Chapter 36 Brunner & Suddarth’s Textbook of Medical-Surgical Nursing 13Th Edition


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Chapter 36  Brunner & Suddarth’s Textbook of Medical-Surgical Nursing 13Th Edition



Complete Chapter Questions And Answers

Sample Questions


1. A teenager is diagnosed with cellulitis of the right knee and fails to respond to oral antibiotics. He then develops osteomyelitis of the right knee, prompting a detailed diagnostic workup that reveals a phagocytic disorder. This patient faces an increased risk of what complication?

  1. A)  Thrombocytopenia
  2. B)  HIV/AIDS
  3. C)  Neutropenia
  4. D)  Hemophilia

Ans: C


Patients with phagocytic cell disorders may develop severe neutropenia. None of the other listed health problems is a common complication of phagocytic disorders.

2. A patient is admitted for the treatment of a primary immunodeficiency and intravenous immunoglobulin (IVIG) is ordered. What should the nurse monitor for as a potential adverse effect of IVIG administration?

  1. A)  Anaphylaxis
  2. B)  Hypertension
  3. C)  Hypothermia
  4. D)  Joint pain

Ans: A


Potential adverse effects of an IVIG infusion include hypotension, flank pain, chills, and tightness in chest, terminating with a slightly elevated body temperature and anaphylactic reaction. Hypertension, hypothermia, and joint pain are not usual adverse effects of IVIG.

3. A nurse is admitting a patient with an immunodeficiency to the medical unit. In planning the care of this patient, the nurse should assess for what common sign of immunodeficiency?

  1. A)  Chronic diarrhea
  2. B)  Hyperglycemia
  3. C)  Rhinorrhea
  4. D)  Contact dermatitis

Ans: A


The cardinal symptoms of immunodeficiency include chronic or recurrent severe infections, infections caused by unusual organisms or organisms that are normal body flora, poor response to treatment of infections, and chronic diarrhea. Hyperglycemia, rhinorrhea, and contact dermatitis are not symptoms the patient is likely to exhibit.

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4. A young couple visits the nurse practitioner stating that they want to start a family. The husband states that his brother died of a severe infection at age 6 months. He says he never knew what was wrong but his mother had him undergo “blood testing” as a child. Based on these statements, what health problem should the nurse practitioner suspect?

  1. A)  Severe neutropenia
  2. B)  X-linked agammaglobulinemia
  3. C)  Drug-induced thrombocytopenia
  4. D)  Aplastic anemia

Ans: B


There is no evidence of drug-induced thrombocytopenia or aplastic anemia. The child would have only suffered from severe neutropenia if there was evidence of bacterial or fungal infections. The fact the mother of this individual had him tested for gamma- globulin as a child would indicate that his sibling had X-linked agammaglobulinemia. More than 10% of patients with X-linked agammaglobulinemia are hospitalized for infection at less than 6 months of age. Since the condition is X-linked it is important for the couple to undergo genetic testing.

5. The parents of a 1-month-old infant bring their child to the pediatrician with symptoms of congestive heart failure. The infant is ultimately diagnosed with DiGeorge syndrome. What will prolong this infant’s survival?

  1. A)  Stem cell transplantation
  2. B)  Long-term antibiotics
  3. C)  Chemotherapy
  4. D)  Thymus gland transplantation

Ans: D


Transplantation of fetal thymus, postnatal thymus, or human leukocyte antigen (HLA)- matched bone marrow has been used for permanent reconstitution of T-cell immunity in infants with DiGeorge syndrome. Antibiotics and chemotherapy do not address the etiology of the infant’s disease. Stem cell transplantation is not a common treatment modality.

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6. A patient who has received a heart transplant is taking cyclosporine, an immunosuppressant. What should the nurse emphasize during health education about infection prevention?

  1. A)  Eat a high-calorie, high-protein diet.
  2. B)  Limit physical activity in order to conserve energy.
  3. C)  Take prophylactic antibiotics as ordered.
  4. D)  Perform frequent handwashing.

Ans: D


Hand hygiene is imperative in infection control. A well-balanced diet is important, but for most patients this is secondary to hygiene as an infection-control measure. Prophylactic antibiotics are not normally used. Limiting physical activity will not protect the patient from infection.

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