies is
admitted to the hospital with Pneumocystis jiroveci pneumonia (PCP) and a CD4+ T-cell count of
less than 200 cells/L. Based on diagnostic criteria established by the Centers for Disease Control
and Prevention (CDC), which statement by the nurse is correct?
a. "The patient meets the criteria for a diagnosis of an acute HIV infection."
d. "The patient will develop symptomatic chronic HIV infection in less than a year."
32. A patient with a positive rapid antibody test result for human immunodeficiency virus (HIV)
is anxious and does not appear to hear what the nurse is saying. What action by the nurse is
most important at this time?
a. Teach the patient about the medications available for treatment.
c. Remind the patient about the need to return for retesting to verify the results.
d. Ask the patient to notify individuals who have had risky contact with the patient.
33. A patient who is diagnosed with acquired immunodeficiency syndrome (AIDS) tells the
nurse, "I feel obsessed with thoughts about dying. Do you think I am just being morbid?" Which
response by the nurse is best?
b. "It is important to focus on the good things about your life now."
d. "Can you tell me more about the kind of thoughts that you are having?"
34. A pregnant woman with a history of asymptomatic chronic human immunodeficiency virus
(HIV) infection is seen at the clinic. The patient states, "I am very nervous about making my
baby sick." Which information will the nurse include when teaching the patient?
b. Most infants born to HIV-positive mothers are not infected with the virus.
c. Because she is at an early stage of HIV infection, the infant will not contract HIV.
d. It is likely that her newborn will become infected with HIV unless she uses antiretroviral
therapy (ART).
35. Which patient exposure by the nurse is most likely to require postexposure prophylaxis
when the patient's human immunodeficiency virus (HIV) status is unknown?
36. A young adult female patient who is human immunodeficiency virus (HIV)-positive has a
new prescription for efavirenz (Sustiva). Which information is most important to include in the
medication teaching plan?
38. The nurse will most likely prepare a medication teaching plan about antiretroviral therapy
(ART) for which patient?
a. Patient who is currently HIV negative but has unprotected sex with multiple partners
b. Patient who was infected with HIV 15 years ago and now has a CD4+ count of 840/µL
c. HIV-positive patient with a CD4+ count of 160/µL who drinks a fifth of whiskey daily
d. Patient who tested positive for HIV 2 years ago and now has cytomegalovirus (CMV)
retinitis
39. The nurse palpates enlarged cervical lymph nodes on a patient diagnosed with acute human
immunodeficiency virus (HIV) infection. Which action would be most appropriate for the nurse
to take?
40. Which information would be most important to help the nurse determine if the patient
needs human immunodeficiency virus (HIV) testing?
a. Patient age
b. Patient lifestyle
c. Patient symptoms
41. A patient who uses injectable illegal drugs asks the nurse about preventing acquired
immunodeficiency syndrome (AIDS). Which response by the nurse is best?
c. "You should ask those who share equipment to be tested for HIV."
d. "I recommend cleaning drug injection equipment before each use."
42. Which nursing action will be most useful in assisting a college student to adhere to a newly
prescribed antiretroviral therapy (ART) regimen?
a. Give the patient detailed information about possible medication side effects.
c. Encourage the patient to join a support group for students who are HIV positive.
d. Check the patient's class schedule to help decide when the drugs should be taken.
43. A patient with human immunodeficiency virus (HIV) infection has developed
Mycobacterium avium complex infection. Which outcome would be appropriate for the nurse
to include in the plan of care?
44. A patient treated for human immunodeficiency virus (HIV) infection for 6 years has
developed fat redistribution to the trunk, with wasting of the arms, legs, and face. What
instructions will the nurse give to the patient?
45. The nurse prepares to administer the following medications to a hospitalized patient with
human immunodeficiency (HIV). Which medication is most important to administer at the right
time?
46. To evaluate the effectiveness of antiretroviral therapy (ART), which laboratory test result
will the nurse review?
d. Immunofluorescence assay
47. The nurse cares for a patient who is human immunodeficiency virus (HIV) positive and
taking antiretroviral therapy (ART). Which information is most important for the nurse to
address when planning care?
48. Eight years after seroconversion, a human immunodeficiency virus (HIV)-infected patient
has a CD4+ cell count of 800/µL and an undetectable viral load. What is the priority nursing
intervention at this time?
49.Which of these patients being seen at the human immunodeficiency virus (HIV) clinic should
the nurse assess first?
50. An older adult who takes medications for coronary artery disease has just been diagnosed
with asymptomatic chronic human immunodeficiency virus (HIV) infection. Which information
will the nurse include in patient teaching?
51. The registered nurse (RN) caring for an HIV-positive patient admitted with tuberculosis can
delegate which action to unlicensed assistive personnel (UAP)?
a. Teach the patient about how to use tissues to dispose of respiratory secretions.
b. Stock the patient's room with all the necessary personal protective equipment.
c. Interview the patient to obtain the names of family members and close contacts.
d. Tell the patient's family members the reason for the use of airborne precautions.
52. The nurse designs a program to decrease the incidence of human immunodeficiency virus
(HIV) infection in the adolescent and young adult populations. Which information should the
nurse assign as the highest priority?
53. The nurse cares for a patient infected with human immunodeficiency virus (HIV) who has
just been diagnosed with asymptomatic chronic HIV infection. Which prophylactic measures will
the nurse include in the plan of care (select all that apply)?
a. Hepatitis B vaccine
b. Pneumococcal vaccine
d. Trimethoprim-sulfamethoxazole
54. A nurse working in an outpatient clinic is assessing a client who reports night sweats and
fatigue. He states he has had a cough along with nausea and diarrhea. His temperature is 38.1°
C (100.6° F) orally. The client is afraid he has HIV. Which of the following actions should the
nurse take? (Select all that apply.)
55. A nurse is caring for a client who is suspected of having HIV. Which of the following
diagnostic tests and laboratory values are used to confirm HIV infection? (Select all that apply.)
A. Western blot
56. A nurse is assessing a client for HIV. Which of the following are risk factors associated with
this virus? (Select all that apply.)
A. Perinatal exposure
B. Pregnancy
E. Occupational exposure
57. A nurse is completing discharge instructions with a client who has AIDS. Which of the
following statements by the client indicates an understanding of the teaching?
A. "I will wear gloves while changing the pet litter box."
B. "I will rinse raw fruits with water before eating them."
C. "I will wear a mask when around family members who are ill."
58. A nurse is caring for a client who has HIV and has been newly diagnosed with Burkitt's
lymphoma. Which of the following HIV infection stages is the client in?
A. Stage 1
B. Stage 2
C. Stage 3
D. Stage 4
58. The school nurse is preparing to teach a health class to ninth graders regarding sexually
transmitted diseases. Which information regarding acquired immunodeficiency syndrome (AIDS)
should be included?
1. Females taking birth control pills are protected from becoming infected with HIV.
2. Protected sex is no longer an issue because there is a vaccine for the HIV virus.
3. Adolescents with a normal immune system are not at risk for developing AIDS.
4. Abstinence is the only guarantee of not becoming infected with sexually transmitted HIV.
59. The nurse is admitting a client diagnosed with protein-calorie malnutrition secondary to
AIDS. Which intervention should be the nurse's first intervention?
1. Assess the client's body weight and ask what the client has been able to eat.
2. Place in contact isolation and don a mask and gown before entering the room.
3. Check the HCP's orders and determine what laboratory tests will be done.
4. Teach the client about total parenteral nutrition and monitor the subclavian
IV site.
60. The client diagnosed with AIDS is complaining of a sore mouth and tongue. When the nurse
assesses the buccal mucosa, the nurse notes white, patchy lesions covering the hard and soft
palates and the right inner cheek. Which interventions should the nurse implement?
1. Teach the client to brush the teeth and patchy area with a soft-bristle toothbrush.
3. Have the client gargle with an antiseptic-based mouthwash several times a day.
4. Determine what types of food the client has been eating for the last 24 hours.
61. The nurse is describing the HIV virus infection to a client who has been told he is HIV
positive. Which information regarding the virus is important to teach?
1. The HIV virus is a retrovirus, which means it never dies as long as it has a host to live in.
2. The HIV virus can be eradicated from the host body with the correct medical regimen.
3. It is difficult for the HIV virus to replicate in humans because it is a monkey virus.
4. The HIV virus uses the client's own red blood cells to reproduce the virus in the body.
62. The client who has engaged in needle-sharing activities has developed a flu-like infection.
An HIV antibody test is negative. Which statement best describes the scientific rationale for this
finding?
1. The client is fortunate not to have contracted HIV from an infected needle.
4. The antibody test is negative because the client has a different flu virus.
63. The patient in early labor says to the nurse: “I will pass on protection from diseases and the
baby will not ever need any shots.” The best response by the nurse should be:
B. “Yes, immediate antibody immunity from the mother is the first line of defense against
disease for babies.”
D. “Babies are born with IgG, an antibody that crosses the placenta, but it only protects the
baby briefly.”
64. The school nurse starts a clean-up campaign at a local elementary school in an effort to
combat some of the allergens that cause one of the most common allergic response disorders,
which is:
A. anaphylaxis.
B. asthma.
C. contact dermatitis.
D. urticaria.
65. The nurse is discussing the body’s first and second lines of defense against infection with a
community group. The first line of defense includes which of the following?
A. T lymphocytes
C. Teeth
D. Sweat
66. The nurse explains that medication being given to a client with a severe inflammatory
response mimics a hormone secreted by the adrenal cortex. This hormone is:
A. aldosterone.
B. testosterone.
C. histamine.
D. Cortisol
67. The nurse explains that with the exposure to an antigen, the initiator of the inflammatory
response is the presence of histamine, which is released by the:
A. basophils.
B. neutrophils.
C. eosinophils.
D. Monocytes
68. The nurse is bathing an immunodeficient patient who is suffering from Cryptococcus
infestation. The organism is classified as a:
A. virus.
B. protozoa.
C. bacteria.
D. fungus.
69. When a mosquito or a fly carries an organism that infects another living organism, this
mode of transmission is infection via:
A. ingestion.
B. a common vehicle.
C. direct excretion.
D. a vector.
70. The home health nurse is teaching the family that the most effective method to control the
spread of communicable disease is which of the following?
A. Demonstrate and monitor a return demonstration of good hand washing technique by the
family.
C. Isolate the infected person from all contact with noninfected persons
71. The home health nurse recommends air conditioner duct cleaning as a precaution against
diseases caused by:
A. viruses.
B. bacteria.
C. protozoa.
D. fungi.
72. The school nurse cautions a group of parents about children playing barefoot on dirt that
may lead them to be exposed to infections caused by:
A. helminthes.
B. rickettsiae.
C. protozoa.
D. mycoplasms.
73. The large, heavy, and older adult patient, post stroke, develops an infected decubitus on the
sacrum during the hospital stay. When the patient goes home, about 2 weeks later, the patient
returns to the hospital with pneumonia. The distinction between these two infections is which
of the following?
C. The decubitus infection was transmitted from other patients on the unit, but the pneumonia
was transmitted from a neighbor visiting when the patient was at home.
74. The home health nurse, on a visit to administer the fifth in a series of 10 antibiotic doses, is
told that the patient is now complaining about a bothersome vaginal discharge. The nurse will
communicate the problem to arrange for medication and teaches the patient that this condition
is probably the result of:
75. The nurse assesses that the patient who has acquired a nosocomial infection is most likely
the patient with:
C. lice and nits that have come from the Emergency Department.
76. A community picnic is held. Following this, a number of the attendees become ill. The
pathogen in this case was acquired via:
A. vector transmission.
B. airborne transmission.
C. indirect contact.
D. common vehicle.
77. The nurse caring for an immunosuppressed patient is diligent about protecting the patient
from infection. When visitors come in, in addition to having them put on isolation garb, the
nurse would prohibit them bringing:
A. boxed candy.
B. books.
C. potted plants.
78. The parent asks the nurse to explain which type of drugs will not be used in the medical
treatment of their child’s allergic reaction to bee stings.
A. Diuretics and sedatives
79. A patient has had several increasingly severe allergic reactions during last year’s pollen
season. This year, the patient comes regularly to the office to receive some antigen injections.
The nurse teaches that these will:
80. A patient who is receiving daily steroids for control of a condition calls the nurse to ask
advice about whether a small child who has been exposed to influenza should come and visit
because she has not had any symptoms. An appropriate response by the office nurse would be:
A. “It would be up to the patient. Plan not to get overtired with a small child running and
bouncing around.”
B. “Take the child who is not sick to her own doctor and ask this question first.”
C. “No, the child should not visit. Infectious diseases are often most communicable in the
short period before the child actually becomes ill.”
D. “Yes, let the child visit. There is no reason not to visit, because this child is not sick.”
81. The patient with the diagnosis of Clostridium difficile infection asks what has caused the
diarrhea. The nurse responds that it is caused by:
A. fecal–oral contamination.
C. protozoal infection.
D. inflammatory response.
82. The patient receiving a large IM dose of antibiotic was asked to please wait 20 to 30
minutes before checking out. The reason for this request is that:
A. antibiotics are a common source of severe allergic reactions within the first few minutes
after injection.
B. the office staff needs to make sure that it was the right medicine before the patient leaves.
C. the staff wants to make sure that the patient has time to pay for the services delivered that
day.
D. the nurse always forgets to ask patients about allergies before administering the antibiotic.
83. After receiving an injection of penicillin, the patient undergoes an anaphylactic reaction.
The nurse should immediately:
D. administer oxygen.
84. The Centers for Disease Control and Prevention (CDC) has issued new guidelines for
infection control. Nursing care plans for patients with infection mainly address which protocol?
A. Disease-specific precautions
85. The nurse is aware that wound healing can be enhanced with the administration of vitamin:
A. D.
B. C.
C. A.
D. B.
86. The patient is hospitalized with cryptococcal pneumonia and AIDS. The nurse knows that
the Standard Precautions for this patient will include the most important precaution. Which of
the following is correct?
A. Needles and sharps should be placed in puncture-resistant containers on the medicine cart
out of the room.
B. Once gloves are put on, they do not need to be changed until care is finished.
87. The organs involved in immunity include the tonsils, spleen, lymph nodes, and:
A. lungs.
B. pancreas.
C. liver.
D. periosteum.
88. The nurse explains that the difference between medical asepsis and surgical asepsis is that
medical asepsis requires:
89. The school nurse is required to report to the health department all cases of (select all that
apply):
1. rubella.
2. Lyme disease.
3. pediculosis.
4. salmonella.
5. Clostridium difficile.
90. The nurse assesses a high eosinophil count in a pediatric patient. The nurse recognizes that
this elevation is an indicator of ____________________.
Allergy
91. Persons with HIV have fallen victim to PCP, Pneumocystis jiroveci, a serious pulmonary
infection caused by a ____________________.
Fungus
92. The nurse reminds the patient who is to undergo hyperbaric oxygen therapy that the
clothing worn into the chamber must be made of ____________________.
Cotton
2, 4, 1, 3, 5
94. Which immune cell is responsible for the quickest release of histamine that causes the red
itchy welts associated with allergies?
A. mast cell
B. lymphocyte
C. eosinophil
D. Basophil
95. What is the term used to describe white blood cells migrating toward bacteria?
A. Zeiosis
B. phagocytosis
C. chemotaxis
D. Phototaxis
96. When human immunodeficiency virus (HIV) attaches to a host cell what genetic material is
released into the cell’s cytoplasm?
A. chromosome
B. RNA
C. DNA
D. ligand
97. Name the process a cell such as a neutrophil or a macrophage uses to ingest (eat) its prey.
A. halitosis
B. chemotaxis
C. botulism
D. Phagocytosis
A. bacteria
B. plasma cell
100. What is a specific term for a bacterial or other foreign protein that initiates antibody
production by the body?
A. peptide
B. MHCII molecule
C. complement
D. Antigen
101. Which of these cell types can play a primary role in attacking and killing cancer cells?
B. cytotoxic T cell
C. platelet
D. mast cell
102. What is an important mechanism white blood cells use to kill bacteria, fungi and other
invading pathogens?
A. asphyxiation
B. oxidative activity
C. fright
D. Drowning
103. What is the term applied to white blood cells squeezing between endothelial cells lining
the blood vessel to reach the site of an infection?
A. diapedesis
B. chemotaxis
C. phagocytosis
D. Enucleation
104. After a mini-exam, you and a couple of friends spend a day in the sun on Beach #1 in
Dominica. At the end of the day, one of your friends complains of sunburn. His back is very
red, swollen, warm and painful to the touch. Which of the following is most likely to have
caused the swelling?
A. Histamine
B. Kinins
C. Leukotrienes
D. Nitric oxide
E. Thromboxane A2
105. Approximately 5 minutes after being bitten by a mosquito a 26-year-old medical student
observes the lesion at the right. What causes the erythema?
Hemorrhage
B. Lymphatic obstruction
C. Vascular damage
D. Vasodilation
106. A pathology report notes that an abscess was seen in the lung of your patient. The
patient asks for a copy and explanation of this report. Which of the following best describes
how you would describe it?
B. A small area containing pus made up of apoptotic neutrophils with liquefactive necrosis
A. Chemotaxis
B. Emigration
C. Hemostasis
D. Margination
E. Phagocytosis
108. A suppurative exudate contains necrotic debris in addition to neutrophils. Which of the
following is most likely responsible for the necrosis.
B. Extracellular calcium
109. You have suffered a needle stick injury after giving a patient an IM injection, but you have
no information about the patient’s HIV status. What is the most appropriate method for
obtaining this information about the patient?
A The occupational health nurse should discuss HIV status with the patient.
B You should ask the patient to authorize HIV testing as soon as possible.
C HIV testing should be done the next time blood is drawn for other tests.
D The nurse manager for the unit is responsible for obtaining the information.
110. A patient who has received a kidney transplant has been admitted to the medical unit with
acute rejection and is receiving IV cyclosporine (Sandimmune) and methylprednisolone
(Solu-Medrol). Which staff member is best to assign to care for this patient?
A An RN with 3 years of experience in the operating room who is orienting top the medical
unit.
C An RN who has worked on the medical unit for 5 years and is working a double shift
today.
D An RN who floated to the medical unit from the coronary care unit for the day.
111. You are completing an assessment and health history for an HIV-positive patient who is
considering starting antiretroviral therapy with several medications. Which patient information
concerns you the most?
A Patient continues to be sexually active with multiple partners and says that he is careful to
use condoms.
B Patient has many questions and concerns regarding how effective and safe the
medications are
C Patient has been HIV positive for 8 years and has never been on any drug therapy for the
HIV infection
D. Patient tells you that he never has been very consistent about taking medications in the
past.
112. You obtain these assessment data while completing as admission for a patient with a
history of a liver transplant who is receiving cyclosporine (Sandimmune), prednisone
(Deltasone), and mycophenolate (CellCept) to suppress immune function. Which one will be of
most concern?
113. You are evaluating an HIV-positive patient who is receiving IV pentamidine (Pentam) as a
treatment for Pneumocystis carinii pneumonia. Which information is most important to
communicate to the physician?
114. As the nurse manager in a public health department, you are responsible for developing
a plan to reduce the incidence of infection with the human immunodeficiency virus (HIV) in the
community. Which nursing action is best delegated to health assistants working for the agency?
B Supply injection drug users with bleach solution for cleaning needles and syringes
C Educate high-risk community members about the use of condoms in HIV prevention
D Provide pretest and post-test counseling to those patients who are seeking HIV testing
115. Your patient with rheumatoid arthritis (RA) is taking prednisone (Deltasone) and naprozen
(Alleve) to reduce inflammation and joint paint. Which of these symptoms is the strongest
indicator that a change in therapy may be necessary?
C The patient has round and moveable nodules just under the skin.
D The patient states that the RA symptoms are worst in the morning
116. An 18-year-old college student with an exacerbation of systemic lupus erythematosus (SLE)
has been receiving prednisone (Deltasone) 20 mg daily for 4 hours. Which of these medical
orders should you question?
117. You are working with a student nurses who is assigned to care for an HIV-positive patient
with severe esophagitis caused by Candida albicans. Which action by the student indicates that
you need to intervene most quickly?
A The student gives the patient a glass of water after the oral nystatin (Mycostatin)
suspension.
B The student offers the patient a choice of chicken soup or chile con carne for lunch.
C The student places a “No Visitors” sign on the door of the patient’s room
D The student puts on a mask and gown before entering the patient room
118. You are evaluating an HIV-positive patient who is receiving IV pentamidine (Pentam) as a
treatment for Pneumocystis carinii pneumonia. Which information is most important to
communicate to the physician?
119. You are completing an assessment and health history for an HIV-positive patient who is
considering starting antiretroviral therapy with several medications. Which patient information
concerns you the most?
A. Patient has been HIV positive for 8 years and has never been on any drug therapy for the
HIV infection.
B. Patient tells you that he never has been very consistent about taking medications in the
past.
C. Patient continues to be sexually active with multiple partners and says that he is careful to
use condoms.
D. Patient has many questions and concerns regarding how effective and safe the
medications are.
120. You have suffered a needle stick injury after giving a patient an IM injection, but you have
no information about the patient’s HIV status. What is the most appropriate method for
obtaining this information about the patient?
A. You should ask the patient to authorize HIV testing as soon as possible.
B. The nurse manager for the unit is responsible for obtaining the information.
C. The occupational health nurse should discuss HIV status with the patient.
D. HIV testing should be done the next time blood is drawn for other tests.
121. A patient with acquired immunodeficiency syndrome (AIDS) has a negative tuberculosis
(TB) skin test. Which nursing action is indicated next?
122. You are working in an AIDS hospice facility that is also staffed with LPNs and nursing
assistants. Which of these nursing actions is best to delegate to an LPN you are supervising?
A. Assess patients’ nutritional needs and individualize diet plans to improve nutrition.
B. Collect data about the patient’s response to medications used for pain and anorexia.
C. Teach the nursing assistants about how to lower the risk for spreading infections.
D. Assist patients with personal hygiene and other activities of daily living as needed.
122. A patient who has received a kidney transplant has been admitted to the medical unit with
acute rejection and is receiving IV cyclosporine (Sandimmune) and methylprednisolone
(Solu-Medrol). Which staff member is best to assign to care for this patient?
A. An RN who floated to the medical unit from the coronary care unit for the day.
B. An RN with 3 years of experience in the operating room who is orienting top the medical
unit.
C. An RN who has worked on the medical unit for 5 years and is working a double shift
today.
123. Your patient with rheumatoid arthritis (RA) is taking prednisone (Deltasone) and naprozen
(Alleve) to reduce inflammation and joint paint. Which of these symptoms is the strongest
indicator that a change in therapy may be necessary?
A. The patient states that the RA symptoms are worst in the morning
C. The patient has round and moveable nodules just under the skin.
124. A patient with chronic hepatitis C has been receiving interferon alfa-2a (Roferon-A)
injections for the last month. Which information gathered during a visit in the home to conduct
an interview and physical assessment is most important to communicate to the physician?
B. The patient is giving the medication by the IM route to her lateral thigh.
125. You obtain these assessment data while completing as admission for a patient with a
history of a liver transplant who is receiving cyclosporine (Sandimmune), prednisone
(Deltasone), and mycophenolate (CellCept) to suppress immune function. Which one will be of
most concern?
127. An HIV-positive patient who has been started on antiretroviral therapy (ART) is seen in the
clinic for follow-up. Which test will be most helpful in determining the response to therapy?
A. Lymphocyte count
B. ELISA testing
128. You have developed a nursing diagnosis of Imbalanced Nutrition: Less Than Body
Requirements for a hospitalized patient with AIDS who has anorexia and nausea. Which of
these nursing actions is most appropriate to delegate to an LPN who is providing care for this
patient?
129. You assess a 24-year-old with RA who is considering using methotrexate (Rheumatrex) for
treatment. Which information is most important to communicate with the physician?
A. The patient has many concerns about the safety of the drug.
D. The patient says that she has taken methotrexate in the past.
130. An 18-year-old college student with an exacerbation of systemic lupus erythematosus (SLE)
has been receiving prednisone (Deltasone) 20 mg daily for 4 hours. Which of these medical
orders should you question?
131. A patient with wheezing and coughing caused by an allergic reaction to penicillin is
admitted to the emergency department (ED). Which of these medications do you anticipate
administering first?
132. A patient with systemic lupus erythematosus (SLE) is admitted to the hospital for
evaluation and management of acute joint inflammation. Which information obtained in the
admission laboratory testing concerns you most?
133. As the hospital employee health nurse, you are completing a health history for a newly
hired nursing assistant. Which information given by the new employee most indicates the need
for further nursing action prior to orienting the nursing assistant to patient care?
134. The nurse teaches the patient with allergies about anaphylaxis including which of the
following statements?
A. The most common cause of anaphylaxis, accounting for about 75% of fatal anaphylactic
reactions in the U.S., is penicillin.
Local reactions usually involve urticaria and angioedema at the site of the antigen exposure.
Systemic reactions occur within about 30 minutes of exposure involving cardiovascular,
respiratory, gastrointestinal, and integumentary organ systems.
135. Of the following types of cells, which are believed to play a significant role in cutaneous
immune system reactions?
A. Langerhans’ cells
Langerhans’ cells are common to the epidermis and are accessory cells of the afferent
immune system process.
B. Merkel’s cells
Merkel’s cells are the receptor cells in the epidermis that transmit stimuli to the axon via a
chemical response.
C. Melanocytes
Melanocytes are special cells of the epidermis that are primarily involved in producing
melanin, which colors the hair and skin.
D. Phagocytes
Phagocytes are white blood cells that engulf and destroy foreign materials.
136. Which of the following statements describes the clinical manifestations of a delayed
hypersensitivity (type IV) allergic reaction to latex?
A. Signs and symptoms are localized to the area of exposure, usually the back of the
hands.
Clinical manifestations of a delayed hypersensitivity reaction are localized to the area of
exposure.
B. Signs and symptoms can be eliminated by changing glove brands or using powder-free
gloves.
Clinical manifestations of an irritant contact dermatitis can be eliminated by changing glove
brands or using powder-free gloves.
C. Signs and symptoms may worsen when hand lotion is applied before donning latex
gloves.
With an irritant contact dermatitis, avoid use of hand lotion before donning gloves as this
may worsen symptoms as lotions may leach latex proteins from the gloves.
D. Signs and symptoms occur within minutes after exposure to latex.
Described as a latex allergy, when clinical manifestations occur within minutes after
exposure to latex, an immediate hypersensitivity (type I) allergic reaction has occurred.
137. When the nurse assesses the patient and observes blue-red and dark brown plaques and
nodules, she recognizes that these manifestations are associated with
A. Kaposi’s sarcoma.
Kaposi’s sarcoma is a frequent comorbidity of the patient with AIDS.
B. platelet disorders.
With platelet disorders, the nurse observes ecchymoses (bruising) and purpura (bleeding
into the skin).
C. allergic reactions.
Urticaria (wheals or hives) is the manifestation of allergic reactions.
D. syphilis.
A painless chancre or ulcerated lesion is a typical finding in the patient with syphilis.
138. Which of the following reflect the pathophysiology of cutaneous signs of HIV disease?
139. Most skin conditions related to HIV disease may be helped primarily by
140. The nurse is administering didanosine (Videx) to a client with acquired immunodeficiency
syndrome. Which intervention is most
appropriate?
141. The nurse is preparing to administer iron dextran (Imferon) to a client with iron deficiency
anemia. Which action is appropriate?
3. Using the same needle to draw up the solution and to administer the injection
143. Which of the following clients are at an increased risk of developing Kaposi's sarcoma skin
lesions? Select all that apply.
145. An 8-year-old child has been admitted to the oncology unit with a suspected diagnosis of
acute lymphoblastic leukemia. The nurse is obtaining a health history from the parents. During
the interview, the parents ask the nurse if any of the factors discussed would make their child
more at risk for this type of leukemia. What information about potential risk factors is correct
for the nurse to share with the parents?
d) The X-rays that the child had at age 6 for a broken leg
146. When explaining the long-term toxic effects of cancer treatments on the immune system,
what should the nurse tell the client?
a) Long-term immunologic effects have been studied only in clients with breast and lung cancer.
b) Clients with persistent immunologic abnormalities after treatment are at a much greater risk
for infection than clients with a history of splenectomy.
c) The use of radiation and combination chemotherapy can result in more frequent and more
severe immune system impairment.
d) The helper T cells recover more rapidly than the suppressor T cells, which results in positive
helper cell balance that can last 5 years.
147. A child with Down syndrome has an upper respiratory infection (URI). Which of the
following is the nurse's best action? Select all that apply.
a) Restricting visitation of sick siblings
c) Administering oxygen
148. When preparing a teaching plan for a client who is to receive a rubella vaccine during the
postpartum period, the nurse should include which information?
b) The client should avoid contact with children diagnosed with rubella.
149. The nurse is caring for a client being discharged following kidney transplantation. The
client is ordered mofetil to prevent organ rejection. Which nursing instruction is essential
regarding medication use?
150. A healthy 2-month-old infant is being seen in the local clinic for a well-child checkup and
initial immunizations. When analyzing the pediatric record, which immunizations would the
nurse anticipate administering at this appointment? Select all that apply.
151. The nurse is caring for a client newly diagnosed with human immunodeficiency virus (HIV)
obtained from unprotected sex. The nurse is in the room when the client is explaining the
disease to another person. Which statement by the client would the nurse clarify? Select all
that apply.
152. An infant is to receive the diphtheria, tetanus, and acellular pertussis (DTaP) and
inactivated polio vaccine (IPV) immunizations. The child is recovering from a cold and is afebrile.
The child's sibling has cancer and is receiving chemotherapy. Which action is most appropriate?
b) "I stopped smoking last year; this year I'll quit drinking alcohol."
154. The nurse is caring for a client with possible immune deficiency. Which subjective data
would be most indicative?
155. The nurse is caring for a client with possible immune deficiency. Which subjective data
would be most indicative?
"I sneeze and have watery eyes throughout the spring and summer."
Active immunity
157. occurs from antibody transmission and occurs rapidly but it's temporary. may be
transferred by mother to neonate.
Passive immunity
158. The nurse explains to the client that a biopsy of the enlarged lymph node is important
because, if Hodgkin's disease is present, the histologic examination will reveal which of the
following?
a) Reed-Sternberg cells.
b) Duchenne's cells.
c) Tay-Sachs cells.
d) Sarcoidosis cells.
159. A nurse practicing in a nurse-managed clinic suspects that an 8-year-old child's chronic
sinusitis and upper respiratory tract infections may result from allergies. Which laboratory test
would the nurse most likely order? Select all that apply.
a) Metabolic panel
b) Rheumatoid factor
160. Antenatal laboratory testing revealed a negative rubella antibody for a client admitted to
the postpartum unit. Which action takes priority for this client during early puerperium?
d) Rubella counseling and instruction to obtain live rubella virus vaccine during her first
postpartum examination
161. A 12-month-old child is seen in the neighborhood clinic for a regular checkup. Which
statement by the child's mother about the influenza vaccine reflects the need for more
teaching?
a) "The first time a child receives the influenza vaccine, a second dose is recommended in 1
month."
c) "My child is too young to receive the live attenuated intranasal vaccine."
d) "The Haemophilus influenzae vaccine my child has already received helps protect against
some forms of the flu."
162. The nurse is assigning a room for a client admitted with hepatitis A. Which of the following
diagnoses would be an appropriate roommate for this client?
a) Pneumonia
b) Varicella
d) Measles, mumps, rubella (MMR); diphtheria, tetanus toxoids, and acellular pertussis (DTaP);
and hepatitis B (HepB)
The nurse is planning care for a client with human immunodeficiency virus (HIV). Which
statement by the nurse indicates understanding of HIV transmission? Select all that apply.
a) "I will wear a gown, mask, and gloves with all client contact."
b) "I don't need to wear any personal protective equipment due to decreased risk of
occupational exposure."
c) "I will wear a mask if the client has a cough caused by an upper respiratory infection."
d) "I will wear a mask, gown, and gloves when splashing bodily fluids is likely."
165. In a client infected with human immunodeficiency virus (HIV) has a low CD4 level. What
interventions should the nurse implement as a result of this finding?
A 42-year-old client comes to the clinic and is diagnosed with shingles. Which findings confirm
this diagnosis? Select all that apply.
a) Fever
b) Malaise
d) Diarrhea
167. A nurse practicing in a nurse-managed clinic suspects that an 8-year-old child's chronic
sinusitis and upper respiratory tract infections may result from allergies. She orders an
immunoglobulin assay. Which immunoglobulin would the nurse expect to find elevated?
a) Immunoglobulin M
b) Immunoglobulin E
c) Immunoglobulin D
d) Immunoglobulin G
168. Assessment of an IV cocaine user with infective endocarditis should focus on which signs
and symptoms (select all that apply)
a. Retinal hemorrhages
b. splinter hemorrhages
a.formation of antibodies.
171. The reason newborns are protected for the first 6 months of life from bacterial infections
is because of the maternal transmission of
a.IgG.
b.IgA.
c.IgM.
d.IgE.
174. The nurse advises a friend who asks him to administer his allergy shots that
b.he is qualified to do it if the friend has epinephrine in an injectable syringe provided with his
extract.
c.avoiding the allergens is a more effective way of controlling allergies, and allergy shots are not
usually effective.
175. Association between HLA antigens and diseases is most commonly found in what disease
conditions?
a.Malignancies
b.Infectious diseases
c.Neurologic diseases
d.Autoimmune disorders
b.remove normal particles in her blood that are being damaged by autoantibodies.
c.exchange her plasma that contains antinuclear antibodies with a substitute fluid.
d.replace viral-damaged cellular components of her blood with replacement whole blood.
a.drugs.
b.stress.
c.malnutrition.
179. In a person having an acute rejection of a transplanted kidney, what would help the nurse
understand the course of events (select all that apply)?
d.Corticosteroids are the most successful drugs used to treat acute rejection.
e.Acute rejection is common after a transplant and can be treated with drug therapy.
180. Which statement made by the nurse is most appropriate in teaching patient interventions
to minimize the effects of seasonal allergic rhinitis?
D. "You will need to dust your house with a dry feather duster twice a week."
181. When caring for a patient with a known latex allergy, the nurse would monitor the patient
closely for a cross-sensitivity to which foods (select all that apply)?
A. Grapes
B. Oranges
C. Bananas
D. Potatoes
E. Tomatoes
182. Ten days after receiving a bone marrow transplant, a patient develops a skin rash on his
palms and soles, jaundice, and diarrhea. What is the most likely etiology of these clinical
manifestations?
D. Cells in the transplanted bone marrow are attacking the host tissue.
183. A patient's low hemoglobin and hematocrit have necessitated a transfusion of packed red
blood cells (RBCs). Shortly after the first unit of RBCs starts to infuse, the patient develops signs
and symptoms of a transfusion reaction. Which type of hypersensitivity reaction has the patient
experienced?
A. Type I
B. Type II
C. Type III
D. Type IV
184. A patient has begun immunotherapy for the treatment of intractable environmental
allergies. When administering the patient's immunotherapy, what is the nurse's priority action?
185. A healthy 65-year-old man who lives at home is at the clinic requesting a "flu shot." When
assessing the patient, what other vaccinations should the nurse ask the patient about receiving
(select all that apply)?
A. Shingles
B. Pneumonia
C. Meningococcal
186. On initial assessment of an older patient, the nurse knows to look for certain types of
diseases because which immunologic response increases with age?
A. Autoimmune response
B. Cell-mediated immunity
C. Hypersensitivity response
A. Dyspnea
B. Dilated pupils
D. Wheal-and-flare reaction
188. The patient with an allergy to bee stings was just stung by a bee. After administering
oxygen, removing the stinger, and administering epinephrine, the nurse notices the patient is
hypotensive. What should be the nurse's first action?
189. The patient with an autoimmune disease will be treated with plasmapheresis. What should
the nurse teach the patient about this treatment?
B. It will cause anemia because it removes whole blood and RBCs are damaged.
C. It will remove the IgG autoantibodies and antigen complexes from the plasma.
D. It will remove the peripheral stem cells in order to cure the autoimmune disease
190. The patient with diabetes mellitus has been ill for some time with a severe lung infection
needing corticosteroids and antibiotics. The patient does not feel like eating. The nurse
understands that this patient is likely to develop
A. major histoincompatibility.
B. primary immunodeficiency.
C. secondary immunodeficiency.
191. Which statement by the patient who has had an organ transplant would indicate that the
patient understands the teaching about the immunosuppressive medications?
A. "My drug dosages will be lower because the medications enhance each other."
B. "Taking more than one medication will put me at risk for developing allergies."
C. "I will be more prone to malignancies because I will be taking more than one drug."
D. "The lower doses of my medications can prevent rejection and minimize the side effects."
192. Emerging infections can affect health care by (select all that apply)
a.Vancomycin-resistant enterococci
194. Transmission of HIV from an infected individual to another most commonly occurs as a
result of
b.low levels of virus in the blood and high levels of CD4+ T cells.
c.transmission from mother to infant during labor and delivery and breastfeeding.
b.infection of monocytes may occur, but antibodies quickly destroy these cells.
d.a long period of dormancy develops during which HIV cannot be found in the blood and there
is little viral replication.
196. Which statements accurately describe HIV infection (select all that apply)?
c.Untreated HIV infection can remain in the early chronic stage for a decade or more.
d.Untreated HIV infection usually remains in the early chronic stage for 1 year or less.
e.Opportunistic diseases occur more often when the CD4+ T cell count is high and the viral load
is low.
201. Which strategy can the nurse teach the patient to eliminate the risk of HIV transmission?
b.Give the patient a video and a brochure to view and read at home.
c.Tell the patient that the side effects of the drugs are bad but that they go away after a while.
d.Assess the patient's routines and find adherence cues that fit into the patient's life
circumstances.
203. The nurse is caring for a patient newly diagnosed with HIV. The patient asks what would
determine the actual development of AIDS. The nurse's response is based on the knowledge
that what is a diagnostic criterion for AIDS?
204. When teaching a patient infected with HIV regarding transmission of the virus to others,
which statement made by the patient would indicate a need for further teaching?
A. "I will need to isolate any tissues I use so as not to infect my family."
B. "I will notify all of my sexual partners so they can get tested for HIV."
D. "I do not need to worry about spreading this virus to others by sweating at the gym."
205. A hospital has seen a recent increase in the incidence of hospital care-associated infections
(HAIs). Which measure should be prioritized in the response to this trend?
206. The nurse reminds the staff that standard precautions should be used when providing care
for which type of patient?
208. The patient has vancomycin-resistant enterococci (VRE) infection in a surgical wound.
What infection precautions should the nurse use to best prevent transmission of the infection
to the nurse, other patients, staff, and those outside the hospital?
A. Droplet precautions
B. Contact precautions
C. Airborne precautions
D. Standard precautions
209. A pregnant woman who was tested and diagnosed with HIV infection is very upset. What
should the nurse teach this patient about her baby's risk of being born with HIV infection?
C. "Treatment with antiretroviral therapy will decrease the baby's chance of HIV infection."
D. "The duration and frequency of contact with the organism will determine if the baby gets HIV
infection."
210. A 25-year-old male patient has been diagnosed with HIV. The patient does not want to
take more than one antiretroviral drug. What reasons can the nurse tell the patient about for
taking more than one drug?
211. The mother does not want her child to have any extra immunizations for diseases that no
longer occur. What teaching about immunization should the nurse provide this mother?
D. The only way to protect your child is to have the federally required vaccines.
212. An 82-year-old woman is brought to her physician by her daughter with complaints of
some confusion. What testing should the nurse suggest for this patient?
A. Urinalysis
B. Sputum culture
213. The HIV-infected patient is taught health promotion activities including good nutrition;
avoiding alcohol, tobacco, drug use, and exposure to infectious agents; keeping up to date with
vaccines; getting adequate rest; and stress management. What is the rationale behind these
interventions that the nurse knows?
215. When obtaining assessment data from a patient with a microcytic, hypochromic anemia,
the nurse would question the patient about
216. Nursing interventions for a patient with severe anemia related to peptic ulcer disease
include (select all that apply)
217. Nursing interventions for a patient with severe anemia related to peptic ulcer disease
include (select all that apply)
a.thrombosis.
b.cardiomyopathy.
c.pulmonary edema.