NCLEX IMMUNITY QUESTIONS AND ANSWERS
1. The nurse provides home care instructions to a client with systemic lupus erythematosus and tells the client
... [Show More] about methods to manage fatigue. Which statement by the client indicates a need for further instruction?
1. "I should take hot baths because they are relaxing."
2. "I should sit whenever possible to conserve my energy."
3. "I should avoid long periods of rest because it causes joint stiffness."
4. "I should do some exercises, such as walking, when I am not fatigued."
2. The nurse is conducting a teaching session with a client on their diagnosis of pemphigus. Which statement by the client indicates that the client understands the diagnosis?
1. "My skin will have tiny red vesicles."
2. "The presence of the skin vesicles is caused by a virus."
3. "I have an autoimmune disease that causes blistering in the epidermis."
4. "The presence of red, raised papules and large plaques covered by silvery scales will be present on my skin."
3. The nurse is assisting in planning care for a client with a diagnosis of immunodeficiency and should incorporate which action as a priority in the plan?
1. Protecting the client from infection
2. Providing emotional support to decrease fear
3. Encouraging discussion about lifestyle changes
4. Identifying factors that decreased the immune function
4. A client calls the nurse in the emergency department and states that he was just stung by a bumblebee while gardening. The client is afraid of a severe reaction because the client's neighbor experienced such a reaction just 1 week ago. Which action should the nurse take?
1. Advise the client to soak the site in hydrogen peroxide.
2. Ask the client if he ever sustained a bee sting in the past.
3. Tell the client to call an ambulance for transport to the emergency department.
4. Tell the client not to worry about the sting unless difficulty with breathing occurs.
Rationale:
In some types of allergies, a reaction occurs only on second and subsequent contacts with the allergen. The appropriate action, therefore, would be to ask the client if he ever experienced a bee sting in the past. Option 1 is not appropriate advice. Option 3 is unnecessary. The client should not be told "not to worry."
5. The community health nurse is conducting a research study and is identifying clients in the community at risk for wormstoilet allergy. Which client population is most at risk for developing this type of allergy?
1. Hairdressers
2. The homeless
3. Children in day care centers
4. Individuals living in a group home
6. Which interventions apply in the care of a client at high risk for an allergic response to a latex allergy? Select all that apply.
1. Use nonlatex gloves.
2. Use medications from glass ampules. [Show Less]