B. "Have you been camping in the last month?

"
C. "Have you or close contacts had any flulike symptoms
within the last few weeks?"
D. "Have you been in physical contact with anyone who has
the same type of rash?"

8. A client is diagnosed with scleroderma. Which intervention

IMMUNOLOGIC, INFECTIOUS, AND INFLAMMATORY DISORDERS would the nurse anticipate to be prescribed?
A. Maintain bed rest as much as possible.
1. The nurse prepares to give a bath and change the bed linens of
B. Administer corticosteroids as prescribed for
a client with cutaneous Kaposi's sarcoma lesions. The lesions are inflammation.
open and draining a scant amount of serous fluid. Which would the C. Advise the client to remain supine for 1 to 2 hours after
nurse incorporate into the plan during the bathing of this client? meals.
A. Wearing gloves D. Keep the room temperature warm during the day and
B. Wearing a gown and gloves cool at night.
C. Wearing a gown, gloves, and a mask
D. Wearing a gown and gloves to change the bed lin-ens, 9. The client with acquired immunodeficiency syndrome is
and gloves only for the bath diagnosed with cutaneous Kaposi's sarcoma. Based on this
diagnosis, the nurse understands that this has been confirmed by
2. The nurse provides home care instructions to a client with which finding?
systemic lupus erythematosus and tells the client about methods A. Swelling in the genital area
to manage fatigue. Which statement by the client indicates a need B. Swelling in the lower extremities
for further instruction? C. Positive punch biopsy of the cutaneous lesions
A. “I need to take hot baths because they are relaxing." D. Appearance of reddish-blue lesions noted on the skin
B. "I need to sit whenever possible to conserve my energy."
C. "I need to avoid long periods of rest because it causes 10. The nurse is performing an assessment on a client who has
joint stiffness.” been diagnosed with an allergy to latex. In determining the client's
D. "I need to do some exercises, such as walking, when I am risk factors, the nurse would question the client about an allergy
not fatigued." to which food item?
A. Eggs
3. The nurse is assisting in planning care for a client with a B. Milk
diagnosis of immunodeficiency and would incorporate which action C. Yogurt
as a priority in the plan? D. Bananas
A. Protecting the client from infection
B. Providing emotional support to decrease fear 11. The nurse is caring for a postrenal transplantation client taking
C. Encouraging discussion about lifestyle changes cyclosporine. The nurse notes an increase in one of the client's
D. Identifying factors that decreased the immune function vital signs, and the client is complaining of a headache. What vital
sign is most likely increased?
4. A client calls the nurse in the emergency department and A. Pulse
reports being just stung by a bumblebee while gardening. The client B. Respirations
is afraid of a severe reaction because the client's neighbor C. Blood pressure
experienced such a reaction just 1 week ago. Which action would D. Pulse oximetry
the nurse take?
A. Advise the client to soak the site in hydrogen per-oxide. 12. Amikacin is prescribed for a client with a bacterial infection.
B. Ask the client if they ever sustained a bee sting in the The nurse instructs the client to contact the primary health care
past. provider (PHCP) immediately if which occurs?
C. Tell the client to call an ambulance for transport to the A. Nausea
emergency department. B. Lethargy
D. Tell the client not to worry about the sting unless C. Hearing loss
difficulty with breathing occurs. D. Muscle aches

5. The community health nurse is conducting a research study and
is identifying clients in the community at risk for latex allergy.
Which client population is most at risk for developing this type of
allergy?
A. Hairdressers
B. The homeless
C. Children in day care centers
D. 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.
I. Use nonlatex gloves.
II. Use medications from glass ampules.
III. Place the client in a private room only.
IV. Keep a latex-safe supply cart available in the client's area.
V. Avoid the use of medication vials that have rubber stoppers.
VI. Use only a blood pressure cuff from an electronic device to
measure the blood pressure.
13. You give an intradermal injection of allergen to a patient who
is undergoing skin testing for allergies. A few minutes later, the
patient complains about feeling anxious, short of breath, and
dizzy. You notice that the patient has reddened blotches on the
face and arms. All of these therapies are available on your
emergency cart. Which action should you take first?
A. Start oxygen at 4 L/min using a nasal cannula.
B. Obtain IV access with a large-bore IV catheter.
C. Administer epinephrine (Adrenalin) 0.3 mL
subcutaneously
D. Give albuterol (Proventil) with a nebulizer
14. An HIV-positive patient who has been started on antiretroviral
therapy (ART) is seen in the clinic for follow-up. Which test will
be most helpful in determining the response to therapy?
A. Lymphocyte count
B. ELISA testing
C. Western blot
D. Viral load testing

A. I, II, III, & IV 15. Patrick, a healthy adolescent has meningitis and is receiving
B. I, II, IV, & V I.V. and oral fluids. The nurse should monitor this client’s fluid
C. I, II, IV, & VI intake because fluid overload may cause:
D. I, II, III, IV, & V A. Dehydration
B. Hypovolemic shock
7. A client presents at the primary health care provider's office C. Cerebral edema
with complaints of a ringlike rash on the upper leg. Which question D. Heart failure
would the nurse ask first?
A. "Do you have any cats in your home?"
16. The mother of Gian, a preschooler with spina bifida tells the
nurse that her daughter sneezes and gets a rash when playing
with brightly colored balloons, and that she recently had an allergic
reaction after eating kiwifruit and bananas. The nurse would
suspect that the child may have an allergy to:
A. Bananas
B. Color dyes
C. Kiwifruit
D. Latex
17. A 10-year-old client contracted severe acute respiratory
syndrome (SARS) when traveling abroad with her parents. The
nurse knows she must put on personal protective equipment to
protect herself while providing care. Based on the mode of SARS
transmission, which personal protective equipment should the
nurse wear?
A. Gloves
B. Gown and gloves
C. Gown, gloves, and mask
D. Gown, gloves, mask, and eye goggles or eye shield
18. A tuberculosis intradermal skin test to detect tuberculosis
infection is given to a high-risk adolescent. How long after the test
is administered should the result be evaluated?
A. Immediately
B. Within 24 hours
C. In 48 to 72 hours
D. After 5 days
19. A child is admitted to the pediatric unit with a diagnosis of
suspected meningococcal meningitis. Which of the following
nursing measures should the nurse do first?
A. Assess vital signs
B. Institute seizure precautions
C. Assess neurologic status
D. Place in respiratory isolation
20. A client is diagnosed with methicillin-resistant staphylococcus
aureus pneumonia. What type of isolation is most appropriate for
this client?
A. Reverse isolation
B. Respiratory isolation
C. Contact isolation
D. Standard precautions
21. The nurse is assessing a 48-year-old client diagnosed with
multiple sclerosis. Which clinical manifestation warrants
immediate intervention?
A. The client has scanning speech and diplopia.
B. The client has dysarthria and scotomas.
C. The client has muscle weakness and spasticity.
D. The client has a congested cough and dysphagia.
22. The client newly diagnosed with multiple sclerosis (MS) states,
“I don’t understand how I got multiple sclerosis. Is it genetic?” On
which statement should the nurse base the response?
A. Genetics may play a role in susceptibility to MS, but the
disease may be caused by a virus.
B. There is no evidence suggesting there is any
chromosomal involvement in developing MS.
C. Multiple sclerosis is caused by a recessive gene, so both
parents had to have the gene for the client to get MS.
D. Multiple sclerosis is caused by an autosomal dominant
gene on the Y chromosome, so only fathers can pass it
on.
23. The client diagnosed with an acute exacerbation of multiple
sclerosis is placed on high-dose intravenous injections of
corticosteroid medication. Which nursing intervention should be
implemented?
A. Discuss discontinuing the proton pump inhibitor with the
HCP.
B. Hold the medication until after all cultures have been
obtained.
C. Monitor the client’s serum blood glucose levels
frequently.
D. Provide supplemental dietary sodium with the client’s
meals.
24. Several clients are admitted to an adult medical unit. The nurse
would ensure airborne precautions for a client with which of the
following medical conditions?
A. A diagnosis of AIDS and cytomegalovirus
B. A positive PPD with an abnormal chest x-ray
C. A tentative diagnosis of viral pneumonia
D. Mycoplasma pneumonia
25. Which of the following is the first priority in preventing
infections when providing care for a client?
A. Wearing gowns and goggles
B. Using a barrier between client’s furniture and nurse’s
bag
C. Handwashing
D. Wearing gloves
26. An adult woman is admitted to an isolation unit in the hospital
after tuberculosis was detected during a pre-employment physical.
Although frightened about her diagnosis, she is anxious to
cooperate with the therapeutic regimen. The teaching plan includes
information regarding the most common means of transmitting the
tubercle bacillus from one individual to another. Which
contamination is usually responsible?
A. Eating utensils
B. Hands
C. Milk products
D. Droplet nuclei
27. The nurse in charge is evaluating the infection control
procedures on the unit. Which finding indicates a break in
technique and the need for education of staff?
A. The nurse puts on a mask, a gown, and gloves before
entering the room of a client in strict isolation.
B. A nurse with open, weeping lesions of the hands puts on
gloves before giving direct client care.
C. The nurse aide is not wearing gloves when feeding an
elderly client.
D. A client with active tuberculosis is asked to wear a mask
when he leaves his room to go to another department for
testing.
28. The charge nurse observes a new staff nurse who is changing
a dressing on a surgical wound. After carefully washing her hands
the nurse dons sterile gloves to remove the old dressing. After
removing the dirty dressing, the nurse removes the gloves and
dons a new pair of sterile gloves in preparation for cleaning and
redressing the wound. The most appropriate action for the charge
nurse is to:
A. Discuss dressing change technique with the nurse at a
later date.
B. Congratulate the nurse on the use of good technique.
C. Interrupt the procedure to inform the nurse of the need
to wash her hands after removal of the dirty dressing
and gloves.
D. Interrupt the procedure to inform the staff nurse that
sterile gloves are not needed to remove the old dressing.
29. The nurse is evaluating whether a nonprofessional staff
understands how to prevent the transmission of HIV. Which of the
following behaviors indicates the correct application of universal
precautions?
A. An aide wears gloves to feed a helpless client.
B. A pregnant worker refuses to care for a client known to
have AIDS.
C. A lab technician rests his hand on the desk to steady it
while recapping the needle after drawing blood.
D. An assistant puts on a mask and protective eyewear
before assisting the nurse to suction a tracheostomy.
30. Jayson, 1-year-old child, has a staph skin infection. Her brother
has also developed the same infection. Which behavior by the
children is most likely to have caused the transmission of the
organism?
A. Sharing pacifiers
B. Coughing on each other
C. Bathing together
D. Eating off the same plate
31. Which question is least useful in the assessment of a client
with AIDS?
 A. Are you a drug user?
B. Do you have many sex partners?
C. What is your method of birth control?
D. How old were you when you became sexually active?
32. A nurse is caring for a child who was admitted to the pediatric
unit with infectious diarrhea. The nurse should be alert to what
assessment finding as an indicator of dehydration?
A. Labile BP
B. Weak pulse
C. Fever
D. Diaphoresis
33. When a disease infects a host a portal of entry is needed for
an organism to gain access. What has been identified as the portal
of entry for tuberculosis?
A. Integumentary system
B. Urinary system
C. Respiratory system
D. Gastrointestinal system
34. An immunosuppressed patient is receiving chemotherapy
treatment at home. What infection-control measure should the
nurse recommend to the family?
A. Family members should avoid receiving vaccinations until
the patient has recovered from his or her illness.
B. Wipe down hard surfaces with a dilute bleach solution
once per day.
C. Maintain cleanliness in the home, but recognize that the
home does not need to be sterile.
D. Avoid physical contact with the patient unless absolutely
necessary.
35. The nurse is caring for a patient with multiple sclerosis (MS).
The patient tells the nurse the hardest thing to deal with is the
fatigue. When teaching the patient how to reduce fatigue, what
action should the nurse suggest?
A. Taking a hot bath at least once daily
B. Resting in an air-conditioned room whenever possible
C. Increasing the dose of muscle relaxants
D. Avoiding naps during the day
36. A patient with Guillain-Barre syndrome has experienced a
sharp decline in vital capacity. What is the nurse's most
appropriate action?
A. Administer bronchodilators as ordered.
B. Remind the patient of the importance of deep breathing
and coughing exercises.
C. Prepare to assist with intubation.
D. Administer supplemental oxygen by nasal cannula.
37. The nurse is working with a patient who is newly diagnosed
with MS. What basic information should the nurse provide to the
patient?
A. MS is a progressive demyelinating disease of the nervous
system.
B. MS usually occurs more frequently in men.
C. MS typically has an acute onset.
D. MS is sometimes caused by a bacterial infection.
38. The nurse is creating a plan of care for a patient who has a
recent diagnosis of MS. Which of the following should the nurse
include in the patient's care plan?
A. Encourage patient to void every hour.
B. Order a low-residue diet.
C. Provide total assistance with all ADLs.
D. Instruct the patient on daily muscle stretching.
39. A male patient presents to the clinic complaining of a headache.
The nurse notes that the patient is guarding his neck and tells the
nurse that he has stiffness in the neck area. The nurse suspects
the patient may have meningitis. What is another well-recognized
sign of this infection?
A. Negative Brudzinski's sign
B. Positive Kernig's sign
C. Hyperpatellar reflex
D. Sluggish pupil reaction
40. The nurse caring for a patient diagnosed with Guillain-Barre
syndrome is planning care with regard to the clinical
manifestations associated with this syndrome. The nurse's
communication with the patient should reflect the possibility of
what sign or symptom of the disease?
A. Intermittent hearing loss
B. Tinnitus
C. Tongue enlargement
D. Vocal paralysis
41. A middle-aged woman has sought care from her primary care
provider and undergone diagnostic testing that has resulted in a
diagnosis of MS. What sign or symptom is most likely to have
prompted the woman to seek care?
A. Cognitive declines
B. Personality changes
C. Contractures
D. Difficulty in coordination
42. The nurse is developing a plan of care for a patient with
Guillain-Barre syndrome. Which of the following interventions
should the nurse prioritize for this patient?
A. Using the incentive spirometer as prescribed
B. Maintaining the patient on bed rest
C. Providing aids to compensate for loss of vision
D. Assessing frequently for loss of cognitive function
43. You are the clinic nurse caring for a patient with a recent
diagnosis of myasthenia gravis. The patient has begun treatment
with pyridostigmine bromide (Mestinon). What change in status
would most clearly suggest a therapeutic benefit of this
medication?
A. Increased muscle strength
B. Decreased pain
C. Improved GI function
D. Improved cognition
44. The critical care nurse is admitting a patient in myasthenic
crisis to the ICU. The nurse should prioritize what nursing action
in the immediate care of this patient?
A. Suctioning secretions
B. Facilitating ABG analysis
C. Providing ventilatory assistance
D. Administering tube feedings
45. A nurse is planning the care of a 28-year-old woman
hospitalized with a diagnosis of myasthenia gravis. What approach
would be most appropriate for the care and scheduling of
diagnostic procedures for this patient?
A. All at one time, to provide a longer rest period
B. Before meals, to stimulate her appetite
C. In the morning, with frequent rest periods
D. Before bedtime, to promote rest
46. The nurse caring for a patient in ICU diagnosed with Guillain-
Barre syndrome should prioritize monitoring for what potential
complication?
A. Impaired skin integrity
B. Cognitive deficits
C. Hemorrhage
D. Autonomic dysfunction
47. A patient with a family history of allergies has suffered an
allergic response based on a genetic predisposition. This atopic
response is usually mediated by what immunoglobulin?
A. Immunoglobulin A
B. Immunoglobulin M
C. Immunoglobulin G
D. Immunoglobulin E
48. An office worker takes a cupcake that contains peanut butter.
He begins wheezing, with an inspiratory stridor and air hunger and
the occupational health nurse is called to the office. The nurse
should recognize that the worker is likely suffering from which
type of hypersensitivity?
A. Anaphylactic (type 1)
B. Cytotoxic (type II)
C. Immune complex (type III)
D. Delayed-type (type IV)
49. A nurse is caring for a teenage girl who has had an C. Sedation
anaphylactic reaction after a bee sting. The nurse is providing D. Malignant hyperthermia
patient teaching prior to the patient's discharge. In the event of an
anaphylactic reaction, the nurse informs the patient that she 58. A nurse is performing the initial assessment of a patient who
should self-administer epinephrine in what site? has a recent diagnosis of systemic lupus erythematosus (SLE).
A. Forearm What skin manifestation would the nurse expect to observe on
B. Thigh inspection?
C. Deltoid muscle A. Petechiae
D. Abdomen B. Butterfly rash
C. Jaundice
50. A patient was tested for HIV using enzyme immunoassay (EIA) D. Skin sloughing
and results were positive. The nurse should expect the primary
care provider to order what test to confirm the EIA test results? 59. A patient with systemic lupus erythematosus (SLE) is
A. Another EIA test preparing for discharge. The nurse knows that the patient has
B. Viral load test understood health education when the patient makes what
C. Western blot test statement?
D. CD4/CD8 ratio A. “I'll make sure I get enough exposure to sunlight to keep
up my vitamin D levels.”
51. A nursing student learning about antibody-mediated immunity B. “I'll try to be as physically active as possible between
learns that the cell with the most direct role in this process begins flare-ups.”
development in which tissue or organ? C. “I'll make sure to monitor my body temperature on a
A. Bone marrow regular basis.”
B. Spleen D. “I'll stop taking my steroids when I get relief from my
C. Thymus symptoms.”
D. Tonsils
60. A patient who has been newly diagnosed with systemic lupus
52. A patient with severe environmental allergies is scheduled for erythematosus (SLE) has been admitted to the medical unit. Which
an immunotherapy injection. What should be included in teaching of the following nursing diagnoses is the most plausible inclusion
the patient about this treatment? in the plan of care?
A. The patient will be given a low dose of epinephrine before A. Fatigue Related to Anemia
the treatment. B. Risk for Ineffective Tissue Perfusion Related to Venous
B. The patient will remain in the clinic to be monitored for Thromboembolism
30 minutes following the injection. C. Acute Confusion Related to Increased Serum Ammonia
C. Therapeutic failure occurs if the symptoms to the Levels
allergen do not decrease after 3 months. D. Risk for Ineffective Tissue Perfusion Related to
D. The allergen will be administered by the peripheral Increased Hematocrit
intravenous route.
61. A clinic nurse is caring for a patient with suspected gout. While
53. A patient's decreased mobility is ultimately the result of an explaining the pathophysiology of gout to the patient, the nurse
autoimmune reaction originating in the synovial tissue, which should describe which of the following?
caused the formation of pannus. This patient has been diagnosed A. Autoimmune processes in the joints
with what health problem? B. Chronic metabolic acidosis
A. Rheumatoid arthritis (RA) C. Increased uric acid levels
B. Systemic lupus erythematosus D. Unstable serum calcium levels
C. Osteoporosis
D. Polymyositis 62. Allopurinol (Zyloprim) has been ordered for a patient receiving
treatment for gout. The nurse caring for this patient knows to
54. A patient is suspected of having rheumatoid arthritis and her assess the patient for bone marrow suppression, which may be
diagnostic regimen includes aspiration of synovial fluid from the manifested by which of the following diagnostic findings?
knee for a definitive diagnosis. The nurse knows which of the A. Hyperuricemia
following procedures will be involved? B. Increased erythrocyte sedimentation rate
A. Angiography C. Elevated serum creatinine
B. Myelography D. Decreased platelets
C. Paracentesis
D. Arthrocentesis 63. A nurse is educating a patient with gout about lifestyle
modifications that can help control the signs and symptoms of the
55. A nurse is providing care for a patient who has just been disease. What recommendation should the nurse make?
diagnosed as being in the early stage of rheumatoid arthritis. The A. Ensuring adequate rest
nurse should anticipate the administration of which of the B. Limiting exposure to sunlight
following? C. Limiting intake of alcohol
A. Hydromorphone (Dilaudid) D. Smoking cessation
B. Methotrexate (Rheumatrex)
C. Allopurinol (Zyloprim) 64. A nurse is working with a community group promoting healthy
D. Prednisone aging. What recommendation is best to help prevent osteoarthritis
(OA)?
56. A nurse is performing the health history and physical A. Avoid contact sports.
assessment of a patient who has a diagnosis of rheumatoid B. Get plenty of calcium.
arthritis (RA). What assessment finding is most consistent with C. Lose weight if needed.
the clinical presentation of RA? D. Engage in weight-bearing exercise.
A. Cool joints with decreased range of motion
B. Signs of systemic infection 65. The nurse working with clients who have autoimmune diseases
C. Joint stiffness, especially in the morning understands what component of cell-mediated immunity is the
D. Visible atrophy of the knee and shoulder joints problem?
A. CD4+ cells
57. A patient has a diagnosis of rheumatoid arthritis and the B. Cytotoxic T cells
primary care provider has now prescribed cyclophosphamide C. Natural killer cells
(Cytoxan). The nurse's subsequent assessments should address D. Suppressor T cells
what potential adverse effect?
A. Infection
B. Acute confusion
66. The student nurse is learning about the functions of different A. Contact
antibodies. Which principles does the student learn? (Select all that B. Droplet
apply.) C. Airborne
I. IgA is found in high concentrations in secretions from mucous D. Positive pressure isolation
membranes.
II. IgD is present in the highest concentrations in mucous 74. A patient has a concentration of S. aureus located on his skin.
membranes. The patient is not showing signs of increased temperature, redness,
III. IgE is associated with antibody-mediated hypersensitivity or pain at the site. The nurse is aware that this is a sign of a
reactions. microorganism at which of the following stages?
IV. IgG comprises the majority of the circulating antibody A. Infection
population. B. Colonization
V. IgM is the first antibody formed by a newly sensitized B cell. C. Disease
D. Bacteremia
A. II, III, & IV
B. I, III, IV, & V 75. An infectious outbreak of unknown origin has occurred in a
C. I, II, III, IV, & V long-term care facility. The nurse who oversees care at the facility
D. II, III, IV, & V should report the outbreak to what organization?
A. Centers for Disease Control and Prevention (CDC)
67. The nurse is teaching a client experiencing inflammation. Which B. American Medical Association (AMA)
sign of inflammation should the nurse include in the teaching? C. Environmental Protection Agency (EPA)
(Select all that apply.) D. American Nurses Association (ANA)
I. Paralysis
II. Redness 76. A medical nurse is careful to adhere to infection control
III. Swelling protocols, including handwashing. Which statement about
IV. Paresthesia handwashing supports the nurses practice?
V. Pain A. Frequent handwashing reduces transmission of
pathogens from one patient to another.
A. I, II, IV, & V B. Wearing gloves is known to be an adequate substitute
B. I, II, & III for handwashing.
C. II, III, & V C. Bar soap is preferable to liquid soap.
D. II, III, & IV D. Waterless products should be avoided in situations where
running water is unavailable.
68. The nurse conducts screening for inflammatory diseases with
clients of a community health clinic. Which test should the nurse 77. A male patient with gonorrhea asks the nurse how he can
perform? reduce his risk of contracting another sexually transmitted
A. MRI infection. The patient is not in a monogamous relationship. The
B. X-ray nurse should instruct the patient to do which of the following?
C. Skin test A. Ask all potential sexual partners if they have a sexually
D. Urine test transmitted disease
B. Wear a condom every time he has intercourse.
69. The nurse cares for a client newly diagnosed with inflammation. C. Consider intercourse to be risk-free if his partner has no
Which laboratory test should the nurse expect to be prescribed? visible discharge, lesions, or rashes.
A. Erythrocyte sedimentation rate (ESR) D. Aim to limit the number of sexual partners to fewer than
B. Prothrombin time (PT) five over his lifetime.
C. Serum chemistries
D. Hemoglobin and hematocrit (H/H) 78. The nurse places a patient in isolation. Isolation techniques
have the potential to break the chain of infection by interfering
70. A community health nurse is presenting an educational event with what component of the chain of infection?
and is addressing several health problems, including rheumatic A. Mode of transmission
heart disease. What should the nurse describe as the most B. Agent
effective way to prevent rheumatic heart disease? C. Susceptible host
A. Recognizing and promptly treating streptococcal D. Portal of entry
infections
B. Prophylactic use of calcium channel blockers in high-risk 79. The nurse is caring for a patient who is colonized with
populations methicillin-resistant Staphylococcus aureus (MRSA). What
C. Adhering closely to the recommended child immunization infection control measure has the greatest potential to reduce
schedule transmission of MRSA and other nosocomial pathogens in a health
D. Smoking cessation care setting?
A. Using antibacterial soap when bathing patients with
71. A patient with mitral valve prolapse is admitted for a MRSA
scheduled bronchoscopy to investigate recent hemoptysis. The B. Conducting culture surveys on a regularly scheduled
physician has ordered gentamicin to be taken before the procedure. basis
What is the rationale for this? C. Performing hand hygiene before and after contact with
A. To prevent bacterial endocarditis every patient
B. To prevent hospital-acquired pneumonia D. Using aseptic housekeeping practices for environmental
C. To minimize the need for antibiotic use during the cleaning
procedure
D. To decrease the need for surgical asepsis 80. A patient on Airborne Precautions asks the nurse to leave his
door open. What is the nurses best reply?
72. A male patient comes to the clinic and is diagnosed with A. “I have to keep your door shut at all times. I’ll open
gonorrhea. Which symptom most likely prompted him to seek the curtains so that you don’t feel so closed in.”
medical attention? B. “I’ll keep the door open for you, but please try to avoid
A. Rashes on the palms of the hands and soles of the feet moving around the room too much.”
B. Cauliflower-like warts on the penis C. “I can open your door if you wear this mask.”
C. Painful, red papules on the shaft of the penis D. “I can open your door, but I’ll have to come back and
D. Foul-smelling discharge from the penis close it in a few minutes.”

73. A nursing home patient has been diagnosed with Clostridium 81. The nurse is caring for a client with severe systemic
difficile. What type of precautions should the nurse implement to inflammation. Which medication should the nurse expect to find
prevent the spread of this infectious disease to other residents? listed on the client's medication administration record (MAR)?
 A. Esomeprazole
B. Dexamethasone 90. What is responsible for initiating the inflammatory response in
C. Regular insulin addition to immunoglobulin E (IgE)?
D. Sumatriptan A. Eosinophils
B. Lymphocytes
82. The nurse prepares to administer dexamethasone to a client C. Basophils
with diabetes experiencing inflammation. For which side effect D. Neutrophils
should the nurse monitor in the client?
A. Hyperglycemia 91. Family members are caring for a patient with HIV in the
B. Increased temperature patients home. What should the nurse encourage family members
C. Hyperkalemia to do to reduce the risk of infection transmission?
D. Hypotension A. Use caution when shaving the patient.
B. Use separate dishes for the patient and family members.
83. A client with inflammation caused by a severe ankle injury is C. Use separate bed linens for the patient.
being prepared for discharge. Which intervention to reduce D. Disinfect the patients bedclothes regularly.
inflammation should the nurse include when teaching the client and
family? (Select all that apply.) 92. A 16-year-old male patient comes to the free clinic and is
I. Application of ice packs subsequently diagnosed with primary syphilis. What health
II. Coping skills problem most likely prompted the patient to seek care?
III. Aerobic exercise A. The emergence of a chancre on his penis
IV. Limiting fluid intake B. Painful urination
V. Positioning C. Signs of a systemic infection
D. Unilateral testicular swelling
A. I, II, & III
B. II, III, & V 93. A patient on the medical unit is found to have pulmonary
C. I, II, & V tuberculosis (TB). What is the most appropriate precaution for the
D. II, III, & IV staff to take to prevent transmission of this disease?
A. Standard precautions only
84. Where are histamine-releasing mast cells located? B. Droplet precautions
A. Circulating in the blood C. Standard and contact precautions
B. Circulating in the lymph D. Standard and airborne precautions
C. Attached to organ tissue
D. Embedded in the bone marrow 94. An adult patient in the ICU has a central venous catheter in
place. Over the past 24 hours, the patient has developed signs and
85. A hospitalized patient has been prescribed dexamethasone symptoms that are suggestive of a central line associated
(Decadron) for an allergic reaction. Which teaching instruction bloodstream infection (CLABSI). What aspect of the patients care
should the patient be given with discharge relative to this drug? may have increased susceptibility to CLABSI?
A. Report blurry vision. A. The patients central line was placed in the femoral vein.
B. Take the medication on an empty stomach. B. The patient had blood cultures drawn from the central
C. Do not operate heavy machinery. line.
D. Take this medication with meals. C. The patient was treated for vancomycin-resistant
enterococcus (VRE) during a previous admission.
86. After a bone marrow transplant, a patient is placed on a D. The patient has received antibiotics and IV fluids through
protocol of chemotherapy and radiation and the nursing diagnosis the same line.
of risk for injury is added. Which nursing assessment should cause
the nurse concern? 95. What is the best rationale for health care providers receiving
A. Increased urine output the influenza vaccination on a yearly basis?
B. Decreasing bilirubin levels A. To decrease nurses’ susceptibility to health care-
C. Increasing blood pressure associated infections
D. Increasing abdominal girth B. To decrease risk of transmission to vulnerable patients
C. To eventually eradicate the influenza virus in the United
87. What is the primary function in the immune process of the States
spleen? D. To prevent the emergence of drug-resistant strains of
A. Filter microorganisms from the blood. the influenza virus
B. Store lymphocytes used to fight infections.
C. Produce additional RBCs (red blood cells). 96. A patient has presented at the ED with copious diarrhea and
D. Stimulate WBC production. accompanying signs of dehydration. During the patient’s health
history, the nurse learns that the patient recently ate oysters from
88. A skin test shows redness and swelling a few days after the Gulf of Mexico. The nurse should recognize the need to have
injection. What type of hypersensitivity reaction should the nurse the patient’s stool cultured for microorganisms associated with
document? what disease?
A. I A. Ebola
B. II B. West Nile virus
C. III C. Legionnaires disease
D. IV D. Cholera

89. A nurse explains that in autoimmune diseases, the body 97. A patient's diagnostic testing revealed that he is colonized
identifies its own proteins as foreign matter and sets out to with vancomycin-resistant enterococcus (VRE). What change in
destroy itself. Which are examples of autoimmune diseases? the patients health status could precipitate an infection?
(Select all that apply.) A. Use of a narrow-spectrum antibiotic
I. SLE B. Treatment of a concurrent infection using vancomycin
II. Type 1 diabetes mellitus (DM) C. Development of a skin break
III. Rheumatoid arthritis (RA) D. Persistent contact of the bacteria with skin surfaces
IV. Osteoarthritis
V. Pancreatitis 98. A clinic nurse is caring for a male patient diagnosed with
gonorrhea who has been prescribed ceftriaxone and doxycycline.
A. I, II, & III The patient asks why he is receiving two antibiotics. What is the
B. II, III, & IV nurse's best response?
C. I, II, & IV
D. II, IV, & V
 A. There are many drug-resistant strains of gonorrhea, so
more than one antibiotic may be required for successful
treatment.
B. The combination of these two antibiotics reduces the
later risk of reinfection.
C. Many people infected with gonorrhea are infected with
chlamydia as well.
D. This combination of medications will eradicate the
infection twice as fast than a single antibiotic.

99. A student nurse completing a preceptorship is reviewing the

use of standard precautions. Which of the following practices is
most consistent with standard precautions?
A. Wearing a mask and gown when starting an IV line
B. Washing hands immediately after removing gloves
C. Recapping all needles promptly after use to prevent
needlestick injuries
D. Double-gloving when working with a patient who has a
blood-borne illness

100. A patient is admitted from the ED diagnosed with Neisseria

meningitides. What type of isolation precautions should the nurse
institute?
A. Contact precautions
B. Droplet precautions
C. Airborne precautions
D. Observation precautions