Inflammation & Immunity
What is the process of making antigens less effective before administering them into the body for therapeutic purposes?
Attenuation
A patient that has a low white blood cell count has a decreased inflammatory response, including impaired phagocytosis. Which step of the phagocytosis process is the first to be affected by a low white blood cell count?
Attraction
A patient with a type I allergy is treated with antihistamines and corticosteroids. What other measure can help the patient to prevent future recurrence of allergies?
Avoidance therapy
A differential white blood cell count has been ordered for a patient with sepsis. What elevated result does the nurse anticipate?
Band neutrophils
Which drug would be a part of the rescue therapy for a patient who had acute rejection of a transplanted kidney?
Basiliximab
A patient is having a type I hypersensitivity reaction to peanuts. Which immune cells would the nurse expect to be highly activated during this process?
Basophils
Which type of white blood cell is most involved in immunoglobulin E presentation?
Basophils
A patient has developed an immediate rejection of a transplanted kidney. What could be the reason for this hyperacute rejection?
Blood vessel occlusion in the new organ
Where are various types of body cells, including the cells involved in inflammation and immune response, produced in the human body?
Bone Marrow
Where are various types of body cells, including the cells involved in inflammation and immune response, produced in the human body?
Bone marrow
What are the physiologic roles of natural killer (NK) cells? Select all that apply.
Nonselectively attack non-self cells Attack mutated and malignant cells Attack grafts and transplanted organs
The nurse recalls that which condition is associated with inflammation that occurs with infection?
Otitis media
Which inflammations in the human body are caused by infections? Select all that apply.
Otitis media, appendicitis.
A patient who received a kidney transplant reports a gradual decline of renal function despite being compliant with drug therapy. What may be the causes? Select all that apply.
Scarring and fibrosis formation Chronic ischemia caused by vessel injury
Which diseases can be categorized as autoimmune diseases? Select all that apply.
Scleroderma Rheumatic fever Goodpasture's syndrome
A patient presents with fever, arthralgia, rash, malaise, lymphadenopathy, nephritis, and polyarthritis. The patient has been admitted to the hospital several times in the past month and was last discharged one week ago. What does the nurse suspect this patient is experiencing?
Serum sickness
The nurse is caring for a patient with limited mobility. When the nurse repositions the patient, he observes a red spot on the patient's hip. However, the patient denies a sensation of pain in that area. Which stage of inflammation does this represent?
Stage I
A patient visits the doctor's office because of a suspected ingrown toenail. The toenail is red and painful, and the side of the toenail exudes pus upon pressure. Which stage of inflammation is the patient primarily experiencing?
Stage II
In what stage of inflammation is there an increased number of circulating neutrophils and exudate formed?
Stage II
Epinephrine administration is essential during anaphylaxis. What is the mechanism of action of this drug?
Stimulates the alpha- and beta-adrenergic receptors
The nurse is monitoring a patient with an indwelling Foley catheter. If the patient reports pain associated with the catheter, what other symptoms could the nurse observe through visual inspection of the area to determine if the patient is experiencing an inflammatory response? Select all that apply.
Swelling, Redness
A patient is ordered desensitization therapy for allergy. What does the nurse tell the patient about desensitization therapy?
The allergen is administered in increasing doses.
The nurse is caring for a patient with a myocardial infarction in the hospital. Which statements about the healing process in this patient are correct? Select all that apply.
The heart muscle is a nondividing tissue. White blood cells (WBCs) trigger new blood vessel growth. Scar tissue prevents formation of a hole in the muscle.
Which statement accurately explains otitis media?
The inflammatory response is triggered by the invasion of foreign organisms.
What is the correct cell phase sequence of a B-lymphocyte following exposure to an antigen? Place your answers in the correct order.
1. Committed lymphocyte stem cell 2. Unsensitized B-lymphocyte 3. Sensitized B-lymphocyte (plasma cell) 4. Sensitized B-memory cell
A nursing student is learning about hypersensitivity reactions. In what order do the mechanisms of a type intravenous (IV) hypersensitivity occur?
1. Exposure to causative agent 2. Activation of T-cells 3. Release of chemical mediators 4. Accumulation of macrophages at infection site
The nurse recalls that stem cells differentiate and mature in what order? Place cells in order of maturity.
1. Hematopoietic stem cell 2. Multipotent stem cell 3. Myeloid progenitor cell 4. Megakaryocyte
The nurse is reviewing discharge teaching with a patient who suffered an anaphylactic reaction to a bee sting. Which statement by the patient indicates the need for further teaching?
"I am immune to bee stings now that I have had a reaction."
Which statement should be included when a student nurse is discussing the action of interleukin-1?
"Interleukin-1 stimulates the production of prostaglandins."
A patient in an acute-care hospital setting calls the nurse because she notices a small area of redness around her IV cannula. The patient is concerned that she has developed a life-threatening blood infection. What can the nurse tell the patient to calm her fears?
"Redness is a hallmark of inflammation, and inflammation is not always accompanied by infection."
A patient with anaphylaxis is admitted to the emergency department (ED). Place the interventions in the correct order for the nurse to perform.
1. Assess the respiratory status of the patient. 2. Ensure that tracheotomy equipment is ready. 3. Apply oxygen using a high-flow, non-rebreather mask at 90% to 100%. 4. Administer epinephrine as quickly as possible.
What are the functions of the antibody immunoglobulin (Ig) G? Select all that apply.
Activates classic component pathway Is expressed on second and subsequent exposures to antigens
A woman who is breastfeeding is diagnosed with rheumatoid arthritis. She does not want to stop breastfeeding. Which medication is safest for her to take?
Adalibumab (Humira)
Which is an example of a type I hypersensitivity reaction?
Angioedema
A patient has developed serum sickness. What is the most likely cause?
Antibiotic therapy
The nurse is caring for a patient experiencing an anaphylactic reaction to an intravenous (IV) infusion. Which action would the nurse take immediately?
Apply oxygen using a high-flow non-rebreather mask.
A patient has developed a serious infection and has no acquired immunity against it. Which type of immunity would be helpful in treating the infection?
Artificial passive
A patient has been brought to the emergency department (ED) after being bitten by a poisonous snake. What is the nature of protection that the nurse provides when injecting the patient with antivenom?
Artificial passive immunity
Which type of immunity does the patient receive when he or she is administered an antivenom after sustaining a snake bite?
Artificial passive immunity
A patient is experiencing reduced chest movement and impaired airflow, hypotension, and a rapid, weak, irregular pulse. What should be the nurse's first priority?
Assessing gas exchange
Which type of white blood cell is effective during a viral infection?
Cytolytic T-cells
What type of hypersensitivity occurs when a patient receives the wrong blood type during a transfusion, leading to a hemolytic transfusion reaction?
Cytotoxic reactions
Which type of hypersensitivity is a cell-mediated immunity with T-lymphocyte as the reactive cell?
Delayed hypersensitivity
A patient with fever has a high neutrophil count. Which growth factor increases the number and maturity of neutrophils?
Granulocyte colony-stimulating factor
A patient receiving antibiotic therapy for 2 months reports high fever, arthralgia, and rashes. Diagnostic reports of the patient indicate polyarthritis and enlarged lymph nodes. What is the best explanation for these clinical manifestations?
Deposition of immune complexes in blood vessel walls
What is the function of a monocyte during inflammation?
Destruction of bacteria and cellular debris
What is the key function of neutrophils?
Help in nonspecific ingestion and phagocytosis of microorganisms
Which cells are involved in the general inflammation process? Select all that apply.
Eosinophils, neutrophils, basophils, macrophages
What is the function of the cytokine tumor necrosis factor (TNF)?
Facilitates acute inflammatory response to infectious bacteria.
A patient who received a kidney transplant is experiencing chronic rejection. What changes does the nurse anticipate in this patient?
Gradual reduction in the functioning of the transplanted organ
What are the risk factors for hyperacute rejection? Select all that apply.
Human leukocyte antigen (HLA) mismatching Receiving a previous transplantation Difference in donors and recipient blood group
Which immunoglobulin (Ig) antibody is found abundantly in secretions but has very low circulating levels?
IgA
A patient is diagnosed with a type I hypersensitivity. Which antibody level increases during this type of allergy?
IgE
Which immunoglobulin (Ig) antibody binds to basophils and is involved in causing antigen-antibody mediated hypersensitivity reactions?
IgE
A patient is scheduled to undergo desensitization therapy during which a very dilute solution of allergen (1:100,000) is injected. This process induces the formation of antibodies against the allergen. Which antibody is produced during this process?
IgG
Which statements describe the cause of decreased heart function in a patient following myocardial infarction (MI)? Select all that apply.
Inability of the heart muscles to replace the damaged tissue, because of its non-dividing nature Inability of the scar tissue to function like the lost tissue, leading to compromised cardiac function White blood cells involved in the process trigger new blood vessel growth and scar tissue formation
Which statement about the immunoglobulin A (IgA) antibody is correct?
It exists in mucous membranes and intestinal mucosa.
Which type of hypersensitivity may be associated with rhinorrhea?
Type I hypersensitivity
What are causes of acute rejection? Select all that apply.
Lysis of organ cells by cytotoxic T-cells Blood vessel necrosis of the new organ
While looking through patient charts, the nurse studies pictures taken from a blood smear. Which cells would the nurse expect to appear as immature cells rather than mature cells? Select all that apply.
Monocytes, Tissue mast cells, Band neutrophils
A patient presents with acute rejection. What prescribed drugs does the nurse administer to the patient? Select all that apply.
Muromonab-CD3 Antilymphocyte globulin (ALG)
Which cells in the human body contribute to the cell-mediated immune system? Select all that apply.
Natural killer cell Helper/inducer T-cell
A patient has been diagnosed with lung inflammation due to COPD, but the alveolar macrophage levels are still relatively low. Which immune function will be decreased in this patient?
Phagocytosis
Lymphocytes provide cell-mediated immunity through a variety of T-cells. What is the function of suppressor T-cells?
Prevent hypersensitivity on exposure to non-self cells or proteins.
A patient's serum contains a highly elevated level of immunoglobulin E (IgE) antibodies (140 IU/mL). What could be the possible effects of this elevated IgE? Select all that apply.
Pruritus and inflammation Excessive release of histamine
When assessing a patient, the nurse notices an area of inflammation on the skin. The nurse would likely be less concerned about the potential for infection in the presence of what other skin abnormalities? Select all that apply.
Rash, Intact blister
What is the role of decongestants in the treatment of a type I hypersensitivity?
Reduce edema
What are the functions of leukocytes? Select all that apply.
They destroy foreign invaders. They help with complement activation. They produce antibodies against invaders. They help in recognizing self versus non-self.
Secretion of histamine, serotonin, and kinins in the initial stage of inflammation causes constriction of the small veins and dilates the arteriole in the area of injury. This causes warmth and redness in the tissue. Which cells are responsible for this action?
Tissue mast cells
