Patho test 2

A client refuses to take the 81 mg of aspirin ordered by the physician, stating, "I do not have any pain." The best response by the nurse would be:

"The 81 mg of aspirin daily will help protect you from a stroke or a heart attack."

A student makes the statement to a colleague, "Blood plasma is essentially just a carrier for the formed cells like red blood cells and white blood cells." What would be the most accurate response to this statement?

"Actually, plasma plays a significant role in nutrient and waste transport."

The father of a 2-year-old boy recently diagnosed with hemophilia A asks the nurse how to prevent complications for his son. The best response would be:

"Avoid administering aspirin and nonsteroidal anti-inflammatory drugs."

A nursing student asks her instructor, "I don't understand this coagulation system. When we donate blood, what keeps it from clotting in the bag?" The instructor responds:

"Citrate is added to the blood bag, which prevents it from clotting."

A client has been diagnosed with Coxiella burnetii infection. She asked the health care provider how she could have gotten this disease. The health care provider's best response is:

"Drinking contaminated milk."

The family of an elderly patient are wondering why his 'blood counts' are not rising after his last GI bleed. They state, "He has always bounced back after one of these episodes, but this time it isn't happening. Do you know why?" The nurse will respond based on which of the following pathophysiological principles?

"Due stress, the red blood cells of older adults are not replaced as promptly as younger people."

A client is newly diagnosed with impaired platelet function, thrombocytopathia. Which of the following questions is most appropriate for the nurse to ask in order to determine the possible cause of this problem?

"Have you been taking aspirin or any nonsteroidal anti-inflammatory drugs (NSAIDs)?"

Mature red blood cells have a life span of approximately how many days?

120

Mature red blood cells have a life span of approximately:

120 days

Accounting for age, illness, and risk factors, a transfusion is recommended when the hemoglobin is at which of the following levels?

<7 g/dL

A patient diagnosed with systemic lupus erythematosus (SLE) has been experiencing a low neutrophil count. How would this type of neutropenia be classified?

Acquired, autoimmune secondary neutropenia

A client is brought to the physician's office with a raised red macular rash on the trunk and arms accompanied by a fever. A diagnosis of measles is made. Which type of immunity does this disease process provide?

Active natural immunity

An infant is suspected of having a severe combined T- and B-cell immunodeficiency disorder. Which of the following effects on the infant makes early detection a priority?

Administering live attenuated virus vaccines can be fatal.

Which of the following would be the best treatment option to prevent perinatal transmission of HIV antibodies to a fetus from the HIV-positive mother?

Administration of zidovudine to the mother during pregnancy, labor, and delivery

A client presents to the Urgent Care with erythematous, papular, and vesicular lesions associated with intense pruritus and weeping. The client states he was in the woods and thinks he may have come in contact with poison ivy .The reaction may be classified as:

Allergic contact dermatitis

Anticoagulant drugs prevent thromboembolic disorders. How does warfarin, one of the anticoagulant drugs, act on the body?

Alters vitamin K, reducing its ability to participate in the coagulation of the blood

Which of the following clients is at the greatest risk for developing an intracellular pathogen infection?

An AIDS client with a decreased CD4+ TH1 count

Which is not correct about an opportunistic infection?

An opportunistic infection primarily affects a host with a normal immunity.

Following a bone marrow biopsy, which of the following assessments would indicate the patient is experiencing a complication as a result of this diagnostic procedure?

BP 90/60, heart rate 132, excess bleeding and hematoma noted at insertion site.

Select the statement that best describes the cause of antibiotic resistance.

Bacteria that harbor plasmids increase their resistance to antibiotics.

Which of the following types of white blood cells are related to the connective tissue mast cells and respond in allergic and hypersensitivity reactions?

Basophils

A diagnosis of acquired immunodeficiency syndrome (AIDS) is identified when the CD4+ T cell count reaches which level?

Below 200 cells/μL

The provider is treating her client with regular blood transfusions and iron chelation therapy. The nurse knows the client has which type of anemia?

Beta-thalassemia

A nurse is teaching parents of a child with scarlet fever. Which of the following statements indicates that the parents understand the treatment for the child?

"I will give the antibiotic for the full 10 days."

The nurse is caring for a client who has been told that he is HIV infected. The client asks the nurse, "Can my partner and I ever have sex again?" Which of the following is an appropriate response by the nurse?

"If you use latex condoms with water-soluble lubricant consistently, sex is safer, but not completely risk free."

A 60-year-old male client with an acute viral infection is receiving interferon therapy. The physician is teaching the family of the client about the diverse actions of the treatment and the ways that it differs from other anti-infective therapies. Which of the following teaching points listed below should the physician least likely include?

"Interferon can bolster your father's immune system through the stimulation of natural killer cells that attack viruses."

A client who had a pulmonary embolism is receiving IV heparin and has just begun taking his first dose of warfarin (Coumadin). The client asks the nurse, "How long will this pill take in order to prevent me from developing more clots. I would like to go home soon." The nurse responds:

"It usually takes 2 to 3 days for warfarin to become therapeutic, meaning your blood will be thin enough to prevent further clot formation."

The physician knows the client, G1P0 has correctly understood the prenatal education regarding sexually transmitted infection as evidenced by which of the following statements listed below?

"My baby could become infected either across the placenta or during the birth itself."

A client who was exposed to hepatitis A at a local restaurant has recovered from the disease. At her annual physical, the client asks the health care provider if she should go to her health department and get the hepatitis A "shot." The best response, based on the concepts of adaptive immunity, by the health care provider would be:

"No, since having an active case, you have already developed antigens against hepatitis A."

A nurse is teaching a group of clients about health promotion activities and lifestyle changes. A client tells the nurse he has smoked 2 packs of cigarettes a day for the last 4 years and has been told he is at risk for developing respiratory infections. The best response would be:

"Smoking can increase the risk of inhalation-acquired diseases."

The dietary student is studying folic acid deficiency. The faculty member knows the student is ready to teach patients about this topic when the student makes which of the following statements?

"The 30-year-old client who is trying to become pregnant should evaluate her folic acid intake."

A 6-month-old infant was born with a murmur. The pediatrician is recommending valve replacement/repair surgery based on which of the following lab values indicating intravascular hemolysis?

Excess of hemoglobin in the blood plasma (hemoglobinemia)

Select the statement that best describes the effectiveness of vaccination in the elderly population.

Experimental evidence suggests that vaccination is less successful in inducing immunization in older persons than in younger adults.

Aplastic anemia is the result of which of the following conditions?

Failure of multipotent stem cells to grow

A student nurse is accidentally stuck by a needle. To decrease the risk of blood-borne pathogens and to provide immediate protection from infection, the emergency room nurse expects to administer which of the following?

Gamma globulin

Cell-mediated immunity is involved in resistance to infectious diseases caused by bacteria and some viruses. It is also involved in cell-mediated hypersensitivity reactions. Which of these does not cause a cell-mediated hypersensitivity reaction?

Blood transfusion

A young woman diagnosed with prostacyclin deficiency is admitted to the hospital with recurrent deep-vein thrombosis and an ovarian infarction asks the nurse why she keeps having these problems. Understanding the role of prostacyclin in hemostasis, the nurse explains that prostacyclin enables which of the following?

Blood vessel vasodilation and inhibition of platelet aggregation

After birth, red blood cells are normally made in which of the following locations?

Bone marrow

Select the option that best describes the production of T lymphocytes.

Bone marrow - thymus - lymph nodes

A patient is brought to the emergency room with complaints of facial muscle paralysis and increasing upper extremity weakness several hours after eating canned peppers. Histologic examination reveals a bacterial infection and further testing reveals a decrease in the release of the neurotransmitter acetylcholine from cholinergic neurons. The nurse explains to the patient that which of the following is the most likely cause of this illness?

Botulism exotoxin

An elderly patient is brought to the emergency department with garbled speech, unilateral facial drooping, and weakness. One hour after admission, the patient dies. An autopsy reveals the presence of polycythemia. Which of the following was the most likely cause of the patient's death?

Cerebral thrombosis

The nurse will most likely assess which of the following clinical manifestations in a client was diagnosed with Creutzfeldt-Jakob disease?

Change in behavior and memory, loss of coordination leading to encephalopathy.

An elderly client asks the nurse why so many older people develop anemia. The best response would be:

Chronic disease

A patient tells the nurse that the primary care provider prescribed an antibiotic. The patient was instructed to take the antibiotic three times a day for ten days. After the 4th day, the patient was feeling much better and decided to stop taking the medication. What complication could result from stopping the antibiotic early?

Chronic infection

Which description does the nurse recognize fits a client in the prodromal stage of an infection?

Client is experiencing vague symptoms of fatigue and low grade fever.

A nurse is teaching a client about nutritional components needed for erythropoiesis. Which of the following is essential for DNA synthesis and nuclear maturation of a red blood cell?

Cobalamin

The nurse is caring for a patient who is receiving a bone marrow transplant. What does the nurse understand the patient may receive in order to increase the success rates of the transplantation?

Colony-stimulating factor

A patient receiving chemotherapy has a leukopenia. Which of the following types of medication would promote long-term improvement in the patient's immune response?

Colony-stimulating factor (CSF)

A lactation nurse visits a new mother after delivery of her first child and encourages the mother to breastfeed her infant, even for a short time. Which statement made by the nurse correctly explains the importance of breastfeeding?

Colostrum will provide the infant with passive immunity for several months to diseases to which the mother has immunity.

In providing education to a sexually active 22-year-old female, which of the following would be most beneficial to discuss to decrease her risk for contracting HIV?

Consistent use of latex condoms with sexual activity

A client suspects they may have developed an allergic response to latex. What most common allergic response would the nurse expect to find?

Contact dermatitis

A patient is diagnosed with a mild case of an autoimmune disorder and is beginning a treatment regimen. Which of the following is the mainstay of treatment with an autoimmune disorder?

Corticosteroids and immunosuppressants

Which of the types of T cells is responsible for destroying pathogens by punching holes in their cell membrane and by secreting cytokines/lymphokines?

Cytotoxic T cells

The nurse is caring for a client who has a low levels of T lymphocytes. The nurse plans care for a client with which of the following?

Decreased immune response

The nurse knows high incidences of infectious illnesses among the older adults who reside in a long term care facility are most likely to have diminished immune capacity because of:

Decreased numbers and responsiveness of T lymphocytes

A nurse is caring for a newborn that has developed a low platelet count. Which of the following could be the cause?

Decreased thrombopoietin (TPO)

A newborn has a clotting disorder that results in the body being unable to produce fibrin. Which of the following could be the cause?

Deficiency of fibrinogen

The nurse has just administered a Mantoux test to a client. Select the reaction that best describes the anticipated response.

Delayed-type hypersensitivity

A clinical research study is evaluating cells that bridge both the innate and adaptive immune systems. A nurse has identified the dendritic cells (DCs) as a key component. Which of the following statements validates this finding?

Dendritic cells (DCs) directly sense pathogens, capture foreign agents, and transport them to secondary lymphoid tissues. Once activated, they undergo a maturation process and function as antigen-presenting cells (APCs) capable of initiating adaptive immunity.

A public health nurse notes an increase in regional throat cancer cases. Upon epidemiological studies, many of the throat cancer clients also had oral exposure to human papillomavirus (HPV). This exposure to HPV would be considered by:

Direct contact with infected secretions

Your ESRD patient is receiving two units of packed red blood cells for anemia (Hgb of 8.2). Twenty minutes into the first transfusion, the nurse observes the patient has a flushed face, hives over upper body trunk, and is complaining of pain in lower back. His vital signs include pulse rate of 110 and BP drop to 95/56. What is the nurse's priority action?

Discontinue the transfusion and begin an infusion of normal saline.

Which of the following responses of the adaptive immune system provides protection against virus-infected cells?

Distinct antigenic properties allow T cells to isolate specific organisms.

A 62-year-old female with a diagnosis of acute and chronic renal failure secondary to diabetes mellitus is receiving her weekly injection of epoetin, a supplementary form of erythropoietin. Which of the following statements best captures the necessity of this medication?

Erythropoietin causes the erythrocyte colony forming units to proliferate and mature.

A lymph node biopsy pathology report notes the presence of Reed-Sternberg cells on a patient suspected of having a lymphoma. The nurse interprets the report as indicating which of the following?

Hodgkin's lymphoma

A patient with end-stage kidney disease is receiving a kidney donated by a family member. When caring for this patient, what does the nurse know is the major target involved in organ transplant rejection?

Human leukocyte antigens (HLAs)

A client with acute leukemia has developed gout. The nurse is aware that this results from:

Hyperuricemia

A nurse is monitoring a patient with anemia and low oxygen levels. The nurse knows that which of the following stimulates the secretion of erythropoietin?

Hypoxia

A patient receives an interleukin-2 (IL-2) infusion to treat cancer. Which of the following responses explains how this cytokine will affect the growth of cancer cells?

IL-2 stimulates growth of cytotoxic T lymphocytes.

A client experiences an allergic reaction. Select the immunoglobulin that would bind to mast cells and release histamine.

IgE

Which of the following immunoglobulins (Ig) is released in response to allergy or parasitic infections?

IgE

The nurse is aware that the only class of immunoglobulins to cross the placenta is:

IgG

Which of the following immunoglobulins (Ig) is the most abundant of circulating antibodies?

IgG

Three days ago, a mother delivered her full-term infant who had been identified as having an in utero infection. The infant is receiving antibiotic and phototherapy, and the mother is breastfeeding. Which of the following types of immunoglobulins could most reasonably be expected to predominate in the infant's immune system?

IgG, IgA, IgM

A premature neonate in the ICU suspected of having an infection has blood drawn for class specific antibodies. Which of the following confirms that the neonate has developed a congenital infection?

IgM antibodies are elevated.

The nurse is reviewing the functions of immunoglobulins and determines which of the following as a correct action?

IgM/first to challenge the antigen

While being on subcutaneous heparin injections for deep vein thrombosis during her latter pregnancy, a patient begins to experience major side effects. Her OB physician has called in a specialist who thinks the patient is experiencing heparin-induced thrombocytopenia. The nurse should anticipate which of the following orders?

Immediately discontinue the heparin therapy.

Which of the following sequences accurately describes the stages of a disease?

Incubation, prodromal, acute, convalescent, and resolution.

A client tells the nurse she is at risk to prematurely deliver her baby and is concerned that the baby does not have a developed immune system. The best response would be:

Infants born prematurely may be deficient immunity.

A fomite is which one of the following?

Infection transfer agent

A patient with a history of cancer and recent chemotherapy was hospitalized with fever, weakness, shortness of breath and productive cough. A bronchoscopy with transbronchial biopsy showed granulomas containing the fungus Histoplasma. Based on patient history and the biopsy results, a nurse can conclude that the most likely cause of this infection was due to which of the following?

Inhalation of fungi and decreased host defenses permitting an opportunistic infection.

A school age child with a history of asthma has brought a note home from school stating there has been one case of meningitis (Neisseria meningitides) in the school. Since the mother is a nurse, she is very concerned since she knows the portal of entry of this pathogen is:

Inhalation via the respiratory tract such as through breathing or yawning.

Following a lecture on hemostasis, a nursing student accidently cuts her hand while preparing supper for her family. She watches the laceration very closely. Sure enough, the first thing she notes is:

Initially, it takes a few seconds for blood to appear as a result of vessel spasm.

A 40-year-old woman who experiences severe seasonal allergies has been referred by her family physician to an allergist for weekly allergy injections. The woman is confused as to why repeated exposure to substances that set off her allergies would ultimately benefit her. Which of the following phenomena best captures the rationale for allergy desensitization therapy?

Injections of allergens simulate production of IgG, combining with the antigens to prevent activation of IgE antibodies.

Natural killer cells are specialized lymphocytes that are one of the major parts of which immunity?

Innate

A client has been admitted for immune thrombocytopenic purpura. The client has not responded to corticosteroid treatment. The priority nursing intervention for this client would include which of the following treatment measures?

Insert an intravenous catheter, so immune globulin can be administered in a timely manner.

The nurse is assessing a client diagnosed with anemia and notes that the client's skin and mucous membranes are pale. The nurse interprets this as:

Insufficient hemoglobin

The rate at which hemoglobin is synthesized depends on availability of which of the following?

Iron

A female patient comes to the clinic with symptoms of fatigue and heavy menses over the last 6 months. Laboratory tests reveal a microcytic hemochromic anemia. Based on these results, the nurse anticipates teaching the patient about which type of anemia?

Iron deficiency anemia

A patient has a hematocrit of 32% and is diagnosed with iron deficiency anemia. The nurse anticipates which of the following treatments to be prescribed?

Iron replacement therapy

A young man has been diagnosed with hemophilia, and the nurse is planning his discharge teaching. The nurse knows to include what in her discharge teaching?

Prevent trauma to the body.

A client newly diagnosed with the neurodegenerative disease Creutzfeldt-Jakob disease (CJD) asks why antibiotics are not part of the treatment plan. How should the nurse respond?

Prions are not affected by antibiotics.

Select the statement that best describes the major difference between prokaryotes and eukaryotes.

Prokaryotes lack an organized nucleus.

Which of the following is the priority intervention for a nurse caring for a patient with wasting syndrome from HIV?

Promote nutritional intake

Heparin is an anticoagulant given by injection to prevent the formation of blood clots. How does heparin work?

Promotes the inactivation of clotting factors

The nurse is planning care for a client with a diagnosis of primary immunodeficiency. Which of the following is a priority intervention to incorporate into the plan?

Protecting the client from infection

Which of the following manifestations might the nurse expect to observe in an AIDS patient? Select all that apply.

Pulmonary tuberculosis • Cognitive impairment • Gastroenteritis • Non-Hodgkin's lymphoma

Which of the following would be tested by a complete blood count (CBC)?

Red blood cells and platelets

The nurse is caring for a client diagnosed with sickle cell disease. Select the most important factor for the nurse to be aware of that may cause the cells to sickle.

Reduced oxygen tension while the client sleeps

If an Rh-negative mother is giving birth to an Rh-positive infant, the nurse should be prepared to administer:

Rh immune globulin

A client is being evaluated for atopic dermatitis possibly caused by a latex-related allergic reaction. The nurse will review which of the following labs to determine if an allergy is present?

Serum IgE

When looking at a granulocyte under a microscope, the anatomy student would describe it as:

Shaped like a sphere with multi-lobar nuclei.

The first physical line of defense in innate immunity is:

Skin and mucous membranes

The nurse planning care for a client with acute lymphoblastic leukemia should include the use of which of the following in the plan of care?

Soft bristle toothbrush

The treatment prescribed for an autoimmune disorder is primarily dependent upon what?

The current manifestations of the disease and the mechanisms that cause the disease process

The nurse is caring for a 2-day-old newborn infant who appears lethargic and has a yellowish tint to the skin. Select the most likely cause of this newborn's signs and symptoms.

The inability of the immature liver to conjugate bilirubin

A newborn has been lethargic, is not nursing well, and is basically looking ill. Following lab tests, it has been found that the newborn has IgM present in his blood. How should the nurse interpret this finding?

The presence of IgM suggests the infant has a current infection.

Which of the following serves as the rationale for AIDS treatment with antiretroviral therapy?

Triple therapy with reverse transcriptase, protease, and fusion inhibitors

Children born to mothers who are infected with HIV are considered uninfected if the children become HIV antibody negative after 18 months of age, have no other laboratory evidence of HIV infection, and have not met the surveillance case definition criteria for AIDS in children.

True

Which of the following is the most common mode of transmission of HIV?

Vaginal and anal intercourse

An HIV-positive mother passes the virus to her infant during delivery. This type of transmission is known as:

Vertical transmission

A nurse is discussing precautions that are necessary to avoid excessive bleeding with a patient who has been diagnosed with Type 1 von Willebrand disease. The nurse reassures the patient that typically which of the following happens?

Vessel spasm

The nurse is caring for a client who is a strict vegetarian; the client is at greatest risk for the development of:

Vitamin B12 deficiency anemia

To form a platelet plug, platelets must adhere to the vessel inner layer. For this to occur, which protein molecule is required?

Von Willebrand factor

A nursing student is assigned to care for a client who has AIDS. The student is unsure of what personal protective equipment should be worn while caring for this client. Which of the following statements is appropriate direction from the student's nursing instructor?

Wear gloves if there is a chance you will come in contact with the client's blood or body fluids.

A high school teenager comes to the emergency room with symptoms that include the abrupt onset of severe pharyngitis and a high fever. The teenager reports that in the previous four days he has "just not felt well." The nurse anticipates orders to include which of the following?

White blood cell count

A nurse is caring for a client in the intensive care unit who has sustained severe trauma and now has developed disseminated intravascular coagulation (DIC). The nurse is aware that the client is experiencing:

Widespread coagulation and bleeding in the vascular compartment

A mother is diagnosed with a bacterial infection and is worried that her newborn infant will also contract the infection. Which of the following statements should the nurse include in the teaching plan for the client?

Your newborn has maternal IgG antibodies that were transferred through the placenta before birth, providing some protection from infection.

Sometimes the host's white blood cells are unable to eliminate the microorganism, but the body is able to contain the dissemination of the pathogen. What is this called?

abscess

The nurse is caring for a client with chronic myelogenous leukemia (CML)and notes that the client has splenomegaly, and an increased basophil count as well as night sweats, bone pain, and a low grade fever. The nurse interprets the symptoms as indicating that the client is in which phase of the clinical course of CML?

accelerated

In reference to infectious disease, a patient cannot be which one of the following?

agent

The nursing caring for a 62-year-old client with diffuse large B-cell lymphoma plans care based on the knowledge that this client's lymphoma is:

aggressive

Which of the following is the most abundant type of plasma proteins?

albumin

A client is applying to nursing school and has come to the clinic with a request to be tested for immunity to hepatitis B. Which type of testing would be the best to determine immunity?

antibody titer

The nurse is caring for a client with an infection of candida albicans. Which type of antimicrobial agent will the nurse plan to administer to effectively treat this disease?

antifungal

When talking about the various types of granulocytes, which granule contains heparin, an anticoagulant?

basophils

A client was involved in an auto accident and suffered massive internal injuries that resulted in a large blood loss. Select the type of anemia the client is at greatest risk to develop.

blood loss

A number of fungi, such as ringworm, athlete's foot, and jock itch, are incapable of growing at a core body temperature. Hence, their infection is limited to cooler cutaneous surfaces. What are these pathogens known as?

dermatophytes

The nurse caring for a client in the induction therapy phase understands that the intent of the therapy is to:

elicit a remission.

The microbiology technician explains to the student that which of the following blood cells is the most common?

erythrocyte

There are two pathways that can be activated by the coagulation process. One pathway begins when factor XII is activated. The other pathway begins when there is trauma to a blood vessel. What are these pathways?

extrinsic and intrinsic pathways

The school nurse is teaching a health class to a group of high school students. She is preparing a lecture on HIV/AIDS. The nurse would know to include what information about the transmission of AIDS in her lecture? (Select all that apply.)

• AIDS is transmitted through blood-to-blood contact. • AIDS is transmitted through sexual contact. • AIDS is transmitted from the mother to her unborn baby.

The practitioner knows the client has hemoglobin S (HbS). The practitioner explains to the client that which of the following are the major consequences of this disorder? Select all that apply.

• Chronic hemolytic anemia • Blood vessel occlusion

Two years after chemotherapy and radiation therapy for lung cancer, a 72 year old patient notices that they seem to be extremely tired all the time. The physician suspects the patient may have developed aplastic anemia. The nurse assessing the patient will likely find which of the following clinical manifestations of aplastic anemia? Select all that apply.

• Complaints of weakness and fatigue. • Small spots of skin hemorrhages over entire body. • Excess bleeding from gums and nose.

The nurse is caring for a client who is HIV positive and is newly diagnosed with Mycobacterium tuberculosis (TB). Which of the following symptoms does the nurse associate with TB? Select all that apply.

• Cough • Fever • Night sweats

An infant (5 days old) has lab results revealing an elevated level of unconjugated bilirubin, due to hemolysis of RBCs. Because of this, which assessment findings would correlate with this abnormal lab result? Select all that apply.

• Difficulty to arouse (lethargy) • Jaundice

A patient was diagnosed with normocytic-normochromic anemia. Based on this diagnosis, which of the following anemias does the nurse determine falls into this category? Select all that apply.

• Hemolytic anemia • Sickle cell anemia • Thalassemia

The destruction of old blood cells is facilitated by a group of large phagocytic cells found in which of the following? Select all that apply.

• Liver • Bone marrow • Lymph nodes

The nurse is teaching a group of parents about foods that commonly cause allergic reactions in children. The most important information to provide would be: Select all that apply.

• Milk • Eggs • Peanuts • Shellfish

Which of the following diagnostic test results are abnormal? Select all that apply.

• White blood cells: 3.8 × 109/L • Platelets: 500 × 103 • Red blood cells: 6.6 × 1012/L

For HIV to reproduce in the human body, which of the following processes must occur?

It must change its RNA into DNA.

The nurse is educating a pregnant client about the importance of folic acid. Select the food that has the highest levels of folic acid.

Kale

The pediatrician knows that the most common cause of cancer in children is which of the following?

Leukemia

A teenage male develops a severe case of "athlete's foot." He asks, "How did I get this?" The health care worker explains that certain fungi become infectious (called dermatophytes) and exhibit which of the following characteristics?

Limited to cooler cutaneous surfaces

The practitioner is examining a client and notes that he has small, punctate skin hemorrhages on his abdomen and chest. This finding is suggestive of which of the following lab results?

Low platelets

A 53-year-old female hospital patient has received a kidney transplant following renal failure secondary to hypertension. As part of the teaching while she was on the organ wait list, she was made aware that she would need to take anti-rejection drugs for the rest of her life. Which aspect of the immune system underlies this necessity?

MHC molecules will never develop in the cells of the donor organ and effector cells will be continually stimulated.

When collecting a client's history the client states that he is receiving treatment to maintain remission from leukemia. What does the nurse document that the client is receiving?

Maintenance therapy

Megaloblastic anemias caused by folic acid or vitamin B12 deficiencies can seriously affect RBC production. Which of the following lab results would correlate with this diagnosis?

Mean corpuscular hemoglobin (MCV) 120 fL (high)

A person has been exposed to a particular antigen and a now experiences a repeat exposure. What stimulates a quicker immune response?

Memory T cells

A theory that has been postulated to describe the mechanisms by which infectious agents or other foreign substances trigger an immune response against autoantigens is known as what?

Molecular mimicry

Which of the following is least likely to contribute to the spread of HIV infection?

Mosquitoes

The nurse in the emergency department knows clients exposed to Clostridium botulinum, an agent of bioterrorism, would likely be exhibiting which of the following clinical manifestations listed below?

Muscle weakness in extremities eventually leading to paralysis of respiratory muscles.

Which disorder does the nurse know is considered to be an autoimmune disease?

Myasthenia gravis

While caring for a pediatric client admitted with a viral infection, the nurse knows that which type of cell will be the child's primary defense against the virus?

Natural killer (NK) cells

A nurse sends a blood sample to the lab for analysis. Assuming the sample is normal, the nurse anticipates which of the following white blood cells (WBCs) will account for the highest percentage?

Neutrophils

A nurse orienting to the surgical suite is studying medications that affect platelet function and notes that the most common medications are which of the following?

Nonsteroidal anti-inflammatory drugs (NSAIDs) and aspirin

The school nurse has several children with hemophilia A. After recess, one hemophilia student comes to the school nurse complaining of pain in their knee from falling on the playground. The nurse notes there is swelling in the knee and pain on palpation. The nurse should:

Notify parents to pick up child and possibly administer Factor VIII.

A child has a congenital condition in which the thymus gland is absent. What should the nurse include in the education of care of this patient to the parents?

Observe and report signs and symptoms of infection.

The process by which microbes are coated to allow for more efficient recognition by phagocytes is known as:

Opsonization

While explaining immunity to a client, the nurse responds, "The body's internal organs are protected from pathogens because:

Our mucosal tissue contains all the necessary cell components to fight a pathogen with an immune response."

The client with chronic kidney disease and congestive heart failure is weak and dyspneic. Lab work reveals a hemaglobin of 6.5g/dL. Which type of blood product will the provider order?

Packed red blood cells

The nurse is caring for an infant wih DiGeorge syndrome. Which of the following organs does the nurse know will be underdeveloped or absent?

Parathyroid and thymus glands

Which of the following patients would be diagnosed with wasting syndrome?

Patient with HIV, fever, diarrhea, and significant involuntary weight loss

Which of the following interventions would be most appropriate by the nurse caring for a client in the neutropenic phase of cyclic neutropenia?

Perform/assist with oral care

The client with a history of gastrectomy presents with severe anemia, mild jaundice, and spastic ataxia. The lab work demonstrates an elevated mean corpuscular volume (MCV). The practitioner suspects the client has which type of anemia?

Pernicious

A 75-year-old patient with a history of heart valve replacement arrives at the outpatient clinic with multiple red pinpoint lesions. The nurse identifies the lesions as being which of the following?

Petechiae

A nurse is reviewing a client's complete blood count (CBC) which indicates thrombocytopenia. Based on this result which action should the nurse include in the plan of care?

Place the client on bleeding precautions.

Which one of the following is responsible for Rocky Mountain spotted fever?

rickettsia

The infectious agents that cause Rocky Mountain spotted fever and epidemic typhus are transmitted to the human body via vector such as a tick. What are these infectious agents?

rickettsiae

The mother of an infant born with profound mental retardation and hearing loss tells the nurse that she had a viral infection in the first trimester of her pregnancy. The nurse identifies which of the following congenital infections as the cause of the fetal defects?

rubella

A client laboratory report indicates neutropenia. The nurse is aware the client is at greatest risk for development of infection. The most important area for the nurse to assess would be:

skin

A client's history and physical documents the presence of an indolent lymphoma. The nurse plans care for which of the following types of lymphoma?

slow growing

The practitioner carefully monitors his client who exhibits hemoglobin S (HbS) genes. The practitioner know that the client is predisposed to life-threatening infection due to damage by HbS to which of the following organs?

spleen

When red blood cells age, which of the following organs are responsible for their destruction?

spleen

A client is suspected of having a parasitic infection with roundworms. For what laboratory testing will the nurse prepare the client to most rapidly identify this infection?

stool exam for ova

A client is ordered to receive a quinolone, ciprofloxacin (Cipro), to treat a bacterial infection. The nurse instructs the client to monitor for which potentially dangerous side effect associated with quinolone therapy?

tendon rupture

The nurse is reviewing the client's medical record for the results of a Western blot test with the understanding that:

the Western blot is used to confirm a diagnosis of HIV infection.

Many different proteins, enzymes, and hormones are involved in maintaining hemostasis. Which protein is required for platelet adhesion?

von Willebrand factor

A client presents at the clinic complaining of unplanned weight loss of up to 10% of her body weight. She states that she has had diarrhea, more than twice a day. She goes on to say the she has fever and weakness that "just won't go away." After a complete history and physical, an enzyme-linked immunosorbent assay test is ordered. This order is based on what suspected diagnosis?

wasting syndrome

Which of the following procedures reduces the potential for infection primarily by addressing the portal of entry?

wearing gloves when contact with blood or body fluids is anticipated

Global infectious diseases are now being recognized. These diseases, known as endemic to one part of the world, are now being found in other parts of the world because of international travel and a global marketplace. Which of the following is considered a global infectious disease?

west nile virus

Infections that are passed from animals to humans are known as:

zoonotic

A student states, "It seems like helper T cells do a lot more than just 'help' the cellular immunity process". Which of the following responses listed below best conveys an aspect of the role of CD4+ helper T cells in immunity?

A child has a congenital condition in which the thymus gland is absent. What should the nurse include in the education of care of this patient to the parents?

The nurse evaluating a client's bloodwork determines that a client has an increased risk for infection based on which of the following lab results?

Absoulute neutrophil count of 800/uL

The nurse is caring for a client who has just learned that he is HIV positive. The client asks the nurse how long he has been able to infect others. Select the best response by the nurse.

"You can infect others before the HIV antibody is detectable in your blood."

A college student has been called into the student health office because she tested positive for HIV on the enzyme-linked immunosorbent assay (ELISA). The student asks, "What is this Western blot assay going to tell you?" The best response by the health care provider is:

"The Western blot is a more sensitive assay that looks for the presence of antibodies to specific viral antigens."

The neonate displays a yellow discoloration of her skin on the third day of life. The neonatologist explains this condition to the parents. Which of the following statements is most accurate?

"The increase in bilirubin, which causes the jaundice, is related to the increased red blood cell breakdown."

A patient was recently diagnosed with acquired immunodeficiency syndrome (AIDS) and started on antiviral therapy. The nurse evaluates the patient's understanding of the antiviral drug when the patient correctly identifies which of the following as the pharmacological mechanism of action?

"The primary target of most antiviral compounds is viral RNA or DNA synthesis."

A sixth grade science teacher asks the students to explain the role of cilia in the lower respiratory tract. Which student response is the best?

"These little hairs move germs trapped in mucous toward the throat so the body can cough them out."

A patient has been diagnosed with anemia. The physician suspects an immune hemolytic anemia and orders a Coombs test. The patient asks the nurse what this test will tell the doctor. The nurse replies:

"They are looking for the presence of antibody or complement on the surface to the RBC."

A client tells the nurse that he has recently begun to take over-the-counter (OTC) calcium supplements to ensure that his blood will clot. The best response by the nurse would be:

"This is not necessary, unless it has been prescribed by your health care provider."

A 5-year-old child is experiencing itchy, watery eyes and an increased respiratory rate with some inspiratory wheezes. He has been outside playing in the yard and trees. The mother asks, "Why does he get like this?" The health care worker's best response is:

"This is what we call a type I hypersensitivity reaction and usually occurs a few minutes after exposure to his allergen. It is primarily caused by mast cells in his body."

A nurse is teaching parents expecting their first child about the benefits of umbilical cord blood donation. The nurse determines teaching was effective based on which of the following statements?

"Umbilical cord blood can provide stem cells for transplantation."

A client tells the health care provider he has heard several myths about viruses. The most appropriate information for the nurse to provide would be:

"Viruses can produce symptoms of disease months to years later."

A 12-month-old infant is displaying pale skin, rapid heart rate, and increased respiratory rate. The parents bring the child to the clinic. Which statement by the parents points the health care worker to suspect iron deficiency anemia?

"We give him regular cow's milk with all his meals and snacks."

A client has been diagnosed with an abscess. Upon assessment of the client, the nurse would expect to find:

A localized pocket of infection composed of devitalized tissue, microorganisms, and the host's phagocytic white blood cells

The nurse is teaching a client infected with the flu about viruses. Which of the following would the nurse use to describe a viral infection?

A parasitic relationship between an organism and host is present.

Which of the following patients has the highest risk of contracting an opportunistic infection?

A patient who has had HIV for 3 years and has a CD4+ count of 50 cells/μL

A middle school student is scheduled to receive booster immunizations and the father asks the nurse why the booster is necessary. What characteristic of the adaptive immune system listed below would provide the rationale for the nurse's response?

A secondary response causes a sharp rise in antibody levels.

A client is admitted with a suspected diagnosis of Hodgkin lymphoma (HL). Select the diagnostic manifestation that would confirm the diagnosis.

Presence of Reed-Sternberg cells

The cells that mediate humoral immunity do so because they are capable of producing:

Antibodies

Substances foreign to the host that can stimulate an immune response are known as:

Antigens

The cloning of the genes for most of the hematopoietic growth factors has been accomplished. The recombinant proteins that are produced are used in a wide range of clinical problems. What diseases have these proteins been used to fight?

Aplastic anemia and the anemia of kidney failure

Transmissible neurodegenerative diseases such as Creutzfeldt-Jakob disease are associated with:

prion

In the usual course (stages) after a pathogen has entered the host body, the stage when the host initially develops the appearance of signs/symptoms like a mild fever and body aches is:

prodromal

The daughter of a 79-year-old woman asks the nurse why her mother gets so many infections. The daughter states, "My mother has always been healthy, but now she has pneumonia. Last month she got cellulitis from a bug bite she scratched. The month before that was some other infection. How come she seems to get sick so often now?" What is the nurse's best response?

As people get older, their immune system does not respond as well as it did when they were younger.

A client is taking a vacation in a foreign country. The nurse teaches the client about giardiasis, a common traveler's infection. Which of the following statements should be included in the teaching plan?

Avoid eating food and drinking beverages that might be contaminated.

Which of the following statements most accurately conveys an aspect of lymphatic system activity?

B and T lymphocyte development begins in the bone marrow and ends in the peripheral lymphoid structures.

Select the type of lymphocyte that matures in the bone marrow.

B lymphocytes

Immunologically active sites on antigens are recognized as:

Epitopes

Which of the following colony-stimulating factors (CSFs) is given to ESRD patients to help with their chronic anemia?

Erythropoietin (EPO).

A client diagnosed with sepsis has a critically low neutrophil count. The nurse expects which drug or drug class to be used to stimulate white blood cell production?

Granulocyte CSF (G-CSF) such as filgrastim (Neupogen)

Which of the following would be considered an example of transmitting an infection from person-to-person through shared inanimate objects (fomites)?

HIV from a contaminated IV drug user needle

A 10 year old child with strep throat asks the nurse, "why are there large bumps [lymph nodes] on their neck when their throat gets sore?" The nurse replies that lymph nodes:

Help your body fight off infections by allowing special cells [lymphocytes and macrophages] move through the lymph chain and engulf and destroy germs.

A nurse is caring for a client receiving heparin therapy. Five days after the start of therapy the nurse notices a sudden decrease in the platelet count. Which of the following complications of heparin therapy can cause platelets to decrease?

Heparin-induced thrombocytopenia

Which one of the following is a common opportunistic infection in AIDS patients?

Pneumocystis jiroveci

A patient presents to the clinic with symptoms of elevated blood pressure, dizziness, red face, pain in fingers and toes, headache, and difficulty concentrating. A blood smear reveals an increased number of erythrocytes. Based on these findings, the nurse anticipates which of the following diagnoses?

Polycythemia vera

The client explains to her new provider that she receives periodic phlebotomies to decrease their red blood cell mass. The provider believes the client may have which of the following?

Polycythemia vera

Which one of the following is the main effect of HIV infection?

Poor helper T-cell function

The nurse is preparing a client with suspected leukemia for a bone marrow and biopsy. What preferred site will the nurse be sure is accessible for the physician?

Posterior iliac crest

Which of the following anatomical sites would the nurse expect to monitor when caring for an adult patient who has just had a bone marrow aspiration performed?

Posterior iliac crest

Which of the following statements is an accurate descriptor of the role of viruses in human infections?

Some viruses are capable of transforming normal host cells into malignant cells.

A client has developed an infection from an exogenous source. The nurse recognizes this as acquired from:

Sources in the external environment, such as the water, food, soil, or air

The clinical picture, or presentation of a disease in the body, is called what?

Symptomatology of the disease

A geriatrician is following a number of clients on a subacute geriatric medical unit, some of whom require diagnostic blood work. Which of the following clients would be most likely to have an erythrocyte sedimentation rate (ESR) screening test ordered? An adult with:

Systemic lupus erythematosus.

A client has immunity that was mediated by specific T lymphocytes and provides defense against intracellular microbes such as viruses. This immunity is recognized as:

T lymphocytes

Which of the following explains how T lymphocytes and B lymphocytes differ?

T lymphocytes mature in the thymus gland; B lymphocytes mature in the bone marrow.

The nurse knows the cells primarily programmed to remove the invading organisms and remember the antigen to respond rapidly during the next exposure are:

T-and B-lymphocytes.

The nurse understands that a positive ELISA test reported in a baby born to a woman who is HIV positive indicates which of the following?

The baby has antibodies from the mother and it is uncertain whether the baby is infected with HIV.

A student asks, "What does cell-mediated immunity mean to the client?" The instructor responds. "This means:

The body is trying to defend itself against intracellular microbe invasion by engulfing and destroying the microbe."

Why is early diagnosis essential for an infant with severe combined immunodeficiency disorders (SCIDs)?

There is better opportunity for successful treatment.

A nurse is discussing precautions that are necessary to avoid excessive bleeding with a patient who has been diagnosed with Type 1 von Willebrand disease. The nurse reassures the patient that typically which of the following happens?

There is no treatment except to avoid aspirin.

A nurse assessing a client with an acute exacerbation of polycythemia vera notes coolness to the right leg and foot, pale color and an absent right pedal pulse. Based on these findings the nurse suspects that the client has developed which of the following complications?

Thrombosis in the right leg

The nurse is preparing to administer medication to a client. Select the medication that the nurse would administer to prevent platelet aggregation.

Ticlopidine (Ticlid)

Which is the reason why bed rest and analgesics are expected treatments for infectious mononucleosis?

To relive fever, headache, and sore throat

An infant from parents of Mediterranean decent has been diagnosed with a severe form of β-thalassemia anemia. The nurse caring for this infant knows that the infant will likely receive which of the following medical treatments?

Transfusion therapy

A patient was diagnosed with HIV. The nurse is teaching the patient about types of drug therapy. Which of the following antiviral agents is developed solely for the treatment of HIV infections and works by inhibiting an HIV-specific enzyme that is necessary for late maturation events in the virus life cycle?

protease inhibitors

The bacteriologist is staining the slides of a client diagnosed with scarlet fever and rheumatic fever. The slide identifies S. pyogenes and stains purple by crystal violet dye. The result would indicate:

gram positive organism

Which one of the following organisms causes peptic ulcers?

heliobacter pylori

Anemia refers to a deficiency of:

hemoglobin

When explaining what is occurring when their child has an acute bronchial asthma attack, the nurse will emphasize that which mediator is primarily responsible for the bronchial constriction?

histamine

A client is suffering from the effects of the opportunistic infection, Cryptosporidium parvum. An important nursing intervention would be to encourage which of the following?

hydration

What is the term for parasitic relationships between microorganisms and the human body in which the human body is harmed?

infectious disease

HIV is considered to be a retrovirus because:

it carries its genetic information in ribonucleic acid (RNA) rather than deoxyribonucleic acid (DNA).

The nurse knows that the hypoxic patient will produce erythropoietin to stimulate red blood cell production. The nurse knows this hormone is produced in which of the following?

kidneys

Following an injury resulting in a small cut from a knife, the first cells to go to the area of the cut would be the:

neutrophils

The nurse is caring for a client who has AIDS and suffers from wasting syndrome. Which of the following is the priority nursing consideration for this client?

nutrition

A woman experiences a viral infection while pregnant. Which of the following types of immunity does an infant have at birth against this infection?

passive

Transmission of the rabies virus from a dog bite would be best described by which of the following mechanisms of entry?

penetration