Chapter 35: Assessment of 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? Activation of the complement system Stimulation of colony-stimulating factors A cell-mediated response Naturally acquired active immunity

A cell-mediated response Explanation: A cell-mediated response occurs when T cells survey proteins in the body, actively analyze the surface features, and respond to those that differ from the host by directly attacking the invading antigen. An example of a cell-mediated response is one that occurs when an organ is transplanted. The complement system cooperates with antibodies to attract phagocytes and coat antigens to make them more recognizable for phagocytosis and stimulate inflammation and is not related to the surgery. Colony-stimulating factors prompt the bone marrow to produce, mature, and promote the functions of blood cells. Naturally acquired active immunity is a direct result of infection by a specific microorganism.

A client is given a dose of ketorolac, a nonsteroidal anti-inflammatory drug for complaints of abdominal pain. Ten minutes after receiving the medication, the client's eyes, lips, and face begin to swell, and the nurse hears stridor. What priority measure should the nurse prepare to do? Intubate the client. Perform an electrocardiogram (ECG). Assess the client's vital signs. Administer epinephrine.

Administer epinephrine. Explanation: Anaphylaxis is a rapid and profound type I hypersensitivity response. A massive release of histamine causes vasodilation; increased capillary permeability; angioneurotic edema (acute swelling of the face, neck, lips, larynx, hands, feet, genitals, and internal organs); hypotension; and bronchoconstriction. A nurse must administer 0.2 mg of epinephrine subcutaneously to a client experiencing a severe allergic reaction. It is outside of the nurse's practice to intubate a client. Performing an ECG and assessing the vital signs delays the treatment of the client and can have negative outcomes. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 35: Assessment of Immune Function, Medical Management, p. 1066.

Which of the following is accurate regarding acquired immunity? Select all that apply. An immunologic response acquired during life but not present at birth Usually develops as a result of exposure to an antigen through immunization Can develop by contracting a disease A nonspecific immunity present at birth Also know as innate immunity

An immunologic response acquired during life but not present at birth Usually develops as a result of exposure to an antigen through immunization Can develop by contracting a disease Acquired immunity is a immunologic responses acquired during life but not present at birth, and usually develops as a result of exposure to an antigen through immunization (vaccination) or by contracting a disease, both of which generate a protective immune response. Natural (innate) immunity is a nonspecific immunity present at birth that provides protection against an infectious agent without ever encountering it before. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 35: Assessment of Immune Function, Acquired Immunity, p. 1007.

While taking the health history of a newly admitted client, the nurse asks for a list of the client's current medications. Which of the following medication classifications would place the client at risk for impaired immune function? Antimetabolites Antihypertensives Inotropics Pancreatic enzymes

Antimetabolites Explanation: Antimetabolites can cause leukopenia, eosinoplilia, aplastic bone marrow, and pancytopenia. The other choices do not directly affect the immune system. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 35: Assessment of Immune Function, Table 35-5, p. 1019.

A client has breast cancer. The nurse is concerned about a compromised immune system in this client for which reason? Antineoplastic drug therapy Excess circulating lymphocytes Deficient circulating antibodies Excess circulating hemoglobin

Antineoplastic drug therapy Explanation: Clients who receive chemotherapy are immunosuppressed. Antineoplastic drugs cause a compromised immune system. Breast cancer is not associated with an excess of lymphocytes, a deficiency of circulating antibodies, or an excess of hemoglobin. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 35: Assessment of Immune Function, Table 35-5, p. 1019.

Which condition is associated with impaired immunity relating to the aging client? Increase in humoral immunity Breakdown and thinning of the skin Decrease in inflammatory cytokines Increase in peripheral circulation

Breakdown and thinning of the skin Explanation: The aging process stimulates changes in the immune system. Age-related changes in many body systems also contribute to impaired immunity. Changes such as poor circulation, as well as the breakdown of natural mechanical barriers such as the skin, place the aging immune system at even greater disadvantage against infection. As the immune system undergoes age-associated alterations, its response to infections progressively deteriorates. Humoral immunity declines and the number of inflammatory cytokines increase with age. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 35: Assessment of Immune Function, p. 1015.

Which immunoglobulin assumes a major role in bloodborne and tissue infections? IgA IgG IgM IgD

IgG Explanation: IgG assumes a major role in bloodborne and tissue infections. IgA protects against respiratory, gastrointestinal, and genitourinary infections. IgM appears as the first immunoglobulin produced in response to bacterial and viral infections. IgD possibly influences B-lymphocyte differentiation. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 35: Assessment of Immune Function, Chart 35-2, p. 1010.

Which medication classification is known to inhibit prostaglandin synthesis or release? Nonsteroidal anti-inflammatory drugs in large doses Antibiotics (in large doses) Adrenal corticosteroids Antineoplastic agents

Nonsteroidal anti-inflammatory drugs in large doses Explanation: Nonsteroidal anti-inflammatory drugs (NSAIDs), in large doses, inhibit prostaglandin synthesis or release. NSAIDs include aspirin and ibuprofen. Antibiotics in large doses are known to cause bone marrow suppression. Adrenal corticosteroids and antineoplastic agents are known to cause immunosuppression. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 35: Assessment of Immune Function, Table 35-5, p. 1019.

What organ is considered lymphoid tissue? Pancreas Intestines Spleen Liver

Spleen Explanation: Lymphoid tissues, such as the thymus gland, tonsils and adenoids, spleen, and lymph nodes, play a role in the immune response and prevention of infection. The pancreas, intestines, and liver are not lymphoid tissue. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 35: Assessment of Immune Function, Lymphoid Tissues, p. 1005.

T-cell and B-cell lymphocytes are the primary participants in the immune response. What do they do? T-cell and B-cell lymphocytes distinguish harmful substances and ignore those natural and unique to a person. T-cell and B-cell lymphocytes respond to the body's invasion by macrophages. T-cell and B-cell lymphocytes react to the body's lack of B12 . T-cell and B-cell lymphocytes distinguish harmful treatments from curative treatments.

T-cell and B-cell lymphocytes distinguish harmful substances and ignore those natural and unique to a person. Explanation: T-cell and B-cell lymphocytes are the primary participants in the immune response. They distinguish harmful substances and ignore those natural and unique to a person. Options B, C, and D are incorrect. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 35: Assessment of Immune Function, White Blood Cell Action, p. 1006.

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? The client's immune system cannot mount a response to the skin test. The client has only mild TB, which is not enough to cause a reaction. The solution used for the skin test was probably outdated. The skin test was improperly performed.

The client's immune system cannot mount a response to the skin test. Explanation: The inflammatory response is a major function of the immune system that is elicited in response to invading foreign material. A person with AIDS has a poorly functioning or non-functioning immune system that will not respond to the injected skin test. Any TB organisms should cause a reaction to the skin test in people with intact immune systems. The nurse cannot accurately speculate on how the skin test was performed or that the solution was outdated. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 35: Assessment of Immune Function, Inflammatory Response, p. 1007.

The immune system is a complicated and intricate system that contains specialized cells and tissues that protect us from external invaders and our own altered cells. Which term is used to define any substances capable of inducing a specific immune response and of reacting with the products of that response? antigens antibodies lymphokines lymphocytes

antigens Explanation: Antigens, which are protein markers on cells, are substances capable of inducing a specific immune response and of reacting with the products of that response. Reference: Hinkle, J.L., and Cheever, K.H. Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed. Philadelphia: Lippincott Williams & Wilkins, 2018, Chapter 35: Assessment of Immune Function, p. 1004.

Chronic illnesses may contribute to immune system impairment in various ways. Renal failure is associated with deficiency in circulating lymphocytes. increased incidence of infection. decreased bone marrow function. altered production of white blood cells.

deficiency in circulating lymphocytes. Explanation: Renal failure is associated with a deficiency in circulating lymphocytes. Diabetes mellitus is associated with increased incidence of infection. Chemotherapy causes decreased bone marrow function. Leukemia is associated with altered production of white blood cells. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 35: Assessment of Immune Function, p. 1018.

The nurse is reviewing the client's medications. What antihistamines are contraindicated for a client with narrow-angle glaucoma? Select all that apply. fexofenadine diphenhydramine loratadine cetirizine brompheniramine

diphenhydramine loratadine cetirizine brompheniramine Diphenhydramine, loratadine, brompheniramine, and cetirizine are antihistamines contraindicated with clients with narrow-angle glaucoma. The antihistamines have the potential to induce angle closure. Fexofenadine should be used cautiously in patients with hepatic or renal impairment. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 35: Assessment of Immune Function, p. 1127. Chapter 35: Assessment of Immune Function - Page 1127

Decades ago, before the role of the tonsils and adenoids was better understood, it was typical after repeated bouts with tonsillitis to have a tonsillectomy and adenoidectomy. Today it is understood that the tonsils and adenoids are lymphoid tissues that: filter bacteria from tissue fluid. increase the efficacy of antibiotics. eliminate cancer cells. program T lymphocytes.

filter bacteria from tissue fluid. Explanation: The tonsils and adenoids filter bacteria from tissue fluid. Because they are exposed to pathogens in the oral and nasal passages, they can become infected and locally inflamed.

What types of cells are the primary targets of the healthy immune system? Select all that apply. infectious cells foreign cells cancerous cells typical cells

infectious cells foreign cells cancerous cells The immune system's primary targets are infectious, foreign, or cancerous cells. Reference: Hinkle, J.L., and Cheever, K.H. Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed. Philadelphia: Lippincott Williams & Wilkins, 2018, Chapter 35: Assessment of Immune Function, p. 1005.

When obtaining a health history from a patient with possible abnormal immune function, what question would be a priority for the nurse to ask? "Have you ever been treated for a sexually transmitted infection?" "When was your last menstrual period?" "Do you have abdominal pain or discomfort?" "Have you ever received a blood transfusion?"

"Have you ever received a blood transfusion?" Explanation: A history of blood transfusions is obtained, because previous exposure to foreign antigens through transfusion may be associated with abnormal immune function. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 35: Assessment of Immune Function, Medications and Blood Transfusions, p. 1018.

A client with an autoimmune disorder asks, "Why is autoimmune disease more prevalent in the women in my family?" Which response will the nurse make to this client? "There is not enough evidence to prove this." "It's because you take better care of your family than yourself." "Women have more stress than men and it weakens immunity." "It's believed to be caused by the differences in the sex hormones."

"It's believed to be caused by the differences in the sex hormones." Explanation: There are differences in the immune system functions of men and women. Research has revealed that sex hormones are integral signaling modulators of the immune system and the presence of autoimmune disease. Sex hormones play definitive roles in lymphocyte maturation, activation, and synthesis of antibodies and cytokines. Even though some autoimmune diseases are genetically linked, overall men do not have stronger genes than women. There is no evidence that the client relinquishes self-care for family care. Even though stress influences immunity, there is no evidence that women have more stress than men.

A patient tells the nurse, "I can't believe I have ineffective immune function and am getting sick again. I exercise rigorously and compete regularly." What is the best response by the nurse? "Something must be seriously wrong. You should not be getting sick since you are so healthy." "Maybe you need to stop exercising so much. It can't be good for you." "It is possible that you are immunocompromised and may have HIV." "Rigorous exercise can cause negative effects on immune response."

"Rigorous exercise can cause negative effects on immune response." Explanation: Although factors that are not consistent with a healthy lifestyle are predominately responsible for ineffective immune function, positive lifestyle factors can also negatively affect immune function and require assessment. For example, rigorous exercise or competitive exercise— usually considered a positive lifestyle factor—can be a physiologic stressor and cause negative effects on immune response (Walsh, Gleeson, Shephard, et al., 2011). Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 35: Assessment of Immune Function, Lifestyle Factors, p. 1018.

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? "They really do not have a function and should be removed." "These tissues filter bacteria from tissue fluid." "The tissue acts as an emergency reservoir of blood." "The tissue removes blood and bacteria."

"These tissues filter bacteria from tissue fluid." Explanation: Tonsils and adenoids filter bacteria from tissue fluid. Because they are exposed to pathogens in the oral cavity, they can become infected and locally inflamed. The spleen acts as an emergency reservoir of blood and removes blood and bacteria, not the tonsils. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 35: Assessment of Immune Function, Pharynx, Tonsils, and Adenoids, p. 481.

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? "White blood cells are produced in the plasma." "White blood cells are produced in the thymus gland." "White blood cells are produced in the lymphatic tissue." "White blood cells are produced in the bone marrow."

"White blood cells are produced in the bone marrow." Explanation: White blood cells (leukocytes) are produced in the bone marrow. They are not produced in the plasma, thymus gland, or the lymphatic tissue. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 35: Assessment of Immune Function, Bone Marrow, p. 1005.

A client with pneumonia is diagnosed with agranulocytosis. To which medications will the nurse suspect the client is experiencing an adverse effect? Select all that apply. Digoxin Warfarin Aspirin Propylthiouracil Gentamicin sulfate

Aspirin Propylthiouracil Gentamicin sulfate Correct response: Incorrect response: Your selection: Explanation: In large doses, antibiotics, corticosteroids, cytotoxic agents, salicylates, nonsteroidal anti-inflammatory drugs (NSAIDS), and anesthetic agents can cause immune suppression. Aspirin is an NSAID that has agranulocytosis as an adverse effect. Propylthiouracil is an antithyroid medication that causes agranulocytosis. Gentamicin sulfate is an antibiotic and has agranulocytosis as an adverse effect. Digoxin and warfarin are not identified as having immunosuppression or agranulocytosis as adverse effects.

Which of the following is a medical condition that is an example of a humoral immune response? Parasitic infection Asthma Fungal infection Transplant rejection

Asthma Explanation: Refer to Box 36-2 in the text. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 35: Assessment of Immune Function, Chart 35-1, p. 1009.

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? Accompany the client to the diagnostic tests Educate the client about the diagnostic procedures and answer their questions about the possible diagnosis Encourage the client to ask the physician for information about treatment options for the possible diagnosis Assist the client with scheduling the procedures

Educate the client about the diagnostic procedures and answer their questions about the possible diagnosis Explanation: It is the nurse's role to counsel, educate, and support clients throughout the diagnostic process. Many clients may be extremely anxious about the results of diagnostic tests and the possible implications of those results for their employment, insurance, and personal relationships. This is an ideal time for the nurse to provide counseling and education. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 35: Assessment of Immune Function, p. 1019.

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? Etanercept (Enbrel) infliximab (Remicade) Epoetin alfa (Epogen) Adalimumab (Humira)

Epoetin alfa (Epogen) Explanation: Colony-stimulating factors are cytokines that prompt the bone marrow to produce, mature, and promote the functions of blood cells. CSFs enable stem cells in bone marrow to differentiate into specific types of cells such as leukocytes, erythrocytes, and platelets. Pharmacologic preparation of CSFs, such as epoetin alfa (Epogen), is used to promote the natural production of blood cells in people whose own hematopoietic functions have become compromised. The other medications in A, B, and D are tumor necrosis factor inhibitors. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 35: Assessment of Immune Function, Colony-Stimulating Factors, p. 1013.

The nurse is caring for a female patient who has an exacerbation of lupus erythematosus. What does the nurse understand is the reason that females tend to develop autoimmune disorders more frequently than men? Androgen tends to enhance immunity. Estrogen tends to enhance immunity. Testosterone tends to enhance immunity. Leukocytes are increased in females.

Estrogen tends to enhance immunity. Explanation: Autoimmune disorders tend to be more common in women because estrogen tends to enhance immunity. Androgen, on the other hand, tends to be immunosuppressive. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 35: Assessment of Immune Function, Autoimmune Disorders, p. 1017.

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? Exposure to foreign antigens may cause altered immune function. Blood products cause a high risk for exposure to HIV. Blood products cause a high risk for hepatitis B. Blood products cause lower antibody titers.

Exposure to foreign antigens may cause altered immune function. Explanation: A history of blood transfusions is obtained because previous exposure to foreign antigens through transfusion may be associated with abnormal immune function. There is only a small risk for HIV transmission from transfusions received after 1985. The risk for exposure to hepatitis B from blood transfusions is extremely small. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 35: Assessment of Immune Function, Medications and Blood Transfusions, p. 1018.

A 38-year-old client has been diagnosed with rheumatoid arthritis, an autoimmune disease. During the health history assessment. the nurse learns that the client works as an aide at a facility that cares for children infected with AIDS, does moderate cardiovascular exercises every other day, takes no medication, has no allergies, and eats mainly a vegetarian diet with fish and chicken one to two times each week. Which factor is the most important consideration in determining the status of the client's immune system? Age Diet Gender Environment

Gender Explanation: The immune system functions of men and women differ. For example, many autoimmune diseases have a higher incidence in females than in males, a phenomenon believed to be correlated with sex hormones. Autoimmune diseases tend to be more common in women because estrogen tends to enhance immunity. Androgen, on the other hand, tends to be immunosuppressive. Autoimmune diseases are a leading cause of death by disease in females of reproductive age. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 35: Assessment of Immune Function, p. 1014.

At 39 weeks' gestation, a pregnant client visits the physician for a scheduled prenatal checkup. The physician determines that the fetus has developed an infection in utero and sends the client for an emergency cesarean delivery. The client is very concerned about the health of her unborn child. Based on knowledge of the immune system, the delivery room nurse explains about which immunoglobulin that will be increased in the fetus at the time of birth and will be actively fighting the infection? IgG IgA IgM IgD

IgG Explanation: IgG composes 75% of total immunoglobulin. It appears in serum and tissues, assumes a major role in bloodborne and tissue infections, and crosses the placenta. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 35: Assessment of Immune Function, Chart 35-2, p. 1010.

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? Polypharmacy Immunosenescence Reduced vitamin intake Decline in self-care activities

Immunosenescence Explanation: Immunosenescence is the term for age-related changes in the immune system. These changes have been linked to the increased rates of illness and mortality in older adults, and an increased incidence of infections. There is no evidence that polypharmacy has caused an increase in infections in the older adult. The development of infections is not directly linked to vitamin intake or self-care activities.

A nurse is developing a teaching plan for a community presentation on smoking cessation. Based on current research regarding the effects of cigarette smoking on the immune system, which alterations in immune function can be attributed to smoking and should be included in the teaching presentation? Select all that apply. Increased white blood cell count Decreased T-cell function Decreased IgE antibody production Decreased natural killer cells Increased risk of infection

Increased white blood cell count Decreased T-cell function Decreased natural killer cells Increased risk of infection Smoking causes an increased white blood cell count (indicating inflammation), an elevated T-cell count (with decreased function), decreased antibody production (IgG, IgA, IgM), increased IgE (allergic response), and fewer natural killer cells (increased risk for infection) in the immune system.

A nurse is taking the health history of a newly admitted client and asks for a list of the client's current medications. Which medication classification would NOT place the client at risk for impaired immune function? Antimetabolites Antineoplastic agents Inotropics Adrenal corticosteroids

Inotropics Explanation: Antimetabolites, antineoplastic agents, and adrenal corticosteroids all can cause immunosuppression. Inotropics do not directly affect the immune system.

Which of the following is a center for immune cell proliferation? Lymph node Spleen Pancreas Liver

Lymph node Explanation: The lymph nodes remove foreign material from the lymph system before it enters the bloodstream. They are centers for immune cell proliferation. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 35: Assessment of Immune Function, Lymphoid Tissues, p. 1006.

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? Naturally acquired active immunity Artificially acquired active immunity Naturally acquired passive immunity Artificially acquired passive immunity

Naturally acquired active immunity Explanation: Immunity to measles that develops after the initial infection is an example of naturally acquired active immunity. Artificially acquired active immunity results from the administration of a killed or weakened microorganism or toxoid (attenuated toxin), whereas passive immunity develops when ready-made antibodies are given to a susceptible client. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 35: Assessment of Immune Function, Acquired Immunity, p. 1007.

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

The client appears mildly ill, listless, and disheveled. Explanation: The beginning of the physical examination is a general appraisal of the client's health. The nurse notes whether the client appears healthy, acutely or mildly ill, malnourished, extremely tired, or listless. The next thing the nurse will do is obtain vital signs and then performs a more comprehensive examination. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 35: Assessment of Immune Function, Assessment of the Immune System, p. 1014.

A 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. What is the most important factor related to the client's assessment? The client's use of other drugs The client's age The client's diet The client's home environment

The client's use of other drugs Explanation: The nurse needs to review the client's drug history. This data will help to assess the client's susceptibility to illness because certain past illnesses and drugs, such as corticosteroids, suppress the inflammatory and immune responses. The client's age, home environment, and diet do not have any major implications during assessment because they do not indicate susceptibility to illness. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 35: Assessment of Immune Function, Assessment of the Immune System, p. 1014.

The body has several mechanisms to fight disease, one of which is sending chemical messengers. The messengers released by lymphocytes, monocytes, and macrophages have differing roles in the immune response. Which messenger enables cells to resist viral replication and slow viral replication? interferons interleukins tumor necrosis factor colony-stimulating factor

interferons Explanation: Interferons are chemicals that primarily protect cells from viral invasion. They enable cells to resist viral infection and slow viral replication. They have been used as adjunctive therapy in the treatment of AIDS. Interferons also have been used to treat some forms of cancer such as leukemia because they stimulate NK cell activity. Interferon is administered parenterally because digestive enzymes destroy its protein structure. Reference: Hinkle, J.L., and Cheever, K.H. Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed. Philadelphia: Lippincott Williams & Wilkins, 2018, Chapter 35: Assessment of Immune Function, p. 1013.

This type of T lymphocyte is responsible for altering the cell membrane and initiating cellular lysis. Choose the T lymphocyte. Helper T cell Suppressor T cell Cytotoxic T cell Memory T cell

Cytotoxic T cell Explanation: The cytotoxic T cells (also known as killer T cells) attack the antigen directly and release cytotoxic enzymes and cytokines. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 35: Assessment of Immune Function, Types of T Lymphocytes, p. 1011.

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? Eosinophils Macrophages Basophils Neutrophils

Macrophages Explanation: Macrophages move toward the antigen and destroy it. Eosinophils are only slightly phagocytic. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 35: Assessment of Immune Function, Natural Immunity, p. 1006.

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? Through the mucous membranes of the throat Through the skin Breathing in airborne dust From being outside in the cold weather and decreasing resistance

Through the mucous membranes of the throat Explanation: In a streptococcal throat infection, the streptococcal organism gains access to the mucous membranes of the throat. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 35: Assessment of Immune Function, Recognition Stage, p. 1008.

The spleen acts as a filter for old red blood cells, holding a reserve of blood in case of hemorrhagic shock. It is also an area where lymphocytes can concentrate. It can become enlarged (splenomegaly) in certain hematologic disorders and cancers. To assess an enlarged spleen, the nurse would palpate the area of the: Upper mediastinum. Lower right abdomen. Upper left quadrant of the abdomen. Lower margin around the liver.

Upper left quadrant of the abdomen. Explanation: The spleen is located to the left of the stomach, in the upper left of the abdomen. It plays an important role in the immune system. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 35: Assessment of Immune Function, Lymphoid Tissues, p. 1005.

A client has undergone a kidney transplant. The nurse is concerned about a compromised immune system in this client for which reason? Use of anti-rejection drugs Excess circulating lymphocytes Deficient circulating antibodies Excess circulating hemoglobin

Use of anti-rejection drugs Explanation: Clients who receive a kidney transplant must take immunosuppressant drugs to prevent rejection of the transplant. These drugs cause a compromised immune system. Renal transplant is not associated with excess lymphocytes, deficient circulating antibodies, or excess hemoglobin. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 35: Assessment of Immune Function, Medications and Blood Transfusions, p. 1018.

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? Age Diet Use of other drugs Home environment

Use of other drugs Explanation: The nurse needs to review the client's drug history. These data will help her to assess the client's susceptibility to illness because certain past illnesses and drug use, such as corticosteroids, suppress the inflammatory and immune responses. The client's age, home environment, and diet do not have any major implications during assessment because they do not indicate the client's susceptibility to illness. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 35: Assessment of Immune Function, p. 1018.

The nurse is reviewing the client's medications. What antihistamines are contraindicated for a client with narrow-angle glaucoma? Select all that apply. fexofenadine diphenhydramine loratadine cetirizine brompheniramine

diphenhydramine loratadine cetirizine brompheniramine Diphenhydramine, loratadine, brompheniramine, and cetirizine are antihistamines contraindicated with clients with narrow-angle glaucoma. The antihistamines have the potential to induce angle closure. Fexofenadine should be used cautiously in patients with hepatic or renal impairment. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 35: Assessment of Immune Function, p. 1127.

While taking the health history of a newly admitted client, the nurse reviews general lifestyle behaviors. What strategies would have a positive effect on the immune system? Humor, rigorous physical stress, and biofeedback Biofeedback, relaxation, and hypnosis Relaxation, intense competitive exercise, and humor Hypnosis, humor, and chronic illness

Biofeedback, relaxation, and hypnosis Explanation: Growing evidence indicates that strategies such as relaxation, imagery techniques, biofeedback, humor, hypnosis, and conditioning can positively influence a measurable immune system response. Intense or rigorous competitive exercise can cause negative effects on the immune system, especially if the environment is stressful while undergoing exercise. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 35: Assessment of Immune Function, Psychoneuroimmunologic Factors, p. 1018.

An experiment is designed to determine specific cell types involved in cell-mediated immune response. The experimenter is interested in finding cells that attack the antigen directly by altering the cell membrane and causing cell lysis. Which cells should be isolated? Macrophages Helper T cells B cells Cytotoxic T cells

Cytotoxic T cells Explanation: Cytotoxic T cells (killer T cells) attack the antigen directly by altering the cell membrane and causing cell lysis (disintegration) and by releasing cytolytic enzymes and cytokines. Lymphokines can recruit, activate, and regulate other lymphocytes and white blood cells. These cells then assist in destroying the invading organism.

A 34-year-old client is diagnosed with chronic hepatitis C. Testing reveals that the client is a candidate for treatment. The nurse anticipates that which therapy could be used to treat the client's condition? Erythropoietin Interleukin-5 Monoclonal antibodies Interferon

Interferon Explanation: Interferons are used to treat immune-related disorders (e.g., multiple sclerosis) and chronic inflammatory conditions (e.g., chronic hepatitis). Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 35: Assessment of Immune Function, p. 1013.

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

Natural killer cells Explanation: Natural killer cells are lymphocyte-like cells that circulate throughout the body looking for virus-infected cells and cancer cells. Cytokines are chemical messengers released by lymphocytes, monocytes, and macrophages. Interleukins carry messages between leukocytes and tissues that form blood cells. Interferons are chemicals that primarily protect cells from viral infections. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 35: Assessment of Immune Function, Natural Immunity, p. 1006.

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? Artificially acquired active immunity Naturally acquired active immunity Passive immunity Natural passive immunity

Naturally acquired active immunity Explanation: Naturally acquired active immunity occurs as a direct result of infection by a specific microorganism. An example is the immunity to measles that develops after the initial infection. Not all invading microorganisms produce a response that gives lifelong immunity. Artificially acquired immunity is obtained by receiving a killed or weakened microorganism or toxoid. Passive immunity is acquired when ready-made antibodies are given to a susceptible person. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 35: Assessment of Immune Function, Natural Immunity, p. 1006.

Which medication classification is known to inhibit prostaglandin synthesis or release? Nonsteroidal anti-inflammatory drugs (in large doses) Antibiotics (in large doses) Adrenal corticosteroids Antineoplastic agents

Nonsteroidal anti-inflammatory drugs (in large doses) Explanation: Nonsteroidal anti-inflammatory drugs include aspirin and ibuprofen. Antibiotics in large doses are known to cause bone marrow suppression. Adrenal corticosteroids and antineoplastic agents are known to cause immunosuppression. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 35: Assessment of Immune Function, Table 35-5, p. 1019.

A nurse is caring for a client with multiple sclerosis. Client education about the disease process includes which explanation about the cause of the disorder? The immune system recognizes one's own tissues as "foreign." The immune system recognizes one's own tissues as "self." Regulatory mechanisms fail to halt the immune response. Excess cytokines cause tissue damage.

The immune system recognizes one's own tissues as "foreign." Explanation: The immune system's recognition of one's own tissues as "foreign" rather than self is the basis of many autoimmune disorders, including multiple sclerosis. When regulatory mechanisms fail to halt the immune response or excess cytokines are produced, pathology occurs (e.g., allergies, hypersensitivity). Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 35: Assessment of Immune Function, Immune Regulation, p. 1007.

The body has several mechanisms to fight disease, one of which is sending chemical messengers. The messengers released by lymphocytes, monocytes, and macrophages have differing roles in the immune response. Which messenger promotes inflammation, fever, and angiogenesis? interleukins interferons tumor necrosis factor colony-stimulating factors

interleukins Explanation: Interleukins carry messages between leukocytes and tissues that form blood cells. Some interleukins enhance the immune response, whereas others suppress it (Martini & Bartholomew, 2016). Examples of interleukin activity include promotion of inflammation and fever, production of antibodies, and formation of new blood vessels (known as angiogenesis). Reference: Hinkle, J.L., and Cheever, K.H. Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed. Philadelphia: Lippincott Williams & Wilkins, 2018, Chapter 35: Assessment of Immune Function, p. 1011.

Which immunity type becomes active as a result of infection by a specific microorganism? naturally acquired active immunity artificially acquired active immunity naturally acquired passive immunity artificially acquired passive immunity

naturally acquired active immunity Explanation: Naturally acquired active immunity occurs as a direct result of an infection by a specific microorganism.

A nursing instructor is giving a lecture on the immune system. The instructor's discussion on phagocytosis will include: neutrophils and monocytes. plasma cells and memory cells. regulator T cells and helper T cells. lymphokines and suppressor T cells.

neutrophils and monocytes. Explanation: Neutrophils and monocytes are phagocytes, cells that perform phagocytosis. Reference: Hinkle, J.L., and Cheever, K.H. Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed. Philadelphia: Lippincott Williams & Wilkins, 2018, Chapter 35: Assessment of Immune Function, p. 1014.

A client comes into the emergency department reporting difficulty walking and loss of muscle control in the arms. Once the nurse begins the physical examination, which assessment should be completed if an immune dysfunction in the neurosensory system is suspected? Assess for ataxia using the finger-to-nose test and heel-to-shin test Assess joint mobility using passive range of motion. Review the urinalysis report for hematuria Assess for hepatosplenomegaly by measuring abdominal girth

Assess for ataxia using the finger-to-nose test and heel-to-shin test Explanation: Ataxia should be assessed when suspecting immune dysfunction in the neurosensory system. Joint movement, a urinalysis results positive for hematuria , and measuring abdominal girth are not used to assess for issues with the neurosensory system in relation to immune dysfunction.

Which assessment should be completed if immune dysfunction is suspected in the neurosensory system? Ataxia Hematuria Urinary frequency Burning upon urination

Ataxia Explanation: Ataxia should be assessed when immune dysfunction in the neurosensory system is suspected. Hematuria, discharge, and frequency of and burning upon urination are associated with the genitourinary system. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 35: Assessment of Immune Function, Chart 35-3, p. 1014.

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

Digestive enzymes destroy its protein structure. Explanation: Interferon is administered parenterally because digestive enzymes destroy its protein structure. The medicine does not have an oral preparation. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 35: Assessment of Immune Function, Interferons, p. 1013.

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? Neutrophil Basophil Monocyte Lymphocyte

Lymphocyte Explanation: The lymphocyte provides humoral immunity — recognition of a foreign antigen and formation of memory cells against the antigen. Humoral immunity is mediated by B and T lymphocytes and can be acquired actively or passively. The neutrophil is crucial to phagocytosis. The basophil plays an important role in the release of inflammatory mediators. The monocyte functions in phagocytosis and monokine production. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 35: Assessment of Immune Function, Humoral Immune Response, p. 1008.

A 25-year-old client receives a knife wound to the leg in a hunting accident. Which type of immunity was compromised? Specific immunity Passive immunity Adaptive immunity Natural immunity

Natural immunity Explanation: Natural immunity, which is nonspecific, provides a broad spectrum of defense against and resistance to infection. It is considered the first line of host defense following antigen exposure, because it protects the host without remembering prior contact with an infectious agent. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 35: Assessment of Immune Function, p. 1006.

Which type of cells destroys antigens already coated with antibody? Null Natural killer (NK) Memory T-cell Suppressor T-cell

Null Explanation: Null cells destroy antigens already coated with antibody. NK cells defend against microorganisms and some types of malignant cells. Memory T cells remember contact with an antigen and, on subsequent exposures, mount an immune response. Suppressor T-cells suppress the immune response. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 35: Assessment of Immune Function, Null Lymphocytes and Natural Killer Cells, p. 1012.

A nurse encourages a client with an immunologic disorder to eat a nutritionally balanced diet to promote optimal immunologic function. Which snacks have the greatest probability of stimulating autoimmunity? Raisins and carrot sticks Potato chips and chocolate milk shakes Fruit salad and mineral water Applesauce and saltine crackers

Potato chips and chocolate milk shakes Explanation: A diet containing excessive fat, such as that found in potato chips and milk shakes, seems to contribute to autoimmunity — overreaction of the body against constituents of its own tissues. Raisins, carrot sticks, fruit, mineral water, applesauce, and saltine crackers are snacks containing adequate amounts of vitamin A, zinc, and carotene, which are beneficial for the body. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 35: Assessment of Immune Function, Nutrition, p. 1015.

Which condition is associated with impaired immunity relating to the aging client? Antibody production increases Renal function decreases Skin becomes thicker Incidence of autoimmune disease decreases

Renal function decreases Explanation: Decreased renal circulation, filtration, absorption, and excretion contribute to the risk for urinary tract infections. Antibody production decreases, the skin becomes thinner, and the incidence of autoimmune disease increases with age. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 35: Assessment of Immune Function, Table 35-4, p. 1015.

A client has had a splenectomy after sustaining serious internal injuries in a motorcycle accident, including a ruptured spleen. Following removal of the spleen, the client will be susceptible to: infection because the spleen removes bacteria from the blood. bleeding because the spleen synthesizes vitamin K. acidosis because the spleen maintains acid-base balance. anemia because the spleen produces red blood cells.

infection because the spleen removes bacteria from the blood. Explanation: One function of the spleen is to remove bacteria from circulation; therefore, the client will be more susceptible to infection. Reference: Hinkle, J.L., and Cheever, K.H. Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed. Philadelphia: Lippincott Williams & Wilkins, 2018, Chapter 35: Assessment of Immune Function, p. 1005.

Which of the following cell types are involved in humoral immunity? B lymphocytes Helper T lymphocyte Suppressor T lymphocyte Memory T lymphocyte

B lymphocytes Explanation: B lymphocytes are involved in the humoral immune response. T lymphocytes are involved in cellular immunity. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 35: Assessment of Immune Function, Response to Invasion, p. 1007.

A nurse is monitoring a client who developed facial edema after receiving a medication. Which white blood cells stimulated the edema? Basophils Eosinophils Monocytes Neutrophils

Basophils Explanation: The client's edema is related to an allergic reaction to the medication. Basophils are responsible for releasing histamine during an allergic reaction. Eosinophils' major function is phagocytosis of antigen-antibody complexes that are formed in allergic reactions. Monocytes and neutrophils are predominately phagocytic. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 35: Assessment of Immune Function, White Blood Cell Action, p. 1006.

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? The nurse ensures a written consent is obtained prior to testing. The nurse should send the client to have the blood drawn without informing him about the specific screening test. The nurse will call the client with the results of the test. The nurse will inform the client that the results will have to be reported to the Centers for Disease Control and Prevention (CDC).

The nurse ensures a written consent is obtained prior to testing. Explanation: The nurse ensures that a written consent is obtained before testing for human immunodeficiency virus (HIV) and keeps the results of HIV testing confidential. The client should never be tested without his knowledge. The physician will review the results when the client comes in for a follow-up visit. It is not necessary for the nurse to report results to the CDC.

A client with lupus erythematosus wants to know why autoimmune disorders are much more common in women. What is the best response by the nurse? "Estrogen tends to enhance immunity." "Androgen tends to enhance immunity." "Estrogen tends to be immunosuppressive." "Androgen tends to be immunosuppressive."

"Estrogen tends to enhance immunity." Explanation: Autoimmune disorders are more common in women because estrogen tends to enhance immunity. Autoimmune disorders reflect an over-functioning immune system. Androgen tends to be immunosuppressive, which would not lead to an autoimmune disorder. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 35: Assessment of Immune Function, Autoimmune Disorders, p. 1017.

A client presents at the clinic with an allergic disorder. The client asks the nurse what an "allergic disorder" means. What would be the nurse's best response? "It means you are very sensitive to something inside of yourself." "It is a hyperimmune response to something in the environment that is usually harmless." "It is a muted response to something in the environment." "It is a harmless reaction to something in the environment."

"It is a hyperimmune response to something in the environment that is usually harmless." Explanation: An allergic disorder is characterized by a hyperimmune response to weak antigens that usually are harmless. The antigens that can cause an allergic response are called allergens. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 35: Assessment of Immune Function, Allergic Disorders, p. 1064.

The nursing instructor is discussing the development of human immunodeficiency disease (HIV) with the students. What should the instructor inform the class about helper T cells? They are activated on recognition of antigens and stimulate the rest of the immune system. They attack the antigen directly by altering the cell membrane and causing cell lysis. They have the ability to decrease B-cell production. They are responsible for recognizing antigens from previous exposure and mounting an immune response.

They are activated on recognition of antigens and stimulate the rest of the immune system. Explanation: Helper T cells are activated on recognition of antigens and stimulate the rest of the immune system. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 35: Assessment of Immune Function, Types of T Lymphocytes, p. 1011.

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: Antibodies reside in the plasma Antibodies are released into the bloodstream B-lymphocytes respond to a specific antigen Lymphocytes migrate to areas of the lymph node

Lymphocytes migrate to areas of the lymph node Explanation: Recognition of antigens as foreign, or non-self, by the immune system is the initiating event in any immune response. Recognition involves the use of lymph nodes and lymphocytes for surveillance. Lymph nodes are widely distributed internally throughout the body and in the circulating blood, as well as externally near the body's surfaces. They continuously discharge small lymphocytes into the bloodstream. These lymphocytes patrol the tissues and vessels that drain the areas served by that node. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 35: Assessment of Immune Function, Function of the Immune System, p. 1006.

A client undergoing a skin test has been intradermally injected with a disease-specific antigen on the inner forearm. The client becomes anxious because the area begins to swell. Which technique may be used to decrease anxiety in this client? Advise the client to use prescribed analgesics Apply ice packs to reduce the swelling Gently rub the swollen area to accelerate blood flow Assure the client that this is a normal reaction

Assure the client that this is a normal reaction Explanation: The nurse should assure the client that this is a normal reaction. When disease-specific antigens are injected, the injection area swells as a result of the client developing antibodies against the antigen that is introduced. The nurse should also keep in mind that the client is not necessarily actively infectious if the test result is positive. Rubbing the area gently or even applying ice packs may only aggravate the swelling. The swollen area should be left open to heal by itself. The nurse should await the physician's instructions before advising the client to use any prescribed analgesics.

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? Administer the medications that the physician ordered. Call the pharmacy and let them know the client has several drug allergies. Consult drug references to make sure the medicines do not contain substances which the client is hypersensitive. Give the client one medicine at a time and observe for allergic reactions.

Consult drug references to make sure the medicines do not contain substances which the client is hypersensitive. Explanation: Clear identification of any substances to which the client is allergic is essential. The nurse must consult drug references to verify that prescribed medications do not contain substances to which the client is hypersensitive. Administering the medications or giving one at a time may cause the client to have an allergic reaction. The nurse may call the pharmacy but still maintains responsibility for the medications administered. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 35: Assessment of Immune Function, Assessment of the Immune System, p. 1014.

The nurse is obtaining the medical history of a client with Crohn's disease. What medication would the nurse include when asking about what medications the client has taken for suppression of the inflammatory and immune response? Nonsteroidal anti-inflammatory Angiotensin-converting enzyme inhibitors (ACE-I) Diuretics Corticosteroids

Corticosteroids Explanation: The nurse obtains a history of immunizations, recent and past infectious diseases, and recent exposure to infectious diseases. The nurse reviews the client's drug history because certain drugs, such as corticosteroids, suppress the inflammatory and immune responses. Nonsteroidal anti-inflammatory medication does not suppress the inflammatory and immune responses of Crohn's disease. An ACE-I prevents the conversion of angiotensin I to angiotensin II and does not suppress the inflammatory or immune response. Diuretics also do not suppress the immune response but help reduce excess fluid from the kidneys. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 35: Assessment of Immune Function, Health History, p. 1014.

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? Stem cells Cytokines Lymphoid tissues Red blood cells

Lymphoid tissues Explanation: The immune system actually is a collection of specialized white blood cells and lymphoid tissues that cooperate to protect a person from external invaders and the body's own altered cells. The function of these structures is assisted and supported by the activities of natural killer cells, antibodies, and nonantibody proteins such as cytokines and the complement system. Red blood cells and stem cells are not part of the immune system. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 35: Assessment of Immune Function, Lymphoid Tissues, p. 1005.

Which type of immunity becomes active as a result of infection by a specific microorganism? Naturally acquired active immunity Artificially acquired active immunity Naturally acquired passive immunity Artificially acquired passive immunity

Naturally acquired active immunity Explanation: Naturally acquired active immunity occurs as a result of an infection by a specific microorganism. Artificially acquired active immunity results from the administration of a killed or weakened microorganism or toxoid. Passive immunity develops when ready-made antibodies are given to a susceptible individual. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 35: Assessment of Immune Function, p. 1006.

The nurse is teaching a client who has been diagnosed with Hashimoto's thyroiditis. Which statement correctly describes the process of autoimmunity? The normal protective immune response attacks the body, damaging tissues. The body produces inappropriate or exaggerated responses to specific antigens. The body overproduces immunoglobulins. A deficiency results from improper development of immune cells or tissues.

The normal protective immune response attacks the body, damaging tissues. Explanation: Autoimmunity happens when the normal protective immune response paradoxically turns against or attacks the body, leading to tissue damage. It is not an immune deficiency. An exaggerated immune response describes a hypersensitivity. An overproduction of immunoglobulins is the definition of gammopathies. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 35: Assessment of Immune Function, Table 35-1, p. 1005.

An older adult client, who leads a sedentary lifestyle, and a younger client, who has a very stressful and active lifestyle, require a vaccine against a particular viral disorder. The nurse knows 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? The older client because of age The older client because of lifestyle The younger client because of age The younger client because of lifestyle

The older client because of age Explanation: Vaccines are less effective in an older adult than in a younger adult because the activity of the immune system declines with the aging process. The lifestyle or gender of the client does not have great implications on the effectiveness of a vaccine. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 35: Assessment of Immune Function, Gerontologic Considerations, p. 1014.

A patient who suffered severe partial thickness burns to the face and trunk is at risk for depletion of essential proteins and immunoglobulins. The stressors associated with this patient's major injury have caused what immune process to occur? Cortisol is released from the adrenal cortex, which contributes to immunosuppression. Circulating lymphocytes will cause lymph node enlargement and altered lymph drainage. T lymphocytes are stimulated and produce antibodies. With the help of macrophages, B lymphocytes recognize the antigen of a foreign invader.

Cortisol is released from the adrenal cortex, which contributes to immunosuppression. Explanation: Major burns cause impaired skin integrity and compromise the body's first line of defense. Loss of large amounts of serum occurs with burn injuries and depletes the body of essential proteins, including immunoglobulins. The physiologic and psychological stressors associated with surgery or injury stimulate cortisol release from the adrenal cortex; increased serum cortisol also contributes to suppression of normal immune responses (Jeckel, Lopes, Berleze, et al., 2010). Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 35: Assessment of Immune Function, Special Problems, p. 1018.

The client is about to have a skin test for an allergic disorder. What critical instruction should the nurse give this client? Avoid red meat for 48 to 72 hours before the test. Avoid strenuous physical activity for 24 hours before the test. Avoid antihistamines and cold preparations for 48 to 72 hours before the test. Avoid sunlight for 48 to 72 hours before the test.

Avoid antihistamines and cold preparations for 48 to 72 hours before the test. Explanation: The nurse should instruct the client to avoid taking prescribed or over-the-counter antihistamine or cold preparations for at least 48 to 72 hours before a skin test because this reduces the potential for false-negative test results. The nurse should not ask the client to avoid red meat, strenuous physical activity, or sunlight because these do not affect the test results. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 35: Assessment of Immune Function, Quality and Safety Nursing Alert, p. 1063.

The nurse is caring for an elderly client with a respiratory infection. While reviewing age-related changes in the immune system, the nurse identifies which factor as having contributed to this client's infection? Impaired ciliary action as a result of exposure to environmental toxins Failure of the immune system to differentiate "self" from "non-self" Decreased phagocytosis by Kupffer cells Decreased sensation and slowing of reflexes

Impaired ciliary action as a result of exposure to environmental toxins Explanation: Impaired ciliary action from exposure to smoke and environmental toxins contributes to impaired clearance of pulmonary secretions and an increased incidence of respiratory infections in the elderly. Failure of immune system to differentiate "self" from "non-self" leads to an increased incidence of autoimmune diseases. Decreased phagocytosis by the liver's Kupffer cells leads to increased incidence and severity of hepatitis B. Decreased sensation and slowing of reflexes leads to increased risk of skin injury, skin ulcers, abrasions, burns, and other trauma. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 35: Assessment of Immune Function, Table 35-4, p. 1015.

A client is diagnosed with an immune system disorder caused by a congenital alteration in the proper development of immune cells. The nurse is aware that this immune system disorder is classified as which type? autoimmune deficiency hypersensitivity gammopathy primary immune deficiency

primary immune deficiency Explanation: Primary immune deficiencies result from the improper development of immune cells or tissues. These disorders are usually congenital or inherited. The terms autoimmune disease or autoimmune disorder, not autoimmune deficiency, are used to refer broadly to improper function of the immune system, not specifically disorders with a congenital basis. Hypersensitivity is an overreaction of the immune system to an antigen. Gammopathy relates to an overproduction of immunoglobulins. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 35: Assessment of Immune Function, Table 35-1, p. 1005.

What is the function of the thymus gland? Produce stem cells Programs B lymphocytes to become regulator or effector B cells. Develop the lymphatic system Programs T lymphocytes to become regulator or effector T cells.

Programs T lymphocytes to become regulator or effector T cells. Explanation: The thymus gland is located in the neck below the thyroid gland. It extends into the thorax behind the top of the sternum. The thymus gland produces lymphocytes during fetal development. It may be the embryonic origin of other lymphoid structures such as the spleen and lymph nodes. After birth, the thymus gland programs T lymphocytes to become regulator or effector T cells. The thymus gland becomes smaller during adolescence but retains some activity throughout the life cycle. Options A, B, and C are incorrect. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 35: Assessment of Immune Function, Cellular Immune Response, p. 1010.

The nurse is caring for a client recovering from a major burn. Burns affect the immune system by causing a loss of large amounts of which of the following? Serum, which depletes the body's store of immunoglobulins Plasma, which depletes the body's store of catecholamines Plasma, which depletes the body's store of calcitonin Serum, which depletes the body's store of glucagon

Serum, which depletes the body's store of immunoglobulins Explanation: Major burns cause impaired skin integrity and compromise the body's first line of defense. Loss of large amounts of serum occurs with burn injuries and depletes the body of essential proteins, including immunoglobulins. Loss of serum or plasma does not deplete the body of catecholamines (adrenal gland), calcitonin (thyroid gland), or glucagon (pancreas). Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 35: Assessment of Immune Function, Special Problems, p. 1018.

A nurse is taking the health history of a newly admitted client. Which of the following conditions would NOT place the client at risk for impaired immune function? Previous organ transplantation Surgical removal of the appendix History of radiation therapy Surgical history of a splenectomy

Surgical removal of the appendix Explanation: Removal of the appendix would have no direct effect on the immune system. Organ transplantation requires immunosuppressive drugs, which cause impaired immune function. Radiation therapy destroys lymphocytes. The spleen is an important part of the immune system, and removal of it increases the client's risk for poor immune function. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 35: Assessment of Immune Function, Chronic Illness and Surgery, p. 1017.

A client has recently been diagnosed with rheumatoid arthritis, and is also receiving further testing for disorders of the immune system. The client works as an aide at a facility caring for children infected with AIDS. Which factors will hold significant implications during the client's assessment? Select all that apply. work environment history of immunizations and allergies use of other drugs age diet Her home environment

work environment history of immunizations and allergies use of other drugs age diet Her home environment It is important for the nurse to obtain a history of past immunizations and infectious diseases, any allergies, and any recent exposure to infectious diseases. The nurse also needs to review the client's drug history. These data will help the nurse to assess the client's susceptibility to illness because certain past illnesses and drugs, such as corticosteroids, suppress the inflammatory and immune responses. The nurse should question the client about the practices that put her at risk for AIDS, such as her work environment. The client's age, home environment, and diet do not have any major implications during the assessment because they do not indicate the client's susceptibility to illness. Reference: Hinkle, J.L., and Cheever, K.H. Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed. Philadelphia: Lippincott Williams & Wilkins, 2018, Chapter 35: Assessment of Immune Function, p. 1014.

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? "Stem cell transplantation has been discontinued based on concerns about safety, efficacy, resource allocation, and human cloning." "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." "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." "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."

"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." Explanation: Research has shown that stem cells can restore an immune system that has been destroyed (Ko, 2012). Stem cell transplantation has been carried out in humans with certain types of immune dysfunction, such as severe combined immunodeficiency; clinical trials using stem cells are underway in clients with a variety of disorders having an autoimmune component, including systemic lupus erythematosus, rheumatoid arthritis, scleroderma, and multiple sclerosis. Research with embryonic stem cells has enabled investigators to make substantial gains in developmental biology, gene therapy, therapeutic tissue engineering, and the treatment of a variety of diseases (Ko, 2012). However, along with these remarkable opportunities, many ethical challenges arise, which are largely based on concerns about safety, efficacy, resource allocation, and human cloning. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 35: Assessment of Immune Function, p. 1013.

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

Artificially acquired active immunity Explanation: Artificially acquired immunity is obtained by receiving a killed or weakened microorganism or toxoid. Passive immunity develops when ready-made antibodies are given to a susceptible person. The antibodies provide immediate but short-lived protection from the invading antigen. Newborns receive passive immunity to some diseases for which their mothers have manufactured antibodies. Naturally acquired active immunity occurs as a direct result of infection by a specific microorganism. An example is the immunity to measles that develops after the initial infection . Not all invading microorganisms produce a response that gives lifelong immunity. There is not a type of immunity called forced immunity. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 35: Assessment of Immune Function, Acquired Immunity, p. 1007.

A client is diagnosed with rheumatoid arthritis. When teaching the client and family about rheumatoid arthritis, the nurse should provide which information? Clients with autoimmune disorders may have false-negative but not false-positive serologic tests. Advanced medical intervention can cure most autoimmune disorders. Autoimmune disorders include connective tissue (collagen) disorders. Autoimmune disorders are distinctive, aiding differential diagnosis.

Autoimmune disorders include connective tissue (collagen) disorders. Explanation: Connective tissue disorders are considered autoimmune disorders. Clients with autoimmune disorders may have either false-positive or false-negative serologic tests for syphilis. Other common laboratory findings in these clients include Coombs-positive hemolytic anemia, thrombocytopenia, leukopenia, immunoglobulin excesses or deficiencies, antinuclear antibodies, antibodies to deoxyribonucleic acid and ribonucleic acid, rheumatoid factors, elevated muscle enzymes, and changes in acute phase-reactive proteins. No cure exists for autoimmune disorders; treatment centers on controlling symptoms. Autoimmune disorders aren't distinctive; they share common features, making differential diagnosis difficult. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 35: Assessment of Immune Function, Autoimmune Disorders, p. 1017.

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? Radiation destroys lymphocytes. Radiation causes an excess of circulating lymphocytes. Radiation causes a deficiency of circulating hemoglobin. Radiation causes an excess of circulating hemoglobin.

Radiation destroys lymphocytes. Explanation: Radiation destroys lymphocytes and decreases the ability to mount an effective immune response. Radiation is not associated with an excess of lymphocytes or an excess or deficiency of hemoglobin. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 35: Assessment of Immune Function, Neoplastic Disease, p. 1018.

Which stage of the immune response occurs when the differentiated lymphocytes function in either a humoral or a cellular capacity? Recognition stage Proliferation stage Response stage Effector stage

Response stage Explanation: In the response stage, the differentiated lymphocytes function in either a humoral or a cellular capacity. Recognition of antigens as foreign or non-self by the immune system is the initiating event in any immune response. In the proliferation stage, the circulating lymphocytes containing the antigenic message return to the nearest lymph node. In the effector stage, either the antibody of the humoral response of the cytotoxic T cell of the cellular response reaches and connects with the antigen on the surface of the foreign invader. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 35: Assessment of Immune Function, p. 1008.

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

T-cell lymphocytes survey proteins in the body and attack the invading antigens. Explanation: During a cell-mediated response, T-cell lymphocytes survey proteins in the body, actively analyze the surface features, and respond to those that differ from the host by directly attacking the invading antigen. For example, a cell-mediated response occurs when an organ is transplanted. Immunoglobulins hinder the antigens physically by neutralizing their toxins through agglutination or by causing them to precipitate. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 35: Assessment of Immune Function, Cellular Immune Response, p. 1010.

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? The client will have a productive cough. The injection area swells if the client has developed antibodies against the antigen. The injection area will become painful with in duration if the client has antibodies against the antigen. The injection area will break out in a fine macular rash.

The injection area swells if the client has developed antibodies against the antigen. Explanation: The injection area swells if the client has developed antibodies against the antigen. The client is not necessarily actively infectious if the test results are positive. Although a productive cough is one of the symptoms of active tuberculosis, it may also indicate other diseases and disorders. The area should not be painful, and the client should not break out with a rash. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 35: Assessment of Immune Function, Diagnostic Evaluation, p. 1019.

A 64-year-old male client, who leads a sedentary life-style, and a 31-year-old female client, who has a very stressful and active life-style, 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? The male client because of his age The male client because of his life-style The female client because of her age The female client because of her life-style

The male client because of his age Explanation: Vaccines are less effective in an older adult than in a younger adult because the activity of the immune system declines with the aging process. The lifestyle or gender of the client does not have great implications on the effectiveness of a vaccine. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 35: Assessment of Immune Function, Gender, p. 1014.

Which statement accurately reflects current stem cell research? Stem cell transplantation cannot restore immune system functioning. Stem cell transplantation has been performed in the laboratory only. Clinical trials are underway only in clients with acquired immune deficiencies. The stem cell is known as a precursor cell that continually replenishes the body's entire supply of both red and white cells.

The stem cell is known as a precursor cell that continually replenishes the body's entire supply of both red and white cells. Explanation: The stem cell is known as a precursor cell that continually replenishes the body's entire supply of both red and white cells. Stem cells comprise only a small portion of all types of bone marrow cells. Research conducted with mouse models has demonstrated that once the immune system has been destroyed experimentally, it can be completely restored with the implantation of just a few purified stem cells. Stem cell transplantation has been carried out in human subjects with certain types of immune dysfunction, such as severe combined immunodeficiency. Clinical trails are underway in clients with a variety of disorders with an autoimmune component, including systemic lupus erythematosus, rheumatoid arthritis, scleroderma, and multiple sclerosis. Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 35: Assessment of Immune Function, p. 1013.