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Test Bank For Brunner & Suddarth's Textbook of Medical- Surgical Nursing 15th Edition By Janice L Hinkle, Kerry H. Cheever, Et al. chapter 32$2.99
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Chapter 32: Management of Patients with Immune Deficiency Disorders
Hinkle: Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 15th Edition
MULTIPLE CHOICE
1. A client has just been diagnosed with a primary immune deficiency disease (PIDD). The client has
done some research online and believes this is an unlikely diagnosis due to the client’s age. At which
stage of life are people most commonly diagnosed with PIDD?
A. Early childhood
B. Infancy
C. Adolescence
D. Early adulthood
ANS: B
Rationale: The majority of PIDDs, which are a grouping of rare genetic disorders that impair the
immune system, are commonly diagnosed in infancy, with a male to female ratio of 5 to 1. However,
some PIDDs are not diagnosed until adolescence or early adulthood. There are more than 200 forms of
PIDDs with 270 different genes associated with this condition.
PTS: 1 REF: p. 1005
NAT: Client Needs: Safe, Effective Care Environment: Management of Care
TOP: Chapter 32: Management of Clients With Immune Deficiency Disorders
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Remember
NOT: Multiple Choice
2. A client with Wiskott–Aldrich syndrome (WAS) is admitted to the medical unit. The nurse caring for
the client should prioritize which intervention?
A. Protective isolation
B. Fresh-frozen plasma (FFP) administration
C. Chest physiotherapy
D. Nutritional supplementation
ANS: A
Rationale: Clients with WAS are at a grave risk for infection; infection prevention is a priority aspect
of nursing care. Nutritional supplementation may be necessary, but infection prevention is paramount.
Chest physiotherapy and FFP administration are not indicated.
PTS: 1 REF: p. 1006
NAT: Client Needs: Safe, Effective Care Environment: Safety and Infection Control
TOP: Chapter 32: Management of Clients With Immune Deficiency Disorders
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply
NOT: Multiple Choice
3. A pediatric nurse is working with an interdisciplinary team and parents to care for a 6-month-old client
who has recently been diagnosed with severe combined immune deficiency (SCID). Which treatment
is likely of most benefit to this client’s type of primary immune deficiency disease (PIDD)?
A. Combined radiotherapy and chemotherapy
B. Antibiotic therapy
C. Hematopoietic stem cell transplantation (HSCT)
D. Treatment with colony-stimulating factors (CSFs)
ANS: C
, Rationale: HSCT is a curative modality for some PIDDs, such as SCID. The stem cells may be from
embryos or adults. SCID’s onset is typically manifested by 6 months of age or earlier. SCID causes a
child to be born with little or no immune system and historically resulted in frequent deaths due to
multiple infections. Newborn screening in recent years has resulted in early inventions with HSCT and
gene therapy. Radiation and chemotherapy, antibiotics, and CSF do not provide a cure.
PTS: 1 REF: p. 1005
NAT: Client Needs: Physiological Integrity: Reduction of Risk Potential
TOP: Chapter 32: Management of Clients With Immune Deficiency Disorders
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply
NOT: Multiple Choice
4. A client with a diagnosis of primary immunodeficiency disease informs the nurse that the client has
been experiencing a new onset of a dry cough and occasional shortness of breath. After determining
that the client's vital signs are within reference ranges, what action should the nurse take?
A. Administer a nebulized bronchodilator.
B. Perform oral suctioning.
C. Assess the client for signs and symptoms of infection.
D. Teach the client deep breathing and coughing exercises.
ANS: C
Rationale: Dyspnea and cough are among the varied signs and symptoms that may suggest infection in
an immunocompromised client. There is no indication for suctioning or the use of nebulizers. Deep
breathing and coughing exercises do not address the client's complaints or the likely etiology.
PTS: 1 REF: p. 1006
NAT: Client Needs: Physiological Integrity: Reduction of Risk Potential
TOP: Chapter 32: Management of Clients With Immune Deficiency Disorders
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply
NOT: Multiple Choice
5. A nurse caring for a client who has an immunosuppressive disorder knows that continual monitoring
of the client is critical. What is the primary rationale behind the need for continual monitoring?
A. So that the client's functional needs can be met immediately
B. So that medications can be given as prescribed and signs of adverse reactions noted
C. So that early signs of impending infection can be detected and treated
D. So that the nurse's documentation can be thorough and accurate
ANS: C
Rationale: Continual monitoring of the client's condition is critical, so that early signs of impending
infection may be detected and treated before they seriously compromise the client's status. Continual
monitoring is not primarily motivated by the client's functional needs or medication schedule. The
nurse's documentation is important, but less so than infection control.
PTS: 1 REF: p. 1007
NAT: Client Needs: Physiological Integrity: Reduction of Risk Potential
TOP: Chapter 32: Management of Clients With Immune Deficiency Disorders
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Understand
NOT: Multiple Choice
6. A nurse is planning the care of a client who requires immunosuppression to ensure engraftment of
depleted bone marrow during a transplantation procedure. What is the most important component of
infection control in the care of this client?
A. Administration of IVIG
, B. Antibiotic administration
C. Appropriate use of gloves and goggles
D. Thorough and consistent hand hygiene
ANS: D
Rationale: Hand hygiene is usually considered the most important aspect of infection control. IVIG
and antibiotics are not considered infection control measures, though they enhance resistance to
infection and treat infection. Gloves and goggles are sometimes indicated but are less effective than
hand hygiene.
PTS: 1 REF: p. 1007
NAT: Client Needs: Safe, Effective Care Environment: Safety and Infection Control
TOP: Chapter 32: Management of Clients With Immune Deficiency Disorders
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply
NOT: Multiple Choice
7. A home health nurse is caring for a client who has an immunodeficiency. What is the nurse's priority
action to help ensure successful outcomes and a favorable prognosis?
A. Encourage the client and family to be active partners in the management of the
immunodeficiency.
B. Encourage the client and family to manage the client's activity level and activities of daily
living effectively.
C. Make sure that the client and family understand the importance of monitoring fluid
balance.
D. Make sure that the client and family know how to adjust dosages of the medications used
in treatment.
ANS: A
Rationale: Encouraging the client and family to be active partners in the management of the
immunodeficiency is the key to successful outcomes and a favorable prognosis. This transcends the
client's activity and functional status. Medications should not be adjusted without consultation from
the primary provider. Fluid balance is not normally a central concern.
PTS: 1 REF: p. 1007 NAT: Client Needs: Health Promotion and Maintenance
TOP: Chapter 32: Management of Clients With Immune Deficiency Disorders
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply
NOT: Multiple Choice
8. Since the emergence of the human immunodeficiency virus (HIV), there have been significant changes
in epidemiologic trends. At present, members of which group are most affected by new cases of HIV?
A. Male-to-male sexual contact
B. Heterosexual contact
C. Male-to-male sexual contact with injection drug use
D. People 25 to 29 years of age
ANS: A
Rationale: In the United States from 2012 to 2016, male-to-male sexual contact accounted for
approximately 67% of new cases, male-to-male contact with injection use 3%, heterosexual contact
24%, and people 25 to 29 years of age 32.9%.
PTS: 1 REF: p. 1008 NAT: Client Needs: Health Promotion and Maintenance
TOP: Chapter 32: Management of Clients With Immune Deficiency Disorders
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Remember
NOT: Multiple Choice
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