Chapter 33: Introduction to the Immune System

A 38-year-old client has begun to suffer from rheumatoid arthritis and is being assessed for disorders of the immune system. The client works as an aide at a facility that cares for children infected with AIDS. Which is the most important factor related to the client's assessment? Age Diet Use of other drugs Home environment

use of other drugs

When obtaining a health history from a patient with possible abnormal immune function, what question would be a priority for the nurse to ask? "Have you ever been treated for a sexually transmitted infection?" "When was your last menstrual period?" "Do you have abdominal pain or discomfort?" "Have you ever received a blood transfusion?"

"Have you ever received a blood transfusion?"

An infection control nurse is presenting an in-service reviewing the immune response. The nurse describes the clumping effect that occurs when an antibody acts like a cross-link between two antigens. What process is the nurse explaining? Agglutination Cellular immune response Humoral response Phagocytic immune response

Agglutination

Immunoglobulins (also known as antibodies) promote the destruction of invading cells in various ways, using different mechanisms. Which mechanism is used by immunoglobulins to destroy pathogenic antigens? All options are correct. neutralization agglutination precipitation

All options are correct

A gardener sustained a deep laceration while working and requires sutures. The date of the client's last tetanus shot was over 10 years ago. Based on this information, the client will receive a tetanus immunization which will allow for the release of what? Antibodies Antigens Cytokines Phagocytes

Antibodies

Which of the following cell types are involved in humoral immunity? B lymphocytes Helper T lymphocyte Suppressor T lymphocyte Memory T lymphocyte

B lymphocytes

A nurse is monitoring a client who developed facial edema after receiving a medication. Which white blood cells stimulated the edema? Basophils Eosinophils Monocytes Neutrophils

Basophils

A patient is being treated in the intensive care unit for sepsis related to ventilator-associated pneumonia. The patient is on large doses of three different antibiotics. What severe outcome should the nurse monitor for in the lab studies? Leukocytosis Bone marrow suppression Oral thrush Rash

Bone marrow supression

A client's recent diagnostic testing included a total lymphocyte count. The results of this test will allow the care team to gauge what aspect of the client's immunity? Humoral immune function Antigen recognition Cell-mediated immune function Antibody production

Cell-medicated immune function

Which of the following accurately describes effector or cytotoxic T-cells? Cells that are programmed to identify specific proteins or antigens Cells that can either destroy a foreign cell or mark it for aggressive destruction Cells that respond to chemical indicators of immune activity and stimulate other lymphocytes to be more aggressive and responsive Cells that respond to rising levels of chemicals associated with an immune response to suppress or slow the reaction

Cells that can either destroy a foreign cell or mark it for agressive destruction

A client is being treated for cancer and the nurse has identified the nursing diagnosis of Risk for Infection Due to Protein Losses. Protein losses inhibit immune response in what way? Causing apoptosis of cytokines Increasing interferon production Causing CD4+ cells to mutate Depressing antibody response

Depressing antibody response

A client is fighting an active infection. What function will cytokines perform in this immune response? Determining whether a cell is foreign Determining if lymphokines will be activated Determining whether the T cells will remain in the nodes and retain a memory of the antigen Determining whether the immune response will be the production of antibodies or a cell-mediated response

Determining whether the immune response will be the production of antibodies or a cell-mediated response

A client's natural immunity is enhanced by processes that are inherent in the physical and chemical barriers of the body. What is a chemical barrier that enhances natural immunity? Cell cytoplasm Interstitial fluid Gastric secretions Cerebrospinal fluid

Gastric secretions

A client's exposure to which of the following microorganisms is most likely to trigger a cellular response? Herpes simplex Staphylococcus aureus Pseudomonas aeruginosa Beta hemolytic Streptococcus

Herpes simplex

Which of the following protective responses begin with the B lymphocytes? Humoral Phagocytic Cellular Recognition

Humoral

At 39 weeks' gestation, a pregnant client visits the physician for a scheduled prenatal checkup. The physician determines that the fetus has developed an infection in utero and sends the client for an emergency cesarean delivery. The client is very concerned about the health of her unborn child. Based on knowledge of the immune system, the delivery room nurse explains about which immunoglobulin that will be increased in the fetus at the time of birth and will be actively fighting the infection? IgG IgA IgM IgD

IgG

A client with a history of dermatitis takes corticosteroids on a regular basis. The nurse should assess the client for which of the following complications of therapy? Immunosuppression Agranulocytosis Anemia Thrombocytopenia

Immunosupression

What types of cells are the primary targets of the healthy immune system? Select all that apply. infectious cells foreign cells cancerous cells typical cells

Infectious cells foreign cells cancerous cells

The nurse is aware that the phagocytic immune response, one of the body's responses to invasion, involves the ability of cells to ingest foreign particles. Which of the following engulfs and destroys invading agents? Eosinophils Macrophages Basophils Neutrophils

Macrophages

In which process is the antigen-antibody molecule coated with a sticky substance that facilitates phagocytosis? Opsonization Apoptosis Agglutination Immunoregulation

Opsonization

A 16-year-old has been brought to the emergency department by his parents after falling through the glass of a patio door, suffering a laceration. The nurse caring for this client knows that the site of the injury will have an invasion of what? Interferons Phagocytic cells Apoptosis Cytokines

Phagocytic cells

A client is admitted with cellulitis and experiences a consequent increase in white blood cell count. During what process will pathogens be engulfed by white blood cells that ingest foreign particles? Apoptosis Phagocytosis Antibody response Cellular immune response

Phagocytosis

A patient is admitted with an infected leg, and the nurse notes an increase in his white blood cell (WBC) count. The nurse is aware that, during the immune response, pathogens are engulfed by WBCs that ingest foreign particles. What is this process known as? Apoptosis Phagocytosis Antibody response Cellular immune response

Phagocytosis

The nurse is taking the health history of a newly admitted client. Which condition would place the client at risk for impaired immune function? Previous organ transplantation Surgical removal of the appendix Negative history for radiation therapy Surgical history of a partial gastrectomy

Previous organ transplantation

A client is taking immunosuppressive medications to prevent the rejection of a transplanted kidney. Which adverse effect(s) should the nurse closely monitor in this client? respiratory or urinary system infections depression, memory impairment, and coma rheumatoid arthritis heart failure

Respiratory or urinary system infections

The nurse should recognize a client's risk for impaired immune function if the client has undergone surgical removal of which of the following? Thyroid gland Spleen Kidney Pancreas

Spleen

The nurse is providing care for a client who has multiple sclerosis. The nurse recognizes the autoimmune etiology of this disease and the potential benefits of what treatment? Stem cell transplantation Serial immunizations Immunosuppression Genetic engineering

Stem cell transplantation

A nurse is explaining how the humoral and cellular immune responses should be seen as interacting parts of the broader immune system rather than as independent and unrelated processes. What aspect of immune function best demonstrates this? The movement of B cells in and out of lymph nodes The interactions that occur between T cells and B cells The differentiation between different types of T cells The universal role of the complement system

The interactions that occur between T cells and B cells

Which statement accurately reflects current stem cell research? Stem cell transplantation cannot restore immune system functioning. Stem cell transplantation has been performed in the laboratory only. Clinical trials are underway only in clients with acquired immune deficiencies. The stem cell is known as a precursor cell that continually replenishes the body's entire supply of both red and white cells.

The stem cell is known as a precursor cell that continually replenishes the body's entire supply of both red and white cells

The spleen acts as a filter for old red blood cells, holding a reserve of blood in case of hemorrhagic shock. It is also an area where lymphocytes can concentrate. It can become enlarged (splenomegaly) in certain hematologic disorders and cancers. To assess an enlarged spleen, the nurse would palpate the area of the: Upper mediastinum. Lower right abdomen. Upper left quadrant of the abdomen. Lower margin around the liver.

Upper left quadrant of the abdomen

Our bodies contain a variety of immunoglobulins. Which of these immunoglobulins is found in sweat, tears, mucus, and bile? IgG IgA IgM IgE

IgA

Upon reviewing the results of a complete blood count on a patient who is diagnosed with an acute infection what will the nurse expect to see elevated? Basophil count Eosinophil count Hematocrit Neutrophil count

Neutrophil count

An emergency department (ED) nurse has provided care for many patients who have primary and secondary diagnoses of immune dysfunction. Which of the following patients likely has the highest risk of a disruption to normal immune functioning? A woman who was motivated to come to the ED because of a severe migraine A woman who presented for care for a complaint of vertigo A child who has just been treated for a greenstick fracture to her radius A man who has recently completed medical treatment for prostate cancer

A man who has recently completed medical treatment for prostate cancer

A nurse is reviewing the immune system before planning an immunocompromised client's care. How should the nurse characterize the humoral immune response? Specialized cells recognize and ingest cells that are recognized as foreign. T lymphocytes are assisted by cytokines to fight infection. Lymphocytes are stimulated to become cells that attack microbes directly. Antibodies are made by B lymphocytes in response to a specific antigen.

Antibodies are made by B lymphocytes in response to a specific antigen.

An experiment is designed to determine specific cell types involved in cell-mediated immune response. The experimenter is interested in finding cells that attack the antigen directly by altering the cell membrane and causing cell lysis. Which cells should be isolated? Macrophages Helper T cells B cells Cytotoxic T cells

Cytotoxic T cells

When the body is in contact with an allergen, this lymphocyte, located in the respiratory and intestinal mucosa, triggers the release of histamine. Choose that lymphocyte. Ig A Ig D Ig E Ig G

Ig E

What immunoglobulin is present in small amounts and is thought to be related to allergic responses? IgM IgG IgE IgA

IgE

A client has been diagnosed with breast cancer and is being treated aggressively with a chemotherapeutic regimen. As a result of this regimen, the client has an inability to fight infection because bone marrow is unable to produce a sufficient amount of: lymphocytes. cytoblasts. antibodies. capillaries.

Lymphocytes

A 20-year-old client cut a hand while replacing a window. While reviewing the complete blood count (CBC) with differential, the nurse would expect which cell type to be elevated first in an attempt to prevent infection in the client's hand? Eosinophils Neutrophils B cells Monocytes

Neutrophils

A client's injury has initiated an immune response that involves inflammation. What are the first cells to arrive at this client's site of inflammation? Eosinophils Red blood cells Lymphocytes Neutrophils

Neutrophils

The nurse is assessing a client's risk for impaired immune function. What assessment finding should the nurse identify as a risk factor for decreased immunity? The client takes a beta blocker for the treatment of hypertension. The client is under significant psychosocial stress. The client had a pulmonary embolism 18 months ago. The client has a family history of breast cancer.

The cleint is under significant psychosocial stress

A nursing instructor is giving a lecture on the immune system. The instructor's discussion on phagocytosis will include: neutrophils and monocytes. plasma cells and memory cells. regulator T cells and helper T cells. lymphokines and suppressor T cells.

Neutrophils and monocytes

An individual's exposure to an airborne pathogen has prompted an immune response that includes both cellular and humoral components. Which of the following activities is most closely associated with the humoral immune response? T cells directly attack the foreign pathogen. A circulating lymphocyte containing an antigenic message returns to the nearest lymph node. B lymphocytes produce antibodies that are specific to the pathogen. Granulocytes and macrophages engulf and destroy the invading agents.

B lymphocytes produce antibodies that are specific to the pathogen

A woman has been diagnosed with breast cancer and is being treated aggressively with a chemotherapeutic regimen. As a result of this regimen, she has an inability to fight infection due to the fact her bone marrow is unable to produce a sufficient amount of what? Lymphocytes Cytoblasts Antibodies Capillaries

Lymphocytes

A client undergoing a skin test has been intradermally injected with a disease-specific antigen on the inner forearm. The client becomes anxious because the area begins to swell. Which technique may be used to decrease anxiety in this client? Advise the client to use prescribed analgesics Apply ice packs to reduce the swelling Gently rub the swollen area to accelerate blood flow Assure the client that this is a normal reaction

Assure the client that this is a normal reaction

Decades ago, before the role of the tonsils and adenoids was better understood, it was typical after repeated bouts with tonsillitis to have a tonsillectomy and adenoidectomy. Today it is understood that the tonsils and adenoids are lymphoid tissues that: filter bacteria from tissue fluid. increase the efficacy of antibiotics. eliminate cancer cells. program T lymphocytes.

Filter bacteria from tissue fluid.

A nurse is admitting a client who exhibits signs and symptoms of a nutritional deficit. Inadequate intake of what nutrient increases a client's susceptibility to infection? Vitamin B12 Unsaturated fats Proteins Complex carbohydrates

Proteins

Which immunity type becomes active as a result of infection by a specific microorganism? naturally acquired active immunity artificially acquired active immunity naturally acquired passive immunity artificially acquired passive immunity

Naturally acquired active immunity