Deck 49: The Child With Alterations in Immune Function

Question 1

An 11-year-old boy with rheumatoid arthritis wants to participate in the school sports programs. The boy asks the nurse to recommend a sporting activity for him. Which activity would be the most appropriate for the nurse to recommend?

A)Baseball
B)Basketball
C)Football
D)Swimming

Answer 1

Swimming

Question 2

A child with human immunodeficiency virus (HIV) also has oral candidiasis. Mouth care for this child should be with:

A)Listerine.
B)Normal saline.
C)Viscous lidocaine.
D)Scope.

Answer 2

Normal saline.

Question 3

A parent of a newborn asks the nurse why young children seem to become ill so often when compared with older children and adults. Which of the following does the nurse's best response address?

A)Lower numbers of natural killer cells in younger children
B)High levels of IgA in the newborn
C)Absent lymphoid tissue in the young child
D)Underdeveloped thymus glands in the infant

Answer 3

Lower numbers of natural killer cells in younger children

Question 4

A teenage girl has recently been diagnosed with systemic lupus erythematosus (SLE). In teaching the girl about her disease, the nurse explains that the teenager needs to avoid which typical teenage activity?

A)Receiving a manicure and a pedicure
B)Daily hair shampoos
C)Using a tanning bed
D)Attending late night parties and dances

Question 5

The nurse is caring for a child with rheumatoid arthritis. Which is an appropriate nonpharmacologic measure to reduce the joint pain associated this disease?

A)Elevation of the extremity
B)Immobilization
C)Massage
D)Application of moist heat

Question 6

A two-month-old infant has been diagnosed with severe combined immunodeficiency disease (SCID). The physician talked with the parents about the planned treatment and prognosis for the infant. Which statement by the parents indicates the need for additional education?

A)"My child will receive intravenous immune globulins as a way to help him fight infection."
B)"Within days of receiving a stem cell transplant, my child will be cured."
C)"If my child needs a blood transfusion, it should be with irradiated blood cells."
D)"Antibiotics will be used as necessary to help my child fight infections."

Question 7

The nurse is discussing the immune protection of the newborn with a pregnant woman. The nurse tells the mother that her body will provide her baby with what type of antibodies?

A)IgM
B)IgA
C)IgD
D)IgG

Question 8

A premature infant is at greater risk for infection than a full-term infant because of a reduced number of which immunoglobulin?

A)IgE
B)IgG
C)IgA
D)IgM

Question 9

The nurse is planning care for a child with acquired immune deficiency syndrome (AIDS). Which vaccines should be avoided in the child with AIDS?

A)Inactivated polio vaccine (a killed virus vaccine)
B)Tetanus toxoid vaccination
C)Varicella vaccine (an attenuated virus vaccine)
D)Acellular pertussis vaccine

Question 10

A nurse is planning care for a child with human immunodeficiency virus (HIV). The highest-priority nursing problem for this child is:

A)Ineffective tissue perfusion, peripheral.
B)Ineffective thermoregulation.
C)Risk for fluid volume deficit.
D)Risk for infection.

Question 11

The nurse is preparing the hospital room for admission of a child with multiple allergies including cow's milk, peanuts, and latex. The nurse's priority responsibility in preparing for this child would include:

A)Evaluating the hospital room for equipment containing latex.
B)Ordering an EpiPen for the child.
C)Notifying dietary of the milk and peanut allergy.
D)Placing a sign on the door which identifies all allergies.

Question 12

A child has been placed on an oral corticosteroid for a rash caused by graft-versus-host disease. The nurse will monitor the child for the common side effects of corticosteroids including:

A)Hyperglycemia.
B)Hepatic toxicity.
C)Seizures.
D)Renal toxicity.

Question 13

After a severe allergic reaction, an EpiPen is prescribed for the 10-year-old child. Instructions to be given to the child and the family would include:

A)The child should always have the EpiPen readily available.
B)The parents should learn to administer the EpiPen as the child is too young to self-administer.
C)Once an EpiPen has been administered, there is no need for additional follow-up.
D)The EpiPen has an expiration date that should be checked regularly, and the pen should be replaced as needed.
E)The child should wear a MedicAlert bracelet.

Question 14

The nurse is caring for a child who experiences an anaphylactic shock reaction. In which position will the nurse place the child?

A)In Trendelenburg position
B)Flat, with legs slightly elevated
C)In high Fowler's position
D)In reverse Trendelenburg position

Question 15

A child has an anaphylactic reaction to contrast dye used in an X-ray. After the emergency is over and the child is stable in the intensive care unit, the nurse explains to the parents what happens in anaphylaxis. The nurse explains that histamine is released during an anaphylactic reaction and that the action of histamine includes:

A)Release of IgE antibodies.
B)Smooth muscle contraction.
C)Increased capillary permeability.
D)Vasoconstriction.
E)Red cell destructions

Question 16

Children with severe combined immune deficiency (SCID) often receive blood products. Any blood products administered to children with SCID who have T-cell deficiencies should be irradiated and cytomegalovirus-negative because of the risk of:

A)Transfusion reaction from lymphocytes and platelets in the donor blood.
B)Transfusion reaction and infection from lymphocytes in the donor blood.
C)Infection and graft-versus-host disease from lymphocytes in the donor blood.
D)Infection and graft-versus-host disease from erythrocytes in the donor blood.

Question 17

A child is receiving didanosine, a nucleoside reverse transcriptase inhibitor, for human immunodeficiency virus (HIV). The lab value the nurse should monitor is:

A)Glucose.
B)Sodium.
C)Potassium.
D)Red blood cell count.

Question 18

A problem the nurse anticipates for a family who has a child with acquired immunodeficiency syndrome (AIDS) is:

A)Anticipatory grieving.
B)Risk for impaired parenting.
C)Family coping, compromised.
D)Parental role conflict.

Question 19

An adolescent has systemic lupus erythematosus (SLE). Which action by the teen indicates acceptance of the body changes that occur because of SLE?

A)Attends school but doesn't stay for after-school activities
B)Discusses the body changes with health care personnel only
C)Discusses the body changes with her best friend
D)Only attends small parties at friends' homes