A nurse is teaching a group of nursing students about the patho of Mycobacterium Tuberculosis. Which statement indicates the need for further teaching?
A. “In healthy adults, the immune system usually contains MTB by forming granuloma”
B. “Granulomas can isolate the bacilli leading to latent TB that may remain inactive for a person’s entire life”
C. “Macrophages are able to completely destroy MTB through phagocytosis”
D. “A decrease in immunity may cause reactivation of latent TB and spread to other body systems”
C. “Macrophages are able to completely destroy MTB through phagocytosis”
A 36 year old female has been prescribed rifampin for TB treatment for the past month. Which finding should the nurse recognize as a priority to report to the provider immediately? SATA
a. Mild stomach upset after taking the medication
b. Yellowing of the skin and sclera
c. Reddish orange discoloration of body fluids
d. Dark/tea colored urine
b. Yellowing of the skin and sclerosis
c. Reddish orange discoloration of body fluids
d. Dark/tea colored urine
Which of the following groups is at the highest risk for latent TB infection?
a) Children born in the United States
b) Immigrants from Western Europe
c) Residents of rural areas
d) Refugees from high-prevalence regions
d) Refugees from high-prevalence regions
Which of the following is the most effective method for preventing the spread of tuberculosis in healthcare setting?
a) Administering the BCG vaccine to all healthcare workers
b) Implementing contact precautions for all patients with cough
c) Isolating patients with active TB in negative pressure rooms
d) Requiring N95 respirators for all staff entering patient rooms
c) Isolating patients with active TB in negative pressure rooms
The nurse is providing discharge teaching to a patient with Fibromyalgia. Which statement made by the patient indicates the need for an immediate follow up with the HCP?
a. “I’ve been feeling more tired than usual after my daily walks”
b. “I’ve started to feel numbness and weakness in my left arm”
c. “I still have muscle pain, even though I take my medication every night”
d. “some days I can’t sleep well, even when I stick to my sleep routine”
B. “I’ve started to feel numbness and weakness in my left arm”
Rationale: Numbness and weakness is nota typical sign of Fibromyalgia this may indicate a serious problem.
The nurse is assessing a client with fibromyalgia. Which findings should the nurse expect?Select all that apply.
A. Widespread musculoskeletal pain
B. Fatigue that is not relieved by rest
C. Cognitive difficulties such as memory problems
D. Symmetrical joint deformities
E. Non-restorative sleep
Correct Answers:A, B, C, E
A:Widespread pain is a hallmark of fibromyalgia.
B:Clients often report chronic fatigue that is not relieved by sleep.
C:”Fibro fog” (cognitive issues) is common.
E:Sleep disturbances with non-restorative sleep are frequent.
Incorrect Answer: D
D:Symmetrical joint deformities are linked to rheumatoid arthritis, not fibromyalgia.
A nurse is caring for a patient with fibromyalgia who has been prescribed pregabalin (Lyrica). Which of the following statements by the patient indicates a need for further education about the medication?
A) “I should take this medication with or without food as prescribed.”
B) “I may experience dizziness or drowsiness as side effects.”
C) “I can stop taking this medication abruptly if I don’t feel it’s working.”
D) “This medication may help reduce my pain and improve my sleep quality.”
C. “I can stop taking this medication abruptly if I don’t feel it’s working.”
Rationale:Pregabalin should not be discontinued abruptly, as this can lead to withdrawal symptoms. Patients should be educated to consult their healthcare provider before making any changes to their medication regimen. Gradual tapering is typically recommended when discontinuing pregabalin.
A nurse is providing education to a group of clients about fibromyalgia. Which statement made by a participant indicates a correct understanding of the condition?
A) “Fibromyalgia is caused by an autoimmune disease that attacks the joints.”
B) “Fibromyalgia involves chronic widespread pain and may also cause fatigue and sleep disturbances.”
C) “Fibromyalgia is always diagnosed during childhood and affects men more often than women.”
D) “Fibromyalgia has a clear single cause and can be cured with antibiotics.”
B. “Fibromyalgia involves chronic widespread pain and may also cause fatigue and sleep disturbances.”
Rationale: Fibromyalgia is a complex, poorly understood syndrome characterized by chronic widespread musculoskeletal pain, heightened sensitivity to pressure, and symptoms such as fatigue, intestinal disturbances, and changes in sleep and mood. It is more common in women and often goes undiagnosed. The exact cause is unknown, though genetic, stress-related, and environmental factors may contribute.
Options A, C, and D are incorrect because fibromyalgia is not autoimmune, does not primarily affect men or only children, and has no known single cause or cure.
The nurse is teaching a patient with multiple sclerosis about strategies to manage fatigue and prevent exacerbations. Which statements made by the patient indicate correct understanding? Select all that apply.
A. “I will try to keep my home environment cool.”
B. “I should schedule my most demanding activities early in the day.”
C. “I can take hot showers to help relax my muscles.”
D. “I will take frequent rest periods between activities.”
E. “I should avoid emotional stress when possible.”
F. “I’ll double my exercise intensity on days when I feel stronger.”
Correct Answers: A, B, D, E
Rationale:
A. Correct – Heat can worsen MS symptoms; keeping the environment cool helps prevent exacerbations.
B. Correct – Planning activities in the morning conserves energy.
C. Incorrect – Hot showers can trigger fatigue and worsen symptoms.
D. Correct – Rest periods reduce fatigue and help maintain function.
E. Correct – Emotional stress can trigger relapses, so stress management is important.
F. Incorrect – Overexertion can worsen symptoms; patients should pace themselves.
The nurse is providing teaching to a patient newly diagnosed with multiple sclerosis. Which statement by the patient indicates a need for further teaching?
A. “I should avoid taking hot baths.”
B. “Rest periods during the day will help me manage fatigue.”
C. “Exercise, like swimming, may help me maintain mobility.”
D. “Once I start treatment, I won’t have flare-ups anymore.”
Correct Answer: D
Rationale: MS is a chronic, progressive disease characterized by remissions and exacerbations. Treatment can reduce the frequency and severity of relapses but does not cure or completely prevent flare-ups. The other statements are correct self-management strategies.
A patient with MS is prescribed interferon beta-1a (Avonex). Which nursing instruction is most important?
A. “Report any flu-like symptoms immediately.”
B. “Rotate injection sites with each dose.”
C. “Take the medication only when symptoms flare.”
D. “Avoid high-potassium foods while on this medication.”
Correct Answer: B
Rationale: Interferon beta-1a is given via injection, and rotating injection sites helps prevent skin irritation and tissue damage. Flu-like symptoms are common but usually subside; they don’t need to be reported unless severe. This medication must be taken consistently, not just during flare-ups. Potassium intake is not affected.
The nurse is assessing a patient with multiple sclerosis. Which finding requires immediate intervention?
A. Blurred vision
B. Spasticity of the legs
C. New onset of dysphagia
D. Urinary frequency
Correct Answer: C
Rationale: Dysphagia (difficulty swallowing) is a priority because it places the patient at risk for aspiration, which can lead to pneumonia. The other findings are common symptoms of MS and need to be managed but are not immediately life-threatening.
A nurse is teaching a group of women about risk factors for systemic lupus erythematosus (SLE). Which statement by a participant indicates a correct understanding of the teaching?
A. “Women between the ages of 20 and 40 are at higher risk because of estrogen influence on the immune system.”
B. “Men are more likely to develop lupus because they produce more testosterone.”
C. “Vitamin D has no role in the development or flare-ups of lupus.”
D. “Lupus affects only the skin and joints, so it is less serious than other autoimmune diseases.”
Correct Answer: A. “Women between the ages of 20 and 40 are at higher risk because of estrogen influence on the immune system.”
Rationale: Women aged 20–40 are at the highest risk because estrogen promotes immune responses, increasing the risk of autoimmune diseases. Men are not more likely, vitamin D deficiency can contribute to lupus flares, and lupus can affect multiple organs such as the kidneys, brain, and other systems.
A nurse is assessing a client with systemic lupus erythematosus (SLE). Which of the following findings should the nurse recognize as a priority concern?
A. Butterfly rash across the nose and cheeks
B. Joint pain with inflammation
C. Inflammation of the glomerulus in the kidneys
D. Hair loss and mouth ulcers
Correct Answer: C. Inflammation of the glomerulus in the kidneys
Rationale: While rashes, joint pain, and mucous membrane ulcers are common in lupus, renal involvement is the most serious complication. It can progress to renal failure if not identified and managed promptly. Therefore, glomerulonephritis is the highest priority finding.
Which laboratory test is most commonly used as the initial screening tool for systemic lupus erythematosus (SLE)?
a. Complete blood count (CBC)
b. Erythrocyte sedimentation rate (ESR)
c. Antinuclear antibody test (ANA)
d. Anti-double-stranded DNA test (anti-dsDNA)
Correct Answer: C. Antinuclear antibody (ANA) test
Rationale: The ANA test is positive in about 98% of individuals with SLE. It’s typically the first test ordered when lupus is suspected
A nurse is caring for a client with systemic lupus erythematosus (SLE) who has been prescribed hydroxychloroquine (Plaquenil). Which of the following client statements indicates a need for further teaching?
A. “I should have regular eye exams while taking this medication.”
B. “This medication will help reduce my joint pain and fatigue.”
C. “I can stop taking the medication once my symptoms improve.”
D. “I may not see results from this medication for a few months.”
Correct Answer: C. “I can stop taking the medication once my symptoms improve.”
Rationale: Stopping the medication abruptly without medical guidance can lead to exacerbation of symptoms. A,B, & C should be taught to patients before they start taking this medication.
A patient with a history of severe peanut allergy is brought to the emergency department after accidental exposure. The patient is experiencing difficulty breathing, hypotension, and hives. Which medication should the nurse administer first?
A. Diphenhydramine (Benadryl)
B. Epinephrine auto-injector (EpiPen)
C. Albuterol inhaler
D. Prednisone
Correct Answer: B. Epinephrine auto-injector (EpiPen)
Epinephrine has to be given first because it works the fastest to open the airway, raise blood pressure, and stop the reaction. The other meds like Benadryl, albuterol, and steroids help, but they don’t act quick enough in an emergency. That’s why epinephrine is always the priority to save the patient’s life.
nurse is teaching a client about the process of a type I hypersensitivity reaction. Which client statement shows correct understanding?
A. “The allergen itself directly causes tissue damage during an allergic reaction.”
B. “My body makes IgE antibodies that attach to mast cells after the first exposure.”
C. “The first time I’m exposed to an allergen, my body will immediately release histamine.”
D. “Allergic reactions are caused only by inhaled allergens like pollen or dust.”
Correct Answer: B. “My body makes IgE antibodies that attach to mast cells after the first exposure.”
The sensitization phase happens after the first exposure: the body produces IgE antibodies, which attach to mast cells and basophils. These cells are now “primed” and ready to react during the next exposure.
What statement by the client indicates additional instruction is needed?
A: “I don’t need to go to the hospital after using it.”
B. “I must carry two autoinjectors with me at all times.”
C. “I will write the expiration date on my calendar.”
D. “This can be injected right through my clothes.”
Correct answer is A.
Clients would be instructed to call 911 and go to the hospital for monitoring after using the auto-injector. The medication may wear off before the offending agent has cleared the client’s system. The other statements show good understanding of this treatment.
A nurse is teaching a patient about risk factors for allergies. Which of the following statements by the patient indicates the need for further teaching?
A. - “Having both parents with allergies increases my risk.”
B. - “Living in a highly polluted area may contribute to allergies.”
C. - “Exposure to various microorganisms in childhood can prevent allergies.”
D - “Allergies are directly inherited, so I’ll have the same ones as my parents.”
Answer: D
Rationale:
Correct: Having two allergic parents increases the risk of developing allergies by up to 80%.
Correct: Environmental factors, including air pollution, can contribute to allergy development.
Correct: The hygiene hypothesis suggests that exposure to certain microorganisms may help prevent allergies.
Incorrect: While the predisposition to have allergies is genetic, specific allergies are not inherited. This statement indicates a misunderstanding and requires further teaching.
A client with malignant melanoma asks the nurse why the provider recommends surgical excision with a wide margin. Which explanation is most accurate?
A . “ Melanoma has a higher risk of spreading near tissue and lymph nodes.”
B . “ Removing a large area allows for less risk of scarring.”
C . “ Wide excision decreases the chance of complications.”
D. “ Another treatment.”
A . “Melanoma has high risk of spreading to nearby tissue and lymph nodes.”
R A T I O N A L E : Melanoma is typically metastatic; wide excision with margins reduces the risk of metastasis or spreading.
A nurse is teaching a patient about the warning signs of melanoma using the “ABCDE” method. Which patient statement indicates a need for further teaching?
a. “If one half of a mole looks different from the other half, I should get it checked.”
b. “If a mole has irregular or scalloped edges, that can be warning sign.”
c. “A mole with several colors, like tan, black, and red should be evaluated.”
d. “If a mole is smaller than 6mm, I don’t need to worry about it.”
Answer: D “If a mole is smaller than 6mm, I don’t need to worry about it.”
rationale: even samll lesions can be suspicious if they are changing (evolving), so assuming only large spots are concerning shows a misunderstanding.
The nurse is reinforcing teaching with a client about performing a skin self-exam at home. Which instruction should the nurse include?
a. Use a comb or hair dryer to part your hair so you can check your scalp.
b. It is best to perform the exam before bathing when the skin is dry.
c. You only need a hand-held mirror to check your entire body.
d. Avoid asking family for help to maintain privacy.
Answer: a. Use a comb or hair dryer to part your hair so you can check your scalp.
Rationale: The scalp can be difficult to see, and using a comb or hair dryer helps visualize the skin more clearly. The best time to check is after a bath/shower. Not before (B). a full-length mirror plus a hand-held mirror are recommended (C). family member or partners can be helpful to check hard-to-see areas like the back or scalp (D)
which of the following patients should the nurse prioritize for further evaluation based on the ABCDE criteria?
a. A 10-year-old with symmetrical brown moles that has been present since childhood
b. A 50-year-old with a mole tha thas recently become asymmetrical and is now black and blue in color
c. A 25-year-old with a small red papule that has not changed in years
d. A 70-year-old with dry skin and multiple age spots
Answer: B. a 50-year-old with a mole that has recently become asymmetrical and is now black and blue in color
Rationale: options B includes asymmetry, color variation, and evolution. WHIch are all part of the ABCDE criteria for melaona. THis patient’s lesions show concerning signs and should be prioritized for immediate evaluation. THe other patient have lesions that appear benign or stable.
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Exam 176
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chapter 40 pathophysiology of mobility68
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Sickle Cell Disease7
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Hematologic conditions30
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Inflammation and Immunity20
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Chapter 16 Concept of Inflammation and Immunity pp. 316-332123
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chapter 33 assessment of the hematologic system144
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chapter 17 Concepts of Care for Patients with Allergy and Immunity Condition157
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Chapter 34 Concepts of Care for Patient's with Hematologic Conditions pp 828-83356
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Chapter 24 Alterations of Hematologic Function in Children pp 569-57141
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Test 248
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Exam 397
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Final Exam28
