Question 1

A patient who is receiving immunotherapy has just received an allergen injection. Which assessment finding is most important to communicate to the health care provider?

Accepted Answer

A local reaction larger than quarter size may indicate that a decrease in the allergen dose is needed. An increase in IgG indicates that the therapy is effective. Redness and swelling at the site are not unusual. Because immunotherapy usually takes 1 to 2 years to achieve an effect,an improvement in the patient's symptoms is not expected after a few months.

Question 2

A patient who is receiving an IV antibiotic develops wheezes and dyspnea. In which order should the nurse implement these prescribed actions? (Put a comma and a space between each answer choice [A,B,C,D,E]).

Accepted Answer

The nurse should initially discontinue the antibiotic because it is the likely cause of the allergic reaction. Next,oxygen delivery should be maximized,followed by treatment of bronchoconstriction with epinephrine administered IM or IV. Diphenhydramine will work more slowly than epinephrine,but will help prevent progression of the reaction. Because the patient currently does not have evidence of hypotension,the dopamine infusion can be prepared last.

Question 3

Immediately after the nurse administers an intracutaneous injection of an allergen on the forearm,the patient complains of itching at the site,weakness,and dizziness. What action should the nurse take first?

Accepted Answer

Application of a tourniquet will decrease systemic circulation of the allergen and should be the first reaction. The other actions may occur,but the tourniquet application slows the allergen progress into the patient's system,allowing treatment of the anaphylactic response. A local antiinflammatory cream may be applied to the site of a cutaneous test if the itching persists. Epinephrine will be needed if the allergic reaction progresses to anaphylaxis. Other testing may be delayed and rescheduled after development of anaphylaxis.

Question 4

A nurse has obtained donor tissue typing information about a patient who is waiting for a kidney transplant. Which results should be reported to the transplant surgeon?

Accepted Answer

Positive crossmatching is an absolute contraindication to kidney transplantation because a hyperacute rejection will occur after the transplant. The other information indicates that the tissue match between the patient and potential donor is acceptable.

Question 5

A clinic patient is experiencing an allergic reaction to an unknown allergen. Which action is appropriate for the registered nurse (RN)to delegate to a licensed practical/vocational nurse (LPN/LVN)?

Accepted Answer

LPN/LVNs are educated and licensed to administer medications under the supervision of an RN. RN-level education and the scope of practice include assessment of health history,focused physical assessment,and patient teaching.

Question 6

The health care provider asks the nurse whether a patient's angioedema has responded to prescribed therapies. Which assessment should the nurse perform?

Accepted Answer

Angioedema is characterized by swelling of the eyelids,lips,and tongue. Wheal and flare lesions,clear nasal drainage,and hypotension and tachycardia are characteristic of other allergic reactions.

Quiz 13: Altered Immune Responses and Transplantation

A patient who is receiving immunotherapy has just received an allergen injection. Which assessment finding is most important to communicate to the health care provider?

A patient who is receiving an IV antibiotic develops wheezes and dyspnea. In which order should the nurse implement these prescribed actions? (Put a comma and a space between each answer choice [A,B,C,D,E]) .

Immediately after the nurse administers an intracutaneous injection of an allergen on the forearm,the patient complains of itching at the site,weakness,and dizziness. What action should the nurse take first?

A nurse has obtained donor tissue typing information about a patient who is waiting for a kidney transplant. Which results should be reported to the transplant surgeon?

A clinic patient is experiencing an allergic reaction to an unknown allergen. Which action is appropriate for the registered nurse (RN) to delegate to a licensed practical/vocational nurse (LPN/LVN) ?

The health care provider asks the nurse whether a patient's angioedema has responded to prescribed therapies. Which assessment should the nurse perform?