Chapter 11

A client with infectious mononucleosis asks the nurse why the lymph nodes are enlarged. Which statement is the nurse's appropriate response? "Your lymph nodes trap and destroy viruses." "Your lymph nodes are blocked and need to be drained." "Your lymph nodes are infected and should be removed." "Your lymph nodes multiply to fight infection."

"Your lymph nodes trap and destroy viruses."

A client who has just given birth to a healthy newborn says to the nurse, "I have to go back to work in 6 weeks. It seems like I should not bother to start breastfeeding for such a short time." What is the nurse's best response? "Your newborn gains some protection against infections even if you only breastfeed for the first 6 weeks." "Breastfeeding will help you lose weight in the postpartum period, even if just for a short time." "Did you know your employer is obliged to provide you time to express breast milk while you are at work?" "Have you explored options to allow you to be off work longer? Breastfeeding for at least 1 year is best."

"Your newborn gains some protection against infections even if you only breastfeed for the first 6 weeks."

Which client is at the greatest risk for developing an intracellular pathogen infection? A teenager who attends a crowded high school A client with AIDS who has a decreased CD4+ TH1 count A client with breast cancer who has a WBC count of 8000 A client with hyperthyroidism who has received treatment with radioactive iodine

A client with AIDS who has a decreased CD4+ TH1 count

The nurse is administering a measles, mumps, and rubella (MMR) vaccination to a pediatric client. When the nurse explains immunity to the mother, which type of immunity will she explain that this vaccination provides? Active natural immunity Active artificial immunity Passive natural immunity Passive artificial immunity

Active artificial immunity

A nurse is planning to teach a parent group about the spread of infection, the importance of vaccines, and active immunity. Which statements should be included in the teaching plan? Select all that apply. Active immunity can be acquired through the process of vaccination or from environmental exposure to an antigen. Active immunity allows the host's own immune system to develop an immunologic response. Active immunity is long-lasting and can improve on repeated exposures to an antigen. Active immunity can be passed from mother to fetus in order to provide temporary immune protection to a newborn. Immunization with IgG antibodies will provide long-term immunity against many infectious diseases.

Active immunity can be acquired through the process of vaccination or from environmental exposure to an antigen. Active immunity allows the host's own immune system to develop an immunologic response. Active immunity is long-lasting and can improve on repeated exposures to an antigen.

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 Active artificial immunity Passive natural immunity Passive artificial immunity

Active natural immunity

Passive immunity is immunity that is transferred from another source and lasts only weeks to months. What is an example of passive immunity? An injection of γ-globulin (gamma-globulin) An immunization Exposure to poison ivy Allergy shots

An injection of γ-globulin (gamma-globulin)

The nurse knows that inflammation plays a key role in the pathogenesis of many common pathophysiologic states. Which diseases should be nurse include in the teaching plan for senior citizens? Select all that apply. Atherosclerosis Coronary artery disease Non-insulin-dependent diabetes mellitus (NIDDM) Renal failure Osteoporosis

Atherosclerosis Coronary artery disease Non-insulin-dependent diabetes mellitus (NIDDM)

Select the type of lymphocyte that matures in the bone marrow. B lymphocytes T lymphocytes Macrophages Cytotoxic T lymphocytes

B lymphocytes

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 statement 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. Dendritic cells (DCs) spontaneously kill target tumor and/or infected cells without previous exposure to surface antigens. Dendritic cells (DCs) destroy the invading organism through the process of phagocytosis. Dendritic cells (DCs) can also act as opsonins and can coat cellular particles on pathogens and enhance the phagocytic function of innate cells.

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

Select the statement that best describes the effectiveness of vaccination in the older adult population. Experimental evidence suggests that vaccination is less successful in inducing immunization in older persons than in younger adults. Older adults who are immunized have the same effective response in immunity as younger persons do. Age does not influence the effectiveness; it depends on the amount of medication you receive. Vaccinations are only effective in older adult populations if their families have been vaccinated.

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

Which immunoglobulin is primarily found in secretions and has a primary function of providing local immunity on mucosal surfaces? IgG IgM IgA IgD

IgA

The nurse is aware that the only class of immunoglobulins to cross the placenta is: IgG IgM IgA IgD

IgG

Which immunoglobulin (Ig) is the most abundant of circulating antibodies? IgA IgE IgG IgM

IgG

The nurse is reviewing the functions of immunoglobulins and determines which immunoglobulin is associated with its correct action? IgM, the first antibody to be produced by a developing fetus. IgA, plays a role in B-cell differentiation. IgE, functions as a receptor for antigen. IgD, prevents the attachment of viruses and bacterial to epithelial cells.

IgM, the first antibody to be produced by a developing fetus

A nurse is caring for a child diagnosed with DiGeorge syndrome with thymic hypoplasia. Which immune response would the nurse anticipate in this child? Increased risk of infection No change in immunity Reduced risk of infection Reduced antigen response

Increased risk of infection

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 Immunity Macrophages Antibodies

Memory T cells

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? Complement Bradykinin Leukotrienes Natural killer (NK) cells

Natural killer (NK) cells

Which type of immunity is achieved by an infant from its mother through antibodies transferred in utero or in breast milk? Naturally acquired passive immunity Artificially acquired active immunity Artificially acquired passive immunity Naturally acquired active immunity

Naturally acquired passive immunity

A blood smear is being examined and a stain has been added that will identify granulocytes. Which cell types will be visible with the stain? Select all that apply. Neutrophil Eosinophil Macrophage Basophil Monocytes

Neutrophil Eosinophil Basophil

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 client to the parents? Observe and report any signs of bleeding. Observe and report signs and symptoms of infection. Report if the child has 2 to 3 loose stools in a day. Do not immunize the child with inactive or live viruses.

Observe and report signs and symptoms of infection

Which statement correctly identifies the role of the C3b subcomponent of the complement system? Opsonizes microbes to facilitate phagocytosis Dilates arterioles Lyses cells Induces rapid degranulation of mast cells

Opsonizes microbes to facilitate phagocytosis

A client is being evaluated for atopic dermatitis possibly caused by a latex-related allergic reaction. The nurse will review which lab results to determine if an allergy is present? Serum IgE Serum IgG Basophils Neutrophils

Serum IgE

In an attempt to best explain the innate immune system to a class of first-year nursing students, the instructor should describe what characteristic? The innate immune system is mediated by molecules called antibodies and is the principal defense against extracellular microbes and toxins. The response of the innate immune system is rapid, usually within minutes to hours, and prevents the establishment of infection and deeper tissue penetration of microorganisms. The innate immune system consists of lymphocytes and their products, including antibodies. The innate immune system is mediated by specific T-cells and defends against intracellular microbes such as viruses.

The response of the innate immune system is rapid, usually within minutes to hours, and prevents the establishment of infection and deeper tissue penetration of microorganisms.

The nurse is explaining to a colleague the basis of a client's allergy to dust. What statement by the nurse most accurately describes antigens in this situation? They have a characteristic four-polypeptide structure consisting of at least two identical binding sites. They possess the ability to communicate critical information by cell-to-cell contact. Synthesis by leukocytes and the ability to act on other leukocytes interferes with virus multiplication. They are substances foreign to the host that can stimulate an immune response.

They are substances foreign to the host that can stimulate an immune response

A client is diagnosed with a bacterial infection of the respiratory system. The nurse teaches the client about the body's natural defenses and identifies which of the following as most likely to be fighting the antigen? Antibodies Cytotoxic T cell Self-antigens Helper T cells

antibodies

The cells that mediate humoral immunity do so because they are capable of producing: Platelets Antibodies Stem cells Helper T cells

antibodies

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

complement

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

cytokines

Immunologically active sites on antigens are recognized as: Epitopes Antigens Effector cells Opsonins

epitopes

Lymphocytes are categorized as either granulocytes or agranulocytes. True or false

false

Passive immunity is achieved through immunization. True or false

false

A client has recently received a pneumococcal vaccine and the client's B cells are consequently producing antibodies. Which cells may enhance this production of antibodies? Helper T cells Regulatory T cells Cytotoxic T cells Natural killer cells

helper T cells

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

humoral

Antibodies are also known as __________.

immunoglobulins

Adaptive immune responses, also called acquired or specific immunity, are composed primarily of which type of cells? Granulocytes Lymphocytes Epithelial cells Toll-like receptors

lymphocytes

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

opsonization

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." the person's immune system is trying to eliminate all responses to certain antigens." the person's immune system is trying to rapidly mature more killer cells to protect against any microbial invasion." our body is trying to systematically control the immune response.

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

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

thymus

B cells are primarily associated with humoral immunity. True or false

true

T cells mature in the thymus and are active in cellular immunity. true or false

true

Toll-like receptors play a role in the pathogen sensation process of innate immunity. True or false

true

A client seeks treatment in the clinic for exposure to poison ivy with a rash over the right arm and hand. The nurse is aware that what toxin is found in the oils on poison ivy that is responsible for eliciting an allergic reaction? Urushiol Lymphocytes Kupffer cells Streptococcus pneumonia

urushiol