NURS 505 Exam 4 (7, 10, 14) (15, 16) (18?)
The cascade of complement proteins form a ring around the antigen-antibody complex and have what actions on non-self-cells? Select all that apply. a) Altering the antigen's membrane b) Inducing chemotaxis to draw phagocytic cells c) Increasing phagocyte activity d) Releasing histamine e) Developing memory cells for future immunity
A, B, C, D Complement proteins react in a cascade fashion to form a ring around the antigen-antibody complex. The complement can destroy the antigen by altering the membrane, allowing an osmotic inflow of fluid that causes the cell to burst. They also induce chemotaxis (attraction of phagocytic cells to the area), increase the activity of phagocytes, and release histamine. B cells produce memory cells that will recognize an antigen if it appears again and initiate the immune response more quickly than on first encounter.
True or False. Autoimmune disease occurs when mutant cells escape the normal immune system surveillance and begin to multiply.
False Neoplasms occur when mutant cells escape the normal surveillance of the immune system and begin to grow and multiply. Autoimmune disease occurs when the body responds to specific self-antigens to produce antibodies against its own cells.
True or False. The greater the concentration of solutes in solution to which water is moving via osmosis, the lower the osmotic pressure.
False. The greater the concentration of solutes in solution to which the water is flowing with osmosis, the higher the osmotic pressure.
A nurse is caring for a 46-year-old female patient who is taking paclitaxel for ovarian cancer. Two or three days after the infusion of the drug, the nurse must closely monitor for:
Neurotoxicity
After teaching a group of students about arachidonic acid, the instructor determines that additional teaching is needed when the students identify which substance as being released due to this acid? a) Bradykinin b) Prostaglandins c) Leukotrienes d) Thromoboxanes
a) Bradykinin Bradykinin causes the release of arachidonic acid, not vice versa. Arachidonic acid causes the release of prostaglandins, leukotrienes, and thromboxanes.
A child is prescribed an anthracycline drug. The nurse would teach the parents to observe for signs and symptoms of what adverse effect? a) Cardiotoxicity b)Dehydration c)Gallbladder disease d)Esophageal varices
a) cardiotoxicity Children who receive an anthracycline drug (e.g., doxorubicin) are at increased risk of developing cardiotoxic effects (e.g., heart failure) during treatment or after receiving the drug. Efforts to reduce cardiotoxicity include using alternative drugs when effective, giving smaller cumulative doses of anthracycline drug, and observing clients closely so that early manifestations can be recognized and treated before heart failure occurs.
The nurse is providing care for a group of adult clients. Which client's health is most likely affected by disruptions to histocompatibility antigens? a) client who is being treated for systemic lupus erythematosus (SLE) b) client with diabetic retinopathy who is losing his vision c) client with an infected surgical incision d) client who requires dialysis for acute kidney injury
a) client who is being treated for systemic lupus erythematosus (SLE) Autoimmune disorders, such as SLE, can result from disruptions to histocompatibility antigens. Retinopathy, infections and acute kidney injury do not have this etiology.
Isotonic, Hypertonic, or Hypotonic a) dextrose 10% in water b) 0.9% NaCl c) 0.45% NaCl d) 0.33% NaCl
a) hypertonic b) isotonic c) & d) hypotonic
Once the inflammatory response is under way, which cells engulf and digest the injured cells or the invader? a) Basophils b) Neutrophils c) Eosinophils d) Monocytes
b) Neutrophils
The nurse is assessing a new client admitted to a nursing home. The client asks the nurse to explain interleukins. The nurse would include which information? a) "Interleukins directly affect acid-base balance." b) "Interleukins help the immune system with inflammation." c) "Interleukins directly affect infection." d) "Interleukins directly affect anemia."
b) interleukins help the immune system with inflammation
A neonatal intensive care unit nurse is caring for an infant diagnosed with respiratory syncytial virus (RSV). What route of delivery will the nurse use when ribavirin is administered to this infant? a) oral suspension b) topical c) intravenous d) inhaled
d) inhaled Is inhaled systemically
During which phase is the cell involved in gathering the substances needed to produce the building blocks for DNA? a) G1 b) G0 c) S d) G2
a) G1 The G1 phase involves the cell collecting materials to make the substances and produce the building blocks for DNA. The G0, or resting phase, involves the cell functioning as it is supposed to do. The S phase involves the actual synthesis of DNA. The G2 phase involves the cell producing all the substances needed to make the mitotic spindles.
A middle-aged patient has received a diagnosis of GI stromal tumor following an extensive diagnostic workup. Imatinib has been recommended as a component of the patient's drug regimen. What patient education should the nurse provide to this patient? a) "It's important that you let us know if you develop any significant swelling or puffiness." b) "Try to keep your PICC line dressing as dry as possible at all times." c) "You'll likely experience a lot of dry mouth while you're taking this drug, so it's helpful to chew ice chips." d) "If you experience significant nausea after taking a dose, stop taking the drug and schedule an appointment at the clinic."
a) It is important that you let us know if you develop any significant swelling or puffiness Patients must understand the importance of reporting edema or weight gain while taking imatinib. The patient will not likely have a PICC line. Nausea and dry mouth are not common adverse effects and the patient should not unilaterally stop taking the drug.
A client has been exposed to a pathogen and is mounting an immune response involving myelocytic cells. What physiologic process is this client most likely experiencing? a) Neutrophils are phagocytizing the pathogenic cells b) Natural killer cells are attacking the invasive microorganism c) Activated B cells are forming memory cells specific to the pathogen d)Activated B cells are releasing immunoglobulins
a) Neutrophils are phagocytizing the pathogenic cells B cells and NK cells are lymphocytic cells, whereas neutrophils are myelocytes.
A client became ill with an influenza virus several days ago. Today, the client describes being free of symptoms. What component of the immune system will be predominant today? a) Suppressor T cells b)Complement proteins c)Interleukins d) Cytokines
a) Suppressor T cells Suppressor T cells play an important role in limiting the immune response and preventing it from become too aggressive or too prolonged. Complement proteins, interleukins, and cytokines would be more significant during the active response to the pathogens.
The nurse is caring for a client with a complex medical history. What aspect of the client's health status is most likely caused by disruptions to the structure and function of histocompatibility antigens? a) The client's mobility is decreased because of rheumatoid arthritis. b) The client has type 2 diabetes that is controlled with diet and exercise. c)The client is experiencing chronic lower back pain. d) The client has had urinary tract infections three times in the past year.
a) The client's mobility is decrease because of rheumatoid arthritis AUTOIMMUNE AND HISTOCOMPATIBILITY (and transplants) Histocompatibility antigens are implicated in the etiology of several autoimmune conditions, including rheumatoid arthritis. They would be less likely to influence the development of type 2 diabetes, back pain or infections.
Which client would be most likely to benefit from the administration of interferon therapy? a) A client with leukemia b) A client with tuberculosis c) A premature neonate d) A client with asthma and seasonal allergies
a) a client with leukemia Interferons prevent viral replication and suppress some malignant cell reproduction. Consequently, they are used in the treatment of some cancers but not in bacterial infections, asthma or hypersensitivities. A premature neonate is vulnerable to infection but interferons do not broadly confer protection against infections.
A client is experiencing an inflammatory response following an injury. What assessment finding would confirm the role of thromboxanes in the inflammatory process? a) Bleeding has stopped at the injury site b) The skin surrounding the injury site has become reddened c) The client's pain is steadily decreasing d) The client's heart rate and blood pressure have risen
a) bleeding has stopped at the injury site Platelet aggregation and blood clotting are the result of the action of thromboxanes. They have no effect on pain or vital signs. They cause vasoconstriction, which would be more associated with pallor than redness.
A client with breast cancer is receiving goserelin (Zoladex). What aspect of the client's most recent laboratory results would suggest an adverse effect of this particular drug? a) Elevated serum calcium b)Decreased hemoglobin and hematocrit c) Increased international normalized ratio d) Increased blood urea nitrogen and creatinine
a) elevated serum calcium Goserelin is associated with a risk of hypercalcemia. Renal dysfunction is important to dosage management of almost all antineoplastic drugs and is not specific to goserelin. Changes in INR or red cell indices would not be directly associated with goserelin treatment.
Fewer adverse effects are associated with monoclonal antibody therapy than those of cytotoxic drugs. However, some of the potential adverse effects of monoclonal antibodies can be life threatening, including which effect? a) heart failure and bleeding problems b) changes in cognition and personality changes c) ischemic heart disease d) bronchoconstriction and pulmonary edema
a) heart failure and bleeding problems Although some adverse effects of monoclonal antibodies are rare, they are serious (e.g., heart failure, bleeding problems, electrolyte imbalances) and vary with a particular drug. None of the other options are adverse reactions associated with this therapy.
A client is prescribed acetylsalicylic acid for fever and headache. What is the action of acetylsalicylic acid? a) inhibiting prostaglandin synthesis in the central and peripheral nervous system b) providing selective action by inhibiting prostaglandin synthesis in the CNS c) inhibiting the release of norepinephrine to increase blood pressure d)suppressing the function of the hypothalamus to decrease inflammation
a) inhibiting prostaglandin synthesis in the central and peripheral nervous system Acetylsalicylic acid inhibits prostaglandin synthesis in the central nervous system and the peripheral nervous system. Acetylsalicylic acid does not provide selective action by inhibiting prostaglandin synthesis in the CNS. Acetylsalicylic acid does not inhibit the release of norepinephrine to increase blood pressure. Acetylsalicylic acid does not suppress the function of the hypothalamus to decrease inflammation.
A client is receiving immunizations before traveling to a storm-stricken region of the tropics where cholera, typhoid, and malaria are in epidemic. While specific immunizations to combat specific diseases would be administered, why would an injection of IgA also be administered? a) To increase local antibody response b) To increase humoral response c) To increase cellular response d) To increase cellular stimulation
a) to increase local antibody response Antibodies (mostly immunoglobulin A [IgA]) secreted at these sites act locally rather than systemically, combating foreign substances (especially pathogens) that are inhaled, swallowed, or otherwise come in contact with external body surfaces.
A 23-year-old client is prescribed zidovudine for treatment of human immunodeficiency virus (HIV). Which statement indicates that the client has understood the client teaching regarding the action of this medication? a) "Zidovudine inactivates the virus and prevents recurrence of the disease." b) "Zidovudine therapy may result in the development of resistant strains." c) "Zidovudine slows the progression of the disease but does not cure it." d)"Zidovudine prevents the occurrence of opportunistic infections."
c) "Zidovudine slows the progression of the disease but does not cure it" Zidovudine slows the progression of the disease but does not cure the disease. Zidovudine does not inactivate the virus, result in resistant strains, or prevent the occurrence of opportunistic infections.
Once a person has been exposed to a particular antigen and a repeat exposure occurs, what stimulates a quicker immune response? a) Immunity b) Macrophages c) Memory T cells d) Antibodies
c) Memory T cells The memory T and B lymphocytes that are generated remain in the body for a longer time and can respond more rapidly on repeat exposures to an antigen related to their acquired memory.
A client who waiting for an organ transplant asks the nurse why the donor organ must be matched. Which response by the nurse would be most appropriate? a) "Matching helps ensure that the proper organ is prepared." b) "Matching prevents you from having a reaction." c) "The closer the match, the less risk there is of rejection." d) "Matching is required by law before any transplant."
c) The closer the match the less risk there is of rejection All transplants, except autotransplantation, produce an immune response. Therefore, matching a donor's HLA markers as closely as possible to those of the recipient for histocompatibility is essential. The more closely the foreign cells can be matched, the less aggressive the immune reaction will be to the donated tissue.
A nurse is caring for a client who has undergone organ transplant surgery. The client asks the nurse what antibodies are. What is the best response by the nurse? a) Body's ability to recognize and destroy specific pathogens b) Body's ability to prevent infectious diseases c) Any foreign substance or molecule entering the body that stimulates an immune response d) A protein substance that the body produces in response to an antigen
d) a protein substance that the body produces in response to an antigen An antibody is a protein substance that the body produces in response to an antigen. Immunity is the body's ability to recognize and destroy specific pathogens and to prevent infectious diseases. An antigen is any foreign substance or molecule entering the body that stimulates an immune response.
A 16-year-old girl has broken her arm while snowboarding. When she arrives at hospital, she is shocked at the amount of swelling at the injury site. Which statement best explains the physiological rationale for her swelling? a) Migration and proliferation of mast cells, neutrophils, and platelets to the injury site occupy an increased volume of tissue. b) Potent vasodilation increases the total volume of vascular space at the site of inflammation. c) Osmotic flow of plasma into the intravascular space causes increased blood volume and interstitial fluid. d) Loss of plasma proteins causes an increase in interstitial osmotic pressure.
d) loss of plasma proteins causes an increase in interstitial osmotic pressure Swelling is the result of plasma proteins leaving the interstitial space, resulting in increased osmotic pressure of interstitial fluid and movement of fluid into tissues. Blood components, vasodilation, and increased intravascular volume do not account for swelling.
