A nursing student learning about antibody-mediated immunity learns that the cell with the most direct role in this process begins development in which tissue or organ?
a. Bone marrow
b. Spleen
c. Thymus
d. Tonsils
Question 2A client has a leg wound that is in the second stage of the inflammatory response. For what manifestation does the nurse assess?
a. Noticeable rubor
b. Purulent drainage
c. Swelling and pain
d. Warmth at the site
Question 3A clinic nurse is working with an older client. What assessment is most important for preventing infections in this client?
a. Assessing vaccination records for booster shot needs
b. Encouraging the client to eat a nutritious diet
c. Instructing the client to wash minor wounds carefully
d. Teaching hand hygiene to prevent the spread of microbes
Question 4A client is taking prednisone to prevent transplant rejection. What instruction by the nurse is most important?
a. Avoid large crowds and people who are ill.
b. Check over-the-counter meds for acetaminophen.
c. Take this medicine exactly as prescribed.
d. You have a higher risk of developing cancer.
Question 5A nurse is assessing an older client for the presence of infection. The client's temperature is 97.6 F (36.4 C). What response by the nurse is best?
a. Assess the client for more specific signs.
b. Conclude that an infection is not present.
c. Document findings and continue to monitor.
d. Request that the provider order blood cultures.
Question 6The student nurse learns that the most important function of inflammation and immunity is which purpose?
a. Destroying bacteria before damage occurs
b. Preventing any entry of foreign material
c. Providing protection against invading organisms
d. Regulating the process of self-tolerance
Question 7A nurse on the postoperative nursing unit provides care to reduce the incidence of surgical wound infection. What actions are best to achieve this goal? (Select all that apply.)
a. Administering antibiotics for 72 hours
b. Disposing of dressings properly
c. Leaving draining wounds open to air
d. Performing proper hand hygiene
e. Removing and replacing wet dressings
Question 8A postoperative client has the following orders:
IV lactated Ringer's 125 mL/hr
NG tube to low continuous suction
Replace NG output every 4 hours with normal saline over 4 hours
Morphine sulfate 2 mg IV push every hour as needed for pain
NPO
Up in chair tonight
At 1600 (4:00 PM), the nurse measures the nasogastric (NG) output from noon to be 200 mL. What is the client's total IV rate for the next 4 hours? (Record your answer using a whole number.) _____ mL/hr
Question 9A postoperative client is being discharged with a prescription for oxycodone hydrochloride with acetaminophen (Percocet). What instructions does the nurse give the client? (Select all that apply.)
a. Check all over-the-counter medications for acetaminophen.
b. Do not take more pills each day than you are prescribed.
c. Eat a diet that is high in fiber and drink lots of water.
d. If this gives you diarrhea, loperamide (Imodium) can help.
e. You shouldn't drive while you are taking this medication.
Question 10A nurse is admitting an older client for surgery to the inpatient surgical unit. The client relates a prior history of acute confusion after a previous operation. What interventions does the nurse include on the client's plan of care to minimize the poten
a. Allow family and friends to visit as the client desires.
b. Ask the client about coping techniques frequently used.
c. Instruct the nursing assistant to ensure the client is bathed.
d. Place the client in a room secluded at the end of the hall.
e. Provide the client with uninterrupted periods of sleep.
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