A client calls the clinic to report exposure to poison ivy and an itchy rash that is not helped with over-the-counter antihistamines. What response by the nurse is most appropriate?

Correct Answer: A

Rationale: Rationale for Correct Answer (A): Antihistamines do not help poison ivy. Poison ivy rash is a type IV delayed hypersensitivity reaction, not a histamine-mediated reaction. Therefore, antihistamines will not provide relief. The most appropriate response is to educate the client on the ineffectiveness of antihistamines for poison ivy. Summary of Incorrect Choices: B: There are different antihistamines to try. This is incorrect because antihistamines are not effective for poison ivy rash. C: You should be seen in the clinic right away. Immediate clinic visit is not necessary unless there are severe symptoms or complications. D: You will need to take some IV steroids. IV steroids are not the first-line treatment for poison ivy rash. Topical steroids are usually sufficient.

Correct Answer: C

Rationale: The correct answer is C: Artificially acquired active immunity. The tetanus toxoid vaccine contains inactivated tetanus toxin, which stimulates the immune system to produce antibodies against tetanus. This process results in the person developing immunity to tetanus in the future. It is considered active immunity because the individual's immune system is actively involved in producing antibodies. A: Artificially acquired passive immunity involves receiving pre-formed antibodies, which provide immediate but temporary protection. This is not the case with the tetanus toxoid vaccine. B: Naturally acquired active immunity occurs when a person is exposed to the pathogen and develops immunity through their own immune response. This is not the case with the tetanus toxoid vaccine. D: Naturally acquired passive immunity involves receiving antibodies from another source, such as through breastfeeding. This is not how the tetanus toxoid vaccine works.

Correct Answer: B

Rationale: The correct answer is B: Ask the client if he ever sustained a bee sting in the past. This answer is correct because knowing the client's past history with bee stings can help the nurse assess the risk of a severe reaction. If the client has a history of severe reactions, the nurse may need to take immediate action. Choice A is incorrect because soaking the site in hydrogen peroxide is not the appropriate initial action for a bee sting. Choice C is incorrect because calling an ambulance is not necessary unless there are severe symptoms present, such as difficulty breathing or anaphylaxis. Choice D is incorrect because telling the client not to worry about the sting unless difficulty breathing occurs can be dangerous, as severe allergic reactions can happen rapidly and without warning.

Correct Answer: B

Rationale: The correct answer is B: Ototoxicity. Aminoglycosides are known to cause damage to the inner ear, resulting in hearing loss and balance issues. The nurse should monitor for symptoms such as tinnitus, dizziness, and hearing loss. Seizures (A) are not a common adverse effect of aminoglycosides. Renal toxicity (C) is a potential side effect, but ototoxicity is more specific to aminoglycosides. Hepatotoxicity (D) is not a typical adverse effect associated with aminoglycosides. Therefore, monitoring for ototoxicity is essential in clients taking aminoglycosides.

Correct Answer: D

Rationale: The correct answer is D: Greater than 30% plasma cells in bone marrow. This scenario is indicative of multiple myeloma, a plasma cell disorder. High Ca and renal insufficiency suggest hypercalcemia and kidney damage due to monoclonal protein deposition. Anemia and MCV suggest bone marrow involvement. Choice A is not specific for multiple myeloma. Choice B is used to evaluate bone metastasis. Choice C is invasive and not typically done for initial diagnosis of multiple myeloma. Therefore, D is the best option for definitive diagnosis in this case.