Medical-Surgical Nursing Exam 16

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1. The nurse who provides teaching to the female patient regarding prevention of recurrent urinary tract infections includes which of the following statements?

  1. Void immediately after sexual intercourse.
    Voiding will serve to flush the urethra, expelling contaminants.
  2. Take tub baths instead of showers.
    Showers are encouraged rather than tub baths because bacteria in the bath water may enter the urethra.
  3. Increase intake of coffee, tea, and colas.
    Coffee, tea, colas, alcohol, and other fluids that are urinary tract irritants should be avoided.
  4. Void every 5 hours during the day.
    The patient should be encouraged to void every 2-3 hours during the day and completely empty the bladder.

2. A history of infection specifically caused by group A beta-hemolytic streptococci is associated with which of the following disorders?

  1. Acute glomerulonephritis
    Acute glomerulonephritis is also associated with varicella zoster virus, hepatitis B, and Epstein-Barr virus.
  2. Acute renal failure
    Acute renal failure is associated with hypoperfusion to the kidney, parenchymal damage to the glomeruli or tubules, and obstruction at a point distal to the kidney.
  3. Chronic renal failure
    Chronic renal failure may be caused by systemic disease, hereditary lesions, medications, toxic agents, infections, and medications.
  4. Nephrotic syndrome
    Nephrotic syndrome is caused by disorders such as chronic glomerulonephritis, systemic lupus erythematosus, multiple myeloma, and renal vein thrombosis.

3. Rejection of a transplanted kidney within 24 hours after transplant is termed

  1. hyperacute rejection.
    Hyperacute rejection may require removal of the transplanted kidney.
  2. acute rejection.
    Acute rejection occurs within 3-14 days of transplantation.
  3. chronic rejection.
    Chronic rejection occurs after many years.
  4. simple rejection.
    The term simple is not used in the categorization of types of rejection of kidney transplants.

4. When caring for a patient with an uncomplicated, mild urinary tract infection (UTI), the nurse knows that recent studies have shown which of the following drugs to be a good choice for short-course (e.g. 3-day) therapy?

  1. Levofloxacin (Levaquin)
    Levofloxacin, a floroquinolone, is a good choice for short-course therapy of uncomplicated, mild to moderate UTI. Clinical trial data show high patient compliance with the 3-day regimen (95.6%) and a high eradication rate for all pathogens (96.4%).
  2. Trimethoprim sulfamethoxazole (TMP-SMZ, Bactrim, Septra)
    Trimethoprim sulfamethoxazole is a commonly used medication for treatment of a complicated UTI, such as pyelonephritis.
  3. Nitrofurantoin (Macrodantin, Furadantin)
    Nitrofurantoin is a commonly used medication for treatment of a complicated UTI, such as pyelonephritis.
  4. Ciprofloxacin (Cipro)
    Ciprofloxacin is a good choice for treatment of a complicated UTI. Recent studies have found ciprofloxacin to be significantly more effective than TMP-SMX in community-based patients and in nursing home residents.

5. Which of the following terms refers to difficult or painful sexual intercourse?

  1. Dyspareunia
    Dyspareunia is a common problem of the aged female.
  2. Amenorrhea
    Amenorrhea refers to absence of menstrual flow.
  3. Dysmenorrhea
    Dysmenorrhea refers to painful menstruation.
  4. Endometriosis
    Endometriosis is a condition in which endometrial tissue seeds in other areas of the pelvis.

6. The opening into the vagina on the perineum is termed the

  1. introitus.
    The introitus is the vaginal orifice.
  2. adnexa.
    Adnexa is a term used to describe the fallopian tubes and ovaries together.
  3. cervix.
    The cervix is the bottom (interior) part of the uterus that is located in the vagina.
    hymen.
  4. The hymen is a tissue that may cover the vaginal opening partially or completely before vaginal penetration.

7. Which of the following hormones is primarily responsible for stimulating the production of progesterone?

  1. Luteinizing hormone
    Luteinizing hormone is released by the pituitary gland.
  2. Follicle-stimulating hormone
    Follicle-stimulating hormone is responsible for stimulating the ovaries to secrete estrogen.
  3. Estrogen
    Estrogens are responsible for developing and maintaining the female reproductive tract.
  4. Androgen
    Androgens, secreted in small amounts by the ovaries, are involved in early development of the follicle and also affect the female libido.

8. When the results of a Pap smear are reported as class 5, the nurse recognizes that the common interpretation is

  1. malignant.
    A class 5 Pap smear, according to the Bethesda Classification, indicates squamous cell carcinoma.
  2. normal.
    A class 1 Pap smear is interpreted as normal.
  3. probably normal.
    A class 2 Pap smear is interpreted as probably normal.
  4. suspicious.
    A class 3 Pap smear is interpreted as suspicious.

9. For women aged 19-39 years, recommended health screening diagnostic testing includes which of the following?

  1. Pap smear
    A Pap smear is recommended for women aged 19-39 years, as well as for women aged 40 and older.
  2. Mammography
    Mammography is recommended for health screening for women aged 40 years and older.
  3. Cholesterol and lipid profile
    Cholesterol and lipid profile is recommended for women aged 40 years and older.
  4. Bone mineral density testing
    Bone mineral density testing is recommended for women aged 40 years and older.

10. Which of the following statements reflects nursing care of the woman with mild to moderate ovarian hyperstimulation syndrome (OHSS)?

  1. Advise the patient to decrease her activity, monitor her urine output and to return for frequent office visits.
    Management in mild and moderate cases of OHSS consists of decreased activity, monitoring of urine output and frequent office visits as designated by the reproductive endocrinologist.
  2. Advise the patient to measure her weight and abdominal circumference daily.
    Treatment of severe, not mild to moderate, OHSS includes daily measurements of weight and abdominal circumference.
  3. Advise the patient to monitor her heart rate and to report if her pulse falls below 60 beats per minute.
    Symptoms of OHSS include abdominal discomfort, distention, weight gain and ovarian enlargement.
  4. Prepare the patient for immediate hospitalization.                                                                 The patient with severe OHSS is hospitalized for monitoring and treatment.

11. Which of the following terms is used to describe a procedure in which cervical tissue is removed as result of detection of abnormal cells?

  1. Conization
    The procedure is also called a cone biopsy.
  2. Colporrhaphy
    Colporrhaphy refers to repair of the vagina.
  3. Cryotherapy
    Cryotherapy refers to destruction of tissue by freezing.
  4. Perineorrhaphy
    Perineorrhaphy refers to sutural repair of perineal lacerations.

12. Of the following terms, which is used to refer to a type of gestational trophoblastic neoplasm?

  1. Hydatidiform mole
    Hydatidiform mole occurs in 1 in 1000 pregnancies.
  2. Dermoid cyst
    A dermoid cyst is an ovarian tumor of undefined origin that consists of undifferentiated embryonal cells.
  3. Doderlein’s bacilli
    Doderlein’s bacilli is one component of normal vaginal flora.
  4. Bartholin’s cyst
    Bartholin’s cyst is a cyst in a paired vestibular gland in the vulva.

13. When the female client reports a frothy yellow-brown vaginal discharge, the nurse suspects the client has a vaginal infection caused by

  1. trichomonas vaginalis.
    Trichomonas vaginalis causes a frothy yellow-white or yellow-brown vaginal discharge.
  2. candida albicans.
    Candidiasis causes a white, cheeselike discharge clinging to the vaginal epithelium.
  3. gardnerella vaginalis.
    Gardnerella vaginalis causes a gray-white to yellow-white discharge clinging to the external vulva and vaginal walls.
  4. chlamydia.
    Chlamydia causes a profuse purulent discharge.

14. The nurse providing education regarding sexually transmitted diseases includes which of the following statements regarding herpes virus 2(herpes genitalis)?

  1. In pregnant women with active herpes virus, babies delivered vaginally may become infected with the virus.
    Therefore, a cesarean delivery may be performed if the virus recurs near the time of delivery.
  2. Transmission of the virus requires sexual contact.
    Asexual transmission by contact with wet surfaces or self-transmission (i.e., touching a cold sore and then touching the genital area) can occur.
  3. Transmission occurs only when the carrier has symptoms.
    Transmission is possible even when the carrier does not have symptoms.
  4. The virus is very difficult to kill.
    Usually, the virus is killed at room temperature by drying.

15. An opening between the bladder and the vagina is called a

  1. vesicovaginal fistula.
    A vesicovaginal fistula may occur because of tissue injury sustained during surgery, vaginal delivery, or a disease process.
  2. cystocele.
    A cystocele is a downward displacement of the bladder toward the vaginal orifice.
  3. rectocele.
    A rectocele is a bulging of the rectum into the vagina.
  4. rectovaginal fistula.
    A rectovaginal fistula is an opening between the rectum and the vagina.

16. Which of the following statements defines laparoscopic myomectomy—an alternative to hysterectomy for the treatment of excessive bleeding due to fibroids?

  1. Removal of fibroids through a laparoscope inserted through a small abdominal incision.
    Laparoscopic myomectomy is the removal of fibroids through a laparoscope inserted through a small abdominal incision.
  2. Cauterization and shrinking of fibroids using a laser or electrical needles.
    Laparoscopic myolysis is the procedure in which a laser or electrial needles are used to cauterize and shrink the fibroid.
  3. Coagulation of the fibroids using electrical current.
    Laparoscopic cryomyolysis is the procedure in which electric current is used to coagulate the fibroids.
  4. Resection of the fibroids using a laser through a hyserscope passed through the cervix.
    Hysteroscopic resection of myomas is the procedure in which a laser is used through a hyserscope passed through the cervix; no incision or overnight stay is needed.

17. Stage 3 of breast development, according to Tanner, occurs when

  1. the areola (a darker tissue ring around the nipple) develops.
    Stage 3 also involves further enlargement of breast tissue.
  2. breast budding begins.
    Breast budding is the first sign of puberty in a female.
  3. the areola and nipple form a secondary mound on top of breast tissue.
    In stage 4, the nipple and areola form a secondary mound on top of breast tissue.
  4. the breast develops into a single contour
    In stage 5, the female demonstrates continued development of a larger breast with a single contour.

18. When the female patient demonstrates thickening, scaling, and erosion of the nipple and areola, the nurse recognizes that the patient is exhibiting signs of

  1. Paget’s disease.
    Paget’s disease is a malignancy of mammary ducts with early signs of erythema of nipple and areola.
  2. acute mastitis.
    Acute mastitis is demonstrated by nipple cracks or abrasions along with reddened and warm breast skin and tenderness.
  3. fibroadenoma.
    Fibroadenoma is characterized as the occurrence of a single, nontender mass that is firm, mobile, and not fixed to breast tissue or chest wall.
  4. peau d’orange (edema).
    Peau d’orange is associated with the breast and demonstrates an orange peel apearance of breast skin with enlargement of skin pores.

19. The nurse teaches the female patient who is premenopausal to perform breast self-examination (BSE)

  1. on day 5 to day 7, counting the first day of menses as day 1.
    BSE is best performed after menses, when less fluid is retained.
  2. with the onset of menstruation
    Because most women notice increased tenderness, lumpiness, and fluid retention before their menstrual period, BSE is not recommended with the onset of menses.
  3. on day 2 to day 4, counting the first day of menses as day 1.
    Because the tenderness, lumpiness, and fluid retention problems noticed by women in relation to onset of menses generally continue through menses, BSE is not recommended during that time.
  4. any time during the month.
    Because most women notice increased tenderness, lumpiness, and fluid retention before their menstrual period, BSE is best performed when the time for menses is taken into account.

20. Which type of biopsy is used for nonpalpable lesions found on mammography?

  1. Stereotactic
    Stereotactic biopsy utilizes computer location of the suspicious area found on biopsy, followed by core needle insertion and sampling of tissue for pathologic examination.
  2. Excisional
    Excisional biopsy is the usual procedure for any palpable breast mass.
  3. Incisional
    Incisional biopsy is performed on a palpable mass when tissue sampling alone is required.
  4. Tru-Cut core                                                                                                                                 Tru-Cut core biopsy is used when a tumor is relatively large and close to the skin surface.

21. The nurse recognizes which of the following statements as accurately reflecting a risk factor for breast cancer?

  1. Mother affected by cancer before 60 years of age
    Risk for breast cancer increases twofold if first-degree female relatives (sister, mother, or daughter) had breast cancer.
  2. Onset of menses before 14 years of age
    Increased risk is associated with early menarche (i.e., menses beginning before 12 years of age).
  3. Multiparity
    Nulliparity and later maternal age for first birth are associated with increased risk for breast cancer.
  4. No alcohol consumption
    Alcohol use remains controversial; however, a slightly increased risk is found in women who consume even one drink daily and doubles among women drinking three drinks daily.

22. Which of the following terms is used to describe removal of the breast tissue and an axillary lymph node dissection leaving muscular structure intact as surgical treatment of breast cancer?

  1. Modified radical mastectomy
    A modified radical mastectomy leaves the pectoralis major and minor muscles intact.
  2. Segmental mastectomy
    In a segmental mastectomy, varying amounts of breast tissue are removed, including the malignant tissue and some surrounding tissue to ensure clear margins.
  3. Total mastectomy
    In a total mastectomy, breast tissue only is removed.
  4. Radical mastectomy
    Radical mastectomy includes removal of the pectoralis major and minor muscles in addition to breast tissue and axillary lymph node dissection.

23. Ductal lavage is used for

  1. women at higher risk for benign proliferative breast disease.
    Performed in the doctor’s office, a microcatheter is inserted through the nipple while instilling saline and retrieving the fluid for analysis. It has been shown to identify atypical cells in this population and has been found to be adept at detecting cellular changes within the breast tissue.
  2. women at low risk for breast cancer.
    Ductal lavage is used for women at higher risk, not low risk, for benign proliferative breast disease.
  3. screening women over age 65.
    Ductal lavage is used for women at higher risk for benign proliferative breast disease; it is not used as a screening tool.
  4. women with breast implants.
    Ductal lavage is used for women at higher risk for benign proliferative breast disease; it is not specific for women with breast implants.

24. The 2000 NIH Consensus Development Conference Statement states that what percentage of women with invasive breast cancer should consider the option of systemic chemotherapy, not just women whose tumors are greater than 1cm in size?

  1. 100% (all)
    The 2000 Consensus Development Conference Statement states that all women with invasive breast cancer should consider the option of systemic chemotherapy, not just women whose tumors are greater than 1 cm in size.
  2. 75%
    All women (100%) with invasive breast cancer should consider the option of systemic chemotherapy, not just women whose tumors are greater than 1 cm in size.
  3. 50%
    All women (100%) with invasive breast cancer should consider the option of systemic chemotherapy, not just women whose tumors are greater than 1 cm in size.
  4. 25%
    All women (100%) with invasive breast cancer should consider the option of systemic chemotherapy, not just women whose tumors are greater than 1 cm in size.

25. Which of the following terms refers to surgical removal of one of the testes?

  1. Orchiectomy
    Orchiectomy is required when the testicle has been damaged.
  2. Circumcision
    Circumcision is excision of the foreskin, or prepuce, of the glans penis.
  3. Vasectomy
    Vasectomy is the ligation and transection of part of the vas deferens to prevent the passage of the sperm from the testes.
  4. Hydrocelectomy
    Hydrocelectomy describes the surgical repair of a hydrocele, a collection of fluid in the tunica vaginalis.

26. The term or disease associated with buildup of fibrous plaques in the sheath of the corpus cavernosum causing curvature of the penis when it is erect is known as

  1. Peyronie’s disease.
    Peyronie’s disease may require surgical removal of the plaques when the disease makes sexual intercourse painful, difficult, or impossible.
  2. Bowen’s disease
    Bowen’s disease refers to a form of squamous cell carcinoma in situ of the penile shaft.
  3. phimosis.
    Phimosis refers to the condition in which the foreskin is constricted so that it cannot be retracted over the glans.
  4. priapism.
    Priapism refers to an uncontrolled, persistent erection of the penis occurring from either neural or vascular causes.

27. Which of the following terms is used to describe the opening of the urethra on the dorsum of the penis?

  1. Epispadias
    Epispadias is a congenital anomaly in which the urethral opening is on the dorsum of the penis and is usually repaired through plastic surgery when the boy is very young.
  2. Hypospadias
    Hypospadias is a congenital anomaly in which the urethral opening is on the underside of the penis and is usually repaired through plastic surgery when the boy is very young.
  3. Urethral stricture
    Urethral stricture is a condition in which a section of urethra is narrowed.
  4. Urethritis
    Urethritis refers to inflammation of the urethra and is commonly associated with sexually transmitted disease.

28. The nurse teaches the patient who has been prescribed Viagra which of the following guidelines?

  1. Do not take more than one tablet per day of your prescribed dose.
    Taking Viagra more than once a day will not improve its effects and the patient may experience back and leg aches as well as nausea and vomiting.
  2. Viagra should be taken immediately before intercourse.
    Viagra should be taken one hour before intercourse.
  3. Viagra will result in erection formation.
    Viagra will not create the erection; the erection must be created by sexual stimulation.
  4. Viagra will restore sex drive.
    Viagra will not restore desire or sex drive.

29. The obstructive and irritative symptom complex caused by benign prostatic hypertrophy is termed

  1. prostatism.
    Symptoms of prostatism include increased frequency of urination, nocturia, urgency, dribbling, and a sensation that the bladder has not completely emptied.
  2. prostatitis.
    Prostatitis is an inflammation of the prostate gland.
  3. prostaglandin.
    Prostaglandins are physiologically active substances present in tissues with vasodilator properties.
  4. prostatectomy.
    Prostatectomy refers to the surgical removal of the prostate gland.

30. Proteins formed when cells are exposed to viral or foreign agents that are capable of activating other components of the immune system are referred to as

  1. interferons.
    Interferons are biologic response modifiers with nonspecific viricidal proteins.
  2. antibodies.
    Antibodies are protein substances developed by the body in response to and interacting with a specific foreign substance.
  3. antigens.
    Antigens are substances that induce formation of antibodies.
  4. complements.                                                                                                                                Complement refers to a series of enzymatic proteins in the serum that, when activated, destroy bacteria and other cells.

31. Cytotoxic T cells

  1. lyse cells infected with virus.
    Cytotoxic T cells play a role in graft rejection.
  2. are important in producing circulating antibodies.
    B cells are lymphocytes important in producing circulating antibodies.
  3. attack foreign invaders (antigens) directly.
    Helper T cells are lymphocytes that attack antigens directly.
  4. decrease B cell activity to a level at which the immune system is compatible with life.
    Suppressor T cells are lymphocytes that decrease B-cell activity to a level at which the immune system is compatible with life.

32. During which stage of the immune response does the circulating lymphocyte containing the antigenic message return to the nearest lymph node?

  1. Proliferation
    Once in the node, the sensitized lymphocyte stimulates some of the resident dormant T and B lymphocytes to enlarge, divide, and proliferate.
  2. Recognition
    In the recognition stage, the immune system distinguishes an invader as foreign, or non-self.
  3. Response
    In the response stage, the changed lymphocytes function either in a humoral or cellular fashion.
  4. Effector
    In the effector stage, either the antibody of the humoral response or the cytotoxic T cell of the cellular response reaches and couples with the antigen on the surface of the foreign invader.

33. Which of the following responses identifies a role of T lymphocytes?

  1. Transplant rejection
    Transplant rejection and graft-versus-host disease are cellular response roles of T cells.
  2. Anaphylaxis
    Anaphylaxis is a humoral response role of B-lymphocytes.
  3. Allergic hay fever and asthma
    Allergic hay fever and asthma are humoral response roles of B-lymphocytes.
  4. Bacterial phagocytosis and lysis
    Bacterial phagocytosis and lysis are humoral response roles of B-lymphocytes.

34. Of the following classifications of medications, which is known to inhibit prostaglandin synthesis or release?

  1. Nonsteroidal anti-inflammatory drugs (NSAIDs) in large doses
    NSAIDs include aspirin and ibuprofen.
  2. Antibiotics (in large doses)
    Antibiotics in large doses are known to cause bone marrow suppression.
  3. Adrenal corticosteroids
    Adrenal corticosteroids are known to cause immunosuppression.
  4. Antineoplastic agents
    Antineoplastic agents are known to cause immunosuppression.

35. Which of the following statements reflect current stem cell research?

  1. The stem cell is known as a precursor cell that continually replenishes the body’s entire supply of both red and white cells.
    The stem cell is known as a precursor cell that continually replenishes the body’s entire supply of both red and white cells. Stem cells comprise only a small portion of all types of bone marrow cells.
  2. Stem cell transplantation can restore immune system functioning.
    Research conducted with mouse models has demonstrated that once the immune system has been destroyed experimentally, it can be completely restored with the implantation of just a few purified stem cells.
  3. Stem cell transplantion has been performed in the laboratory only.
    Stem cell transplantation has been carried out in human subjects with certain types of immune dysfunction such as severe combined immunodeficiency (SCID).
  4. Clinical trials are underway in patients with acquired immune deficiencies only.
    Clinical trails are underway in patients with a variety of disorders with an autoimmune component including systemic lupus erythematosus,rheumatoid arthritis, scleroderma, and multiple sclerosis.

36. The nurse’s base knowledge of primary immunodeficiencies includes which of the following statements? Primary immunodeficiencies

  1. develop early in life after protection from maternal antibodies decreases.
    These disorders may involve one or more components of the immune system.
  2. occur most commonly in the aged population.
    Primary immunodeficiencies are seen primarily in infants and young children.
  3. develop as a result of treatment with antineoplastic agents.
    Primary immunodeficiencies are rare disorders with genetic origins.
  4. disappear with age.
    Without treatment, infants and children with these disorders seldom survive to adulthood.

37. Agammaglobulinemia is also known as

  1. Bruton’s disease.
    Bruton’s disease is a sex-linked disease that results in infants born with the disorder suffering severe infections soon after birth
  2. Nezelof syndrome.
    Nezelof syndrome is a disorder involving lack of a thymus gland.
  3. Wiskott-Aldrich syndrome.
    Wiskott-Aldrich syndrome involves the absence of T cells and B cells and the presence of thrombocytopenia.
  4. Common variable immunodeficiency (CVID)
    CVID is another term for hypogammaglobulinemia.

38. When the nurse administers intravenous gamma-globulin infusion, she recognizes that which of the following complaints, if reported by the patient, may indicate an adverse effect of the infusion?

  1. Tightness in the chest
    Flank pain, tightness in the chest, or hypotension indicates adverse effects of gamma-globulin infusion.
  2. Nasal stuffiness
    Nasal stuffiness is not recognized as an adverse effect of gamma-globulin infusion.
  3. Increased thirst
    Increased thirst is not recognized as an adverse effect of gamma-globulin infusion.
  4. Burning urination
    Burning urination is a sign of urinary tract infection, not an adverse effect of gamma-globulin infusion.

39. Ataxia is the term that refers to

  1. uncoordinated muscle movement.
    Ataxia-telangiectasia is an autosomal recessive disorder affecting both T-cell and B-cell immunity.
  2. vascular lesions caused by dilated blood vessels.
    Telangiectasia is the term that refers to vascular lesions caused by dilated blood vessels.
  3. inability to understand the spoken word.
    Receptive aphasia is an inability to understand the spoken word.
  4. difficulty swallowing.
    Dysphagia refers to difficulty swallowing.

40. Which of the following microorganisms is known to cause retinitis in people with HIV/AIDS?

  1. Cytomegalovirus
    Cytomegalovirus is a species-specific herpes virus.
  2. Cryptococcus neoformans
    Cryptococcus neoformans is a fungus that causes an opportunistic infection in patients with HIV/AIDS.
  3. Mycobacterium avium
    Mycobacterium avium is an acid-fast bacillus that commonly causes a respiratory illness.
  4. Pneumocystic carinii                                                                                                                   Pneumocystic carinii is an organism that is thought to be protozoan but believed to be a fungus based on its structure.

41. Of the following blood tests, which confirms the presence of antibodies to HIV?

  1. Enzyme-linked immunoabsorbant assay (ELISA)
    ELISA, as well as Western blot assay, identifies and confirms the presence of antibodies to HIV.
  2. Erythrocyte sedimentation rate (ESR)
    The ESR is an indicator of the presence of inflammation in the body.
  3. p24 antigen
    The p24 antigen is a blood test that measures viral core protein.
  4. Reverse transcriptase
    Reverse transcriptase is not a blood test. Rather, it is an enzyme that transforms single-stranded RNA into a double-stranded DNA.

42. When assisting the patient to interpret a negative HIV test result, the nurse informs the patient that the results mean

  1. his body has not produced antibodies to the AIDS virus.
    A negative test result indicates that antibodies to the AIDS virus are not present in the blood at the time the blood sample for the test is drawn.
  2. he has not been infected with HIV.
    A negative test result should be interpreted as demonstrating that if infected, the body has not produced antibodies (which take from 3 weeks to 6 months or longer). Therefore, subsequent testing of an at-risk patient must be encouraged.
  3. he is immune to the AIDS virus.
    The test result does not mean that the patient is immune to the virus, nor does it mean that the patient is not infected. It just means that the body may not have produced antibodies yet.
  4. antibodies to the AIDS virus are in his blood.
    When antibodies to the AIDS virus are detected in the blood, the test is interpreted as positive.

43. Which of the following substances may be used to lubricate a condom?

  1. K-Y jelly
    K-Y jelly is water-based and will provide lubrication while not damaging the condom.
  2. Skin lotion
    The oil in skin lotion will cause the condom to break.
  3. Baby oil
    Baby oil will cause the condom to break.
  4. Petroleum jelly
    The oil in petroleum jelly will cause the condom to break.

44. More than 500 CD4+ T lymphocytes/mm3 indicates which stage of HIV infection?

  1. CDC category A – HIV asymptomatic
    More than 500 CD4+ T lymphocytes/mm3 indicates CDC category A – HIV asymptomatic.
  2. Primary infection (acute HIV infection or acute HIV syndrome)
    The period from infection with HIV to the development of antibodies to HIV is know as primary infection.
  3. CDC category B – HIV symptomatic
    200-499 CD4+ T lymphocytes/mm3 indicates CDC category B – HIV symptomatic.
  4. CDC category C – AIDS
    Less than 200 CD4+ T lymphocytes/mm3 indicates CDC category C – AIDS.

45. The term used to define the balance between the amount of HIV in the body and the immune response is

  1. viral set point
    The viral set point is the balance between the amount of HIV in the body and the immune response.
  2. window period
    During the primary infection period, the window period occurs since a person is infected with HIV but negative on the HIV antibody blood test.
  3. primary infection stage
    The period from infection with HIV to the development of antibodies to HIV is known as the primary infection stage.
  4. viral clearance rate
    The amount of virus in circulation and the number of infected cells equals the rate of viral clearance.

46. Which of the following statements reflect the treatment of HIV infection?

  1. Treatment of HIV infection for an individual patient is based on the clinical condition of the patient, CD4 T cell count level, and HIV RNA (viral load).
    Although specific therapies vary, treatment of HIV infection for an individual patient is based on three factors: the clinical condition of the patient, CD4 T cell count level, and HIV RNA (viral load).
  2. Treatment should be offered to all patients once they reach CDC category B – HIV symptomatic.
    Treatment should be offered to all patients with the primary infection (acute HIV syndrome).
  3. Treatment should be offered to only selected patients once they reach CDC category B – HIV symptomatic.
    Treatment should be offered to all patients with the primary infection (acute HIV syndrome).
  4. Treatment should be offered to individuals with plasma HIV RNA levels less than 55,000 copies/mL (RT-PCR assay.)
    In general, treatment should be offered to individuals with fewer than 350 CD4+ T cells/mm3 or plasma HIV RNA levels exceeding 55,000 copies/mL (RT-PCR assay).

47. Which of the following body substances causes increased gastric secretion, dilation of capillaries, and constriction of the bronchial smooth muscle?

  1. Histamine
    When cells are damaged, histamine is released.
  2. Bradykinin
    Bradykinin is a polypeptide that stimulates nerve fibers and causes pain.
  3. Serotonin
    Serotonin is a chemical mediator that acts as a potent vasoconstrictor and bronchoconstrictor.
  4. Prostaglandin
    Prostaglandins are unsaturated fatty acids that have a wide assortment of biologic activity.

48. Which type of hypersensitivity reaction involves immune complexes formed when antigens bind to antibodies?

  1. Type III
    Type III hypersensitivity is associated with systemic lupus erythematosus, rheumatoid arthritis, serum sickness, certain types of nephritis, and some types of bacterial endocarditis.
  2. Type I
    Type I or anaphylactic hypersensitivity is an immediate reaction, beginning within minutes of exposure to an antigen.
  3. Type II
    Type II, or cytotoxic, hypersensitivity occurs when the system mistakenly identifies a normal constituent of the body as foreign.
  4. Type IV
    Type IV, or delayed-type, hypersensitivity occurs 24-72 hours after exposure to an allergen.

49. When the patient’s eosinophil count is 50-90% of blood leukocytes, the nurse interprets the result as

  1. indicative of idiopathic hypereosinophilic syndrome.
    When eosinophils make up 50-90% of white cell count, the patient is demonstrating severe eosinophilia.
  2. indicating an allergic disorder.
    Moderate eosinophilia, 15-40% of white cell count consisting of eosinophils, are found in patients with allergic disorders.
  3. suggesting an allergic reaction.
    A level between 5 and 15% eosinophils is nonspecific but does suggest allergic reaction.
  4. normal.
    Eosinophils normally make up 1-3% of the total number of white blood cells.

50. Which of the following interventions is the single most important aspect for the patient at risk for anaphylaxis?

  1. Prevention
    People who have experienced food, medication, idiopathic, or exercise-induced anaphylactic reactions should always carry an emergency kit containing epinephrine for injection to prevent the onset of the reaction upon exposure.
  2. Use of antihistamines
    While helpful, the patient may require epinephrine to treat a potential reaction.
  3. Desensitization
    While helpful, there must be no lapses in desensitization therapy because this may lead to the reappearance of an allergic reaction when the medication is re-instituted.
  4. Wearing of medical alert bracelet                                                                                                              The medical alert bracelet will assist those rendering aid to the patient who has experienced an anaphylactic reaction

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