MICRO Quiz 7 & 8

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The immunoglobulin class that has a dimer form found in mucus, saliva, colostrum, and other body secretions is ________. A) IgA B) IgD C) IgE D) IgG E) IgM

A) IgA

________ is the most abundant class of antibodies in serum. A) IgG B) IgM C) IgA D) IgD E) IgE

A) IgG

The _______ system of blood proteins acts to lyse foreign cells and viruses. A) humoralimmunity B) cell-mediated C) complement D) lymphoid E) none of the choices are correct.

C) complement

Each of the following are granulocytes except ________. A) neutrophils B) eosinophils C) lymphocytes D) basophils E) all of the choices are granulocytes.

C) lymphocytes

Which white blood cells comprise 3% to 7% of circulating WBCs, are phagocytic, and can migrate out into body tissues to differentiate into macrophages? A) Basophils B) Eosinophils C) Neutrophils D) Monocytes E) Lymphocytes

D) Monocytes

The progeny cells of a B-cell clone are called ________. A) antibodies B) sensitized T cells C) activated macrophages D) plasma cells E) bursa cells

D) plasma cells

Gamma globulin can be given as immunotherapy to confer artificial passive immunity. - true - false

- true

Overuse of disinfectants and antiseptics, as well as antibiotics, can result in inflammatory diseases stemming from an inadequate microbiome. - true - false

- true

The second and third lines of host defenses determine whether cells are self or nonself by examining cell surfaces for identifying molecular markers. - true - false

- true

Vaccinating a child against a dangerous pathogen not only protects that child from disease, but it also protects society as a whole, since herd immunity in the population is maintained. - true - false

- true

_____ function in humoral immunity, while _____ function in cell-mediated immunity. A) B cells; T cells B) T cells; B cells C) Monocytes; basophils D) Basophils; T cells E) B cells; neutrophils

A) B cells; T cells

Which part of the IgG molecule will bind with the E. coli antigen? A) Fab B) Fc C) Complement binding site D) Cellular binding site

A) Fab

What structures are found along lymphatic vessels and are heavily clustered in the armpit, groin, and neck? A) Lymph nodes B) Thymus C) Spleen D) GALT E) Tonsils

A) Lymph nodes

All nucleated cells contain ________. A) class I MHC B) class II MHC C) secretory antibodies D) IgE receptors E) IgM molecules

A) class I MHC

When an antibody is covering a foreign microorganism, complement may be activated via the _______ pathway. A) classical B) lectin C) alternative D) interleukin

A) classical

Destruction of lymphocytes with self specificity is called ________. A) clonal deletion B) proliferation C) clonal selection D) differentiation E) hypersensitivity

A) clonal deletion

The histocompatibility complex proteins function in ________. A) recognition of self B) antibody proliferation C) B-cell maturation D) T-cell maturation E) None of the choices are correct.

A) recognition of self

Plasma cells ________. A) secrete antibodies B) function in allergic reactions C) directly destroy target cells D) suppress immune reactions E) activate B cells and other T cells

A) secrete antibodies

Adaptive immunity involves the response of ________. A) skin barriers B) B and T lymphocytes C) lysozyme D) mucous membranes E) interferon

B) B and T lymphocytes

Choose the phrase that describes MHC class I molecules. A) Found on only some types of white blood cells B) Expressed on all human nucleated cells C) Are proteins involved in the complement system D) Are secreted from all human nucleated cells

B) Expressed on all human nucleated cells

Each ________ fragment of an antibody molecule contains the variable regions of a heavy and light chain that folds into a groove for one epitope. A) variable B) Fab C) Fc D) terminal E) hinge

B) Fab

The patient's mother expresses concern about her daughter's fevers. She states that the fevers are a sign that her child is unable to fight this infection. What is a proper response to these concerns? A) It is impossible to determine exactly why she is having these fevers. Doctors call this a fever of unknown origin. B) Fevers are a natural response by the body to help fight infection. C) These fevers are very dangerous, and you have strong reason for concern. D) High fever could be a sign of a tumor of the hypothalamus.

B) Fevers are a natural response by the body to help fight infection.

Following education from the RN, the parents decide to have their son vaccinated. Which of the following is the most important part of the family history to elicit? A) Incidence of autism B) Food or drug allergies C) Dairy sensitivity D) Acute illness during pregnancy

B) Food or drug allergies

Which process involves antibodies coating microorganisms in order to facilitate phagocytosis? A) Neutralization B) Opsonization C) Complement fixation D) Agglutination E) Anamnestic response

B) Opsonization

During what process are hypochlorite and hydrogen peroxide produced to destroy bacteria and inhibit viral replication? A) Inflammation B) Phagocytosis C) Interferon production D) Complement production E) Bradykinin

B) Phagocytosis

Which gland shrinks in size during adulthood and has hormones that function in maturation of T lymphocytes? A) Lymph nodes B) Thymus C) Spleen D) GALT E) Tonsils

B) Thymus

What is the most likely cause of the patient's swollen tonsils? A) Her intense cough caused rupture of the tonsils, and swelling is part of the normal wound-healing process. B) Tonsils consist of lymphatic tissue, and became swollen by filtering out microbes and their toxic products. C) She is dehydrated from poor fluid intake, so the tonsils are retaining fluid. D) Tonsils are sensitive to stimulation, so they became swollen from her constant coughing.

B) Tonsils consist of lymphatic tissue, and became swollen by filtering out microbes and their toxic products.

Following teaching by the medical team, the patient asks "can I just do my airway clearance exercises when I am not feeling well and on the weekends, even though the doctor tells me I have to do them every day?" What is a correct response by the nurse? A) It is okay to skip your airway clearance if you are not feeling sick as long as you are compliant on the weekends. B) Your body does not have the ability to protect itself because of its damaged immunity so you must do airway clearance regularly. C) As long as you perform airway clearance twice as often when you start to feel sick, you will make up the difference. D) Your airway clearance activities can be performed at your convenience.

B) Your body does not have the ability to protect itself because of its damaged immunity so you must do airway clearance regularly.

Substances known as _________provoke a specific immune response so discriminating that only a single molecular fragment, called an __________, actually interacts with the lymphocyte's receptor. A) haptens; epitope B) antigens; epitope C) epitopes; antigen D) antigens; immunogen

B) antigens; epitope

An example of artificial active immunity would be ________. A) chickenpox infection followed by lifelong immunity B) chickenpox vaccine which triggers extended immunity to chickenpox C) giving a person immune serum globulins to chickenpox virus after exposure to the disease D) a fetus acquiring maternal IgG to the chickenpox virus across the placenta E) none of the choices are correct.

B) chickenpox vaccine which triggers extended immunity to chickenpox

The blood cells that function in allergic reactions and inflammation, contain peroxidase and lysozyme, and particularly target parasitic worms and fungi are ________. A) basophils B) eosinophils C) neutrophils D) monocytes E) lymphocytes

B) eosinophils

The body region where a ciliary escalator helps to sweep microbes trapped in mucus away from that body site is the ________. A) skin B) respiratory tract C) digestive tract D) urinary tract E) eyes

B) respiratory tract

Class I MHC genes code for ________. A) certain secreted complement components B) self receptors recognized by T lymphocytes C) all HLA antigens D) receptors located primarily on macrophages and B cells E) all of the choices are correct.

B) self receptors recognized by T lymphocytes

Killed or inactivated vaccines are prepared by ________. A) removal of virulence genes from the microbe B) treatment with formalin, heat, or radiation C) passage of the pathogen through unnatural hosts or tissue culture D) long-term subculturing of the microbe E) all of the choices are correct.

B) treatment with formalin, heat, or radiation

If the patient's mother had previously vaccinated her son against chickenpox, what form of immunity would he have had against the virus? A) Active natural immunity B) Passive natural immunity C) Active artificial immunity D) Passive artificial immunity

C) Active artificial immunity

Choose the statement that best describes the primary action of B cells. A) B cells interact with antigen on antigen-presenting cells B) B cells produce interleukin-2, a lymphocyte growth factor C) B cells divide and differentiate into plasma cells that produce antibody and memory cells. D) B cells become active in cell-mediated immunity

C) B cells divide and differentiate into plasma cells that produce antibody and memory cells.

What process provides many B cells and T cells that are activated against specific antigens? A) Antigen expression B) Antibody production C) Clonal expansion D) Antigen presentation E) Opsonization

C) Clonal expansion

The immunoglobulin class that has an Fc region that binds to receptors on basophils and mast cells is ________. A) IgA B) IgD C) IgE D) IgG E) IgM

C) IgE

The granules of basophils contain ________. A) antibodies B) antigens C) digestive enzymes D) histamine E) lysozyme

D) histamine

The benefit of adaptive immunity is the production of _______ that provide long-lasting protection. A) antibodies B) plasma cells C) T helper cells D) memory cells E) phagocytotic cells

D) memory cells

Plasma cells ________. A) function in cell-mediated immunity B) are derived from T lymphocytes C) function in blood clotting D) produce and secrete antibodies E) all of the choices are correct.

D) produce and secrete antibodies

Lymphocyte maturation involves ________. A) hormonal signals that initiate development B) B cells maturing in bone marrow sites C) T cells maturing in the thymus D) release of mature lymphocytes to begin migration to various lymphoid organs E) All of the choices are correct.

E) All of the choices are correct.

Antigen-presenting cells ________. A) include dendritic cells B) include macrophages C) engulf and modify antigen to be more immunogenic D) hold and present processed antigen on their cell membrane surface E) all of the choices are correct.

E) all of the choices are correct.

Live, attenuated vaccines ________. A) include the Sabin polio vaccine B) include the measles, mumps, rubella vaccine (MMR) C) contain viable microbes that can multiply in the person D) require smaller doses and fewer boosters compared to inactivated vaccines E) all of the choices are correct.

E) all of the choices are correct.

Lymphocytes ________. A) possess MHC antigens for recognizing self B) have membrane receptors that recognize foreign antigens C) gain tolerance to self by destruction of lymphocytes that could react against self D) develop into clones of B and T cells with extreme variations of specificity E) all of the choices are correct.

E) all of the choices are correct.

Diapedesis is the ________. A) loss of blood due to hemorrhaging B) production of only red blood cells C) production of white blood cells, red blood cells, and platelets D) plugging of broken vessels to stop bleeding E) migration of white blood cells from the blood out to the tissues

E) migration of white blood cells from the blood out to the tissues

Which line(s) of defense has been breached for this injury? A) First line of defense B) Second line of defense C) First and second lines of defense D) First, second, and third lines of defense

C) First and second lines of defense

Knowing that the causative organism for this patient's urinary tract infection, E. coli, has a lipopolysaccharide cell wall, which cells are being activated by this infection? A) T helper cells B) T cytotoxic cells C) Natural killer cells D) B cells

D) B cells

The lymphoid tissues of the intestinal tract are collectively referred to as ________. A) lymph nodes B) thymus C) spleen D) GALT E) tonsils

D) GALT

What is the natural progression of healing for this wound? A) Injury, vascular reactions, secondary injury, scar formation B) Injury, edema/pus formation, vascular reactions, scar formation C) Injury, edema/pus formation, scar formation, exudative leaking D) Injury, vascular reactions, edema/pus formation, scar formation

D) Injury, vascular reactions, edema/pus formation, scar formation

Antitoxins ________. A) contain modified bacterial exotoxin molecules B) are always genetically engineered C) contain select antigenic components of a pathogen rather than whole cells or viruses D) confer passive immunity E) utilize DNA strands that will produce the antigen

D) confer passive immunity

When monocytes migrate from the blood out to the tissues they are transformed by inflammatory mediators to develop into ________. A) primary phagocytes B) neutrophils C) killer T cells D) cytotoxic T cells E) macrophages

E) macrophages

What is the proper order of steps for B-cell activation? A) Antigen binding, antigen processing/presentation, T helper cell cooperation/recognition, activation, differentiation, clonal expansion B) Antigen processing/presentation, activation, differentiation, T helper cell cooperation/recognition, antigen binding, clonal expansion C) Activation, clonal expansion, differentiation, antigen processing/presentation, T helper cell cooperation/recognition, antigen binding D) Antigen binding, T helper cell cooperation/recognition, antigen processing/presentation, differentiation, activation, clonal expansion

A) Antigen binding, antigen processing/presentation, T helper cell cooperation/recognition, activation, differentiation, clonal expansion

The lab performs a complete blood count with cell differential while the patient is still in the office. The results show an elevated white blood cell count, as well as a high neutrophil count. What does this indicate? A) Bacterial infection B) Viral infection C) Protozoan infection D) Helminth infection

A) Bacterial infection

The patient asks why the laceration is puffy, and has become itchy. Which of the following statements by the nurse is the most appropriate response? A) This is a normal response to injury. Blood has rushed to the area, fluid is leaking from the damaged vessels, and chemical mediators called cytokines are causing you to itch. B) This is a normal response to injury. Your body is building up pressure around the wound to stop the bleeding, and the wood likely left internal splinters that are causing you to itch. C) This is a concerning sign. I will call the doctor now to lance the swollen area, and in the meantime, I will apply hydrogen peroxide to the wound. D) This is a concerning sign. Edema and pruritus are early signs of gangrene. To help the swelling, hold your hand above your heart to decrease blood flow to the area.

A) This is a normal response to injury. Blood has rushed to the area, fluid is leaking from the damaged vessels, and chemical mediators called cytokines are causing you to itch.

When the patient's mother expresses concern about his sister being reinfected with chickenpox, what is the most appropriate response? A) Your concerns are valid, but his sister developed an active natural immunity to chickenpox because she has already been infected. B) Your concerns are valid and there is a high likelihood that his sister will become infected again. We should probably administer the vaccine. C) Your concerns are valid and there is no way to protect his sister from becoming reinfected except to keep her at least 15 feet from your son at all times. D) Your concerns are valid and if his sister is reinfected, her symptoms will be less severe than her initial chickenpox infection.

A) Your concerns are valid, but his sister developed an active natural immunity to chickenpox because she has already been infected.

The least numerous of all white blood cells that release histamine during inflammation and allergic reactions are ________. A) basophils B) eosinophils C) neutrophils D) monocytes E) lymphocytes

A) basophils

An example of natural active immunity would be ________. A) chickenpox infection followed by lifelong immunity B) chickenpox vaccine, which triggers extended immunity to chickenpox C) giving a person immune serum globulins to chickenpox virus after exposure to the disease D) a fetus acquiring maternal IgG to the chickenpox virus across the placenta E) none of the choices are correct.

A) chickenpox infection followed by lifelong immunity

All of the following pertain to platelets except they ________. A) contain hemoglobin to transport oxygen and carbon dioxide B) function primarily in hemostasis C) originate from giant multinucleate cells called megakaryocytes D) function in blood clotting and inflammation E) are not whole cells but are pieces of cells

A) contain hemoglobin to transport oxygen and carbon dioxide

Leukocytes that are derived from monocytes and have long, thin processes to trap pathogens are ________. A) dendritic cells B) eosinophils C) macrophages D) platelets E) mast cells

A) dendritic cells

When a cell is infected by a virus, __________ is produced and is secreted from the infected cell to protect nearby uninfected cells by binding to surface receptors and initiating synthesis of antiviral proteins. A) interferon B) pyrogen C) interleukin-2 D) exudate

A) interferon

The importance of clonal deletion is that ________. A) lymphocytes with receptors that recognize self markers are eliminated to preserve immune tolerance B) worn-out lymphocytes are destroyed to make way for new cells C) lymphocytes that have been activated during antigen exposure are then removed when the individual recovers D) clones of cells that have the same receptor are deleted to avoid redundancy

A) lymphocytes with receptors that recognize self markers are eliminated to preserve immune tolerance

All the following are events of early inflammation except ________. A) macrophages appear first and begin phagocytosis B) chemical mediators and cytokines are released C) brief vasoconstriction is followed by vasodilation D) exudate and pus can accumulate E) capillaries become more permeable resulting in edema

A) macrophages appear first and begin phagocytosis

Herd immunity involves _______. A) maintaining a certain level of immunized individuals in a society to prevent a pathogen from circulating through the population B) keeping bovine diseases to a minimum so they do not spread to the human population C) encouraging individuals to work and live in close proximity to each other to prevent spread of a disease outside of a population D) maintaining a 100% vaccination rate among farm workers to prevent the spread of zoonotic diseases

A) maintaining a certain level of immunized individuals in a society to prevent a pathogen from circulating through the population

In addition to dendritic cells and macrophages, B cells can also act as antigen-presenting cells. This occurs when ________. A) the antigen is a molecule with a simple, repeating structure and evokes an immune response as a T-cell-independent antigen B) the B cell engulfs the antigen and presents it to the T helper cell C) the B cell engulfs the antigen and presents it to the T cytotoxic cell D) the antigen binds to the B cell and after processing, it is presented to the dendritic cells and macrophages

A) the antigen is a molecule with a simple, repeating structure and evokes an immune response as a T-cell-independent antigen

The region of each antibody molecule where amino acid composition is highly varied from one clone of B lymphocytes to another is the ________. A) variable region B) joining region C) constant region D) light region E) hinge region

A) variable region

Histamine, serotonin, and bradykinin are all ________. A) vasoactive mediators B) mediators of B-cell activity C) mediators of T-cell activity D) mediators that increase chemotaxis E) fever inducers

A) vasoactive mediators

Cytokines are chemicals and proteins that are critical components of the immune system. Which of the following statements is incorrect regarding the function of cytokines? A) All cytokines are synthesized to stimulate the inflammatory response; their purpose is to mediate vascular reactions and diapedesis. B) Cytokines are secreted by a wide variety of cell types, including immune cells, epithelial and endothelial cells. C) Cytokines play a role in both inflammatory stimulation, as well as being anti-inflammatory mediators. D) Cytokines mediate communication between cells; they are crucial for stimulation, suppression and control of all aspects of the immune response.

A) All cytokines are synthesized to stimulate the inflammatory response; their purpose is to mediate vascular reactions and diapedesis.

Neutrophils, eosinophils, and basophils are called _______ because they have prominent cytoplasmic inclusions that, in a stained blood smear, appear with identifying, characteristic colors. A) leukocytes B) granulocytes C) agranulocytes D) monocytes E) None of the choices are correct.

B) granulocytes

Each of the following are benefits of fever except it ________. A) reduces the ability of temperature-sensitive organisms to multiply B) increases the availability of iron C) increases phagocytosis D) increases metabolism E) stimulates hematopoiesis

B) increases the availability of iron

An activated T H cell produces ________, which is a growth factor for T helper cells and cytotoxic T cells. A) interleukin-1 B) interleukin-2 C) interleukin-12 D) antiserum E) complement

B) interleukin-2

The first stage of developing an adaptive immune response involves ________. A) the presentation of antigens B) lymphocyte development and differentiation C) the challenge of B or T cells by antigens D) the production of antibodies

B) lymphocyte development and differentiation

Acellular vaccines and subunit vaccines ________. A) contain modified bacterial exotoxin molecules B) are always genetically engineered C) contain select antigenic components of a pathogen rather than whole cells or viruses D) confer passive immunity E) utilize DNA strands that will produce the antigen

C) contain select antigenic components of a pathogen rather than whole cells or viruses

An example of artificial passive immunity would be ________. A) chickenpox infection followed by lifelong immunity B) chickenpox vaccine which triggers extended immunity to chickenpox C) giving a person immune serum globulins to chickenpox virus after exposure to the disease D) a fetus acquiring maternal IgG to the chickenpox virus across the placenta E) none of the choices are correct.

C) giving a person immune serum globulins to chickenpox virus after exposure to the disease

The chemical found in tears and saliva that hydrolyzes the peptidoglycan in certain bacterial cell walls is ________. A) lactic acid B) hydrochloric acid C) lysozyme D) histamine E) bile

C) lysozyme

Similar to macrophages, ________are products of the monocytic cell line that reside throughout the tissues and present antigen to lymphocytes. A) dendritic cells B) natural killer cells C) mast cells D) neutrophils

C) mast cells

The most numerous WBCs that have multilobed nuclei and are very phagocytic are ________. A) basophils B) eosinophils C) neutrophils D) monocytes E) lymphocytes

C) neutrophils

Hematopoiesis is the ________. A) loss of blood due to hemorrhaging B) production of only red blood cells C) production of white blood cells, red blood cells, and platelets D) plugging of broken vessels to stop bleeding E) migration of white blood cells from the blood out to the tissues

C) production of white blood cells, red blood cells, and platelets

Cytotoxic T cells ________. A) are directly activated by antigens B) lack specificity for antigen C) secrete granzymes and perforins that damage target cells D) secrete interleukin-2 to stimulate B and T cells E) all of the choices are correct.

C) secrete granzymes and perforins that damage target cells

Which of the following is in the correct order from greatest to least phagocytic activity? A) Neutrophils, eosinophils, macrophages B) Neutrophils, macrophages, eosinophils C) Eosinophils, macrophages, neutrophils D) Macrophages, neutrophils, eosinophils E) Macrophages, eosinophils, neutrophils

D) Macrophages, neutrophils, eosinophils

The patient states, "There has to be a way for me to reduce this swelling. There is no way this can be good for me because it is so uncomfortable." Which of the following statements by the nurse is not an appropriate response? A) Swelling helps trap foreign microbes to prevent them from getting into your main circulation. B) Inflammation is a sign that your immune system is fighting the effects of your skin barrier being broken. C) The influx of fluid into the area is helping to dilute toxins. D) Swelling is a result of your bones responding to the influx of calcium-fighting toxins.

D) Swelling is a result of your bones responding to the influx of calcium-fighting toxins.

The nurse examines the child's tonsils while preparing to swab them with the culture swab. A white pustule coating is noted to be covering the tonsils. What is this pus composed of? A) Waste from red blood cells B) Live bacteria C) Fibrin threads D) White blood cells and debris from phagocytosis

D) White blood cells and debris from phagocytosis

An example of natural passive immunity would be ________. A) chickenpox infection followed by lifelong immunity B) chickenpox vaccine which triggers extended immunity to chickenpox C) giving a person immune serum globulins to chickenpox virus after exposure to the disease D) a fetus acquiring maternal IgG to the chickenpox virus across the placenta E) none of the choices are correct.

D) a fetus acquiring maternal IgG to the chickenpox virus across the placenta

The patient asks the nurse to explain what cilia are. All of the following statements are correct except ________. A) cilia form a microscopic brush-like lining B) cilia help move and expel foreign invaders C) cilia compose a sort of microscopic "escalator" to expel invading organisms D) cilia are chemical-excreting natural killer cells

D) cilia are chemical-excreting natural killer cells

The circulating substances that affect the hypothalamus and initiate fever are ________. A) complement B) interferons C) leukotrines D) pyrogens E) lysozymes

D) pyrogens

Class II MHC genes code for ________. A) certain secreted complement components B) self receptors recognized by T lymphocytes C) all HLA antigens D) receptors located primarily on macrophages and B cells E) all of the choices are correct.

D) receptors located primarily on macrophages and B cells

MHC molecules are found on each of the following cells except ________. A) leukocytes B) eosinophils C) epithelial cells D) red blood cells E)Islet of Langerhans cells

D) red blood cells

Immunotherapy is the ________. A) use of antitoxins B) use of immune serum globulin C) conferring of passive immunity D) administering of preformed antibodies E) all of the choices are correct.

E) all of the choices are correct.

Innate chemical defenses include ________. A) lysozyme B) lactic acid and electrolytes of sweat C) skin's acidic pH and fatty acids D) stomach hydrochloric acid E) all of the choices are correct.

E) all of the choices are correct.

Plasma ________. A) is the liquid portion of blood in which blood cells are suspended B) is mostly water C) contains albumin and globulins D) contains fibrinogen E) all of the choices are correct.

E) all of the choices are correct.

To exhibit high immunogenicity, an antigen would preferably________. A) originate in another organism B) be large in size C) have chemical complexity D) have cell surface markers not recognized as self E) all of the choices are features of a good antigen.

E) all of the choices are features of a good antigen.

Which form of adaptive immunity is the patient developing by having this infection? A) Active natural immunity B) Passive natural immunity C) Active artificial immunity D) Passive artificial immunity

A) Active natural immunity

Which of the following is a special binding substance that enhances immunogenicity and prolongs antigen retention at the injection site? A) Adjuvant B) Booster C) Antibodies to toxin D) Gamma globulin E) "Trojan horse" recombinant vaccine

A) Adjuvant

Which statement below characterizes the complement system? A) Complement comprises a team of blood proteins that are activated in a cascade, ultimately leading to pathogen cytolysis, inflammation and enhanced phagocytosis. B) Complement pyrogens stimulate the hypothalamus to raise the body temperature, increasing metabolism and preventing the growth of temperature-sensitive pathogens. C) Complement proteins bind to cell surfaces and induce changes in genetic expression, eliminating not only pathogens, but cancer cells also. D) Complement proteins, produced by a host cell in response to viral attack, are secreted and enter neighboring cells, stimulating the production of antiviral proteins in anticipation of an invasion.

A) Complement comprises a team of blood proteins that are activated in a cascade, ultimately leading to pathogen cytolysis, inflammation and enhanced phagocytosis.

A 16-year-old male with cystic fibrosis is admitted to the inpatient pulmonary unit. He has been hospitalized several times in the past year with respiratory infections, including Pseudomonas and H. influenza. Because of his thick mucous, airway inflammation, and immobile mucosal cilia, microorganisms are unable to be effectively cleared from his lungs. He is supposed to perform vigorous airway mucous clearance measures at home with a vibrating vest and IPV (intrapulmonary percussive ventilation) device. However, the patient states that his treatment takes hours and he does not always feel sick. He estimates his compliance with home airway clearance regimen to be less than 50%. If the patient's cilia are unable to clear his lungs of mucus, which line of host defense is breached? A) First line of defense B) Second line of defense C) Third line of defense D) First and second lines of defense

A) First line of defense

Which statement is true regarding lymphocyte specificity? A) Genetic rearrangement in the DNA that codes for antigen receptors results in up to 10 trillion permutations in the variable regions of B- and T lymphocyte-receptors. B) There is a different gene for every possible antigen that a lymphocyte may encounter. C) B lymphocytes have specificity for a large number of different antigens, however T lymphocytes can recognize only 500 antigens corresponding to the number of gene segments that code for the antigen receptors. D) B- and T cell-receptors are identical and both recognize up to 500 antigens corresponding to the gene segments that code for the antigen receptor variable regions.

A) Genetic rearrangement in the DNA that codes for antigen receptors results in up to 10 trillion permutations in the variable regions of B- and T lymphocyte-receptors.

The morning after the vaccination, the patient's mother calls to report that the infant has developed a low-grade fever. She states, "I am afraid that he is developing meningitis from one of the vaccines, because he is also fussy."What is a proper response by the nurse? A) I understand you are frightened. However, site pain and low fever are common side effects. You can help minimize both with acetaminophen, as the physician recommended. B) Bring your son to the closest ER for evaluation. He may be experiencing a life-threatening reaction to the vaccines. C) You sound upset. Please remember how harmless I told you vaccines were. D) This fever and fussiness are probably from an unrelated illness. It is just a coincidence he received vaccinations around the same time as these symptoms presented.

A) I understand you are frightened. However, site pain and low fever are common side effects. You can help minimize both with acetaminophen, as the physician recommended.

Which process involves antibodies covering surface receptors on a virus or toxin molecule thereby disrupting their activity? A) Neutralization B) Opsonization C) Complement fixation D) Agglutination E) Anamnestic response

A) Neutralization

This body region is protected by fatty acids, acidic pH, lactic acid, and a tough cell barrier with its own normal biota. A) Skin B) Respiratory tract C) Digestive tract D) Urinary tract E) Eyes

A) Skin

After his recovery from chickenpox, which lymphocytes will keep this patient from becoming infected again? A) T helper cells B) Natural killer cells C) T memory cells D) B cells

A) T helper cells

Which of the following statements is false regarding the development of adaptive immunity? A) The fourth stage of adaptive immunity involves the production of antibodies by B and T cells against the antigen that initiated the response. B) The second stage in the development of adaptive immunity requires the antigen to be presented to the T cells on the surface of an APC. C) During the third stage in the development of adaptive immunity, B and T cells are challenged by the antigen and respond by differentiating and proliferating. D) The initiation of adaptive immunity involves the development of lymphocytes with the deletion of cells that would react to self molecules.

A) The fourth stage of adaptive immunity involves the production of antibodies by B and T cells against the antigen that initiated the response.

The human microbiome is considered an important component of the first line of defense. Which statement adequately reflects its role as a defensive barrier? A) The human microbiota competes with pathogens for space and nutrients limiting their ability to cause infection, and trains the immune system to recognize antigens. B) The organisms that comprise the microbiota are able to phagocytose potential pathogens, thereby eliminating them from the human host. C) The human microbiome has evolved with the species so it is able to actively destroy pathogens by raising the body temperature when an infection by a pathogen occurs. D) Cells in the human microbiome secrete cytokines that play a role in stimulating the immune response when a pathogen has entered the system.

A) The human microbiota competes with pathogens for space and nutrients limiting their ability to cause infection, and trains the immune system to recognize antigens.

Which is incorrect about the Fc region of an immunoglobulin? A) Is called the crystallizable fragment B) Forms the antigen binding sites C) Contains an effector molecule that can bind to cells such as macrophages and mast cells D) Contains an effector molecule that can fix complement E) Determines the class to which the immunoglobulin belongs

B) Forms the antigen binding sites

The patient asks the nurse to explain to him why he keeps getting sick from the same bacteria. Which of the following statements is the most appropriate response? A) Your lungs produce these organisms because your cilia are permanently damaged. B) Your mucus traps and harbors the microorganisms and when they can't be cleared, they begin to breach your second and third lines of defense. C) Your disease stunts your immunity, so you are unable to fight those bacteria. D) You don't have second and third line defenses because of your cystic fibrosis.

B) Your mucus traps and harbors the microorganisms and when they can't be cleared, they begin to breach your second and third lines of defense.

The major histocompatibility complex is ________. A) glycoproteins, called MHC antigens, found on all body cells B) a set of genes that code for MHC glycoproteins C) found on the third chromosome D) located in the thymus gland E) all of the choices are correct.

B) a set of genes that code for MHC glycoproteins

The parents are concerned when they hear that vaccines consist of whole microbes, even if they have been inactivated. They state that they do not want whole bacteria being put into their son. What is the most appropriate response by the nurse? A) The bacteria is inactive, so there's no risk of it harming your son. B) The chances of the bacteria infecting your son are very slim. C) Currently available vaccines have do not contain whole bacteria. D) Vaccines are refrigerated and the cold inhibits mutations.

C) Currently available vaccines have do not contain whole bacteria.

A 6-year-old male is brought to his pediatrician's office with chickenpox. He has had symptoms for one week, and his mother is concerned about the patient's 8-year-old sister because she had a long, painful chickenpox infection 2 years prior. Of note, the patient was not vaccinated against chickenpox because his parents did not think it was a serious enough virus to warrant the pain of the injection. Which of the following explanations correctly represents how this patient could have been protected from chickenpox infection? A) He would not have been infected if he were breastfed as a baby because he would have passive natural immunity. B) He would not have been infected if his mother had gamma globulin administered during pregnancy because he would have passive artificial immunity. C) He could have been protected from infection if he received active artificial immunity through the form of a vaccine. D) He may have a primary immunodeficiency disease because healthy humans are not typically infected with chickenpox.

C) He could have been protected from infection if he received active artificial immunity through the form of a vaccine.

What type of molecules act to draw phagocytes to foreign substances? A) MALTs B) RES C) PAMPs D) BALTs E) Lysosomes

C) PAMPs

A 35-year-old male presents to the ER with a laceration on his left hand. The patient reports an hour ago he was working on renovations in his 1945 home, when an old board fell and injured his hand. The laceration is approximately 3 inches long and moderately deep. It appears that the cut was bleeding heavily, but he has stopped the bleeding by holding pressure on the site with an old t-shirt. At this phase of injury, how would the nurse expect the area surrounding the laceration to present? A) Cool and blue B) Pink, warm, and dry C) Red and hot D) Dusky, gray, and clammy

C) Red and hot

Which of the following lymphoid organs or tissues has the immunological function of filtering pathogens from the blood? A) Lymph nodes B) Thymus C) Spleen D) GALT E) Tonsils

C) Spleen

An RN working in a general medical-surgical unit is caring for a 57-year-old female with a bladder infection. Two weeks prior to hospitalization, the patient was experiencing slight burning upon urination. She self-treated by increasing her intake of fluids, but her symptoms continued to worsen. One week later, she developed generalized abdominal pain and a fever. She presented to the hospital when the pain became unbearable and fever reached 104°F. She was admitted to the medical-surgical unit and started on multiple IV antibiotics with concern that she could be developing a kidney infection. Which line(s) of defense has/have been breached in this patient's case? A) Only the first line of defense has been breached. Her second line of defense is fighting off this infection. B) No lines of defense have been breached. Her intact barrier system is keeping her kidneys from becoming infected. C) The second line of defense has been breached. Her lymphocytes are now being challenged by this infection. D) There are no lines of defense for this sort of infection.

C) The second line of defense has been breached. Her lymphocytes are now being challenged by this infection.

The mother of a 6-year-old child brings her daughter to the pediatrician's office because she has had a sore throat, cough, and fever for several days. She reports a fever up to 104°F that worsens at night, but seems to respond to treatment with acetaminophen. The child has not been eating or drinking well because she says, "it hurts to swallow." She is ill appearing, and does not seem interested in playing with the toys that are in the examination room. The physician notes a thick, white exudate on both of the patient's tonsils, which also seem enlarged. A throat culture and complete blood count with differential is ordered. The nurse examines the child and finds that the lymph nodes along of her neck are warm, tender, and slightly enlarged. Her other lymph nodes are nonpalpable or small, nontender, rubbery, and less than 2 mm in size. What is the most accurate interpretation of this finding? A) This is a normal examination of the posterior cervical chain lymph nodes. B) This examination is consistent with a systemic infection. C) This examination is consistent with a localized infection. D) This examination is definitive for an oncologic diagnosis.

C) This examination is consistent with a localized infection.

Antigens that elicit allergic reactions are called ________. A) superantigens B) heterophilic antigens C) allergens D) autoantigens E) none of the choices are correct.

C) allergens

The term ______ is given to any foreign substance that stimulates a specific immune system response. A) antibody B) allergen C) antigen D) foreign body E) none of the choices are correct.

C) antigen

Superantigens are ________. A) body tissues that the immune system mistakes as foreign B) cell markers found in some member of a species but not in other members C) bacterial toxins that activate T cells at a 100 times greater rate than other antigens D) those that evoke allergic reactions E) none of the choices are correct.

C) bacterial toxins that activate T cells at a 100 times greater rate than other antigens

What kind of immunity will be conferred to the infant through vaccination? A) Active natural immunity B) Passive natural immunity C) Passive artificial immunity D) Active artificial immunity

D) Active artificial immunity

Choose the statement that describes the method of Tc cell-mediated killing of a target cell. A) Opsonization B) Neutralization C) Agglutination D) Apoptosis

D) Apoptosis

A 2-week-old infant is brought to a family practice office for a scheduled visit. The parents appear anxious, as this is their first child. They express multiple concerns to the nurse about their son's sleep patterns, feeding, and crying. The RN provides empathetic listening and education to calm their fears, and they are receptive to the teaching. When the RN discusses vaccination with the parents, they refuse to vaccinate their son because they have heard vaccines can cause autism in children. Which of the following statements is not true concerning vaccines? A) They consist of killed or inactivated cells. B) They consist of live but weakened microbes. C) It is possible to be allergic to vaccine preparations. D) Autism only happens in rare instances of vaccination.

D) Autism only happens in rare instances of vaccination.

Which white blood cells comprise 20% to 30% of the circulating WBCs and are the cells that function in the body's third line of defense? A) Basophils B) Eosinophils C) Neutrophils D) Monocytes E) Lymphocytes

E) Lymphocytes

Which process involves a more rapid synthesis and greatly increased titer of antibody when the immune system is subsequently exposed to the same antigen? A) Neutralization B) Opsonization C) Complement fixation D) Agglutination E) Memory response

E) Memory response

Which lymphocytes lack specificity for antigen and are cells that attack cancer cells and virus-infected cells? A) Helper T cells B) Suppressor T cells C) Cytotoxic T cells D) Delayed hypersensitivity T cells E) Natural killer (NK) cells

E) Natural killer (NK) cells

Helper T cells ________. A) secrete antibodies B) function in allergic reactions C) directly destroy target cells D) suppress immune reactions E) activate B cells and other T cells

E) activate B cells and other T cells


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