Patho - Chapter 11: Disorders of the Immune System

A registered nurse is teaching a student nurse about the causes of IgA deficiency. Which statement by the student indicates the need for further teaching?

"IgA deficiency is a very rare primary immune disorder."

In HIV, the most accurate measurement of the degree of immune system impairment is _________________.

CD4 count

A patient diagnosed with rheumatoid arthritis (RA) is talking to the nurse about treatment options. Which of the following is considered to be a standard treatment for RA?

Disease-modifying antirheumatic drugs Rationale: Disease-modifying antirheumatic drugs are a standard treatment for RA.

A client is suffering from scleroderma. Which symptom might develop in the client on exposure to cold?

Raynaud's phenomenon

A patient is confused about the difference between rheumatoid arthritis in osteoarthritis. Which of the following would be inappropriate response by the nurse?

Rheumatoid arthritis is an autoimmune disease, while osteoarthritis is not. Rationale: Because rheumatoid arthritis is an autoimmune disease, disease treatment and progression is different than osteoporosis.

Hypogammaglobulinemia is ___________________. Select all that apply. a disorder of B cells only. a disorder of both B and T cells. always a primary immunodeficiency. a condition that can be acquired or caused by genetic defects. a disorder of T cells only.

- a disorder of B cells only. - a condition that can be acquired or caused by genetic defects.

A patient is to be assessed for the presence of human leukocyte antigen (HLA). Which type of disorder is the clinician most concerned about?

Autoimmune diseases Rationale: Elevated HLA is common in some autoimmune diseases.

Which of the following results in classification of AIDS?

CD4 count of 190 cells per microliter and Pneumocystic infection.

Which diagnostic test would be ordered by the primary healthcare provider to confirm sarcoidosis?

Chest x-ray

A nurse sees a patient's hands such as those shown in the image. Which diagnosis will the nurse likely expect to see on the patient's chart?

Rheumatoid arthritis (RA) Rationale: The swollen joints presented in the image are common in RA.

A patient with a family history of autoimmune diseases presents at the clinic with what she feels is a very strange symptom. She states that she feels she has fewer wrinkles and her skin feels tighter, and she feels she looks younger. She does not understand what may be happening, as she has not used any new cosmetic products. What disorder may the nurse suspect?

Scleroderma Rationale: Scleroderma is an autoimmune disorder affecting collagen which causes tightening of the skin.

A patient is being given instructions for an EpiPen. The patient has severe allergies to bee stings. Which of the following would be correct information for the nurse to provide?

The EpiPen is to be used immediately until you can receive additional needed medical care. Rationale: The EpiPen helps to counteract some of the changes brought on by a severe allergic reaction. Additional medical help will be needed.

A volunteer at the hospital is required to complete a tuberculosis test (Mantoux test), which works on a Type IV hypersensitivity reaction. The person wants to know when to expect the results. What is an appropriate response?

We will complete the test and review the results after 48 hours has passed. Rationale: A delayed hypersensitivity reaction usually takes 24 hours or more to develop.

On the laboratory write-up, an immunoglobulin E (IgE)-mediated response resulting in urticaria is noted. How can these results be interpreted for the patient?

You have an allergic response. Rationale: IgE's and urticaria are common in allergies.

A nurse sees Sjogren's syndrome on a patient's chart. The nurse should follow up specifically with which aspects for this disease during her assessment of the patient? Select all that apply. Swollen hands Dry eyes Tightening of the skin Dry mouth Butterfly rash across face

- Dry eyes - Dry mouth Rationale: Sjogren's tends to present with dry eye and mouth.

A patient believe she has lupus. Which of the following diagnostic tests, if positive, would contribute to the diagnosis of lupus? Select all that apply. Rheumatoid factor Elevated antinuclear antibody (ANA) levels Anti-ds DNA antibodies Mantoux test Leukocytosis

- Elevated antinuclear antibody (ANA) levels Rationale: Elevated ANA levels, which are antibodies, are commonly elevated in lupus. - Anti-ds DNA antibodies Rationale: Anti-ds DNA antibodies elevate in lupus.

What may you expect in DiGeorge syndrome? Select all that apply. Life-threatening condition Poorly developed thymus gland Mild signs and symptoms Elevated T cell levels Genetic cause

- Life-threatening condition - Poorly developed thymus gland - Genetic cause

A nursing student is creating examples for presentation on Type III hypersensitivity reactions. Which of the following should he include in his presentation? Select all that apply. Mantoux testing Hay fever Systemic lupus erythematosus (SLE) Rheumatoid arthritis (RA) Allergic reaction to shellfish

- Systemic lupus erythematosus (SLE) - Rheumatoid arthritis (RA) Rationale: SLE and RA are a Type III hypersensitivity.

A registered nurse is teaching a student nurse about rheumatoid arthritis. Assess the statements made by the student nurse and choose the statement that indicates the need for further teaching.

"Rheumatoid arthritis and osteoarthritis have similar etiologies."

A client with rheumatoid arthritis has Sjögren's syndrome. What should be included in the care plan of the client to treat Sjögren's syndrome? Select all that apply. Administration of ophthalmic solution Thymus gland transplant ART regimen Including citrus fruits in the diet Administration of medications to stimulate salivary gland function

- Administration of ophthalmic solution - Administration of medications to stimulate salivary gland function

A patient has sarcoidosis. Which of the following signs and symptoms for this disease should the nurse look for?

Erythema nodosum Rationale: Erythema nodosum, a skin rash, may develop in sarcoidosis.

A client develops itching, skin erythema, and tongue edema immediately after having peanuts. On examination, the client is found to have low blood pressure. What medication would be given to treat this condition? Select all that apply. Intranasal corticoid Glucocorticoid Antihistamine Epinephrine Aspirin

Glucocorticoid Antihistamine Epinephrine

A physician is to see a patient with rheumatoid arthritis. Which area of the body does the physician expect to show the most signs and symptoms of the disease?

Hands and fingers Rationale: Rheumatoid arthritis frequently effects the joints of the hands.

A patient has severe systemic lupus erythematosus. What organ damage is the clinician most likely to be concerned about?

Kidney Rationale: The kidneys are especially prone to damage by lupus.

A nursing student is looking at a white blood cell (WBC) differential test and cannot find the cell type macrophage listed. Another nurse provides which of the following correct explanation?

Macrophages are derived from monocytes, a type of cell that is reported on a WBC differential test. Rationale: Macrophages are derived from monocytes. Monocytes are reported on a differential WBC.