pathophys ch 8 CAQs

A client has gastroenteritis from eating spinach contaminated with E. coli. While planning care, the nurse should remember that the severity of the client's illness is determined by which characteristic of the bacteria? 1 Virulence 2 Portal of entry 3 Immunogenicity 4 Communicability

1

The nurse teaches a group of clients with acquired immunodeficiency syndrome (AIDS) about ways to protect themselves from infection. What is the rationale for the nurse's behavior? 1 HIV primarily infects and destroys T helper cells. 2 HIV primarily enhances the primary immune response. 3 HIV primarily blocks the action of cytotoxic T lymphocytes. 4 Human immunodeficiency virus (HIV) primarily destroys the cells of humoral immunity.

1

When a nurse is asked which microorganism causes AIDS, how should the nurse answer? 1 It is a retrovirus. 2 It is a DNA virus. 3 It is a herpesvirus. 4 It is a papillomavirus.

1

Which assessment findings will the nurse expect to observe in a client with systemic lupus erythematosus (SLE)? 1 Arthralgias, mouth ulcers, and facial rash 2 Nasal polyps, watery eyes, and rhinorrhea 3 Respiratory wheezing, eczema, and itching 4 Pulmonary edema, ankle edema, and neck vein distention

1

Which information indicates the nurse has an accurate understanding of the function of viral protease in an HIV virus? 1 It makes a DNA copy of viral RNA. 2 It assists budding of new HIV virions. 3 It incorporates viral DNA into host cell DNA. 4 It processes newly synthesized viral proteins.

4

A client has an organ transplant from another person. The client's body mounts an aggressive response against the organ transplanted. Which type of reaction did the client experience? 1 Alloimmune 2 Autoimmune 3 Immunosuppressive 4 Type I hypersensitivity

1

A camp nurse meets with a young male camper who states that he touched poison ivy accidentally but is perfectly fine. The camper seems to think that he is not allergic to poison ivy. What is the nurse's best response? 1 You will likely get an itchy blistering rash in the next few days. Let me check your hand every day this week. 2 You are probably one of the lucky people who are immune to urushiol, the part of poison ivy that causes the itchy blistering rash in people. 3 You could have a secondary antibody immune response if you touch poison ivy again, so stay away from it. A secondary antibody immune response is stronger than the first one. 4 You should stay near people for the rest of the afternoon and evening, in case you break out in hives or have trouble breathing. If that happens, call my cell phone number.

1

A client has a type I hypersensitivity reaction. Which cells release the chemical mediators of inflammation in the immediate phase? 1 Mast cells 2 Complement 3 T lymphocytes 4 Natural killer cells

1

A client has an Arthus reaction after an injection. What will the nurse observe upon assessment of this client? 1 Clotting problems 2 Absence of lesions 3 Decreased neutrophils 4 Raynaud phenomenon

1

A client has an inappropriate, exaggerated response against a noninfectious environmental substance. Which term should the nurse use when reporting this condition to another healthcare professional? 1 Allergy 2 Alloimmunity 3 Autoimmunity 4 Acute rejection

1

Which information from the nurse indicates a correct understanding of the difference between primary and secondary immunodeficiency disorders? 1 Primary immunodeficiencies are congenital, whereas secondary immunodeficiencies are acquired. 2 Primary immunodeficiencies affect T cells, whereas secondary deficiencies affect only B cells. 3 Primary immunodeficiencies are more common than secondary deficiencies, whereas secondary deficiencies are rare. 4 Primary immunodeficiencies are caused by multiple gene defects, whereas secondary immunodeficiencies are from a single gene defect.

1

Which manifestations will the nurse expect to find when assessing a client who is experiencing a type I hypersensitivity reaction? 1 Rhinitis, urticaria, and wheezing 2 Dehydration, anxiety, and tremors 3 Jaundice, fatigue, and decreased urine output 4 Seizures, shortness of breath, and hemorrhage

1

A nurse is teaching about the mechanisms of action for antibiotics. Which information should the nurse include? Select all that apply. 1 Block DNA replication 2 Inhibit protein synthesis 3 Inhibit synthesis of cell wall 4 Interfere with folic acid metabolism 5 Interfere with vitamin B12 metabolism

1, 2, 3, 4

A client has type A blood. Which type of blood can the nurse administer to this client? Select all that apply. 1 A 2 B 3 O 4 AB 5 OB

1, 3

A client has type AB+ blood. How should the nurse interpret this finding? Select all that apply. 1 The client has D antigens. 2 The client has the dd genotype. 3 The client has the DD genotype. 4 The client has A and B antigens. 5 The client has a rare Rh blood group.

1, 3, 4

Which terms can a nurse use to describe urticaria to another health professional? Select all that apply. 1 Hives 2 Atopic 3 Rhinitis 4 Wheal/flare 5 Dermal reaction

1, 4, 5

A child developed hives soon after eating homemade strawberry jam. The child's mother states, "I don't understand what happened. He didn't break out last month when I made this jam." Which information should the nurse consider before answering? 1 The jam was contaminated with bacteria. Endotoxins released by the bacteria caused the hives. 2 Last month, antibodies against antigens normally in strawberries bound to mast cells, making the child sensitized. More jam today caused these mast cells to degranulate and release mast cell products. 3 Last month, the T cells became committed to antigens normally in strawberries. More jam today caused activation of the cellular immune response and triggered localized inflammation in the skin. 4 Last month, antigens normally in strawberries became sensitized and activated the complement system. More jam today caused cytokines to degranulate and trigger cytotoxic T cells to create localized inflammation.

2

A client has an allergic response. When the nurse is checking the laboratory values, which antibody level will be most elevated? 1 IgA 2 IgE 3 IgG 4 IgM

2

A client recently tested positive for human immunodeficiency virus (HIV). The client's fever, muscle aches, and swollen nodes have gone away. Which assessment findings should the nurse expect to see over time before the client develops any acquired immunodeficiency syndrome (AIDS) indicator conditions? 1 Weakness and malaise 2 No signs and symptoms 3 Night sweats and low fever 4 Recurrent swollen lymph nodes

2

A client says, "I have been learning about human immunodeficiency virus (HIV) replication. I know that integrase puts the HIV DNA into the host cell DNA, but I don't understand where integrase comes from in the first place." What is the nurse's best response? 1 Integrase is a normal human host cell enzyme. 2 When HIV enters a host cell, it brings integrase with it. 3 Host cells make integrase to defend against HIV infection. 4 HIV tricks the host cell into thinking the integrase is defective.

2

A client with a B-cell deficiency is receiving intravenous immune globulin. When the client asks about the drug therapy, how should the nurse respond? 1 Treatments last about 7 days. 2 You will need repeated treatments. 3 One treatment will make you healthy. 4 Treatments are given every 12 hours.

2

A client with acquired immunodeficiency syndrome (AIDS) has a decreasing CD4+ count. How should the nurse interpret this finding? 1 Antibodies to HIV are being produced. 2 The number of helper T cells is decreasing. 3 The client is having a positive response to antiviral drug therapy. 4 Neutrophils are being released in response to the HIV infection.

2

A nurse is describing a type of microorganism that must depend on the permissive host to replicate. Which type of microorganism is the nurse discussing? 1 Fungi 2 Viruses 3 Bacteria 4 Protozoa

2

A nurse is teaching about parasitic diseases. Which information should the nurse include in the teaching session? 1 They are rarely transmitted through vectors. 2 They are rarely transmitted from human to human. 3 Alloantigens occur in tapeworm infestations. 4 Alloantigens occur in schistosomiasis.

2

For a client with Graves disease, which type of hypersensitivity reaction should guide nursing care? 1 Type I 2 Type II 3 Type III 4 Type IV

2

How should the nurse explain to the staff the process of human immunodeficiency virus (HIV) replication? 1 Destruction of host white blood cells occurs, depressing immunity so the virus can replicate in the blood without being detected. 2 Insertion of viral RNA into helper T cells leads to conversion to viral DNA and provides genetic instructions to make new virions. 3 Destruction of the red blood cells occurs, causing cell division to occur on cell membrane surfaces such as the gastrointestinal tract mucosa. 4 Insertion of viral DNA directly into host chromosomes, thus providing the genetic instructions to make new cells that produce new virions.

2

A nurse is caring for a client that had an organ transplant rejection. Which information indicates the nurse has a correct understanding of transplant rejection? Select all that apply. 1 Hyperacute rejection is common. 2 White graft indicates hyperacute rejection. 3 Acute rejection occurs within months to years. 4 Acute rejection is a type IV hypersensitivity reaction. 5 Chronic rejection is a type II hypersensitivity reaction.

2, 4

"My doctor said I have an autoimmune disease. What does that mean?" asks a client. How should the nurse respond? 1 You have developed an infection that is destroying your immune cells. 2 Your immune system is not able to create antibodies to help you fight infection. 3 Your immune system is creating antibodies that are destroying your own cells. 4 You have developed urticaria in response to something in your environment.

3

A nurse is caring for a client that has no antigen presentation because of a lack of major histocompatibility complex (MHC) class I molecules. Which diagnosis will the nurse observe written in the client's medical record? 1 DiGeorge syndrome 2 Wiskott-Aldrich syndrome 3 Bare lymphocyte syndrome 4 Acquired immunodeficiency syndrome

3

A nurse is caring for a client with Dengue fever. Which route of transmission will the nurse consider when planning care? 1 Fecal-oral 2 Droplet contact 3 Mosquito vector 4 Direct contact with body fluids

3

A nurse is caring for a client with an alloimmune disease. The nurse is caring for which client? 1 A male client with a penicillin allergy 2 A teenage client with contact dermatitis 3 An infant with hemolytic disease of the newborn 4 A female client with systemic lupus erythematosus

3

A nurse is caring for a client with an infection that produces endotoxins. Which piece of equipment will the nurse obtain to monitor for the clinical manifestation of this type of disease? 1 Otoscope 2 Pulse oximeter 3 Thermometer 4 Skin test supplies

3

Which intervention will the nurse question for a client with immunodeficiencies? 1 Take temperature 2 Ensure adequate nutrition 3 Administer attenuated vaccine 4 Monitor complete blood count with differential

3

Which information indicates the nurse has a correct understanding of the causes for type II hypersensitivity tissue injury? Select all that apply. 1 IgE production increases, causing sensitization. 2 Cytotoxic T lymphocytes destroy target cells directly. 3 Antibody opsonization of cells leads to subsequent phagocytosis. 4 Neutrophils attach to cell receptors, causing release of granules into cells. 5 Antibodies activate complement, and subsequent lysis of target cells occurs.

3, 4, 5

A client asks, "Why do people who have AIDS get Kaposi sarcoma but not people who have normal immune systems?" What is the best response from the nurse? 1 People who have healthy immune systems get Kaposi sarcoma also, especially people who have a lot of sun exposure. 2 A healthy immune system can fight off fungal Infection, but people with AIDS can't fight the fungus and develop Kaposi sarcoma. 3 People who have AIDS get exposed to Epstein-Barr virus, which is associated with Kaposi sarcoma, and their suppressed immune systems are not able to destroy the virus. 4 A healthy immune system can destroy abnormal cells that can develop into cancers, but the suppressed immune system in a person who has AIDS is not able to do so as effectively.

4

A client has a hypersensitivity reaction that is mediated primarily by T lymphocytes. Which type of reaction did the client experience? 1 Type I 2 Type II 3 Type III 4 Type IV

4

A client has a reaction to a liver transplant. Which term will the nurse use to describe this event? 1 Allergic 2 Anaphylaxis 3 Autoimmune 4 Alloimmunity

4

A client has a type III hypersensitivity reaction. Which pathophysiologic process should the nurse consider when planning care for this client? 1 Antibodies bind to antigens on the cell surface. 2 Autoantibodies attack and destroy the body's own tissues. 3 Cytotoxic T cells release toxic enzymes that destroy target tissues. 4 Immune complexes activate the complement system and damage tissues.

4

A client has poison ivy. Which type of reaction did the client experience? 1 Type I 2 Type II 3 Type III 4 Type IV

4

A client is admitted to the hospital with an infection producing endotoxins. When the nurse checks the culture and sensitivity test, which type of microorganism will the nurse observe? 1 Protozoal parasite 2 Tapeworm parasite 3 Gram-positive bacteria 4 Gram-negative bacteria

4

A client requires a transplant. Which cells become a priority for the nurse to check? 1 Mast cells 2 Macrophages 3 White blood cells 4 Human leukocyte antigens (HLAs)

4

A client who is HIV positive receives a reverse transcriptase inhibitor drug. The drug produces a therapeutic effect by which action? 1 Prevents budding of new HIV virions 2 Limits separation of newly synthesized viral proteins 3 Interferes with the movement of viral DNA into host cell DNA 4 Blocks the conversion of viral RNA into double-stranded DNA

4

A client, who has acquired immune deficiency syndrome (AIDS), receives treatment for prevention of Pneumocystis pneumonia. The client states, "I don't understand why I'm getting treatment for an infection I don't have yet." The best response by the nurse is that people with immunosuppression get Pneumocystis pneumonia under which conditions? 1 While they are in the hospital 2 After exposure to organisms in the dust 3 Because they have not been immunized 4 From microorganisms that usually are harmless

4

A nurse administers a skin test for tuberculosis. The nurse reads the results of the skin test based on which type of hypersensitivity reaction? 1 Type I 2 Type II 3 Type III 4 Type IV

4

A nurse administers an attenuated vaccination. Which type of vaccine did the nurse give to the client? 1 A dead microorganism 2 A live, strong microorganism 3 A recombinant microorganism 4 A live, weakened microorganism

4

During the assessment, the nurse discovers a client has recurrent Neisseria menigitides Infection. Which deficiency does the nurse suspect? 1 Innate 2 T cell 3 Antibody 4 Complement

4

Which action by the new nurse will cause the charge nurse to intervene? 1 Giving type B blood to a person with type B blood 2 Giving type O blood to a person with type A blood 3 Giving type A blood to a person with type AB blood 4 Giving type AB blood to a person with type O blood

4