Page 2195 - Saunders Comprehensive Review For NCLEX-RN

actions are most appropriate? Select all that apply.

1. Tell the client that testing is not necessary unless arthralgia
develops.
2. Tell the client to avoid any woody, grassy areas that may

contain ticks.
3. Instruct the client to immediately start to take the antibiotics
that are prescribed.

4. Inform the client to plan to have a blood test 4 to 6 weeks
after a bite to detect the presence of the disease.
5. Tell the client that if this happens again, to never remove the

tick but vigorously scrub the area with an antiseptic.
774. The nurse is preparing a group of Cub Scouts for an overnight camping trip
and instructs the Scouts about the methods to prevent Lyme disease. Which
statement by one of the Scouts indicates a need for further instruction?
1. “I need to bring a hat to wear during the trip.”
2. “I should wear long-sleeved tops and long pants.”
3. “I should not use insect repellents because it will attract the ticks.”
4. “I need to wear closed shoes and socks that can be pulled up over
my pants.”
775. The client with acquired immunodeficiency syndrome is diagnosed with
cutaneous Kaposi’s sarcoma. Based on this diagnosis, the nurse understands
that this has been confirmed by which finding?
1. Swelling in the genital area
2. Swelling in the lower extremities
3. Positive punch biopsy of the cutaneous lesions
4. Appearance of reddish-blue lesions noted on the skin
776. The nurse is conducting allergy skin testing on a client. Which postprocedure
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.
777. The nurse is performing an assessment on a client who has been diagnosed
with an allergy to latex. In determining the client’s risk factors, the nurse
should question the client about an allergy to which food item?
1. Eggs
2. Milk
3. Yogurt
4. Bananas

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