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Flashcards in prepU Immune Deck (13):
1

Which of the following allergies is responsible for most severe food allergy reactions?

a) Seeds 

b) Berries 

c) Peanuts 

d) Seafood

c) Peanuts

Peanut and tree nut allergies are responsible for most severe food allergy reactions and resulting highest patient death rate.

2

An infant is born to a mother who had no prenatal care during her pregnancy. What type of hypersensitivity reaction does the nurse understand may have occurred?

a) Bacterial endocarditis

b) Rh-hemolytic disease

c) Lupus erythematosus

d) Rheumatoid arthritis

b) Rh-hemolytic disease

A type II hypersensitivity, or cytotoxic, reaction, which involves binding either the IgG or IgM antibody to a cell-bound antigen, may lead to eventual cell and tissue damage.

The reaction is the result of mistaken identity when the system identifies a normal constituent of the body as foreign and activates the complement cascade.

Examples of type II reactions are myasthenia gravis, Goodpasture syndrome, pernicious anemia, hemolytic disease of the newborn, transfusion reaction, and thrombocytopenia.

3

While monitoring the patient’s eosinophil level, the nurse suspects a definite allergic disorder when seeing an eosinophil value of what percentage of the total leukocyte count?

a) 3% to 4%

b) 5% to 10%

c) 15% to 40%

d) 1% to 3%

c) 15% to 40%

Eosinophils, which are granular leukocytes, normally make up 0% to 3% of the total number of WBCs.

A level between 5% and 15% is nonspecific but does suggest allergic reaction. Higher percentages of eosinophils are considered to represent moderate to severe eosinophilia.

Moderate eosinophilia is defined as 15% to 40% eosinophils and may be found in patients with allergic disorders.

4

A patient received epinephrine in response to an anaphylactic reaction at 10:00 AM. The nurse knows to observe the patient for a “rebound” reaction that may occur as early as:

a) 10:00 PM.

b) 4:00 PM.

c) 6:00 PM.

d) 2:00 PM.

d) 2:00 PM.

Rebound reactions can occur from 4 to 10 hours after an initial allergic reaction. Therefore the patient needs to be assessed from 2:00 PM to 8:00 PM.

5

Patient teaching about mild allergic responses should include information about the onset of symptoms. The nurse tells the patient that if exposure to an allergen occurs around 8:00 AM, he should expect a mild or moderate reaction by what time?

a) 3:00 PM

b) 11:00 AM

c) 10:00 AM

d) 1:00 PM

c) 10:00 AM

Mild and moderate reactions begin within 2 hours of exposure.

6

Which of the following would the nurse prioritize as the most important action for the patient to take to prevent anaphylaxis? 

a) Avoid potential allergens 

b) Carry an emergency kit 

c) Wear a medical alert bracelet 

d) Desensitization

a) Avoid potential allergens

Because the itching and rash are localized, the employee health nurse should suspect an environmental cause in the workplace.

With the advent of standard precautions, many nurses have experienced allergies to latex gloves. A

llergies to medications, laundry detergents, or bath soaps or dermatologic reactions to stress usually elicit a more generalized or widespread rash.

7

When assessing the skin of a client with allergic contact dermatitis, the nurse would most likley expect to find irritation at which area? 

a) Dorsal aspect of the hand

b) Lower arms

c) Plantar aspects of the feet

d) Ankles

a) Dorsal aspect of the hand

With allergic contact dermatitis, irritation is most common on the dorsal aspects of the hand.

Irritant, phototoxic, and photoallergic types of contact dermatitis are commonly seen on the hands and lower arms.

8

A client develops a facial rash and urticaria after receiving penicillin. Which laboratory value does the nurse expect to be elevated?

a) IgG

b) IgE

c) IgA

d) IgB

b) IgE

9

Which of the following aid in diagnosing the risk of anaphylaxis?

a) Peripheral blood smears 

b) Punch biopsy 

c) Nasal smear 

d) Intradermal testing 
 

d) Intradermal testing

The diagnosis of anaphylaxis risk is determined by prick and intradermal skin testing.

Skin testing of patients who have clinical symptoms consistent with a type I, IgE-mediated reaction has been recommended.

A nasal smear, punch biopsy, and peripheral blood smear would not be used.

10

The nurse is caring for a patient experiencing an anaphylactic reaction. The nurse prepares for the maximum intensity of histamine response to occur within which of the following timeframes?

a) 5 minutes

b) 45 minutes

c) 15 minutes

d) 30 minutes

c) 15 minutes

Maximum intensity is reached within about 15 minutes after antigen contact.

The other timeframes are inaccurate.

11

Which of the following is a contraindication for immunotherapy?

a) Allergic rhinitis 

b) Allergic asthma 

c) Conjunctivitis 

d) Use of a beta-blocker 

d) Use of a beta-blocker

A contraindication of immunotherapy is the use of a beta-blocker or angiotensin-converting inhibitor therapy, which may mask early signs of anaphylaxis.

Indications for immunotherapy are allergic rhinitis, conjunctivitis, or allergic rhinitis.

12

A patient is prescribed an oral corticosteroid for 2 weeks for relief of asthma symptoms. The nurse instructs the patient that side effects include which of the following?

a) Diuresis

b) Hypoglycemia

c) Hypotension

d) Adrenal suppression

d) Adrenal suppression

The nurse should instruct the patient that side effects of oral corticosteroid therapy include adrenal suppression, fluid retention, weight gain, glucose intolerance, hypertension, and gastric irritation.

13

A patient is experiencing an allergic reaction to a dose of penicillin. What should the nurse look for in the patient’s initial assessment?

a) The presence and location of pruritus

b) The severity of cutaneous warmth and flushing

c) Hypotension and tachycardia

d) Dyspnea, bronchospasm, and/or laryngeal edema.