Patho Exam 4

A client diagnosed with type I immediate hypersensitivity disorder from a bee sting is asking the nurse what this means. The nurse's best response is:

'This is an allergic reaction to the antigen of bee venom.'

Which individual situation best exemplifies the processes of innate immunity?

A child who has experienced heat and swelling of a skinned knuckle

Which patient is at the highest risk for developing sepsis?

A patient admitted for end-stage kidney disease

A middle school student is scheduled to receive booster immunizations, and the parent asks the nurse why the booster is necessary. What characteristic of the adaptive immune system would inform the nurse's response?

A secondary response causes a sharp rise in antibody levels.

__________ is a genetic disorder in which there is complete or partial congenital absence of pigment in the skin, hair, and eyes.

Albinism

Which patients need standard precautions?

All patients at all times

Which statement is true regarding drawing blood cultures?

Always draw both sets of blood cultures before administering antibiotics.

A new patient arrives at the clinic. The physician suspects that the patient may have systemic lupus erythematosus (SLE) given the clinical manifestations related to joint pain, skin changes, and a history of pleural effusions. You should anticipate which diagnostic tests will be a priority to facilitate the diagnosis?

Anti-DNA antibody test

Which is not a potential source of an infection that could cause sepsis?

Atherosclerosis

Which cells are primarily programmed to remove the invading organisms and remember the antigen in order to respond rapidly in response to a future exposure?

B and T lymphocytes

For a patient on any type of precautions, when is hand hygiene supposed to be completed?

Before entering or exiting the room

__________ are low molecular weight regulatory proteins that are produced by cells of innate and adaptive immunity.

Cytokines

__________ are virulent proteins released from bacterial cells during growth.

Exotoxins

A contusion involves the separation of the bone ends of a joint with loss of articulation. (T/F)

False

All vaccines used to immunize children against childhood diseases are made of live viruses. (T/F)

False

An epidemic is characterized by the spread of a disease beyond continental boundaries. (T/F)

False

Components of the innate immune system can be physical, chemical, lymphocytes, and/or antibodies. (T/F)

False

Human infants are born lacking antibodies. (T/F)

False

Humoral- and cell-mediated immunity are types of innate immunity. (T/F)

False

Infections occur at the site of the portal of entry. (T/F)

False

Lymphocytes are categorized as either granulocytes or agranulocytes. (T/F)

False

Neutropenia is always caused by cancer treatments; it is not a naturally occurring event. (T/F)

False

Once a client is exposed to the HIV, they will develop AIDS immediately. (T/F)

False

Passive immunity is achieved through immunization. (T/F)

False

Rejection of transplanted organs is normally manifested during and immediately following transplantation. (T/F)

False

Ringworm is caused by parasites that are common in soil. (T/F)

False

The incidence of skin cancer is declining in the United States. (T/F)

False

The opportunistic organisms that produce infections in a client with HIV are able to do so because the immune system of the individual is compromised. (T/F)

False

True or false: Passive immunity is achieved through immunization.

False

What personal protective equipment (PPE) is required for a patient on contact precautions?

Gown and gloves

What is the proper order for donning personal protective equipment?

Gown, mask, goggles, gloves

__________ immunity is mediated by secreted molecules and is the main defense against extracellular microbes.

Humoral

__________ disorders are characterized by the excessive or inappropriate activation of the immune system.

Hypersensitivity

Type I allergic reactions are mediated by __________ class immunoglobulins.

IgE

The nurse in the health department is reading the result of a client's purified protein derivative (PPD) immunization. The site demonstrates a positive reaction to the PPD serum. How can this reaction be classified?

Immune response of helper T 1 cells to tuberculin antigen

__________ involves the supplementation or stimulation of a host's own immune response, often through the use of intravenous immune globulin.

Immunotherapy

How does the flu vaccine work to provide a person with immunity?

It activates the formation of antibodies to the pathogen.

What is a component of proper respiratory hygiene?

It is best to cough into a tissue and promptly dispose of the tissue.

__________ are the weakest part of the skeletal system and are the most susceptible sites for injury.

Joints

A person who was diagnosed with HIV infection 12 years ago and still has a CD4+ cell count of 800 cells/µL and a low viral load is considered be clinically what?

Long-term nonprogressor

Which is one of the first physical lines of defense in innate immunity?

Mucous membranes

Which type of immunity is achieved by an infant from through antibodies transferred in utero or in breast milk?

Naturally acquired passive immunity

Which finding is most likely in a client in the latent period of HIV infection?

Numerous enlarged lymph nodes in the axilla and cervical neck region for 4 months

An immunocompromised client was exposed to hepatitis and will be treated with immunoglobulin G (IgG). Which mechanism of immunity will help improve this client's health?

Passive immunity

Which aspect of pathogen recognition in the innate immune system explains why the immune system does not attack all the body's cells in an autoimmune disease?

Pattern recognition receptors (PRRs) ensure cells are correctly identified.

__________ ulcers can result from obstructed capillary blood flow in as little as 2 hours.

Pressure

Which are interprofessional goals of treating sepsis? Select all that apply.

Prevent and treat infection.; Maintain tissue oxygenation.; Support failing organs.; Keep mean arterial pressure (MAP) above 65 mm Hg.

Which action is not appropriate regarding dirty needles?

Recap them as part of standard practice.

The 'window period' of HIV infection refers to the period of time between infection and which event?

Seroconversion

Which are involved in innate (general) immune defenses? Select all that apply.

Skin, Stomach acid, Urine flow

Which characteristics do primary immunodeficiency and lupus share? Select all that apply.

T-cell and B-cell dysfunctions, Involves the inflammatory response, Damage to organs and organ systems

Which description best characterizes sepsis?

The body's exaggerated response to infection

A patient on droplet precautions needs to leave their room for a computed tomography (CT) scan. How should the nurse address the droplet precautions?

The patient should don a surgical mask for the duration of time spent outside the room.

An unlicensed nursing personnel completed vital signs on a patient using an electric machine. What should happen next?

They should clean the equipment used to take vital signs.

B cells are primarily associated with humoral immunity. (T/F)

True

Bone healing takes place in a similar manner but over a longer time period than soft tissue healing. (T/F)

True

Certain drugs can cause an individual to be especially sensitive to sunlight. (T/F)

True

Clients experiencing neutropenia are at risk for the development of infection by Gram-negative and Gram-positive bacteria as well as fungi. (T/F)

True

DiGeorge syndrome is a primary immunodeficiency disorder affecting T-cells within the immune system. (T/F)

True

Disorders of B-cell function impair the body's ability to produce antibodies against disease. (T/F)

True

Fractures of the hip are more common among the elderly than younger adults. (T/F)

True

Increased epidermal skin turnover is associated with psoriasis. (T/F)

True

Latex allergies may be either a type I or type IV reaction. (T/F)

True

Primary immunodeficiency disorders are recessive traits transmitted to the next generation through genetic mutations of the X chromosome. (T/F)

True

Rheumatic inflammatory disorders such as systemic lupus erythematosus can cause a reduction in neutrophils. (T/F)

True

Scabies is caused by mites and "athlete's foot" by a fungus. (T/F)

True

T cells mature in the thymus and are active in cellular immunity. (T/F)

True

The definitive diagnosis of an infectious disease requires recovery and identification of the infecting organism by microscopic identification of the agent in stains of specimens or sections of tissue, culture isolation and identification of the agents, demonstration of antibody- or cell-mediated immune responses to an infectious agent, or DNA or RNA identification of infectious agents. (T/F)

True

The innate immune system is a quickly reacting system. (T/F)

True

The innate immune system is able to recognize and identify self from nonself as well as microbial organisms. (T/F)

True

The innate immune system utilizes cytokines as part of its response. (T/F)

True

The risk for transmission of HIV from mother to child can be lowered by not breast-feeding and cesarean delivery. (T/F)

True

There are generally fewer treatment options for viral infections than for bacterial infections. (T/F)

True

Toll-like receptors play a role in the pathogen sensation process of innate immunity. (T/F)

True

Treatment of infectious disease is aimed at eliminating the infectious organism and promoting recovery of the infected person. (T/F)

True

True or false: Administration of certain antibiotics may result in a type III hypersensitivity reaction.

True

True or false: Immunodeficiency disorders are autosomal dominant, sex-linked, and autosomal recessive traits.

True

Which diagnoses warrant airborne precautions?

Tuberculosis, measles, disseminated herpes zoster

The nurse is monitoring the client receiving packed red blood cells (PRBCs) for a transfusion reaction to the donor's blood. The nurse knows that a transfusion reaction that can occur with the administration of PRBCs is what type of hypersensitivity disorder?

Type II

The nurse is caring for a client diagnosed with systemic lupus erythematosus. The nurse is reviewing the laboratory reports, noting that the results are demonstrating increased damage to the kidney. The nurse understands that the damage to the kidney is the result of which factors?

Type III hypersensitivity reaction, complement fixation, and inflammation

Which type of hypersensitivity is caused by T-lymphocyte-mediated reactions?

Type IV

A patient in the primary phase of a type I hypersensitivity reaction would most likely experience which process?

Vasodilation of the capillaries from the release of histamine

When is hand hygiene not appropriate?

When in a sterile environment

In which type of circumstance would a type II reaction occur?

When the body loses the ability to recognize self-antigens

Systemic lupus erythematosus (SLE) produces antibodies against all but which type of cells?

White blood cells (WBCs)

Inflammation of a hair follicle and its accompanying sebaceous unit results in __________.

acne

An antibiotic that acts by inhibiting bacterial growth is described as __________.

bacteriostatic

Disorders of the __________ system compromise the effectiveness of the innate immune system.

complement

The __________ system is a contributor to both innate and humoral immunity that requires sequential activation.

complement

When bone fragments protrude through skin following a fracture, the injury is classified as an open, or __________, fracture.

compound

Urticaria, or __________, is a common skin disorder characterized by the development of raised, pink wheals accompanied by intense itching.

hives

Antibodies are also known as __________.

immunoglobulins

Malignant __________ is a rapidly progressing form of cancer that affects the melanocytes.

melanoma

Normal, harmless bacterial inhabitants of the human body are referred to as the _________.

microflora

As the CD4 T-cell count decreases, the body becomes susceptible to __________ infection.

opportunistic

Infection of the bone is known as __________.

osteomyelitis

Malaria and giardiasis are examples of __________ infections.

protozoal

The organ most closely associated with the maturation of T cells is the __________.

thymus

The HIV is a ______________ that destroys the body's immune system by taking over and destroying CD4 T cells.

tolerance retro virus

The Mycobacterium responsible for __________ can occasionally migrate from the lungs and cause infection in bone tissue.

tuberculosis