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Immune & Infectious NCLEX practice questions
Five NCLEX-style questions on HIV, lupus, anaphylaxis, sepsis, isolation precautions and immunizations. Pick your answer, then open it to see the right choice and why. New questions every week.
Question 1
The nurse is caring for a patient on contact precautions. Which action will be most appropriate to prevent the spread of disease?
- A.Transport the patient safely and quickly when going to the radiology department.
- B.Use a dedicated blood pressure cuff that stays in the room and is used for that patient only.
- C.Place the patient in a room with negative airflow.
- D.Wear a gown, gloves, face mask, and goggles for interactions with the patient.
Show answer and rationale ▾Answer and rationale ▴
Answer: B. Use a dedicated blood pressure cuff that stays in the room and is used for that patient only.
Transport the patient safely and quickly when going to the radiology department: While it's important to transport patients safely and efficiently, this action does not directly address the prevention of disease spread associated with contact precautions. Contact precautions primarily involve preventing direct or indirect contact with the patient's bodily fluids or contaminated surfaces. Use a dedicated blood pressure cuff that stays in the room and is used for that patient only: This is the most appropriate action for preventing the spread of disease on contact precautions. Using dedicated equipment for the patient reduces the risk of cross-contamination between patients. It helps prevent the transmission of pathogens from one patient to another through contaminated equipment. Place the patient in a room with negative airflow: Negative airflow rooms are typically used for patients on airborne precautions to prevent the spread of airborne pathogens. While maintaining appropriate airflow is important for infection control, it is not specific to contact precautions. Wear a gown, gloves, face mask, and goggles for interactions with the patient: This option describes the appropriate personal protective equipment (PPE) to wear when caring for a patient on contact precautions. While it's important to wear PPE, using dedicated equipment for the patient is more directly related to preventing disease spread in this scenario
Question 2
A nurse is caring for a client who has severe rheumatoid arthritis in her hands and is unable to feed herself. For which of the following health care team members should the nurse request a referral from the provider?
- A.Physician assistant
- B.Physical therapist
- C.Occupational therapist
- D.Social worker
Show answer and rationale ▾Answer and rationale ▴
Answer: C. Occupational therapist
Physician assistants typically assist with medical diagnoses and treatment plans, not rehabilitation. Physical therapists focus on physical movement and rehabilitation, not typically assisting with activities of daily living such as feeding. Occupational therapists specialize in helping individuals with daily activities, making them the appropriate referral for this client's needs. Social workers typically provide assistance with psychosocial support and community resources, which may be needed but are not as directly related to the client's physical limitations.
Question 3
A group of nurses are discussing risk factors for transmission of human immunodeficiency virus (HIV) from clients: Which of the following individuals should the nurse identify as being at the greatest risk for contracting HIV?
- A.A nurse who works for an insurance company and collects urine samples from clients who have HIV
- B.A personal trainer who works with a client who has HIV
- C.A phlebotomist who collects blood from clients who have HIV
- D.An occupational therapist who works with a client who has HIV
Show answer and rationale ▾Answer and rationale ▴
Answer: C. A phlebotomist who collects blood from clients who have HIV
A nurse who works for an insurance company and collects urine samples from clients who have HIV: While this nurse may interact with clients who have HIV, collecting urine samples does not typically pose a significant risk for HIV transmission. HIV is not transmitted through urine, and the nurse would not be in direct contact with blood or bodily fluids that present a risk. A personal trainer who works with a client who has HIV: A personal trainer is at low risk for contracting HIV while working with a client who has the virus, provided there is no direct exposure to blood or open wounds. HIV is transmitted through specific bodily fluids such as blood, semen, vaginal fluids, and breast milk, and not through casual contact or physical activity like exercise. A phlebotomist who collects blood from clients who have HIV: A phlebotomist is at the greatest risk of contracting HIV because they handle blood directly. If proper precautions, such as gloves and safe needle handling, are not followed, there is an increased risk of exposure to HIV-infected blood. Occupational exposure to blood is one of the most significant routes of HIV transmission in healthcare settings. An occupational therapist who works with a client who has HIV: An occupational therapist working with a client who has HIV is at a low risk of contracting HIV, provided the therapist does not come into direct contact with blood or other potentially infectious bodily fluids. Occupational therapy generally involves helping clients with physical or cognitive tasks and does not typically present a risk for HIV transmission unless there is a breach in infection control practices.
Question 4
A nurse is caring for a client with rheumatoid arthritis. The client is having difficulty with self-feeding due to the pain and hand deformities. The nurse would anticipate a referral will be made to which member of the interprofessional team?
- A.Speech Therapist
- B.Registered Dietician
- C.Physical Therapist
- D.Occupational Therapist
Show answer and rationale ▾Answer and rationale ▴
Answer: D. Occupational Therapist
Speech Therapist: A speech therapist typically works with clients who have communication or swallowing disorders. While they may be involved in assessing and managing difficulties with swallowing, they are not the primary professionals for addressing issues related to hand function or fine motor skills, which are crucial for self-feeding in clients with rheumatoid arthritis. Registered Dietician: A registered dietician is responsible for assessing and planning nutritional needs, which may include recommending dietary modifications for overall health and well-being. However, they do not specifically address the mechanical or functional aspects of eating, such as difficulties due to pain and hand deformities in rheumatoid arthritis. Physical Therapist: Physical therapists focus on improving gross motor function, mobility, and physical strength. While they may help with general mobility and exercise plans to reduce pain and improve joint function, they are not specialists in the fine motor skills and adaptive strategies needed for activities of daily living, such as self-feeding. Occupational Therapist: Occupational therapists specialize in helping clients regain and improve their ability to perform daily activities, particularly those involving fine motor skills. They are well-suited to address issues like pain management, joint protection techniques, and the use of adaptive equipment for self-feeding in clients with rheumatoid arthritis. They work on enhancing the client’s functional independence despite physical limitations.
Question 5
A nurse is caring for a client who has HIV and a CD4-T-cell count of 150/mm³. Which of the following conditions should the nurse monitor the client for?
- A.Hepatitis
- B.Tuberculosis
- C.Gonorrhea
- D.Chlamydia
Show answer and rationale ▾Answer and rationale ▴
Answer: B. Tuberculosis
Hepatitis is a concern for individuals with HIV, but it is not specifically indicated by a low CD4-T-cell count. A CD4-T-cell count of 150/mm³ indicates severe immunosuppression, making the client highly susceptible to opportunistic infections like tuberculosis, which is common in individuals with HIV. While gonorrhea is a risk for sexually active individuals, it is not specifically related to the low CD4-T-cell count. Chlamydia is also a sexually transmitted infection, but similar to gonorrhea, it is not directly linked to the immunocompromised state indicated by the CD4-T-cell count.
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