HCC III Immunity- ATI Quiz Bank with complete
solution
A nurse is assessing a client who has systemic lupus erythematosus an dis
taking hydroxychloroquine. The nurse should report which of the following
adverse effects to the provider immediately?
Blurred vision
When using the urgent vs non-urgent approach to client care, the nurse should
determine that the priority finding to report to the provider is blurred vision, as this is a
manifestation of hydroxychloroquine toxicity and can be an indication of retinal damage.
A nurse is caring for a client who has tuberculosis and new prescriptions for
rifampin and pyrazinamide. Which of the following laboratory tests should the
nurse instruct the client will be required while on the medication regimen?
Liver function tests
Pyrazinamide and rifampin can both cause hepatotoxicity, thus the provider will monitor
liver function regularly.
A nurse is assessing a client for a suspected anaphylactic reaction following a CT
scan with contrast media. For which of the findings should the nurse intervene
first?
Stridor
When using the airway, breathing, circulation approach to client care, the nurse
determines that the priority finding is stridor, which indicates narrowing of the airway.
The nurse should position the head of the client's bed at 45° or more, if tolerable, and
call for emergency assistance.
A nurse in an allergy clinic is caring for a client who has a history of seasonal
allergy symptoms. The client had a radioallergosorbent test (RAST) completed on
a previous visit. The nurse should recognize that an elevation in which of the
following immunoglobulins indicates a positive result?
Immunoglobulin E (IgE)
A RAST involves measuring the quantity of IgE present in the serum after exposure to
specific antigens that are selected based on the client's symptom history. An elevated
IgE indicates a positive response to a RAST.
A nurse is caring for a client who is hospitalized with active pulmonary
tuberculosis and is started on ethamnutol therapy. The nurse should understand
that which of the following should be monitored?
Visual acuity
, A significant adverse effect of ethambutol is optic neuritis, vision loss, and loss of color
discrimination, especially red and green. Baseline vision testing should be performed
before use, and visual acuity monitored at regular intervals.
A nurse is assessing a client who has systematic lupus erythematosus (SLE).
Which of the following findings should the nurse expect?
Facial rash
SLE causes a characteristic facial "butterfly" rash that is dry, scaly, red, and raised.
A nurse is teaching a client about the intradermal purified protein derivative
(PPD). Which of the following information should the nurse include?
"This test is performed if previous results are negative."
The nurse should assess whether the client has tested positive to a prior PPD test. For
clients who have tested positive, chest x-ray is performed to determine exposure.
A nurse is caring for a client who is being admitted for an acute exacerbation of
ulcerative colitis. Which of the following actions should the nurse take first?
Review the client's electrolyte values.
The greatest risk to this client is injury from impaired function of cardiac or respiratory
muscles; therefore, the first action the nurse should take is to review the client's
electrolyte values. The client might have low sodium, potassium, and chloride from
frequent diarrhea.
A nurse is caring for an older adult client who has rheumatoid arthritis and is
taking aspirin 650 mg every 4 hrs. Which of the following diagnostic tests should
the nurse monitor to evaluate the effectiveness of this medication?
Erythrocyte sedimentation rate (ESR)
Rheumatoid arthritis is a chronic inflammatory disease. ESR is useful in detecting and
monitoring tissue inflammation in clients with RA. As the disease improves the ESR
decreases.
A nurse suspects anaphylaxis when caring for a client following the initial
administration of an oral antibiotic. Which of the following should be the nurses
priority intervention?
Count the respiratory rate.
Checking the client's respiratory status is the priority action when following the nursing
process approach to client care.
A nurse is teaching a client who has tuberculosis and is to start combination
drug therapy. Which of the following medications shold the nurse plan to
administer?
Select All That Apply
solution
A nurse is assessing a client who has systemic lupus erythematosus an dis
taking hydroxychloroquine. The nurse should report which of the following
adverse effects to the provider immediately?
Blurred vision
When using the urgent vs non-urgent approach to client care, the nurse should
determine that the priority finding to report to the provider is blurred vision, as this is a
manifestation of hydroxychloroquine toxicity and can be an indication of retinal damage.
A nurse is caring for a client who has tuberculosis and new prescriptions for
rifampin and pyrazinamide. Which of the following laboratory tests should the
nurse instruct the client will be required while on the medication regimen?
Liver function tests
Pyrazinamide and rifampin can both cause hepatotoxicity, thus the provider will monitor
liver function regularly.
A nurse is assessing a client for a suspected anaphylactic reaction following a CT
scan with contrast media. For which of the findings should the nurse intervene
first?
Stridor
When using the airway, breathing, circulation approach to client care, the nurse
determines that the priority finding is stridor, which indicates narrowing of the airway.
The nurse should position the head of the client's bed at 45° or more, if tolerable, and
call for emergency assistance.
A nurse in an allergy clinic is caring for a client who has a history of seasonal
allergy symptoms. The client had a radioallergosorbent test (RAST) completed on
a previous visit. The nurse should recognize that an elevation in which of the
following immunoglobulins indicates a positive result?
Immunoglobulin E (IgE)
A RAST involves measuring the quantity of IgE present in the serum after exposure to
specific antigens that are selected based on the client's symptom history. An elevated
IgE indicates a positive response to a RAST.
A nurse is caring for a client who is hospitalized with active pulmonary
tuberculosis and is started on ethamnutol therapy. The nurse should understand
that which of the following should be monitored?
Visual acuity
, A significant adverse effect of ethambutol is optic neuritis, vision loss, and loss of color
discrimination, especially red and green. Baseline vision testing should be performed
before use, and visual acuity monitored at regular intervals.
A nurse is assessing a client who has systematic lupus erythematosus (SLE).
Which of the following findings should the nurse expect?
Facial rash
SLE causes a characteristic facial "butterfly" rash that is dry, scaly, red, and raised.
A nurse is teaching a client about the intradermal purified protein derivative
(PPD). Which of the following information should the nurse include?
"This test is performed if previous results are negative."
The nurse should assess whether the client has tested positive to a prior PPD test. For
clients who have tested positive, chest x-ray is performed to determine exposure.
A nurse is caring for a client who is being admitted for an acute exacerbation of
ulcerative colitis. Which of the following actions should the nurse take first?
Review the client's electrolyte values.
The greatest risk to this client is injury from impaired function of cardiac or respiratory
muscles; therefore, the first action the nurse should take is to review the client's
electrolyte values. The client might have low sodium, potassium, and chloride from
frequent diarrhea.
A nurse is caring for an older adult client who has rheumatoid arthritis and is
taking aspirin 650 mg every 4 hrs. Which of the following diagnostic tests should
the nurse monitor to evaluate the effectiveness of this medication?
Erythrocyte sedimentation rate (ESR)
Rheumatoid arthritis is a chronic inflammatory disease. ESR is useful in detecting and
monitoring tissue inflammation in clients with RA. As the disease improves the ESR
decreases.
A nurse suspects anaphylaxis when caring for a client following the initial
administration of an oral antibiotic. Which of the following should be the nurses
priority intervention?
Count the respiratory rate.
Checking the client's respiratory status is the priority action when following the nursing
process approach to client care.
A nurse is teaching a client who has tuberculosis and is to start combination
drug therapy. Which of the following medications shold the nurse plan to
administer?
Select All That Apply
