Chapter 11: Innate and Adaptive Immunity

A client has recently received a pneumococcal vaccine and the client's B cells are consequently producing antibodies. Which cells may enhance this production of antibodies?

Helper T cells

A client who was exposed to hepatitis A at a local restaurant has recovered from the disease. At the annual physical, the client asks whether to get the hepatitis A "shot." How will the nurse respond, based on the concepts of adaptive immunity?

· "No, because having an active case, you have already developed antibodies against hepatitis A."

A sixth-grade science teacher asks the students to explain the role of cilia in the lower respiratory tract. Which student response is best?

· "These little hairs move germs trapped in mucus toward the throat so the body can cough them out."

A client with infectious mononucleosis asks the nurse why the lymph nodes are enlarged. Which statement is the nurse's appropriate response?

· "Your lymph nodes trap and destroy viruses."

Which client is at the greatest risk for developing an intracellular pathogen infection?

· A client with AIDS who has a decreased CD4+ TH1 count

The nurse is administering a measles, mumps, and rubella (MMR) vaccination to a pediatric client. When the nurse explains immunity to the mother, which type of immunity will she explain that this vaccination provides?

· Active artificial immunity

The cells that mediate humoral immunity do so because they are capable of producing:

· Antibodies

Substances foreign to the host that can stimulate an immune response are known as:

· Antigens

The nurse is explaining the quality of pleiotropism that is possessed by many cytokines. The quality of pleiotropism implies that such cytokines:

· Are able to act on different types of cells.

Select the type of lymphocyte that matures in the bone marrow.

· B lymphocytes

What is the term for a subset of cytokines that stimulate the production of large numbers of platelets, erythrocytes, lymphocytes, neutrophils, and monocytes, eosinophils, basophils, and dendritic cells?

· Colony-stimulating factors (CSFs)

Once T helper cells are activated, they secrete which substance that activates and influences nearly all of the other cells of the immune system?

· Cytokines

A client's exposure to an antibiotic-resistant microorganism while in the hospital has initiated an immune response. Which process is responsible for the mediated and regulated actions that occur in this situation?

· Cytokines released at cell-to-cell interfaces bind to specific receptors on the cells that they target

A nurse who works in a long-term care facility has observed the high incidence of infectious illnesses among the older adults who reside there. What is the best explanation for a diminished immune capacity in older adults?

· Decreased numbers and responsiveness of T lymphocytes

A clinical research study is evaluating cells that bridge both the innate and adaptive immune systems. A nurse has identified the dendritic cells (DCs) as a key component. Which statement validates this finding?

· Dendritic cells (DCs) directly sense pathogens, capture foreign agents, and transport them to secondary lymphoid tissues. Once activated, they undergo a maturation process and function as antigen-presenting cells (APCs) capable of initiating adaptive immunity.

Which responses of the adaptive immune system provides protection against virus-infected cells?

· Distinct antigenic properties allow T cells to isolate specific organisms.

During a blood transfusion, a client begins to have chills, back pain, and develops a fever. The nurse determines the client is experiencing a transfusion reaction. The nurse educates the client about transfusion reactions. Which statement indicates the cause of the reaction?

· Each person has two HLA haplotypes that identify human cells. Blood typing involves the identification of these haplotypes (ABO compatibility). The closer the matching of HLA types, the greater is the probability of identical antigens and the lower the chance of rejection. A reaction occurs if the immune system views the HLA types as foreign.

Bacteria on a sliver in a boy's finger have initiated an adaptive immune response. Which would cause the boy's lymphocytes and antibodies to recognize immunologically active sites on bacterial surfaces?

· Epitopes

The laboratory finds IgA in a sample of cord blood from a newborn infant. This finding is important because it signifies what?

· Fetal reaction to exposure to an intrauterine infection

A lactation nurse visits a new mother after delivery of her first child and encourages the mother to breast-feed her infant, even for a short time. Which statement made by the nurse correctly explains the importance of breast-feeding?

· For several months, colostrum will provide the infant with passive immunity to diseases to which the mother has immunity.

A client is experiencing a decrease in the number of circulating neutrophils (neutropenia) during an active bacterial infection. The nurse examines the client's lab results looking for which cytokines that is responsible for promoting growth and maturation of neutrophils during inflammatory reactions?

· Granulocyte CSF (G-CSF)

A client receives an interleukin-2 (IL-2) infusion to treat cancer. Which response explains how this cytokine will affect the growth of cancer cells?

· IL-2 stimulates growth of cytotoxic T lymphocytes.

A client comes to the clinic with reports of runny nose, itchy eyes, and congestion due to seasonal allergies. The nurse teaches the client about the allergic reaction. The nurse knows that teaching has been effective when the client identifies which CD4 helper T-cell cytokine as the cause of this Type I hypersensitivity reaction?

· IL-4

The nurse is assisting a new mother with breastfeeding. What does the nurse understand is a primary secretory immunoglobulin (Ig) that is found in the colostrum?

· IgA

Which immunoglobulin is primarily found in secretions and has a primary function of providing local immunity on mucosal surfaces?

· IgA

A client experiences an allergic reaction. Select the immunoglobulin that would bind to mast cells and release histamine.

· IgE

The nurse is aware that the only class of immunoglobulins to cross the placenta is:

· IgG

Which immunoglobulin (Ig) is the most abundant of circulating antibodies?

· IgG

A nurse is evaluating lab results of a client newly diagnosed with bacterial pneumonia. Which immunoglobulin will elevate during the early stage of the infection?

· IgM

The nurse is reviewing the functions of immunoglobulins and determines which immunoglobulin is associated with its correct action?

· IgM, the first antibody to be produced by a developing fetus.

A client is brought to the emergency department after being bitten by a stray dog. To prevent rabies infection, the nurse anticipates administering:

· Immunoglobulins (IgG)

A nurse is teaching a group of seniors about the decline of the immune system due to aging. Which topic should be included in the teaching plan regarding the immune response of older adults? Select all that apply.

· Increase in susceptibility to infections · Higher incidence of cancer · Weakened response to vaccinations

Select the phases that make up the reaction of the complement system.

· Initial activation, amplification of inflammation, membrane attack response

A hospital client with a diagnosis of sepsis is in need of a specific response to microorganisms and a long-lasting immunity to the pathogens in question. Which component of the client's immune system is most able to meet these criteria? A hospital client with a diagnosis of sepsis is in need of a specific response to microorganisms and a long-lasting immunity to the pathogens in question. Which component of the client's immune system is most able to meet these criteria?

· Lymphocytes

Adaptive immune responses, also called acquired or specific immunity, are composed primarily of which type of cells?

· Lymphocytes

An obstetrics nurse is counseling an expectant mother. The mother is concerned about letting people hold her baby once the baby is born, fearing that the infant will get sick. What should the nurse explain to the mother?

· Maternal immunoglobulins cross the placenta and protect the newborn early in life.

A pregnant client gets immunized for influenza while in the second trimester. What response occurs in the newborn after birth with regard to protection from the flu?

· Maternal vaccination may offer fetal and neonatal passive immunity against the flu.

A client had been exposed to a particular antigen and now experiences a repeat exposure. What stimulates a quicker immune response?

· Memory T cells

Innate immunity, also called natural or native immunity, consists of mechanisms that respond specifically to which potential threat?

· Microbes

While caring for a pediatric client admitted with a viral infection, the nurse knows that which type of cell will be the child's primary defense against the virus?

· Natural killer (NK) cells

Which type of immunity is achieved by an infant from its mother through antibodies transferred in utero or in breast milk?

· Naturally acquired passive immunity

A blood smear is being examined and a stain has been added that will identify granulocytes. Which cell types will be visible with the stain? Select all that apply.

· Neutrophil · Eosinophil · Basophil

A teenager with an infected wound asks, "How does my body fight off the germs in my scraped arm?" Which response by the nurse correctly identifies the cells that play a central role to the innate immune response to an infectious microorganism?

· Neutrophils

The process by which microbes are coated to allow for more efficient recognition by phagocytes is known as:

· Opsonization

The entrance of a microbe into an individual's vascular space has initiated opsonization. Which statement explains this process?

· Opsonization coats a microbe to activate phagocytosis recognition.

Which statement correctly identifies the role of the C3b subcomponent of the complement system?

· Opsonizes microbes to facilitate phagocytosis

While explaining immunity to a client, the nurse responds, "The body's internal organs are protected from pathogens because:

· Our mucosal tissue contains all the necessary cell components to fight a pathogen with an immune response.

A woman experiences a viral infection while pregnant. Which type of immunity does an infant have at birth against this infection?

· Passive

A child has a congenital condition in which the thymus gland is absent. Which information should the nurse include as the priority when providing caregiver education?

· Practice strict infection control practices.

Which characteristic of macrophages allows for the process of phagocytosis of pathogens to be initiated by these cells?

· Presence of pattern recognition receptors (PRRs) on the macrophage cell surface

Which process that contributes to immunity takes place in a child's thymus gland?

· Production of mature, immunocompetent T lymphocytes

The nurse is planning care for a client with a diagnosis of primary immunodeficiency. What is the priority intervention to incorporate into the plan?

· Protecting the client from infection

A client is being evaluated for atopic dermatitis possibly caused by a latex-related allergic reaction. The nurse will review which lab results to determine if an allergy is present?

· Serum IgE

A student asks, "What does cell-mediated immunity mean to the client?" The instructor responds, "This means:

· The body is trying to defend itself against intracellular microbe invasion by engulfing and destroying the microbe.

A client experiencing severe neck pain and fever comes to the emergency room and is diagnosed with bacterial meningitis. Knowing that the client's immune system is fighting the infection, the infectious disease nurse correctly identifies which pathway as the activation of the complement system?

· The classical

A newborn has been lethargic and is not nursing well. Testing of cord blood done at birth reveals the presence of IgM. How should the nurse interpret this finding?

· The presence of IgM suggests the newborn has an infection.

In an attempt to best explain the innate immune system to a class of first-year nursing students, the instructor should describe what characteristic?

· The response of the innate immune system is rapid, usually within minutes to hours, and prevents the establishment of infection and deeper tissue penetration of microorganisms.

The nurse is explaining to a colleague the basis of a client's allergy to dust. What statement by the nurse most accurately describes antigens in this situation?

· They are substances foreign to the host that can stimulate an immune response.

Which is the main purpose of the complement system in the presence of invading microorganisms?

· To attack and destroy antigens

A client seeks treatment in the clinic for exposure to poison ivy with a rash over the right arm and hand. The nurse is aware that what toxin is found in the oils on poison ivy that is responsible for eliciting an allergic reaction?

· Urushiol

Select the statement that best describes the effectiveness of vaccination in the older adult population.

· Vaccination is less effective in inducing a full immune response in older persons compared to younger adults.