Chapter 51 Management of Patients With Immunodeficiency

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Chapter 51  Management of Patients With Immunodeficiency

 

 

Complete Chapter Questions And Answers
 

Sample Questions

 

Multiple Choice

1. A healthy high school athlete is diagnosed with fever and cellulitis of the right knee. The infection is resistant to oral antibiotics. He then develops osteomyelitis of the right knee. If untreated, the infection could result in
A) Severe neutropenia

B) Decrease white blood cells C) Normal creatinine clearance D) A fungal infection

Ans: A
Chapter: 51
Client Needs: A-2
Cognitive Level: Application
Difficulty: Difficult
Integrated Process: Nursing Process
Objective: 1
Page and Header: 1562, Phagocytic Dysfunction

Feedback: Patients with phagocytic cell disorders may develop severe neutropenia. With the onset of neutropenia the white blood cell count increases and the creatinine clearance decreases. The patient may be prone to a fungal infection but will not present with cellulitis and

osteomyelitis.

2. A patient is admitted with an immunologic problem and IV gamma-globulin is ordered. What should the nurse monitor for as a potential side effect of IV gamma-globulin?
A) Anaphylactic reaction
B) Hypertension

C) Hypothermia D) Joint pain

Ans: A
Chapter: 51
Client Needs: D-2
Cognitive Level: Application
Difficulty: Moderate
Integrated Process: Nursing Process
Objective: 2
Page and Header: 1563, Phagocytic Dysfunction

Feedback: Potential side effects of an IV gamma-globulin 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 side effects of IV gamma-globulin.

3. You are admitting a patient with an immunodeficiency to your unit. In planning the care of this patient, you are aware that the patient is likely to exhibit what symptom related to the immunodeficiency?
A) Chronic diarrhea

B) Hyperglycemia C) Rhinitis
D) Contact dermatitis

Ans: A
Chapter: 51
Client Needs: D-4
Cognitive Level: Application Difficulty: Moderate
Integrated Process: Nursing Process Objective: 2
Page and Header: 1562, Introduction

Feedback: 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, rhinitis, and contact dermatitis are not symptoms the patient is likely to exhibit.

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 tested for gamma-globulin as a child. Based on these statements, what would the nurse practitioner suspect?

A) Severe neutropenia
B) X-linked agammaglobulinemia C) Drug induced thrombocytopenia D) Aplastic anemia

Ans: B
Chapter: 51
Client Needs: A-2
Cognitive Level: Analysis
Difficulty: Difficult
Integrated Process: Nursing Process Objective: 1
Page and Header: 1564, B-Cell Deficiencies

Feedback: 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?
A) Heart transplant

B) Liver transplant
C) Lung transplant
D) Thymus gland transplant

Ans: D Chapter: 51

Client Needs: D-3
Cognitive Level: Comprehension Difficulty: Moderate
Integrated Process: Nursing Process Objective: 1
Page and Header: 1566, T-Cell Deficiencies

Feedback: Prolonged survival has been reported following the successful transplantation of the thymus gland or spontaneous remission of immunodeficiency. A heart, liver, or lung transplant will not resolve the hypocalcemia.

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