Patho Immunity, Infection and Cancer
Which type of hypersensitivity reaction is associated with rheumatoid arthritis? 1 Delayed 2 Cytotoxic 3 IgE-mediated 4 Immune-complex
4. Immune-complex Rheumatoid arthritis is an autoimmune disorder associated with an immune-complex type of hypersensitivity reaction. Contact dermatitis caused by poison ivy is associated with a delayed type of hypersensitivity reaction. Goodpasture's syndrome is associated with a cytotoxic type of hypersensitivity reaction. Asthma is associated with an IgE-mediated type of hypersensitivity reaction.
The nurse observes that a client who is on intravenous medication is experiencing an anaphylactic reaction. What is the priority nursing intervention in this situation? 1. Elevate lower extremities of the client. 2. Start normal saline infusion immediately. 3. Report to the primary healthcare provider immediately. 4.Stop intravenous medication and administer epinephrine (adrenaline).
4. Stop intravenous medication and administer epinephrine (adrenaline) Intravenous medications can cause an anaphylactic reaction. During anaphylactic reactions, the nurse should immediately stop the intravenous medication and administer epinephrine (adrenaline). The nurse can elevate the client's lower extremities, but only after administering epinephrine (adrenaline). The nurse can start a normal saline infusion and report to the primary healthcare provider, but only after stopping the intravenous medication and administering epinephrine (adrenaline). Test-Taking Tip: Multiple-choice questions can be challenging because students think that they will recognize the right answer when they see it or that the right answer will somehow stand out from the other choices. This is a dangerous misconception. The more carefully the question is constructed, the more each of the choices will seem like the correct response.
Which manifestations may indicate a client has systemic lupus erythematosus (SLE)? Select all that apply. 1. Pericarditis 2.Esophagitis 3.Fibrotic skin 4.Discoid lesions 5.Pleural effusions
1. Pericarditis, 4. Discoid lesions, 5. 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. Topics
While assessing a client with acquired immunodeficiency syndrome, the nurse suspects that the client has developed cryptosporidiosis. Which symptoms support the nurse's suspicion? Select all that apply. 1 Seizures 2 Diarrhea 3 Confusion 4 Weight loss 5 Blurred vision
2. diarrhea and 4. weight loss Cryptosporidiosis is an intestinal infection caused by Cryptosporidium. The symptoms of cryptosporidiosis are diarrhea and weight loss. Seizures and confusion are the symptoms of toxoplasmosis encephalitis. Blurred vision is a symptom of cryptococcosis.
A client is admitted with a diagnosis of stage 0 cervical cancer (carcinoma in situ). What does the nurse emphasize while helping the client understand her diagnosis and prognosis? 1 Five-year survival rates for this cancer are nearly 100% with early treatment. 2 Radiation therapy is as successful as surgery in the treatment of this type of cancer. 3 Cancer has probably extended into the vaginal wall and may require a radical hysterectomy. 4 Stage 0 indicates that the cancer is invasive and may require surgery in addition to radiation therapy
1. Five-year survival rates for this cancer are nearly 100% with early treatment. With carcinoma in situ the epithelium is eroded and replaced by rapidly dividing neoplastic cells. There is no distinct tumor; with treatment the prognosis is excellent. Preinvasive lesions of the cervix are treated with cryotherapy, laser therapy, or loop electrosurgical excision procedure, also known as LEEP. Radiation therapy is used for invasive cervical cancer. Stage II involves the vaginal wall; stage 0 is preinvasive. Stages I to IV are considered invasive by increasing degrees; stage 0 is preinvasive. Treatment is based on the staging.
What is the function of IgG in the body? 1 Activates the degranulation of mast cells 2 Activates the classic complement pathway 3 Prevents upper respiratory tract infections 4 Prevents lower respiratory tract infections
2 Activates the classic complement pathway The classic complement pathway is activated by the IgG and IgM antibodies. IgE antibodies cause a degranulation of mast cells. IgA antibodies are found largely in mucous membrane secretions and play an important role in preventing upper and lower respiratory tract infections.
Which type of immunoglobulin is present in tears, saliva, and breast milk? 1 IgE 2 IgA 3 IgG 4 IgM
2 IgA IgA immunoglobulin is present in tears, saliva, and breast milk. IgE and IgG immunoglobulins are present in plasma and interstitial fluids. IgM immunoglobulin is present in plasma.
The nurse is counseling a client infected with human immunodeficiency virus (HIV) regarding prevention of HIV transmission. Which statement by the client indicates the nurse needs to follow up? 1 "I should abstain from sexual activity." 2 "I can safely have anal sex without any barriers." 3 "I should get HIV counseling if planning for pregnancy." 4 "I will use condoms while having sexual intercourse."
2. "I can safely have anal sex without any barriers" The client with HIV should use barrier protection when engaging in insertive sexual activity such as anal, oral, and vaginal. Therefore the nurse should follow up to provide the client with the correct information. All the other statements are correct and need no follow up. Abstaining from all sexual activity is a safe way to eliminate the risk of exposure to HIV in semen and vaginal secretions. The client should undergo HIV counseling and routinely offer access to voluntary HIV-antibody testing when planning for pregnancy. The most commonly used barrier is a condom, which allows for protected intercourse. Test-Taking Tip: Human immunodeficiency virus (HIV) is transmitted through blood and semen. Therefore the person participating in sexual activity should use sexual barriers to reduce the chances of infection or to prevent infection.
The nurse is teaching a client self-management of skin cancer. Which statement made by the client indicates the need for further learning? 1 "I should use sunscreen when going out." 2 "I should limit sun exposure to between 7 am and 12 pm." 3 "I should wear a hat and opaque clothing when going out." 4 "I should go for a monthly examination of cancerous and precancerous lesions."
2. "I should limit sun exposure to between 7 am and 12 pm." In the self-management of skin cancer, the client should not go out in the sun between 11 am and 3 pm. This is the time when the sunlight is strongest. Using sunscreen protects a client's skin from the sun's rays. The client should wear a hat and opaque clothing when going out. Going for monthly examination of cancerous and precancerous lesions is recommended. Test-Taking Tip: Skin cancer can be spread in many ways. Identify the options that help in decreasing the spread of skin cancer.
What action describes artificial active immunity? 1 Antibodies are passed from one person to another 2 Antibodies against an antigen are made naturally in the body 3 Antibodies are made after an antigen is injected into the body 4 Antibodies are transferred into the body after being made in another body or animal
3. Antibodies are made after an antigen is injected into the body Artificial active immunity is the protection developed by vaccination or immunization, and the immune system responds by making antibodies. Natural passive immunity occurs when antibodies are passed from one person to another, such as in the case of a mother to the fetus. Natural active immunity occurs when the body responds naturally by making antibodies against an antigen. Passive immunity occurs when the antibodies against an antigen are transferred to a person's body after first being made in the body of another person or animal. Test-Taking Tip: Identify option components as correct or incorrect. This may help you identify a wrong answer
A client has an anaphylactic reaction after receiving intravenous penicillin. What does the nurse conclude is the cause of this reaction? 1 An acquired atopic sensitization occurred. 2 There was passive immunity to the penicillin allergen. 3 Antibodies to penicillin developed after a previous exposure. 4 Potent antibodies were produced when the infusion was instituted.
3. Antibodies to penicillin developed after a previous exposure. Hypersensitivity results from the production of antibodies in response to exposure to certain foreign substances (allergens). Earlier exposure is necessary for the development of these antibodies. This is not a sensitivity reaction to penicillin; hay fever and asthma are atopic conditions. It is an active, not passive, immune response. Antibodies developed when there was a previous, not current, exposure to penicillin.
Which key feature would the nurse explain indicates malignancy in an acute immunodeficiency syndrome (AIDS) client? 1 Dry skin 2 Weight loss 3 Kaposi sarcoma 4 Opportunistic infections
3. Kaposi sarcoma Kaposi sarcoma is a key feature that indicates malignancy in an AIDS client. Dry skin is an integumentary manifestation in a client suffering from AIDS. Weight loss is a gastrointestinal manifestation in a client with AIDS. Opportunistic infection is an immunologic manifestation in a client with AIDS.
Which type of immunity is acquired through the transfer of colostrum from the mother to the child? 1 Natural active immunity 2 Artificial active immunity 3 Natural passive immunity 4 Artificial passive immunity
3. Natural Passive Immunity
The nurse manager oversees an organization that provides secondary care for clients with cancer. Which service would be provided by this type of organization? 1 Providing long-term care for fatigue 2 Providing treatment for pain management 3Teaching the client about prevention of infection 4 Teaching the client about adverse effects of the therapy
3. Teaching the client about prevention of infection Secondary care involves the prevention of disease complications. Therefore teaching clients about the prevention of the infection would help prevent complications as cancer clients are at high risk for infection. Long-term care for fatigue would be included as primary or tertiary care, not secondary care. Treatment for chronic care such as pain management in cancer clients is a type of primary care provided to a client. Primary care involves health maintenance measures such as teaching the client about adverse effect of the therapy.
