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Chapter 11: Care of Patients with Immune and Lymphatic Disorders (with HIV and AIDS)

Medical-Surgical Nursing- Concepts & Practice, 3rd Edition by Susan C. deWit, Candice K. Kumagai

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Chapter 11: Care of Patients with Immune and Lymphatic Disorders (with HIV and AIDS)

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

  1. The nurse is caring for a pediatric patient recently diagnosed with severe combined immunodeficiency (SCID) disease. The nurse determines that teaching has been effective after the parent makes which statement?
a. “This disease is like a pediatric version of AIDS.”
b. “My child must be careful not to fall to avoid bleeding.”
c. “My child should not attend day care.”
d. “This problem happened because of chemotherapy treatments.”

 

 

ANS:  C

There are two forms of immune deficiency: primary and acquired. In primary immune deficiency disorders (PIDD), the cause is an inherited genetic mutation and some of PIDD are detected during infancy or early childhood. Patients with this type of disorder experience repeated infections that clearly increase their risk of morbidity and mortality as well as the cost of health care. AIDS is an example of acquired immune deficiency and affects pediatric patients as well as adults. Hemophilia is a disorder in which patients can suffer life-threatening bleeds from a fall. Chemotherapy recipients may develop an acquired immune disorder, but chemotherapy would not cause any type of immune disorder in the child.

 

PTS:   1                    DIF:    Cognitive Level: Application           REF:   217, Box 11-1

OBJ:   1                    TOP:   Primary Immune Deficiency

KEY:  Nursing Process Step: Evaluation

MSC:  NCLEX: Physiological Integrity: Reduction of Risk Potential

 

  1. After an influenza immunization, the patient complains of shortness of breath, breaks out in hives, and begins to twitch. Which ordered medication should the nurse give first?
a. Epinephrine injection
b. Oxygen via mask at 5 L/min
c. Corticosteroid 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.

 

PTS:   1                    DIF:    Cognitive Level: Application           REF:   249

OBJ:   6 (clinical)      TOP:   Anaphylaxis   KEY:  Nursing Process Step: Implementation

MSC:  NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease

 

  1. The nurse is educating a patient with systemic lupus erythematosus (SLE). Which information is most important for the nurse to include in the teaching plan?
a. Train with weights to increase strength.
b. Avoid glycerin-based soaps.
c. Use an SPF 15 sunblock when outdoors.
d. Apply fragrance-free lotions to dry areas twice daily.

 

 

ANS:  D

Skin protection for patients with SLE is a top priority. The patient should be advised to liberally apply fragrance-free lotions to dry areas at least twice daily. Weight training could cause joint strain. SLE patients should choose a mild soap with a glycerin base and select sunscreen that features SPF of 30 or higher.

 

PTS:   1                    DIF:    Cognitive Level: Application           REF:   233, 237, Patient Teaching

OBJ:   7                    TOP:   SLE Teaching

KEY:  Nursing Process Step: Implementation

MSC:  NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease

 

  1. The nurse is educating a patient about his diagnosis of stage II Hodgkin disease. Which statement indicates that the nurse’s teaching has been successful?
a. “The cancer has spread throughout my entire body.”
b. “There is only one lymph node involved.”
c. “The lymph nodes in both of my arms are affected.”
d. “Two nodes in my left arm area are affected.”

 

 

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.

 

PTS:   1                    DIF:    Cognitive Level: Application           REF:   238, Figure 11-5

OBJ:   8                    TOP:   Hodgkin Disease Node Staging

KEY:  Nursing Process Step: Evaluation

MSC:  NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease

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