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Haematogenic Immunity System

日期:2015-11-26 | 来源 :中国护士网 | 作者 :www.angel512.com |点击:

1, for a client to be diagnosed with acquired immunodeficiency syndrome (aids), which of the following conditions must be present?   
   1.infection with human immunodeficiency virus (hiv), tuberculosis, and cytomegalovirus infection   
   2. infection with hw, an alternative lifestyle, and a t-cell count above 200 cells/μl   
   3. infection with hiv, cd4+ count below 200 cells/μl, and a t-cell count above 400 cells/μl   
   4. infection with hiv, a history of acute hiv infection, and a cd4+ t-cell count below 200 cells/μl   
1.4. three criteria must be met for a client to be diagnosed with aids. he must be hiv-positive, have a cd4+ t-cell count below 200 cells/μl, and the presence of one or more specific conditions that include acute infection with hiv. BECause hiv attaches to the cd4+ receptor sites of the t cell, a t-cell value alone is incorrect.   
2. which of the following body fluids most easily transmits human immunodeficiency virus (hiv)?   
    1. feces and saliva   
    2. blood and semen   
    3. breast milk and tears   
    4. vaginal secretions and urine   
2.2. hiv is most easily transmitted in blood, semen, and vaginal secretions. however, it has also been found in urine, feces, saliva, tears, and breast milk.   
3. immediately after giving an injection, a nurse is accidentally stuck with the needle when a client becomes agitated. when is the best time for the employer to test the nurse for human immunodeficiency virus (hiv) antibodies to determine if she became infected as a result of the needle stick?   
    1. immediately and then again in 6 weeks   
    2. immediately and then again in 3 months   
    3. in 2 weeks and then again in 6 months   
    4. in 2 weeks and then again in 1 year   
3. 2. the employer will want to test the nurse immediately to determine whether a preexisting infection is present, and then again in 3 months to detect seroconversion as a result of the needle stick. waiting 2 weeks to perform the first test is too late to detect preexisting infection. testing sooner than 3 months may yield false-negative results.   
4. which of the following blood tests is used first to identify a response to human immunodeficiency virus (hiv) infection?   
    1. western blot   
    2. cd4+ t-cell count   
    3. erythrocyte sedimentation rate   
    4. enzyme-linked immunosorbent assay (elisa)   
4. 4. the elisa is the first screening test for hiv. a western blot test confirms a positive elisa test. other blood tests that support the diagnosis of hiv include cd4+ and cd8+ counts, complete blood counts, immunoglobulin levels, p24 antigen assay, and quantitative ribonucleic acid assays.   
5. which of the following factors makes it difficult to develop a vaccine for human immunodeficiency virus (hiv)?   
    1. hiv is a virus.   
    2. hiv matures early.   
    3. hiv mutates easily.   
    4. hiv spreads through body secretions.   
5. 3. hiv was first identified in 1983. by 1986, two strains existed, hiv-1 and hiv-2. the fact that hiv is a virus, matures early, and spreads through body secretions doesn’t affect the potential for vaccine development against the virus.   
6. which of the following dietary recommendations may help the client with rheumatoid arthritis reduce inflammation?   
    1. fish oil   
    2. vitamin d   
    3. iron-rich foods   
    4. calcium carbonate   
6. 1. the therapeutic effect of fish oil suppresses inflammatory mediator production (such as prostaglandins); how it works is unknown. iron-rich foods are recommended to decrease the anemia associated with rheumatoid arthritis. calcium and vitamin d supplements may help reduce bone resorption.  
7. which of the following nonsteroidal antiinflammatory drugs (nsaids) is most often used to treat rheumatoid arthritis?   
    1. furosemide   
    2. haloperidol   
    3. ibuprofen   
    4. methotrexate   
7. 3. ibuprofen, fenoprofen, naproxen, piroxicam, and indomethacin are nsaids used for clients with rheumatoid arthritis. furosemide is a loop diuretic, and haloperidol is an antipsychotic agent, neither of which is used to treat rheumatoid arthritis. methotrexate is an immunosuppressant used in the early treatment of rheumatoid arthritis.   
8. which of the following methods of transmission has the most risk for exposure to human immunodeficiency virus (hiv) ?   
    1. routine teeth cleaning   
    2. intercourse with your spouse   
    3. unprotected, noninsertive relations   
    4. intercourse with a new partner without a condom   
8. 4. having intercourse with a new partner is risky because of the unknown i.v. drug use and sexual history. use of a condom may increase the protection against hiv exposure. absolutely safe sex practices include autosexual activities, abstinence, and relations in a monogamous uninfected couple. very safe practices include noninsertive relations. having your teeth cleaned is not a risk factor if the dental Office properly sterilizes the equipment.   
9. which of the following clients is most at risk for developing rheumatoid arthritis?   
    1. a 25-year-old woman   
    2. a 40-year-old man   
    3. a 65-year-old woman   
    4. a 70-year-old man   
9. 3. rheumatoid arthritis affects women three times more often than men. the average age of onset is age 55.   
10. to which of the following classifications does human immunodeficiency virus (hiv) belong?   
    1. hantavirus   
    2. retrovirus   
    3. rhinovirus   
    4. rotavirus   
10. 2. hiv is a retrovirus that has ribonucleic acid-dependent reverse transcriptase. hiv doesn’t belong to the other viruses.   
11. a pregnant woman has just been diagnosed with human immunodeficiency virus (hiv). which of the following methods or actions does not put the baby at risk for infection by the virus?   
    1. vaginal birth   
    2. vertical (in utero)   
    3. breast-feeding after birth   
    4. changing diapers after birth   
11.4. hiv infection can occur vertically during pregnancy or a vaginal birth and through breast-feeding. changing diapers doesn’t put the baby at risk for hiv.   
12. which of the following groups or factors is linked to higher morbidity and mortality in   
human immunodeficiency virus (hiv)-infected clients?   
    1. homosexual men   
    2. lower socioeconomic levels   
    3. treatment in a large teaching hospital   
    4. treatment by a physician who specializes in hiv infection   
12. 2. morbidity and mortality have been associated with lower socioeconomic status, receiving care in a community hospital or by a physician without much experience with hiv infections, or lack of access to adequate health care.   
13. after teaching a client about rheumatoid arthritis, which of the following statements indicates the client understands the disease process?   
    1. "it will get better and worse again."   
    2. "once it clears up, it will never come back."   
    3. "i will definitely have to have surgery for this."   
    4. "it will never get any better than it is right now."   
13, 1. the client with rheumatoid arthritis needs to understand it is a somewhat unpredictable disease characterized by periods of exacerbation and remission. there’s no cure, but symptoms can be managed at times. surgery may be indicated in some cases, but not always.   
14. which of the following medications would be prescribed first for a client with rheumatoid arthritis?  
    1. aspirin   
    2. cytoxan   
    3. ferrous sulfate   
    4. prednisone   
14. 1. nonsteroidal anti-inflammatory drugs (nsaids) such as aspirin are considered firstline therapy by some physicians. cytoxan may be used in cases of severe synovitis, rather than as first-line therapy. ferrous sulfate isn’t used to treat rheumatoid arthritis. prednisone may be used to control inflammation when nsaids aren’t tolerated.   
15. human immunodeficiency virus (hiv) primarily attacks the immune system. hw does not. cause which of the following illnesses?   
    1. anemia   
    2. arthritis   
    3. cardiomyopathy   
    4. glaucoma   
15. 4. hiv has been shown to cause neuropathy, cardiomyopathy, psoriasis, arthritis, cervicitis, uveitis, pneumonia, malabsorption of the small bowel, nephritis, gonad dysfunction, anemia, thrombocytopenia, granulocytopenia, and adrenalitis. glaucoma hasn’t been associated with hiv infection.   
16. which of the following blood components is decreased in anemia?   
    1. erythrocytes   
    2. granulocytes   
    3. leukocytes   
    4. platelets   
16. 1. anemia is defined as a decreased number of erythrocytes. leukopenia is a decreased number of leukocytes. thrombocytopenia is a decreased number of platelets. lastly, granulocytopenia is a decreased number of granulocytes.   
17. a middle-aged client arrives at the emergency department complaining of chest and stomach pain. he also reports passing black stools for a month. which of the following interventions is done first?   
    1. give nasal oxygen.   
    2. take his vital signs.   
    3. begin cardiac monitoring.   
    4. draw blood for laboratory analysis.   
17. 2. his vital signs will show hemodynamic stability, and monitoring his heart rhythm may be indicated based on your findings. giving nasal oxygen and drawing blood require a physician’s order and wouldn’t be part of a screening evaluation.   
18. a physician evaluates a client who arrived at the emergency department with chest and stomach pain and a report of black, tarry stools for several months. which of the following orders is appropriate?   
    1. cardiac monitor, oxygen, creatine kinase and lactate dehydrogenase levels   
    2. prothrombin time, partial thromboplastin time, fibrinogen and fibrin split product values   
    3. electrocardiogram, complete blood count, testing for occult blood, comprehensive serum metabolic panel   
   4. electroencephalogram, alkaline phosphatase and aspartate aminotransferase levels, basic serum metabolic panel   
18. 3. an electrocardiogram evaluates the complaint of chest pain, laboratory tests determine anemia, and the stool test for occult blood determines blood in the stool. cardiac monitoring, oxygen, and creatine kinase and lactate dehydrogenase levels are appropriate for a cardiac primary problem. a basic metabolic panel and alkaline phosphatase and aspartate aminotransferase levels assess liver function. prothrombin time, partial thromboplastin time, fibrinogen and fibrin split products are measured to verify bleeding dyscrasias. an electroencephalogram evaluates brain electrical activity.   
19. which of the following goals for medications prescribed to treat rheumatoid arthritis is accurate?   
    1. to cure the disease   
    2. to prevent osteoporosis   
    3. to control inflammation   
    4. to encourage bone regeneration   
19. 3. the goal of medications in the treatment of rheumatoid arthritis is to control inflammation. there is no cure for rheumatoid arthritis. rheumatoid arthritis causes bone erosion at the joints, not osteoporosis. medications aren’t available to replace bone lost through erosion.   
20. a client with anemia may be fired due to a tissue deficiency of which of the following substances?   
    1. carbon dioxide   
    2. factor viii   
    3. oxygen   
    4. t-cell antibodies   
20. 3. anemia stems from a decreased number of red blood cells and the resulting deficiency in oxygen in body tissues. clotting factors, such as factor viii, relate to the body’s ability to form blood clots and aren’t related to anemia, nor is carbon dioxide or t antibodies. 

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