CH 31: Assessment of Immune Function
A 20-year-old client cut a hand while replacing a window. While reviewing the complete blood count (CBC) with differential, the nurse would expect which cell type to be elevated first in an attempt to prevent infection in the client's hand? A) Neutrophils B) Monocytes C) Eosinophils D) B cells
A
A client has a known allergy to peanuts, meaning that the client's immune system has identified peanuts as a foreign invader and has produced specific cells to attack if the client should come in contact with peanuts again. The formation of these specific cells is known as: A) humoral response. B) inflammatory response. C) cell-mediated response. D) memory response.
A
A client has had a kidney transplant performed for end-stage kidney disease. What type of immune response that T-cell lymphocytes perform is related to this type of surgery? A) A cell-mediated response B) Naturally acquired active immunity C) Stimulation of colony-stimulating factors D) Activation of the complement system
A
Which of the following protective responses begin with the B lymphocytes? A) Humoral B) Cellular C) Recognition D) Phagocytic
A
What types of cells are the primary targets of the healthy immune system? Select all that apply. A) foreign cells B) typical cells C) cancerous cells D) infectious cells
A, C, and D
Which of the following is accurate regarding acquired immunity? Select all that apply. A) Can develop by contracting a disease B) A nonspecific immunity present at birth C) An immunologic response acquired during life but not present at birth D) Also know as innate immunity E) Usually develops as a result of exposure to an antigen through immunization
A, C, and E
A client comes to the clinic and informs the nurse that he feels as though he has allergies. What laboratory test results will be a positive indicator for an allergic disorder? A) Neutrophils 60% B) Radioallergosorbent blood test (RAST) of 3 C) Eosinophils 6% D) WBC of 7000/mm3
B
A 38-year-old client has begun to suffer from rheumatoid arthritis and is being assessed for disorders of the immune system. The client works as an aide at a facility that cares for children infected with AIDS. Which is the most important factor related to the client's assessment? A) Diet B) Home environment C) Use of other drugs D) Age
C
A child is brought to the clinic with a rash and is subsequently diagnosed with measles. The parent reports also having had measles as a young child. What type of immunity to measles develops after the initial infection? A) Naturally acquired passive immunity B) Artificially acquired active immunity C) Naturally acquired active immunity D) Artificially acquired passive immunity
C
A nursing instructor is giving a lecture on the immune system. The instructor's discussion on phagocytosis will include: A) regulator T cells and helper T cells. B) plasma cells and memory cells. C) neutrophils and monocytes. D) lymphokines and suppressor T cells.
C
A 25-year-old client receives a knife wound to the leg in a hunting accident. Which type of immunity was compromised? A) Adaptive immunity B) Passive immunity C) Specific immunity D) Natural immunity
D
A nurse is working in a pediatric clinic. After the nurse gives a hepatitis B immunization to an infant, the parent asks what kind of protection this provides for the child. What is the nurse's best response? A) Passive acquired immunity, which lasts many years or a lifetime B) Passive acquired immunity, which is temporary C) Active acquired immunity, which is temporary D) Active acquired immunity, which lasts many years or a lifetime
D
A client is diagnosed with human immunodeficiency virus (HIV). After recovering from the initial shock of the diagnosis, the client expresses a desire to learn as much as possible about HIV and acquired immunodeficiency syndrome (AIDS). When teaching the client about the immune system, the nurse states that humoral immunity is provided by which type of white blood cell? A) Lymphocyte B) Basophil C) Monocyte D) Neutrophil
A
A client is diagnosed with multiple site cancers and has received whole-body irradiation. The nurse is concerned about a compromised immune system in this client for which reason? A) Radiation destroys lymphocytes. B) Radiation causes a deficiency of circulating hemoglobin. C) Radiation causes an excess of circulating hemoglobin. D) Radiation causes an excess of circulating lymphocytes.
A
A laboring mother asks the nurse if the baby will have immunity to some illnesses when born. What type of immunity does the nurse understand that the newborn will have? A) Passive immunity transferred by the mother B) There is no immunity passed down from mother to child. C) Artificially acquired active immunity D) Naturally acquired active immunity
A
A nurse is caring for a client undergoing evaluation for possible immune system disorders. Which intervention will best help support the client throughout the diagnostic process? A) Educate the client about the diagnostic procedures and answer their questions about the possible diagnosis B) Assist the client with scheduling the procedures C) Encourage the client to ask the physician for information about treatment options for the possible diagnosis D) Accompany the client to the diagnostic tests
A
What type of immunoglobulin does the nurse recognize that promotes the release of vasoactive chemicals such as histamine when a client is having an allergic reaction? A) IgE B) IgA C) IgM D) IgG
A
A client is informed of having a low white blood cell count and that the client is at risk for the development of infections. The client asks, "Where do I make new white blood cells?" What is the best response by the nurse? A) "White blood cells are produced in the thymus gland." B) "White blood cells are produced in the bone marrow." C) "White blood cells are produced in the plasma." D) "White blood cells are produced in the lymphatic tissue."
B
The nurse is teaching a client who has been diagnosed with Hashimoto's thyroiditis. Which statement correctly describes the process of autoimmunity? A) The body produces inappropriate or exaggerated responses to specific antigens. B) The normal protective immune response attacks the body, damaging tissues. C) The body overproduces immunoglobulins. D) A deficiency results from improper development of immune cells or tissues.
B
The nursing students are learning about the immune system in their anatomy and physiology class. What would these students learn is a component of the immune system? A) Stem cells B) Lymphoid tissues C) Red blood cells D) Cytokines
B
This type of T lymphocyte is responsible for altering the cell membrane and initiating cellular lysis. Choose the T lymphocyte. A) Memory T cell B) Cytotoxic T cell C) Helper T cell D) Suppressor T cell
B
When obtaining a health history from a patient with possible abnormal immune function, what question would be a priority for the nurse to ask? A) "Do you have abdominal pain or discomfort?" B) "Have you ever received a blood transfusion?" C) "When was your last menstrual period?" D) "Have you ever been treated for a sexually transmitted infection?"
B
A client arrives at the clinic and reports a very sore throat as well as a fever. A rapid strep test returns a positive result and the client is given a prescription for an antibiotic. How did the streptococcal organism gain access to the client to cause this infection? A) From being outside in the cold weather and decreasing resistance B) Through the skin C) Breathing in airborne dust D) Through the mucous membranes of the throat
D
A client has been diagnosed with AIDS and tuberculosis (TB). A nursing student asks the nurse why the client's skin test for TB is negative if the client's physician has diagnosed TB. The nurse's correct reply is which of the following? A) The solution used for the skin test was probably outdated. B) The skin test was improperly performed. C) The client has only mild TB, which is not enough to cause a reaction. D) The client's immune system cannot mount a response to the skin test.
D
An elderly client is diagnosed with cancer. While reviewing age-related changes in the immune system, what does the nurse identify as having contributed to this client's condition? A) Impaired ciliary action from exposure to environmental toxins B) Decreased sensation and slowing of reflexes C) Failure of immune system to differentiate "self" from "non-self" D) Failure of lymphocytes to recognize mutant cells
D
A school nurse is talking about infection with a high school health class. What would be the nurse's best explanation of the process of phagocytosis? A) Engulfment and digestion of bacteria and foreign material B) Removal of bacteria and dead blood cells from circulation C) Release of chemicals to destroy bacteria and foreign material D) Conversion of memory cells to plasma cells
A
An adult client has had mumps when the client was a child. The client had a titer prior to entering nursing school and shows immunity. What type of immunity does this reflect? A) Passive immunity B) Natural passive immunity C) Naturally acquired active immunity D) Artificially acquired active immunity
C
Proteins formed when cells are exposed to viral or foreign agents that are capable of activating other components of the immune system are referred to as A) complements. B) antibodies. C) interferons. D) antigens.
C
The nurse is aware that the phagocytic immune response, one of the body's responses to invasion, involves the ability of cells to ingest foreign particles. Which of the following engulfs and destroys invading agents? A) Basophils B) Eosinophils C) Neutrophils D) Macrophages
D
The nurse notes that an older adult was treated for a wound infection and pneumonia within the last 6 months. Which factor will the nurse attribute to this client's illnesses? A) Reduced vitamin intake B) Decline in self-care activities C) Polypharmacy D) Immunosenescence
D
The nurse is administering a skin test for detection of exposure to tuberculosis. How would the nurse determine if the client was exposed to tuberculosis? A) The injection area swells if the client has developed antibodies against the antigen. B) The injection area will become painful with in duration if the client has antibodies against the antigen. C) The client will have a productive cough. D) The injection area will break out in a fine macular rash.
A
Which condition is associated with impaired immunity relating to the aging client? A) Breakdown and thinning of the skin B) Increase in humoral immunity C) Decrease in inflammatory cytokines D) Increase in peripheral circulation
A
Which of the following cell types are involved in humoral immunity? A) B lymphocytes B) Helper T lymphocyte C) Memory T lymphocyte D) Suppressor T lymphocyte
A
A nurse is explaining treatment options to a client diagnosed with an immune dysfunction. Which statement by the client accurately reflects the teaching about current stem cell research? A) "Currently, stem cell transplantation has only been performed in the laboratory, but future research with embryonic stem cell transplants for humans with immune dysfunction has been promising." B) "Stem cell transplantation has been carried out in humans with certain types of immune dysfunction, and clinical trials using stem cells are underway in clients with a variety of disorders with an autoimmune component." C) "Stem cell transplantation has been discontinued based on concerns about safety, efficacy, resource allocation, and human cloning." D) "Stem cell clinical trials have only been attempted in clients with acquired immune deficiencies, but plans are underway to begin human cloning using embryonic stem cells."
B
Which is an action of cytotoxic T cells? A) Decrease B-cell activity to a level at which the immune system is compatible with life B) Lyse cells infected with virus C) Produce circulating antibodies D) Directly attack foreign antigens
B
Which type of immunity becomes active as a result of infection by a specific microorganism? A) Artificially acquired passive immunity B) Naturally acquired active immunity C) Naturally acquired passive immunity D) Artificially acquired active immunity
B
What is the function of the thymus gland? A) Produce stem cells B) Programs B lymphocytes to become regulator or effector B cells. C) Develop the lymphatic system D) Programs T lymphocytes to become regulator or effector T cells.
D
Which immunity type becomes active as a result of infection by a specific microorganism? A) naturally acquired passive immunity B) artificially acquired passive immunity C) artificially acquired active immunity D) naturally acquired active immunity
D
Which statement accurately reflects current stem cell research? A) Clinical trials are underway only in clients with acquired immune deficiencies. B) Stem cell transplantation cannot restore immune system functioning. C) Stem cell transplantation has been performed in the laboratory only. D) The stem cell is known as a precursor cell that continually replenishes the body's entire supply of both red and white cells.
D
A client is admitted to the hospital with a diagnosis of pneumonia. The client informs the nurse of having several drug allergies. The physician has ordered an antibiotic as well as several other medications for cough and fever. What should the nurse do prior to administering the medications? A) Administer the medications that the physician ordered. B) Give the client one medicine at a time and observe for allergic reactions. C) Consult drug references to make sure the medicines do not contain substances which the client is hypersensitive. D) Call the pharmacy and let them know the client has several drug allergies.
C
The nurse is instructing clients about the importance of taking the shingles vaccine. Which client would benefit from this vaccine? A) A 24-year-old client who is pregnant B) A 17-year-old client who will be attending college and living in a dormitory C) A 32-year-old client who has never had chickenpox D) A 65-year-old client who had chicken pox when he was 12 years old
D
A nurse is taking health history from a new client, which includes asking about a history of blood transfusions. This is important for which reason? A) Exposure to foreign antigens may cause altered immune function. B) Blood products cause a high risk for exposure to HIV. C) Blood products cause a high risk for hepatitis B. D) Blood products cause lower antibody titers.
A
A patient has enlarged lymph nodes in his neck and a sore throat. This inflammatory response is an example of a cellular immune response whereby: A) Lymphocytes migrate to areas of the lymph node B) Antibodies reside in the plasma C) B-lymphocytes respond to a specific antigen D) Antibodies are released into the bloodstream
A
A client who is being treated for complications related to acquired immunodeficiency disorder syndrome (AIDS) is receiving interferon parenterally as adjunctive therapy. Why does the nurse understand this route is being used? A) The medication will work more rapidly parenterally. B) Digestive enzymes destroy its protein structure. C) The medication, given orally, will cause diarrhea. D) The taste of the medication is not palatable.
B
