Brunner & Suddarth's Textbook of Medical-Surgical Nursing 13e Edition
Brunner & Suddarth's Textbook of Medical-Surgical Nursing 13e Edition
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Chapter 36 Brunner & Suddarth’s Textbook of Medical-Surgical Nursing 13e Edition
Complete Chapter Questions With Answers
Sample Questions Are Posted Below
| 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? | |
| A) | Thrombocytopenia | |
| B) | HIV/AIDS | |
| C) | Neutropenia | |
| D) | Hemophilia | |
| Ans: | C | |
| Feedback: | ||
| 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? | |
| A) | Anaphylaxis | |
| B) | Hypertension | |
| C) | Hypothermia | |
| D) | Joint pain | |
| Ans: | A | |
| Feedback: | ||
| 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? | |
| A) | Chronic diarrhea | |
| B) | Hyperglycemia | |
| C) | Rhinorrhea | |
| D) | Contact dermatitis | |
| Ans: | A | |
| 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, rhinorrhea, 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 undergo “blood testing” as a child. Based on these statements, what health problem should the nurse practitioner suspect? | |
| A) | Severe neutropenia | |
| B) | X-linked agammaglobulinemia | |
| C) | Drug-induced thrombocytopenia | |
| D) | Aplastic anemia | |
| Ans: | B | |
| 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) | Stem cell transplantation | |
| B) | Long-term antibiotics | |
| C) | Chemotherapy | |
| D) | Thymus gland transplantation | |
| Ans: | D | |
| Feedback: | ||
| 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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