Which data would the nurse document for a client who returns to the clinic with
induration of the skin 48 hours after receiving a purified protein derivative (PPD) test?
Select all that apply. One, some, or all responses may be correct. - Answer -The client
has been exposed to tuberculosis.
Which action would the nurse take when a client receiving an infusion of penicillin
reports having an anaphylactic reaction to penicillin in the past? Select all that apply.
One, some, or all responses may be correct. - Answer --notifying rapid response
-measuring O2 level
-administering epinephrine
-inserting an indwelling catheter
-assessing the respiratory pattern
Which intervention would the nurse recommend to decrease tuberculosis (TB) in the
community? Select all that apply. One, some, or all responses may be correct. -
Answer -Improving financial resources
Eliminating overcrowded housing
Initiating needle-sharing programs
Improving access for food pantries
Providing barrier contraceptive devices
The nurse understands which vaccine is administered through the intranasal route? -
Answer -influenza live vaccine
Which strategies would the nurse use to reduce pain during or after vaccination in a
child? Select all that apply. One, some, or all responses may be correct. - Answer -
Applying topical anesthetic
Providing tactile stimulation
Holding the child upright during vaccination
A client has a history of a persistent cough, hemoptysis, unexplained weight loss,
fatigue, night sweats, and fever. Which risk would be assessed? - Answer -HIV
The nurse is providing counseling to a client with the diagnosis of systemic lupus
erythematosus (SLE). Which recommendations are essential for the nurse to include?
Select all that apply. One, some, or all responses may be correct. - Answer -"Wear a
large-brimmed hat."
, "Take your temperature daily."
"Balance periods of rest and activity."
The nurse is interviewing a client who was diagnosed with systemic lupus
erythematosus (SLE). Which clinical findings to this disease would the nurse expect the
client to exhibit? Select all that apply. One, some, or all responses may be correct. -
Answer --butterfly facial rash
-inflammation of the joints
Which clinical manifestations may indicate a client has systemic lupus erythematosus
(SLE)? Select all that apply. One, some, or all responses may be correct. - Answer --
pericarditis
-discoid lesions
-pleural effusions
Identify the type of hypersensitivity reaction associated with systemic lupus
erythematosus (SLE). - Answer -type III
A client is experiencing an exacerbation of systemic lupus erythematosus. To reduce
the frequency of exacerbations, what would be important for the nurse to include in the
client's teaching plan? - Answer -techniques to reduce stress
An adolescent has been admitted with a history of symptoms of fatigue, intermittent
fever, weight loss, and arthralgia, and the diagnosis is systemic lupus erythematosus.
Which is the best intervention at this time? - Answer -education about diet, rest, and
exercise
The registered nurse instructs a new employee about providing care for a hospitalized
client with a human immunodeficiency (HIV) infection. Which action made by the new
employee indicates effective learning? - Answer -Keeping a dedicated disposable glove
box in the client's room
Which client has a higher risk for contracting the human immunodeficiency virus (HIV)
infection? - Answer -A client who shares equipment to snort or smoke drugs
Which instruction indicates a lack of understanding of a nurse teaching a human
immunodeficiency virus (HIV)-positive client about strategies to prevent opportunistic
infections? - Answer -"Reuse cups after washing them with warm soapy water."
Which actions transmit the human immunodeficiency virus (HIV)? Select all that apply.
One, some, or all responses may be correct. - Answer -Sharing syringe needles
Breast-feeding a newborn