Chapter 12 Care of Patients with Immune and Lymphatic Disorders

Chapter 12  Care of Patients with Immune and Lymphatic Disorders

Complete Chapter Questions And Answers
 

Sample Questions

MULTIPLE CHOICE

1. When the patient has an immediate allergic reaction to the injection of radiopaque dye, the nurse is aware that this immediate response is a type ___ response, which is _____ generated.
a.
1, antibody
b.
2, mast cell
c.
1, mast cell
d.
2, antibody

ANS: C
An immediate allergic reaction is a type 1 response, which is mast cell generated. Type 2 are delayed reactions.

DIF: Cognitive Level: Application REF: 236 OBJ: 4 (theory)
TOP: Allergies KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity: Reduction of Risk Potential

2. After an influenza immunization, the patient complains of shortness of breath, breaks out in hives, and begins to twitch. What should the nurse initially give?
a.
Epinephrine by injection
b.
O2 by mask at 5 L/min
c.
Corticosteroid by injection
d.
Bronchodilators per nebulization

ANS: A
Epinephrine is the initial line of defense to reverse anaphylaxis, followed by high-flow oxygen, bronchodilators, and corticosteroid injection as necessary.

DIF: Cognitive Level: Application REF: 243 OBJ: 2 (clinical)
TOP: Anaphylaxis KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease

3. Education for the patient with systemic lupus erythematosus (SLE) should include what teaching point?
a.
Training with weights to increase strength
b.
Using alcohol-based skin products
c.
Managing pain with opioids
d.
Using potent sunscreen

ANS: D
Protection against UV rays with a potent sunscreen is advised. NSAIDs are used for pain relief. Alcohol-based skin application and joint strain should be avoided.

DIF: Cognitive Level: Application REF: 247-248 | Nursing Care Plan 12-1
OBJ: 8 (theory) TOP: SLE Teaching
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease

4. The patient reports that he has been diagnosed with stage II Hodgkin’s disease. The nurse interprets this to mean that the infected lymph node involvement could be:
a.
spreading outside of the lymph system.
b.
in a single node.
c.
in both axillae.
d.
in two nodes in the left axilla area.

ANS: D
Stage II indicates that there are two or more involved lymph nodes on the same side of the diaphragm (or body). The lymph nodes affected could be in any part of the lymphatic system. The disease spreading outside of the lymph system indicates stage IV. Single node involvement is stage I, and lymph involvement on both sides of the diaphragm or body is considered stage III.

DIF: Cognitive Level: Application REF: 252 | Figure 12-6
OBJ: 9 (theory) TOP: Hodgkin’s Disease Node Staging
KEY: Nursing Process Step: Assessment
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease

5. MOPP and ABVD therapy for the treatment of Hodgkin’s disease are treatment protocols using:
a.
multiple medications given concurrently.
b.
a combination of heat and exercise and chemotherapy.
c.
alternating radiation and chemotherapy every 4 weeks.
d.
chemotherapy and alternative herbal remedies.

ANS: A
MOPP and ABVD are chemotherapy treatment protocols using a combination of four drugs given concurrently. MOPP is the acronym for the drugs mechlorethamine, vincristine (Oncovin), procarbazine, and prednisone. ABVD is the acronym for the drugs doxorubicin (Adriamycin), bleomycin, vinblastine, and dacarbazine. This treatment protocol is usually used for stages III and IV of the disease.

DIF: Cognitive Level: Application REF: 250 OBJ: 1 (theory)
TOP: Treatment: Hodgkin’s Disease KEY: Nursing Process Step: Planning
MSC: NCLEX: Health Promotion and Maintenance

6. The nurse caring for the patient with lymphedema of the left arm will implement what intervention?
a.
Encourage patient to keep the arms as inactive as possible to reduce further injury.
b.
Clean the arm with mild soap and massage gently.
c.
Take blood pressure and give injections in the right arm.
d.
Keep the arm below the level of the heart to minimize edema.

ANS: C
Taking blood pressure and giving injections in the right arm will reduce the probability of further injury to the left arm. The left arm should be placed above the level of the heart for fluid drainage. Muscle activity enhances the reabsorption of the fluid. Massaging the arm will increase circulation.

DIF: Cognitive Level: Application REF: 253 | Patient Teaching
OBJ: 1 (theory) TOP: Lymphedema
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Basic Care and Comfort