NU372 Week 2 EAQ Evolve Elsevier: Immunity (Custom Quiz)
Identify the type of hypersensitivity reaction associated with systemic lupus erythematosus (SLE). o Type I o Type II o Type III o Type IV
o Type III · SLE is an example of an immune complex-mediated, or type III, hypersensitive reaction. Anaphylaxis is an example of a type I, or immediate hypersensitive reaction. Cytotoxic, or type II, hypersensitive reactions can result in conditions such as myasthenia gravis and Goodpasture syndrome. Graft rejection and sarcoidosis are conditions caused by delayed, or type IV, hypersensitivity reactions.
Which clinical manifestations may indicate a client has systemic lupus erythematosus (SLE)? Select all that apply. o Pericarditis o Esophagitis o Fibrotic skin o Discoid lesions o Pleural effusions
o Pericarditis o Discoid lesions o Pleural effusions · SLE is a chronic, progressive inflammatory connective tissue disorder that can cause major organs and systems to fail. Pericarditis is a cardiovascular manifestation of SLE. Discoid lesion is a skin manifestation that is a key indicator of the presence of SLE. Pleural effusion, a pulmonary manifestation, is a key indicator of the presence of SLE. Esophagitis is one of the gastrointestinal manifestations of systemic sclerosis. Fibrotic skin is one of the skin manifestations of systemic sclerosis.
The nurse reviews the laboratory reports of four clients. Which client would the nurse suspect as having type I-mediated asthma? o Client A o Client B o Client C o Client D
o Client A · Asthma is a type I or IgE-mediated hypersensitivity reaction. Client A, with IgE antibodies in the blood, has type 1-mediated asthma. Client B, with no antibodies, may not have humoral allergy or may have a humoral deficiency. Client C and client D may have either type II or type III hypersensitivity reactions.
Arrange the sequencing required to stimulate antibody-mediated immunity. o Exposure of antigen o Antigen recognition o Sensitization o Antibody production o Antibody-antigen binding o Antigen elimination
o Exposure of antigen o Antigen recognition o Sensitization o Antibody production o Antibody-antigen binding o Antigen elimination · Antibody-mediated immunity reactions start when new antigens invade the human body. After exposure, macrophages recognize the antigen. Next, virgin B lymphocytes become sensitized to the new antigen. After this action, antibody production begins. These antibodies then bind to the antigen and an immune complex forms. Binding of antibodies then causes cellular events to eliminate the antigen.
A client taking ibuprofen for rheumatoid arthritis asks the nurse if acetaminophen can be substituted. Which response by the nurse is appropriate? o "Yes, both are antipyretics and have the same effect." o "Acetaminophen irritates the stomach more than ibuprofen does." o "Acetaminophen is the preferred treatment for rheumatoid arthritis." o "Ibuprofen has anti-inflammatory properties, and acetaminophen does not."
o "Ibuprofen has anti-inflammatory properties, and acetaminophen does not." · Ibuprofen has an anti-inflammatory action that relieves the inflammation and pain associated with arthritis. Ibuprofen is not an antipyretic. Acetaminophen does not cause gastritis; this is an effect of aspirin. Acetaminophen is not a nonsteroidal anti-inflammatory drug (NSAID). NSAIDs are preferred for the treatment of rheumatoid arthritis.
A client employed by a company manufacturing latex gloves reports developing skin dryness, pruritus, and fissures 2 days ago and development of severe skin redness and inflammation in the past 24 hours. Which response would the nurse suspect the client is experiencing? o Type I allergic reaction o Type IV contact dermatitis reaction o Immune complex reaction o Cytotoxic hypersensitivity reaction
o Type IV contact dermatitis reaction · Type IV contact dermatitis is a delayed response to the chemicals used in the manufacturing process of latex gloves. A type IV's clinical manifestations include skin dryness, pruritus, fissuring, and cracking of the skin and occur within 6 to 48 hours after contact. A type I allergic reaction is a response to the natural rubber latex proteins and occurs within minutes of contact with the proteins; skin redness, urticaria, rhinitis, and conjunctivitis are the clinical manifestations. Immune-complex reaction is a type III hypersensitivity. The kidneys, skin, joints, blood vessels, and lungs are common sites for antigen deposits. Cytotoxic hypersensitivity reactions involve immunoglobulin G (IgG) or IgM antibodies directly bonding to antigens on cell surfaces. Cytotoxic hypersensitivity reactions are a type II hypersensitivity.
Which nursing intervention indicates misinformation when providing care for clients with the human immunodeficiency virus (HIV) infection? o "I will ask the client to avoid exposure to new infectious agents." o "I will ask the client about intake of supplemental vitamins and micronutrients." o "I will ask the client to avoid involvement in community activities." o "I will ask the client if he or she is up to date with recommended vaccines."
o "I will ask the client to avoid involvement in community activities." · The HIV infection decreases the client's immunity, making the client prone to infection. HIV-infected clients should avoid exposure to new infectious agents. They should consume nutritional support to maintain lean body mass and ensure appropriate levels of vitamins and micronutrients. They need to remain or become compliant with recommended vaccines to prevent vaccine-preventable diseases. HIV-infected clients may feel isolated and lonely; therefore they should be involved in support groups and community activities.
Which client has a higher risk for contracting the human immunodeficiency virus (HIV) infection? o A client who is involved in mutual masturbation o A client who undergoes voluntary prenatal HIV testing o A client who shares equipment to snort or smoke drugs o A client who engages in insertive sex with a noninfective partner
o A client who shares equipment to snort or smoke drugs · Clients who use equipment to snort (straws) and smoke (pipes) drugs are at the highest risk for becoming infected with HIV because their judgment may be impaired regarding the high-risk behaviors. Safe activities preventing the risk of contracting HIV include mutual masturbation, masturbation, and other activities meeting the "no contact" requirements. A client who undergoes perinatal HIV voluntary testing may reduce the chances of becoming infected. Insertive sexual activities between partners who are not infected with HIV are not at risk of becoming infected with HIV.
The client is on neutropenic precautions. From which direction does the protective environment isolation help prevent the spread of infection? o To the client from outside sources o From the client to others o From the client by using special techniques to destroy infectious fluids and secretions o To the client by using special sterilization techniques for linens and personal items
o To the client from outside sources · Protective environment isolation implies that the activities and actions of the nurse will protect the client from infectious agents because the client's own immune defense ability is compromised (neutropenia). Protective environment isolation is also referred to as reverse isolation. "From the client to others," "From the client by using special techniques to destroy infectious fluids and secretions," and "To the client by using special sterilization techniques for linens and personal items" are incorrect concepts related to protective environment isolation.
Which result would the nurse expect to find when reviewing the serum screening tests of a client with acquired immunodeficiency syndrome (AIDS)? o A decrease in CD4 T cells o An increase in thymic hormones o An increase in immunoglobulin E o A decrease in the serum level of glucose-6-phosphate dehydrogenase
o A decrease in CD4 T cells · The human immunodeficiency virus (HIV) infects helper T-cell lymphocytes; therefore 300 or fewer CD4 T cells per cubic millimeter of blood or CD4 cells accounting for less than 20% of lymphocytes is suggestive of AIDS. The thymic hormones necessary for T-cell growth are decreased. An increase in immunoglobulin E is associated with allergies and parasitic infections. A decrease in the serum level of glucose-6-phosphate dehydrogenase is associated with drug-induced hemolytic anemia and hemolytic disease of the newborn.
A nurse is creating a plan of care for a client with rheumatoid arthritis who has severe pain and swelling of the hand joints. Which details about range-of-motion exercises would the plan include? o Passively performing the exercises for the client o Discontinuing the exercises if the client reports discomfort o Applying heat or cold before the exercises o Increasing the vigor of the exercises to restore mobility
o Applying heat or cold before the exercises · Heat and cold applications reduce inflammation and discomfort. Passively performed exercises by the nurse will depend on the client's tolerance. Avoiding exercise will increase the destructive effects of immobility. Exercises are necessary to prevent contractures and permanent joint damage, but they cannot restore mobility that has been lost.
Which activity by the community nurse is an illness prevention strategy? o Encouraging the client to exercise daily o Arranging an immunization program for chicken pox o Teaching the community about stress management o Teaching the client about maintaining a nutritious diet
o Arranging an immunization program for chicken pox · An illness prevention program protects people from actual or potential threats to health. A chickenpox immunization program is an illness prevention program. It motivates the community to prevent a decline in health or functional levels. A health promotion program encourages the client to maintain his or her present levels of health. The nurse promotes the health of the client by encouraging the client to exercise daily. Wellness education teaches people how to care for themselves in a healthy manner. The nurse provides wellness education by teaching about stress management. The nurse promotes the health of the client by teaching the client to maintain a nutritious diet.
Which task in the care of a client with neutropenia can be delegated to unlicensed assistive personnel (UAP)? o Administering antibiotics o Assisting with personal hygiene o Monitoring for signs and symptoms of infection o Teaching the client and caregivers about how to avoid infection
o Assisting with personal hygiene · UAP assist with the client's personal hygiene. The licensed practical nurse administers antibiotics. Monitoring for signs and symptoms is performed by the licensed practical nurse. The registered nurse teaches the client and caregivers how to avoid infection.
Which action by a client taking immunosuppressant medication for rheumatoid arthritis indicates to the nurse the need for additional teaching? o Has bloodwork for complete blood cell count (CBC) obtained o Performs frequent hand washing o Attends crowded sporting events o Implements a home exercise program
o Attends crowded sporting events · Clients taking immunosuppressant medications need to avoid crowds and people who are sick. Clients will have routine CBC bloodwork obtained to monitor white blood cell count. Frequent hand washing prevents the spread of infection. Implementing a home exercise program helps maintain joint movement without the need to go to a crowded gym.
The nurse is interviewing a client who was diagnosed with systemic lupus erythematosus (SLE). Which clinical findings to this disease would the nurse expect the client to exhibit? Select all that apply. One, some, or all responses may be correct. o Butterfly facial rash o Firm skin fixed to tissue o Inflammation of the joints o Muscle mass degeneration o Inflammation of small arteries
o Butterfly facial rash o Inflammation of the joints · The connective tissue degeneration of SLE leads to involvement of the basal cell layer, producing a butterfly rash over the bridge of the nose and in the cheek region. Polyarthritis occurs in most clients, with joint changes similar to those seen in rheumatoid arthritis. Firm skin fixed to tissue occurs in scleroderma; in an advanced stage the client has the appearance of a living mummy. Muscle mass degeneration occurs in muscular dystrophy; it is characterized by muscle wasting and weakness. Inflammation of small arteries occurs in polyarteritis nodosa, a collagen disease affecting the arteries and nervous system.
The nurse provides care for four clients with hypersensitivity reactions. Which client would the nurse suspect as having a type IV hypersensitive reaction? o Client A o Client B o Client C o Client D
o Client D · Type IV or delayed hypersensitive reactions are cell-mediated immune responses that involve T lymphocytes, not antibodies. These cause erythema and edema in client D within 24 to 48 hours after a skin test. Type I hypersensitivity reaction is known as an anaphylactic reaction mediated by IgE antibodies; it shows as a wheal and flare around the site of injection in client A. Type II hypersensitivity reactions are known as cytotoxic reactions that involve IgM and IgG antibodies and show no response to the skin test in client B. Type III hypersensitivity reactions are known as immune-complex reactions that involve IgG and IgM antibodies. These show erythema and edema after 3 to 8 hours of a skin test in client C. Type IV hypersensitivity reaction is mediated by T lymphocytes. Use this information to select the correct answer.
When developing the plan of care for a client with rheumatoid arthritis, which client consideration would the nurse include? o Surgery o Comfort o Education o Motivation
o Comfort · Because pain is an all-encompassing and often demoralizing experience, the nurse would want to keep the client as pain-free as possible. Surgery corrects deformities and facilitates movement, which is not an immediate need. Concentration and motivation are difficult when a client is in severe pain.
A client with rheumatoid arthritis has been taking a corticosteroid medication for the past year. Prolonged use of corticosteroids puts this client at increased risk for which complication? o Decreased white blood cells o Increased C-reactive protein o Increased sedimentation rate o Decreased serum glucose levels
o Decreased white blood cells · Prolonged use of steroids may cause leukopenia as a result of bone marrow depression. C-reactive protein and sedimentation rate are elevated in acute inflammatory diseases; steroids help decrease them. Serum glucose levels increase with steroid use.
Which vaccine would the nurse administer to provide protection from precancerous lesions and cancers of the vulva, cervix, and vagina in young girls and women? o Rotavirus vaccine o Varicella virus vaccine o HPV vaccine o Meningococcal conjugate vaccine
o HPV vaccine · Human papilloma virus (HPV) vaccine is used to help prevent precancerous lesions of the cervix, vulva, and vagina caused by HPV types 16 and 18. Rotavirus vaccine is a monovalent vaccine developed to provide protection against certain rotaviruses, such as G1, G3, G4, and G9. Varicella virus vaccine is a vaccine administered to provide protection against the varicella virus. Meningococcal conjugate vaccine is a tetravalent conjugate vaccine that provides protection against certain serotypes of meningococcus, such as A, C, Y, and W-135.
Which diagnostic criterion should the nurse use to explain acquired immunodeficiency syndrome (AIDS) to a client with immunodeficiency virus (HIV)? o Contracts HIV-specific antibodies o Develops an acute retroviral syndrome o Is capable of transmitting the virus to others o Has a CD4+T-cell lymphocyte level of less than 200 cells/µL (60%)
o Has a CD4+T-cell lymphocyte level of less than 200 cells/µL (60%) · AIDS is diagnosed when an individual with human immunodeficiency virus (HIV) develops one of the following: a CD4+ T-cell lymphocyte level of less than 200 cells/µL (60%), wasting syndrome, dementia, one of the listed opportunistic cancers (e.g., Kaposi sarcoma [KS], Burkitt lymphoma), or one of the listed opportunistic infections (e.g., Pneumocystis jiroveci pneumonia, Mycobacterium tuberculosis). The development of HIV-specific antibodies (seroconversion), accompanied by acute retroviral syndrome (flulike syndrome with fever, swollen lymph glands, headache, malaise, nausea, diarrhea, diffuse rash, joint and muscle pain) 1 to 3 weeks after exposure to HIV reflects acquisition of the virus, not the development of AIDS. A client who is HIV positive is capable of transmitting the virus with or without the diagnosis of AIDS.
A client has a history of a persistent cough, hemoptysis, unexplained weight loss, fatigue, night sweats, and fever. Which risk would be assessed? o Lung cancer o Cerebrovascular disease o Cardiopulmonary alterations o Human immunodeficiency virus (HIV) infection
o Human immunodeficiency virus (HIV) infection · A client with a history of persistent cough, hemoptysis, unexplained weight loss, fatigue, night sweats, or fever may have a human immunodeficiency virus (HIV) infection or tuberculosis. Lung cancer and cerebrovascular disease are risks to be assessed in the client with a history of tobacco or marijuana use. Cardiopulmonary alterations may be present in a client with a persistent cough (productive or nonproductive), sputum streaked with blood, or voice changes.
A construction worker sustains a puncture wound from a rusty nail and the last immunization for tetanus is unknown. The primary health care provider prescribes tetanus immune globulin. Which type of protection does this immunization offer? o Lifelong passive immunity o Long-lasting active protection o Stimulation of antibody production o Immediate passive short-term immunity
o Immediate passive short-term immunity · Tetanus immune globulin contains ready-made antibodies and confers short-term passive immunity. Passive immunity lasts a short time, not throughout life. Immune globulins confer passive artificial immunity, not long-lasting active immunity. Immune globulins are antibodies; they do not stimulate the production of antibodies.
When would the nurse expect the client who has rheumatoid arthritis to experience the most joint pain and stiffness? o After assistive exercise o When the room is cool o During the evening hours o In the morning on awakening
o In the morning on awakening · Inactivity over an extended time increases stiffness and pain in joints. The client typically has morning stiffness, or gel phenomenon. Assistive exercises help maintain joint mobility. Whether the room is cool is not a factor; cold applications may decrease joint discomfort. The pain is not as severe in the evening as in the morning.
In clients with human immunodeficiency virus (HIV), which potential complication is most important for the nurse to teach prevention strategies? o Infection o Depression o Social isolation o Kaposi sarcoma
o Infection · The client has a weakened immune response. Instructions regarding rest, nutrition, and avoidance of unnecessary exposure to people with infections help reduce the risk for infection. Clients can be taught cognitive strategies to cope with depression, but the strategies will not prevent depression. The client may experience social isolation as a result of society's fears and misconceptions; these are beyond the client's control. Although Kaposi sarcoma is related to HIV infection, there are no specific measures to prevent its occurrence.
The nurse understands which vaccine is administered through the intranasal route? o Rotavirus vaccine o Influenza (live) vaccine o Varicella virus vaccine o Human papillomavirus vaccine
o Influenza (live) vaccine · Influenza (live) vaccine is administered through the intranasal route. The rotavirus vaccine is administered orally. The varicella virus vaccine is given as a subcutaneous injection. The human papillomavirus vaccine is given as intramuscular injection.
Which organism is a common opportunistic infection in a client infected with human immunodeficiency virus (HIV)? o Oropharyngeal candidiasis o Cryptosporidiosis o Toxoplasmosis encephalitis o Pneumocystis jiroveci pneumonia
o Oropharyngeal candidiasis · Oropharyngeal candidiasis is the most common infection associated with HIV because the immune system can no longer control Candida fungal growth. Pneumocystis jiroveci pneumonia (PCP) is more common in a client infected with acquired immunodeficiency syndrome (AIDS). It causes tachypnea and persistent dry cough. Cryptosporidiosis, an intestinal infection caused by Cryptosporidium organisms, presents in clients with AIDS as does toxoplasmosis encephalitis, which is caused by Toxoplasma gondii and is acquired through contact with contaminated cat feces or by ingesting infected undercooked meat.
Which immunization would be required for a 12-year-old client transferring to a new school? Select all that apply. o Tetanus o Influenza o Pertussis o Diphtheria o Meningococcal o Human papillomavirus
o Tetanus o Influenza o Pertussis o Diphtheria o Meningococcal o Human papillomavirus · A 12-year-old client should have received a tetanus, diphtheria, and pertussis (Tdap) booster; an annual influenza vaccination; and the first vaccines in the series for meningococcus and human papillomavirus.
Which interventions would the nurse implement to prevent infection in a preschool child with acute nonlymphoid leukemia who is admitted with a fever and neutropenia? o Placing the child in a private room, restricting ill visitors, and using strict hand-washing techniques o Encouraging a well-balanced diet, including iron-rich foods, and helping the child avoid overexertion o Avoiding taking rectal temperatures, limiting injections, and applying direct pressure for 5 minutes after venipuncture o Offering a moist, bland, soft diet; using toothettes rather than a toothbrush; and providing frequent saline mouthwashes
o Placing the child in a private room, restricting ill visitors, and using strict hand-washing techniques · Children with leukemia most often die of infection; a low neutrophil count is associated with myelosuppressant therapy. Placing the child in a private room, restricting ill visitors, and using strict hand-washing techniques are the best ways to minimize complications. Encouraging a well-balanced diet, including iron-rich foods, and helping the child avoid overexertion are not appropriate measures to prevent infection resulting from neutropenia; they are appropriate for treating the anemia. Avoiding taking rectal temperatures, limiting injections, and applying direct pressure for 5 minutes after venipuncture are not appropriate measures to prevent infection resulting from neutropenia; they are more appropriate for preventing bleeding. Offering a moist, bland, soft diet; using toothettes rather than a toothbrush; and providing frequent saline mouthwashes are not appropriate measures to prevent infection resulting from neutropenia; they are used to ease and treat stomatitis.
Which information would the nurse use to explain a positive diagnosis for human immunodeficiency virus (HIV) infection? o Performance of high-risk sexual behaviors o Evidence of extreme weight loss and high fever o Identification of an associated opportunistic infection o Positive enzyme-linked immunosorbent assay (ELISA) and Western blot tests
o Positive enzyme-linked immunosorbent assay (ELISA) and Western blot tests · Positive ELISA and Western blot tests confirm the presence of HIV antibodies that occur in response to the presence of the HIV. Performance of high-risk sexual behaviors places someone at risk but would not constitute a positive diagnosis. Evidence of extreme weight loss and high fever do not confirm the presence of HIV; these adaptations are related to many disorders, not just HIV infection. The diagnosis of just an opportunistic infection is not sufficient to confirm the diagnosis of HIV. An opportunistic infection (included in the Centers for Disease Control and Prevention surveillance case definition for acquired immunodeficiency syndrome [AIDS]) in the presence of HIV antibodies indicates that the individual has AIDS.
A client with rheumatoid arthritis asks the nurse why it is necessary to inject hydrocortisone into the knee joint. Which reason would the nurse include in a response to this question? o Lubricates the joint o Reduces inflammation o Provides physiotherapy o Prevents ankylosis of the joint
o Reduces inflammation · Steroids have an anti-inflammatory effect that can reduce arthritic pannus formation. Injecting hydrocortisone into the joint does not provide lubrication. Injection of a medication into a joint is not physiotherapy. Ankylosis refers to fusion of joints. It is only indirectly influenced by steroids, which exert their major effect on the inflammatory process.
Which actions transmit the human immunodeficiency virus (HIV)? Select all that apply. One, some, or all responses may be correct. o Multiple mosquito bites o Sharing syringe needles o Breast-feeding a newborn o Dry kissing an infected individual o Anal intercourse o Sharing drinking glasses
o Sharing syringe needles o Breast-feeding a newborn o Anal intercourse · Fluids such as blood and semen are highly concentrated with HIV. HIV may be transmitted parenterally by sharing needles and postnatally through breast milk. HIV may also be transmitted through anal intercourse. HIV is not transmitted by mosquito bites, sharing of drinking glasses, or dry kissing. Deep kissing involving a large amount of salvia does transmit HIV.
Which immune preparation contains antibodies that provide passive immunity? o Toxoid o Killed vaccine o Live attenuated vaccine o Specific immune globulin
o Specific immune globulin · Specific immune globulins contain a high concentration of antibodies directed at specific antigens. Toxoid vaccines contain a bacterial toxin that has been changed to a nontoxic form. Killed vaccines contain killed microbes or isolated microbes. Live attenuated vaccines are composed of live microbes that have been weakened or rendered completely avirulent.
According to the Centers for Disease Control and Prevention (CDC), which stage of the human immunodeficiency virus (HIV) disease is present in the client with a laboratory report revealing a CD4+ T-cell count of 520 cells/mm3? o Stage 1 o Stage 2 o Stage 3 o Stage 4
o Stage 1 · According to the CDC, HIV disease is divided into four stages. A client with a CD4+ T-cell count of greater than 500 cells/mm3 is in the first stage of HIV disease. A client with a CD4+ T-cell count between 200 and 499 cells/mm3 is in the second stage of HIV disease. A client with a CD4+ T-cell count of less than 200 cells/mm3 is in the third stage of HIV disease. The fourth stage of HIV disease indicates a confirmed HIV infection with no information regarding the CD4+ T-cell counts.
A client reports hair loss, joint pain, and a facial rash. The nurse documents in the medical record the presence of a butterfly rash on the client's face. Which disorder would the nurse suspect? o Scleroderma o Angioedema o Rheumatoid arthritis o Systemic lupus erythematosus
o Systemic lupus erythematosus · Systemic lupus erythematosus is an autoimmune connective tissue disorder characterized by joint pain, alopecia, and rashes on the face. A characteristic butterfly rash is a major skin manifestation of systemic lupus erythematosus. Scleroderma is a chronic, inflammatory, autoimmune connective tissue disease characterized by hardening of the skin. Angioedema is the diffuse swelling of the eyes and lips. Rheumatoid arthritis is an inflammatory autoimmune disease process that affects primarily the synovial joints. The primary symptom of rheumatoid arthritis is painful, swollen joints.
Which suggestion would the nurse make to a client with rheumatoid arthritis who asks about ways to decrease morning stiffness? o Wear loose but warm clothing. o Plan a short rest break periodically. o Avoid excessive physical stress and fatigue. o Take a hot bath or shower in the morning.
o Take a hot bath or shower in the morning. · Moist heat increases circulation and decreases muscle tension, which help relieve chronic stiffness. Although wearing loose but warm clothing is advisable for someone with arthritis, it does not relieve morning stiffness. Inactivity promotes stiffness. The practice of avoiding excessive physical stress and fatigue is related to muscle fatigue, not to stiffness of joints.
The nurse is preparing to administer a diphtheria, tetanus, and pertussis vaccine to a child. After completing an assessment, the nurse concludes that the child cannot receive the vaccine safely. Which assessment finding supports the nurse's conclusion? o Fever has developed within 48 hours of previous vaccinations. o The child exhibited a shock-like state after a previous vaccination. o The child has a history of anaphylactic reactions after vaccinations. o The child has an upper respiratory tract infection and mild febrile illness.
o The child has a history of anaphylactic reactions after vaccinations. · Vaccines are contraindicated in children who exhibit anaphylactic reactions because these reactions may be life-threatening. If a fever develops after a child's first vaccination, subsequent vaccines should be administered with caution. If a shock-like state has previously developed after a vaccination, subsequent vaccines should be administered with caution. When a child has an upper respiratory tract infection, vaccinations may be postponed until the infection is resolved.
Which type of vaccines triggers the recipient's immune system to produce antitoxins? o Live vaccines o Killed vaccines o Toxoid vaccines o Specific immune globulins
o Toxoid vaccines · Toxoids are a nontoxic form of bacterial toxins that induce the formation of antitoxins by the recipient's immune system. Examples of these types of vaccines include tetanus toxoid and diphtheria toxoid. Both live and killed vaccines induce the body's immune system to produce antibodies, making the individual actively immune to the microbes. Specific immune globulins are high concentration of antibodies prepared from donated blood directed against specific antigens.
A client experienced a wheal and flare reaction to a skin test after a mosquito bite. Which type of hypersensitivity reaction did the client experience? o Type I o Type II o Type III o Type IV
o Type I · Type I is an immunoglobulin E (IgE)-mediated hypersensitivity reaction that causes a wheal and flare response. A type I reaction displays a pale wheal containing edematous fluid surrounded by a red flare from the hyperemia. Type II is a cytotoxic hypersensitivity reaction involving IgG and IgM antibodies but does not show a wheal and flare response. Type III hypersensitivity reaction is an immune complex-mediated reaction involving erythema and edema within 3 to 8 hours. The type IV hypersensitivity elicits a delayed hypersensitivity reaction involving erythema and edema within 24 to 48 hours of exposure.
On assessment of a healthy adult client reporting development of a skin rash (see image), which type of hypersensitivity reaction does the image portray? o Type I o Type II o Type III o Type IV
o Type IV · The image portrays a type IV hypersensitive reaction that includes delayed hypersensitivity reactions such as contact dermatitis. Atopic dermatitis is a type I hypersensitivity reaction occurring immediately upon exposure to the allergens and typically associated with asthma, hay fever, or eczema. The immunoglobulin E antibody mediates this reaction. Type II hypersensitivity reactions include transfusion reactions, Goodpasture syndrome, immune thrombocytopenic purpura, and Graves disease. Type III hypersensitive reactions include systemic lupus erythematosus and rheumatoid arthritis.
To reduce the incidence of human immunodeficiency virus (HIV) transmission, which basic strategies would the nurse teach a health class? o Using condoms o Using separate toilets o Practicing sexual abstinence o Preventing direct casual contacts o Sterilizing the household utensils
o Using condoms o Practicing sexual abstinence · HIV is found in body fluids such as blood, semen, vaginal secretions, breast milk, amniotic fluid, urine, feces, saliva, tears, and cerebrospinal fluid. A client should use condoms to prevent contact between the vaginal mucous membranes and semen. Practicing sexual abstinence is the best method to prevent transmission of the virus. The HIV virus is not transmitted by sharing the same toilet facilities, casual contacts such as shaking hands and kissing, or by sharing the same household utensils.
