ALLERGY PRACTICE TEST

You are a nurse starting an IV antibiotic to a patient to treat a severe infection. During infusion, the
patient is having a severe allergic reaction. Select all the appropriate interventions for this patient:

1. Slow down the antibiotic infusion

2. Call a rapid response.

3. Place the patient on oxygen

4. Prepare for the administration of Epinephrine

a. 1, 2 and 3 c. 2 and 3

b. 2, 3 and 4 d. 3 and 4

You're assessing a patient's knowledge on how to use their EpiPen in case of an anaphylactic reaction.
You're using an EpiPen trainer device to teach the patient. What demonstrated by the patient shows the
patient knows how to administer the medication? Select all that apply:

1. The patient injects the medication in the subq tissue of the abdomen.

2. The patient massages the site after injection.

3. The patient administers the injection through the clothes.

4. The patient aspirates before injecting the medication.

a. 1, 2 and 3 c. 2 and 3

b. 2, 3 and 4 d. 3 and 4

Nurse John received a patient in the ER for allergy skin testing. Which nursing interventions are most
appropriate? Select all that apply.

1. Record site, date, and time of the test.

2. Give the client a list of potential allergens if identified.

3. Estimate the size of the wheal and document the finding.

4. Tell the client to return to have the site inspected only if there is a reaction.

5.Have the client wait in the waiting room for at least 1 to 2 hours after injection.

a. 1, 2 and 3 c. 1 and 2

b. 2, 3 and 4 d. 3 and 4
 A male patient was taking morphine when suddenly he had a severe anaphylactic reaction after
receiving the medication. The nurse would take which actions? Select all that apply.

1. Administer oxygen.

2. Quickly assess the client’s respiratory status.

3. Document the event, interventions, and client’s response.

4. Leave the client briefly to contact a primary health care provider (PHCP).

5. Keep the client supine regardless of the blood pressure readings.

6. Start an intravenous (IV) infusion of D5W and administer a 500-mL bolus.

a. 1, 2 and 4 c. 1, 2 and 3

b. 1, 2, 3, 5 and 6 d. 1, 2, 3, 4 and 5

While doing your rounds, you noticed that the patient in 3320 is having a sudden and severe
anaphylactic reaction to a medication. The patient's blood pressure is 80/50, heart rate 125, and oxygen
saturation 85%. Audible wheezing is noted along with facial redness and swelling. As the nurse you know
that the first initial treatment for this patient's condition is?

a. IV Diphenhydramine c. IM Epinephrine

b. IV Normal Saline Bolus d. Nebulized Albuterol

You received a patient in the ER due to a bee sting. The patient is in anaphylactic shock. This type of
anaphylactic reaction is known as a?

a. Type I Hypersensitivity Reaction

b. Type II Hypersensitivity Reaction

c. Type III Hypersensitivity Reaction

d. Type IV Hypersensitivity Reaction

The patient has a severe allergy to eggs and mistakenly consumed a spiced chicken egg wrap. The patient
is given Epinephrine intramuscularly. As the nurse, you know this medication will have an effect on the
body?

a. It will prevent a recurrent attack.

b. It will cause vasoconstriction and decrease the blood pressure.

c. It will help dilate the airways.

d. It will help block the effects of histamine in the body.

You're providing care to a patient in anaphylactic shock. What is NOT a typical medical treatment for this
condition, and if ordered the nurse should ask for an order clarification?

a. IV Diphenhydramine

b. Epinephrine

c. Corticosteroids

d. Isotonic intravenous fluids

e. IV Furosemide

What is the MOST important step a nurse can take to prevent anaphylactic shock in a patient?

a. Assessing, documenting, and avoiding all the patient allergies.

b. Administering Epinephrine

c. Administering Corticosteroids

d. Establishing IV access

A patient is having an anaphylactic reaction to an IV medication. What is the FIRST action the nurse
should take?

a. Administer Epinephrine c. Stop the medication

b. Call a Rapid Response d. Administer a breathing treatment

What is the BEST position for a patient in anaphylactic shock?

a. Lateral recumbent c. High Fowler's

b. Supine with legs elevated. d. Semi-Fowler’s

The nurse is providing teaching for a client on dietary intake and anaphylaxis. Which food should the
nurse identify that trigger anaphylaxis in a sensitized individual (Select all that apply)

1. Fish 2. Coconut oil 3. Milk 4. Chocolate 5. Grains

a. 4 and 5 c. 3, 4 and 5

b. 1, 2 and 3 d. 2 and 3

You are the nurse taking care of a patient who is on a course of oral steroids more than once a year for
the treatment of asthma related to allergens. Which alternative therapy should the nurse anticipate
being prescribed for the client to avoid the frequent use of steroids?

a. Immunotherapy c. Plasmapheresis

b. Omalizumab d. Antihistamines

For which allergy will the nurse teach the parents that a child with spina bifida is at increased risk?

a. Drug allergy c. Latex allergy

b. Contact dermatitis d. Food allergy

You are taking care of a patient treated for hemolytic disease. Which statement shows the nurse's
understanding of the cause of the disease?

a. "Neutrophils attempt to phagocytize the RBCs."

b. "antibodies bound with an antigen activate the cascade destroying the RBCs."

c. "Complement activation causes the release of inflammatory chemical mediators resulting in RBC
destruction."

d. "Endogenous antigens stimulate a type II reaction resulting in lysis of the RBC."

You are taking care of a patient with SLE who is being treated with immunosuppressant drugs and
corticosteroids. Which precautions should you provide this client? Select all that apply.

1. Avoid large crowds.

2. Don't get a flu shot.

3. Use contraception to prevent pregnancy

4. Refrain from taking aspirin or ibuprofen.

5. Report signs of infection to the physician

a. 1, 3, 4 and 5 c. 1, 2, 3 and 4
b. 3, 4 and 5 d. 1, 2 and 3

HIV PRACTICE TEST

A nurse is planning care for a 25-year-old female client who has just been diagnosed with human
immunodeficiency virus (HIV) infection. The client asks the nurse, “How could this have
happened?” The nurse responds to the question based on the most frequent mode of HIV
transmission, which is:

a. Hugging an HIV-positive sexual partner with- out using barrier precautions.

b. Inhaling cocaine.

c. Sharing food utensils with an HIV-positive person without proper cleaning of the utensils.

d. Having sexual intercourse with an HIV- positive person without using a condom.

A client with human immunodeficiency virus (HIV) infection is taking zidovudine (AZT). The expected
outcome of AZT is to:

a. Destroy the virus. c. Slow replication of the virus.

b. Enhance the body’s antibody production. d. Neutralize toxins produced by the

virus.

Women who have human papillomavirus (HPV) are at risk for development of:

a. Sterility. c. Uterine fibroid tumors.

b. Cervical cancer. d. Irregular menses.

The primary reason that a herpes simplex virus (HSV) infection is a serious concern to a client with
human immunodeficiency virus (HIV) infection is that it:

a. Is an acquired immunodeficiency virus (AIDS)–defining illness.

b. Is curable only after 1 year of antiviral therapy.

c. Leads to cervical cancer.

d. Causes severe electrolyte imbalances.

In educating a client about human immunodeficiency virus (HIV), the nurse should take into account the
fact that the most effective method known to control the spread of HIV infection is:
a. Premarital serologic screening.

b. Prophylactic treatment of exposed people.

c. Laboratory screening of pregnant women.

d. Ongoing sex education about preventive behaviors.

A male client with human immunodeficiency virus (HIV) infection becomes depressed and tells the
nurse: “I have nothing worth living for now.” Which of the following statements would be the best
response by the nurse?

a. “You are a young person and have a great deal to live for.”

b. “You should not be too depressed; we are close to finding a cure for AIDS.”

c. “You are right; it is very depressing to have HIV.”

d. “Tell me more about how you are feeling about being HIV-positive.”

The typical chancre of syphilis appears as:

a. A grouping of small, tender pimples. c. A painless, moist ulcer.

b. An elevated wart. d. An itching, crusted area.

109. The nurse is interviewing a client with newly diagnosed syphilis. In order to prevent the spread of
the disease, the nurse should focus the interview by:

a. Motivating the client to undergo treatment. c. Increasing the client’s knowledge

of the disease.

b. Obtaining a list of the client’s sexual contacts. d. Reassuring the client that records are
confidential.

110. Benzathine penicillin G, 2.4 million units I.M., is prescribed as treatment for an adult client with
primary syphilis. The nurse should administer the injection in the:

a. Deltoid. c. Quadriceps lateralis of the thigh.

b. Upper outer quadrant of the buttock. d. Mid-lateral aspect of the thigh.

111. A priority nursing diagnosis for a client with primary syphilis is:

a. Deficient knowledge related to lack of information about the mode of transmission.

b. Pain related to cutaneous skin lesions on palms and soles.

c. Ineffective tissue perfusion related to a bleeding chancre.

d. Disturbed body image related to alopecia.

An 18-year-old female college student is seen at the university health center. She undergoes a pelvic
examination and is diagnosed with gonorrhea. Which of the following responses by the nurse would be
best when the client says that she is nervous about the upcoming pelvic examination?

a. “Can you tell me more about how you’re feeling?”

b. “You’re not alone. Most women feel uncomfortable about this examination.”

c. “Do not worry about Dr. Smith. He’s a specialist in female problems.”

d. “We’ll do everything we can to avoid embarrassing you.”

When educating a female client with gonorrhea, the nurse should emphasize that for women gonorrhea:

a. Is often marked by symptoms of dysuria or vaginal bleeding.

b. Does not lead to serious complications.

c. Can be treated but not cured.

d. May not cause symptoms until serious complications occur.

Which of the following groups has experienced the greatest rise in the incidence of sexu- ally transmitted
diseases (STDs) over the past two decades?

a. Teenagers. c. Young married couples.

b. Divorced people. d. Older adults.

A 16-year-old sexually active male client comes to the clinic with a complaint of burning on urination and
a milky discharge from the urethral meatus. Documentation on the client’s chart should include
which of the following information? Select all that apply.

1. History of unprotected sex (sex without a condom).

2. Length of time since symptoms presented.

3. History of fever or chills.

4. Presence of any enlarged lymph nodes on examination.

5. Names and phone numbers of all sexual contacts.

6. Allergies to any medications.

a. 1, 2, 4, and 5 c. 1, 2, 3, 4, 6

b. 1, 2, 3, 5 and 6 d. 1, 3, 4 and 6

A 19-year-old male client is diagnosed with a chlamydial infection. Azithromycin (Zithromax) 1 g is

ordered. The supply of azithromycin is in 250-mg tablets. How many tablets should the nurse
administer?

________________________ tablets.

a. 4 tablets c. 0.4 tablets

b. 40 tablets d. 1 tablets

A female client with gonorrhea informs the nurse that she has had sexual intercourse with her boyfriend
and asks the nurse, “Would he have any symptoms?” The nurse responds that in men the
symptoms of gonorrhea include:

a. Impotence. c. Urine retention.

b. Scrotal swelling. d. Dysuria.

The nurse assesses the mouth and oral cavity of a client with human immunodeficiency virus (HIV)
infection because the most common opportunistic infection initially presents as:

a. Herpes simplex virus (HSV) lesions on the lips. c. Cytomegalovirus (CMV) infection.

b. Oral candidiasis. d. Aphthae on the gingiva.

The nurse is administering Didanosine (Videx) to a client with HIV. Before administering this medication,
the nurse should check which lab test results? Select all that apply.

1. Elevated serum creatinine.

2. Elevated blood urea nitrogen (BUN).

3. Elevated aspartate aminotransferase (AST).

4. Elevated alanine aminotransferase (ALT).

5. Elevated serum amylase.

a. 1, 2, and 5 c. 3, 4 and 5

b. 2, 3, 4 and 5 d. 2, 3 and 4

The nurse is caring for a client from South- east Asia who has HIV-AIDS. The client does not speak or
comprehend the English language. What should the nurse do to provide culturally- appropriate care?

a. Contact the hospital’s chaplain.

b. Do an Internet search for the Joint United Nations Program on HIV/AIDS.

c. Utilize language-appropriate interpreters.

d. Ask a family member to obtain informed consent.

What is most important for the nurse to teach a client newly diagnosed with genital herpes?

a. Use condoms at all times during sexual intercourse.

b. A urologist should be seen only when lesions occur.

c. Oral sex is permissible without a barrier.

d. Determine if your partner has received a vac- cine against herpes.

ANAPHYLAXIS CARDIO PRACTICE TEST

You're assessing a patient's knowledge on how to use their EpiPen in case of an anaphylactic reaction.
You're using an EpiPen trainer device to teach the patient. What demonstrated by the patient shows the
patient knows how to administer the medication? Select all that apply:

1. The patient injects the medication in the subq tissue of the abdomen.

2. The patient massages the site after injection.

3. The patient administers the injection through the clothes.

4. The patient aspirates before injecting the medication.

a. 1, 2 and 3 c. 2 and 3
b. 2, 3 and 4 d. 3 and 4

Nurse John received a patient in the ER for allergy skin testing. Which nursing interventions are most
appropriate? Select all that apply.

1. Record site, date, and time of the test.

2. Give the client a list of potential allergens if identified.

3. Estimate the size of the wheal and document the finding.

4. Tell the client to return to have the site inspected only if there is a reaction.

5.Have the client wait in the waiting room for at least 1 to 2 hours after injection.

a. 1, 2 and 3 c. 1 and 2

b. 2, 3 and 4 d. 3 and 4

A male patient was taking morphine when suddenly he had a severe anaphylactic reaction after receiving
the medication. The nurse would take which actions? Select all that apply.

1. Administer oxygen.

2. Quickly assess the client’s respiratory status.

3. Document the event, interventions, and client’s response.

4. Leave the client briefly to contact a primary health care provider (PHCP).

5. Keep the client supine regardless of the blood pressure readings.

6. Start an intravenous (IV) infusion of D5W and administer a 500-mL bolus.

a. 1, 2 and 4 c. 1, 2 and 3

b. 1, 2, 3, 5 and 6 d. 1, 2, 3, 4 and 5

While doing your rounds, you noticed that the patient in 3320 is having a sudden and severe
anaphylactic reaction to a medication. The patient's blood pressure is 80/50, heart rate 125, and oxygen
saturation 85%. Audible wheezing is noted along with facial redness and swelling. As the nurse you know
that the first initial treatment for this patient's condition is?

a. IV Diphenhydramine c. IM Epinephrine

b. IV Normal Saline Bolus d. Nebulized Albuterol

One of the goals in the treatment of myocarditis is to prevent embolization. The nurse must emphasize
which of the following?

a. Application of elastic pressure stockings c. Taking anticoagulants

b. ROM exercises d. All of these

Scott has suddenly developed shortness of breath, dyspnea, crackles, and a pink-frothy sputum. The
nurse must suspect for?

a. Right-sided heart failure c. Cardiac tamponade

b. Left-sided heart failure d. Pericardial friction rub

The goal in the treatment of Scott’s myocarditis would be

a. Eliminating pain c. Treatment of the underlying infection

b. Prevention of thrombus formation d. Cardiac monitoring

Which of the following actions is the first priority of care for a client exhibiting signs and symptoms of
coronary artery disease?

a. Decrease anxiety c. Administer sublingual nitroglycerin

b. Enhance myocardial oxygenation d. Educate the client about his symptoms

Medical treatment of coronary artery disease includes which of the following procedures?

a. Cardiac catheterization

b. Coronary artery bypass surgery

c. Oral medication therapy

d. Percutaneous transluminal coronary angioplasty

154. A nurse is assessing a client who is taking atorvastatin (Lipitor). For which manifestations should the
nurse specifically assess?

a. Constipation and hemorrhoids

b. Muscle pain and weakness

c. Fatigue and dysrhythmias

d. Flushing and postural hypotension

155. A client, following a total hip replacement, asks a nurse why she is receiving Enoxaparin (Lovenox*)
for the prevention of deep vein thrombosis (DVT) when, with her last hip surgery, she received heparin
subcutaneously. What is the nurse's best response?

a. "Enoxaparin is less expensive and easier to administer than the heparin

b. "There is less risk of bleeding with Enoxaparin, and it doesn't affect your laboratory results.

c. “Enoxaparin is a low-molecular-weight heparin that lasts twice as long as regular heparin.

d. “Enoxaparin can be administered orally, whereas heparin is only administered by injection.

156. The parent of a child diagnosed with rheumatic heart disease questions the nurse following the
doctor's statement that the child has a heart murmur. The nurse explains that a heart murmur is an
abnormal or extra heart sound produced by which malfunctioning structure of the heart?

a. Heart valve

b. Heart vessel

c. Heart chamber

d. Heart conduction

157. Before administering oral digoxin (Lanoxine) to a pediatric client, a nurse notes that the child has
bradycardia and mild vomiting. Which is the nurse's most appropriate action?

a. Explain to the parent that bradycardia is an expected effect of the digoxin.

b. Administer the medication, document the observations, and reevaluate after the next dose.

c. Withhold the medication and immediately notify the prescriber because these are signs of toxicity.

d. Administer an oral beta blocker medication

158. A homeless client visiting a health clinic is noted to have a smooth and reddened tongue and ulcers
at the corners of the mouth. The client was tentatively diagnosed with a hematological disorder, and
laboratory tests were prescribed. Based on this information, a nurse should expect the client's laboratory
results to reveal?

a. low hemoglobin.

b. elevated red blood cells

c. prolonged prothrombin time (PT)

d. low white blood cells.