Chapter 33

What type of cytokine will attract neutrophils and monocytes to remove debris? A) Lymphokines B) Cytotoxic T cells C) Suppressor T cells D) Regulator T cells

A) Lymphokines

A client has not responded to chemotherapy and radiation therapy. What option may be available for treatment for this client? A) If chemotherapy and radiation do not work, there is no other treatment. B) Aldesleukin C) Tumor necrosis factor inhibitors D) Colony-stimulating factor

B) Aldesleukin

When an attenuated toxin is administered to a client, the B lymphocytes create memory cells that recognize the antigen if it invades the body at a future time. What kind of immunity is this? A) Artificially acquired active immunity B) Passive immunity C) Natural immunity D) Naturally acquired active immunity

A) Artificially acquired active immunity

The nurse understands that which cells circulate throughout the body looking for virus-infected cells and cancer cells? A) Natural killer cells B) Cytokines C) Interleukins D) Interferons

A) Natural killer cells

You are caring for a client with a suspected immune system disorder. What test would be ordered if a deficiency or excess of immunoglobulins was suspected? A) Protein electrophoresis B) Enzyme-linked immunosorbent assay C) T-cell and B-cell assays D) Plasmapheresis

A) Protein electrophoresis

A parent of a child who has been having frequent bouts of tonsillitis brings the child back to the clinic for another sore throat. The parent asks the nurse, "What are tonsils good for anyway?" What is the best response by the nurse? A) "They really do not have a function and should be removed." B) "These tissues filter bacteria from tissue fluid." C) "The tissue acts as an emergency reservoir of blood." D) "The tissue removes blood and bacteria."

B) "These tissues filter bacteria from tissue fluid."

A client's immune system has the ability to protect itself from external invaders. What type of immune function is present when this occurs? A) Immunosuppression B) Immunocompetence C) An immune response D) Immune incompatibility

B) Immunocompetence

A client has had mumps when he was 9 years old. He had a titer prior to entering nursing school and shows immunity. What type of immunity does this reflect? A) Artificially acquired active immunity B) Naturally acquired active immunity C) Passive immunity D) Natural passive immunity

B) Naturally acquired active immunity

A client will be starting treatment with the tumor necrosis factor inhibitor, adalimumab (Humira). To begin a new job, the client must receive a tetanus shot because he hasn't received one in 10 years. What should the nurse advise the client? A) The tetanus shot may be taken at any time without regard to TNF inhibitor drug therapy. B) The client should receive the tetanus shot prior to beginning TNF inhibitor drug therapy. C) The client should receive the tetanus shot after beginning TNF inhibitor drug therapy to decrease the complications related to the tetanus. D) The client should get a note from the physician stating the tetanus shot is not able to be taken by the client.

B) The client should receive the tetanus shot prior to beginning TNF inhibitor drug therapy.

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 client will have a productive cough. B) The injection area swells if the client has developed antibodies against the antigen. C) The injection area will become painful with induration if the client has antibodies against the antigen. D) The injection area will break out in a fine macular rash.

B) The injection area swells if the client has developed antibodies against the antigen.

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) IgG B) IgA C) IgM D) IgE

D) IgE

A child is brought to the clinic with a rash. The child is diagnosed with measles. The mother tells the nurse that she had the measles when she was a little girl. What immunity to measles develops after the initial infection? A) Naturally acquired active immunity B) Artificially acquired active immunity C) Naturally acquired passive immunity D) Artificially acquired passive immunity

A) Naturally acquired active immunity

A client will be taking the tumor necrosis factor inhibitor, infliximab (Remicade), for the treatment of rheumatoid arthritis. Prior to beginning this therapeutic regimen, what screening should the client have? A) Screening for tuberculosis B) Screening for peptic ulcer disease C) Screening for syphilis D) Screening for rubella

A) Screening for tuberculosis

A 15-year-old client has been brought to the clinic by his mother and is suspected of having an immune system disorder. What tests would you expect to be ordered for this young client? A) Cerebral spinal fluids aspiration B) Sedimentary rate C) Complete blood count with differential D) Complete chemistry panel

C) Complete blood count with differential

A client with chronic renal failure has begun treatment with a colony-stimulating factor. What medication does the nurse anticipate administering to the client that will promote the production of blood cells? A) Etanercept (Enbrel) B) infliximab (Remicade) C) Epoetin alfa (Epogen) D) Adalimumab (Humira)

C) Epoetin alfa (Epogen)

A client will be receiving a hepatitis B vaccination series prior to employment in a dialysis center. What type of immunity will this provide? A) Forced immunity B) Naturally acquired active immunity C) Passive immunity D) Artificially acquired active immunity

D) Artificially acquired active immunity

A client has dilated cardiomyopathy and has just found out he will be receiving a heart. What medication does the client understand that he will have to take for the duration of his life to help suppress the immune system to prevent rejection of the new heart? A) Infliximab (Remicade) B) Etanercept (Enbrel) C) Adalimumab (Humira) D) Cyclosporine (Sandimmune)

D) Cyclosporine (Sandimmune)

The nurse is beginning the physical examination of a client with a complaint of fatigue. What documentation will the nurse provide to describe this general appraisal of the client's health? A) The client appears mildly ill, listless, and disheveled. B) The client has a blood pressure of 120/72 mm Hg. C) The client is alert and oriented to all spheres. D) The client has palpable peripheral pulses in the upper extremities.

A) The client appears mildly ill, listless, and disheveled.

A 64-year-old male client, who leads a sedentary lifestyle, and a 31-year-old female client, who has a very stressful and active lifestyle, require a vaccine against a particular viral disorder. As the nurse, you would know that in one of these clients, the vaccine will be less effective. In which client is the vaccine more likely to be less effective and why? A) The male client because of his age B) The male client because of his lifestyle C) The female client because of her age D) The female client because of her lifestyle

A) The male client because of his age

A client is cutting vegetable for dinner and accidentally cuts his finger. What response is desirable to destroy foreign agents such as microorganisms to prevent infection from developing in the finger? A) A cell-mediated response B) The release of antibodies C) The release of memory cells D) Passive immunity

B) The release of antibodies

Why would it be important for the nurse to question the client about sexual practices, history of substance abuse, and his lifestyle during the interview process? A) To find out if the client will be compliant with therapeutic treatments B) To determine if the client has practices that put him at risk for acquired immunodeficiency syndrome (AIDS) C) To determine if the client needs a referral to counseling services D) To determine what type of personality the client has

B) To determine if the client has practices that put him at risk for acquired

A client is informed that his white blood cell count is low and that he 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 plasma." B) "White blood cells are produced in the thymus gland." C) "White blood cells are produced in the lymphatic tissue." D) "White blood cells are produced in the bone marrow."

D) "White blood cells are produced in the bone marrow."

The nurse is instructing client's 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 65-year-old client who had chicken pox when he was 12 years old

The nurse is obtaining information from a client with Crohn's disease about his medication history. What medication would the nurse include when asking about what medications the client has taken for suppression of the inflammatory and immune response? A) Ibuprofen (Advil) B) Angiotensin-converting enzyme inhibitors (ACE-I) C) Diuretics D) Corticosteroids

D) Corticosteroids

A client asks the nurse about the importance of taking supplements to maximize immune function. The client is healthy and does not have any medical problems. What is the best information to give to the client? A) Instead of taking supplements, eat a lot of fruits and vegetables, and this will help maximize immune function B) Adopt a vegetarian diet and omit all meats, and you will maximize immune function. C) You should take a variety of vitamin and mineral supplements to maximize immune function. D) Eating a moderate diet that is balanced and varied will maximize immune function.

D) Eating a moderate diet that is balanced and varied will maximize immune function.

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) Activation of the complement system B) Stimulation of colony-stimulating factors C) A cell-mediated response D) Naturally acquired active immunity

C) A cell-mediated response

The anatomy and physiology instructor is explaining a cell-mediated response to the prenursing students. What actions would the instructor explain occur in a cell-mediated response? A) Toxins of invading antigens are neutralized. B) The invading antigens link together (agglutination). C) The invading antigens precipitate. D) T-cell lymphocytes survey proteins in the body and attack the invading antigens.

D) T-cell lymphocytes survey proteins in the body and attack the invading antigens.

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) Cytokines C) Lymphoid tissues D) Red blood cells

C) Lymphoid tissues

What is the function of the thymus gland? A) Produces stem cells B) Programs B lymphocytes to become regulator or effector B cells C) Develops the lymphatic system D) Programs T lymphocytes to become regulator or effector T cells

D) Programs T lymphocytes to become regulator or effector T cells

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) Naturally acquired active immunity B) Artificially acquired active immunity C) Passive immunity transferred by the mother D) There is no immunity passed down from mother to child.

C) Passive immunity transferred by the mother

You are caring for a client on tube feedings. The physician has ordered Osmolite HN as the feeding formula for the client. The family asks why the physician has ordered Osmolite HN instead of another formula to feed their family member. What is an important reason that tube-feeding formulas, such as Impact, Osmolite HN, or Perative, be recommended to clients? A) To suppress immune system function B) To block tumor necrosis factor C) To enhance the production of lymphocytes and NK cells D) To stimulate the immune system to attack tumor cells

C) To enhance the production of lymphocytes and NK cells

A client is treated in the clinic for a sexually transmitted infection, and the nurse suspects that the client is at risk for HIV. The physician determines that the client should be tested for the virus. What responsibility does the nurse have? A) The nurse ensures a written consent is obtained prior to testing. B) The nurse should send the client to have the blood drawn without informing him about the specific screening test. C) The nurse will call the client with the results of the test. D) The nurse will inform the client that the results will have to be reported to the Centers for Disease Control and Prevention (CDC).

A) The nurse ensures a written consent is obtained prior to testing.

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 taste of the medication is not palatable. B) The medication will work more rapidly parenterally. C) The medication, given orally, will cause diarrhea. D) Digestive enzymes destroy its protein structure.

D) Digestive enzymes destroy its protein structure.

You are the clinic nurse caring for a client with a suspected diagnosis of HIV. You are preparing to draw blood for a confirmatory diagnostic test on this client. What is the most important action that the nurse should perform before testing a client for HIV? A) Advise the client to avoid excess fluid intake. B) Advise the client to abstain from having intercourse. C) Advise the client to take off any ornaments and metallic objects. D) Obtain a written consent from the client.

D) Obtain a written consent from the client.

A client is admitted to the hospital with a diagnosis of pneumonia. The client informs the nurse that he has 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) Call the pharmacy and let them know the client has several drug allergies. C) Consult drug references to make sure the medicines do not contain substances which the client is hypersensitive. D) 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.