Chapter 35, 36, 37, 38 Immune test-med surg
Which type of cells is capable of recognizing and killing infected or stressed cells and producing cytokines? a) Natural killer cells b) Null lymphocytes c) Cytotoxic T cells d) Memory cells
a) Natural killer cells
The nurse is performing a physical assessment for a patient at the clinic and palpates enlarged inguinal lymph nodes on the left. What should the nurse document? (Select all that apply.) a) Size b) Temperature c) Consistency d) Reports of tenderness e) Location
a) Size c) Consistency d) Reports of tenderness e) Location
What type of immunoglobulin does the nurse recognize that promotes the release of vasoa ctive chemicals such as histamine when a client is having an allergic reaction? a) IgM b) IgE c) IgA d) IgG
b) IgE
Which of the following is associated with impaired immunity in the aging patient? a) Incidence of autoimmune disease decreases with age b) Skin becomes thicker c) Decreased renal function d) Increased antibody production
c) Decreased renal function
A client who is being treated for complications related to acquired immunodeficiency disorder syndrome (AIDS) is receiving interferon parenterally as adjunctive therapy. Why does the nurse understand this route is being used? a) The taste of the medication is not palatable. b) The medication, given orally, will cause diarrhea. c) Digestive enzymes destroy its protein structure. d) The medication will work more rapidly parenterally.
c) Digestive enzymes destroy its protein structure.
Which of the following protective responses begin with the B lymphocytes? a) Recognition b) Phagocytic c) Humoral d) Cellular
c) Humoral
Which type of cells is capable of directly killing invading organisms and producing cytokines? a) Null lymphocytes b) Cytotoxic T cells c) Natural killer cells d) Memory cells
c) Natural killer cells
A client has had mumps when he was 9 years old. He had a titer prior to entering nursing school and shows immunity. What type of immunity does this reflect? a) Passive immunity b) Artificially acquired active immunity c) Naturally acquired active immunity d) Natural passive immunity
c) Naturally acquired active immunity
A nurse is taking the health history of a newly admitted client. Which of the following conditions would NOT place the client at risk for impaired immune function? a) History of radiation therapy b) Previous organ transplantation c) Surgical removal of the appendix d) Surgical history of a splenectomy
c) Surgical removal of the appendix
A 64-year-old male client, who leads a sedentary lifestyle, and a 31-year-old female client, who has a very stressful and active lifestyle, require a vaccine against a particular viral disorder. As the nurse, you would know that in one of these clients, the vaccine will be less effective. In which client is the vaccine more likely to be less effective and why? a) The female client because of her age b) The male client because of his lifestyle c) The male client because of his age d) The female client because of her lifestyle
c) The male client because of his age
A nurse is working in a pediatric clinic. After giving a hepatitis B immunization to an infant, the mother asks what kind of protection this provides for her child. The correct response is which of the following? a) Active acquired immunity, which is temporary b) Passive acquired immunity, which is temporary c) Passive acquired immunity, which lasts many years or a lifetime d) Active acquired immunity, which lasts many years or a lifetime
d) Active acquired immunity, which lasts many years or a lifetime
Which of the following immunoglobulins assumes a major role in blood-borne and tissue infections? a) IgG b) IgA c) IgM d) IgD
a) IgG
The nurse is obtaining a history from a patient with severe psoriasis. What question would be the most important to ask this patient to determine a genetic predisposition? a) "How did you know you developed this disease?" b) "Does anyone in your family have more than one autoimmune disease?" c) "How many children do you have?" d) "Does your spouse or significant other have an autoimmune disease?"
b) "Does anyone in your family have more than one autoimmune disease?"
Which of the following is a humoral immune response? a) Intracellular infections b) Anaphylaxis c) Transplant rejection d) Delayed hypersensitivity
b) Anaphylaxis
Proteins formed when cells are exposed to viral or foreign agents that are capable of activating other components of the immune system are referred to as a) antigens. b) interferons. c) antibodies. d) complements.
b) interferons.
A nurse is teaching a patient about the side effects of ibuprofen (Motrin). The patient's teaching is determined to be effective based on which of the following patient statements explaining the drugs effect on the immune system? a) "Motrin can cause hemolytic anemia, which will make me feel tired and short of breath." b) "Motrin can cause pancytopenia, which is a decrease in all of my blood cells." c) "Motrin can cause neutropenia, which can increase my risk of infection." d) "Motrin can cause thrombocytopenia; I will need to watch for bruising and bleeding."
c) "Motrin can cause neutropenia, which can increase my risk of infection."
The nursing students are learning about the immune system in their anatomy and physiology class. What would these students learn is a component of the immune system? a) Red blood cells b) Stem cells c) Lymphoid tissues d) Cytokines
c) Lymphoid tissues
A client is treated in the clinic for a sexually transmitted infection, and the nurse suspects that the client is at risk for HIV. The physician determines that the client should be tested for the virus. What responsibility does the nurse have? a) The nurse will call the client with the results of the test. b) The nurse will inform the client that the results will have to be reported to the Centers for Disease Control and Prevention (CDC). c) The nurse ensures a written consent is obtained prior to testing. d) The nurse should send the client to have the blood drawn without informing him about the specific screening test.
c) The nurse ensures a written consent is obtained prior to testing.
A nurse is explaining treatment options to a patient diagnosed with an immune dysfunction. Which of the following statements made by the patient accurately reflects the teaching about current stem cell research? a) "Currently stem cell transplantation has only been performed in the laboratory, but future research with embryonic stem cell transplants for humans with immune dysfunction has been promising." b) "Stem cell transplantation has been discontinued based on concerns about safety, efficacy, resource allocation, and human cloning." c) "Stem cell clinical trials have only been attempted in patients with acquired immune deficiencies but plans are underway to begin human cloning using embryonic stem cells." d) "Stem cell transplantation has been carried out in humans with certain types of immune dysfunction and clinical trials using stem cells are underway in patients with a variety of disorders having an autoimmune component."
d) "Stem cell transplantation has been carried out in humans with certain types of immune dysfunction and clinical trials using stem cells are underway in patients with a variety of disorders having an autoimmune component."
Which of the following is accurate regarding acquired immunity? Select all that apply. a) Usually develops as a result of exposure to an antigen through immunization b) A nonspecific immunity present at birth c) Also know as innate immunity d) An immunologic response acquired during life but not present at birth e) Can develop by contracting a disease
d) An immunologic response acquired during life but not present at birth a) Usually develops as a result of exposure to an antigen through immunization e) Can develop by contracting a disease
A 25-year-old man receives a knife wound to the leg in a hunting accident. Which of the following types of immunity was compromised? a) Adaptive immunity b) Passive immunity c) Specific immunity d) Natural immunity
d) Natural immunity
What chemical is released by cytotoxic T cells? a) Lymphokine b) Antigen c) Antibody d) Microphages
a) Lymphokine
The anatomy and physiology instructor is explaining a cell-mediated response to the pre-nursing students. What actions would the instructor explain occur in a cell-mediated response? a) T-cell lymphocytes survey proteins in the body and attack the invading antigens. b) Toxins of invading antigens are neutralized. c) The invading antigens precipitate. d) The invading antigens link together (agglutination).
a) T-cell lymphocytes survey proteins in the body and attack the invading antigens.
The nursing instructor is discussing the development of human immunodeficiency disease (HIV) with the students. What should the instructor inform the class about helper T cells? a) They are activated on recognition of antigens and stimulate the rest of the immune system. b) They have the ability to decrease B-cell production. c) They are responsible for recognizing antigens from previous exposure and mounting an immune response. d) They attack the antigen directly by altering the cell membrane and causing cell lysis.
a) They are activated on recognition of antigens and stimulate the rest of the immune system.
A client has undergone a kidney transplant. The nurse is concerned about a compromised immune system in this client for which of the following reasons? a) Use of anti-rejection drugs b) Deficient circulating antibodies c) Excess circulating lymphocytes d) Excess circulating hemoglobin
a) Use of anti-rejection drugs
The immune system is a complicated and intricate system that contains specialized cells and tissues that protect us from external invaders and our own altered cells. Which of the following is the term used to define any substance capable of inducing a specific immune response and of reacting with the products of that response? a) Antibodies b) Antigens c) Lymphocytes d) Lymphokines
b) Antigens
A patient comes into the emergency department with complaints of difficulty walking and loss of muscle control in the arms. As the nurse begins the physical examination, which of the following assessment should be completed if an immune dysfunction in the neurosensory system is suspected? a) Assess for hepatosplenomegaly by measuring abdominal girth b) Assess for ataxia using the finger-to-nose test and heel-to-shin test c) Review the urinalysis report for hematuria d) Assess joint mobility using passive range of motion.
b) Assess for ataxia using the finger-to-nose test and heel-to-shin test
Chronic illnesses may contribute to immune system impairment in various ways. Renal failure is associated with which of the following? a) Decreased bone marrow function b) Deficiency in circulating lymphocytes c) Altered production of white blood cells d) Increased incidence of infection
b) Deficiency in circulating lymphocytes
At 39 weeks' gestation, a pregnant female, visits her physician for a scheduled prenatal checkup. The physician determines that the fetus has developed an infection in utero and sends the patient for an emergency C section. The patient is very concerned about the health of her unborn child. Based on the knowledge of the immune system, the delivery room nurse explains about which of the following immunoglobulins that will be increased in the fetus at the time of birth and actively fighting the infection? a) IgA b) IgG c) IgM d) IgD
b) IgG
A 34-year-old man is diagnosed with chronic hepatitis C. Testing reveals that he is a candidate for treatment. The nurse anticipates that which of the following could be used to treat his condition? a) Monoclonal antibodies b) Interferon c) Erythropoietin d) Interleukin-5
b) Interferon
A nurse is taking health history from a new client, which includes asking about a history of blood transfusions. This is important for which of the following reasons? a) Blood products cause lower antibody titers. b) Blood products cause a high risk for exposure to HIV. c) Blood products cause a high risk for hepatitis B. d) Exposure to foreign antigens may cause altered immune function.
d) Exposure to foreign antigens may cause altered immune function.
A 38-year-old female patient has begun to suffer from rheumatoid arthritis. She is also being assessed for disorders of the immune system. She works as an aide at a facility that cares for children infected with AIDS. Which of the following is the most important factor related to the patient's assessment? a) Her age b) Her home environment c) Her diet d) Her use of other drugs
d) Her use of other drugs
A 6-year-old patient is diagnosed with a viral infection of the respiratory system. Which of the following will most likely be trying to fight the antigen? a) Self-antigens b) B cells c) Complements d) Interferons
d) Interferons
When obtaining a health history from a patient with possible abnormal immune function, what question would be a priority for the nurse to ask? a) "Have you ever received a blood transfusion?" b) "When was your last menstrual period?" c) "Do you have abdominal pain or discomfort?" d) "Have you ever been treated for a sexually transmitted infection?"
a) "Have you ever received a blood transfusion?"
A client is admitted to the hospital with a diagnosis of pneumonia. The client informs the nurse that he has several drug allergies. The physician has ordered an antibiotic as well as several other medications for cough and fever. What should the nurse do prior to administering the medications? a) Administer the medications that the physician ordered. b) Call the pharmacy and let them know the client has several drug allergies. c) Consult drug references to make sure the medicines do not contain substances which the client is hypersensitive. d) Give the client one medicine at a time and observe for allergic reactions.
c) Consult drug references to make sure the medicines do not contain substances which the client is hypersensitive.
Which of the following is a process in which the antigen-antibody molecule is coated with a sticky substance that facilitates phagocytosis? a) Immunoregulation b) Agglutination c) Opsonization d) Apoptosis
c) Opsonization
A patient undergoing a skin test has been intradermally injected with a disease-specific antigen on the inner forearm. The patient becomes anxious because the area begins to swell. Which of the following may be used to decrease anxiety in this patient? a) Advise the patient to use prescribed analgesics b) Apply ice packs to reduce the swelling c) Gently rub the swollen area to accelerate the blood flow d) Assure the patient that this is a normal reaction
d) Assure the patient that this is a normal reaction
Which of the following cell types are involved in humoral immunity? a) Memory T lymphocyte b) Helper T lymphocyte c) Suppressor T lymphocyte d) B lymphocytes
d) B lymphocytes
Why would it be important for the nurse to question the client about sexual practices, history of substance abuse, and his lifestyle during the interview process? a) To determine if the client needs a referral to counseling services b) To determine what type of personality the client has c) To find out if the client will be compliant with therapeutic treatments d) To determine if the client has practices that put him at risk for acquired immunodeficiency syndrome (AIDS)
d) To determine if the client has practices that put him at risk for acquired immunodeficiency syndrome (AIDS)
During which stage of the immune response does the circulating lymphocyte containing the antigenic message return to the nearest lymph node? a) Proliferation b) Recognition c) Response d) Effector
a) Proliferation
The nurse understands that which cells circulate throughout the body looking for virus-infected cells and cancer cells? a) Interferons b) Natural killer cells c) Cytokines d) Interleukins
b) Natural killer cells
The nurse is beginning the physical examination of a client with a complaint of fatigue. What documentation will the nurse provide to describe this general appraisal of the client's health? a) The client is alert and oriented to all spheres. b) The client has palpable peripheral pulses in the upperextremities. c) The client appears mildly ill, listless, and disheveled. d) The client has a blood pressure of 120/72 mm Hg.
c) The client appears mildly ill, listless, and disheveled.
Which stage of the immune response occurs when the differentiated lymphocytes function in either a humoral or a cellular capacity? a) Response stage b) Recognition stage c) Proliferation stage d) Effector stage
a) Response stage
Which type of cells destroys antigens already coated with antibody? a) Suppressor T-cell b) Null c) Memory T-cell d) Natural killer (NK)
b) Null
Which of the following adverse effects should the nurse closely monitor in a patient who takes immunosuppressive drugs? a) Depression, memory impairment, and coma b) Respiratory or urinary system infections c) Heart failure, infusion reactions, and life-threatening infections d) Rheumatoid arthritis
b) Respiratory or urinary system infections
A client is informed that his white blood cell count is low and that he is at risk for the development of infections. The client asks, "Where do I make new white blood cells?" What is the best response by the nurse? a) "White blood cells are produced in the lymphatic tissue." b) "White blood cells are produced in the plasma." c) "White blood cells are produced in the bone marrow." d) "White blood cells are produced in the thymus gland."
c) "White blood cells are produced in the bone marrow."
A 38-year old female has recently been diagnosed with rheumatoid arthritis. She is also receiving further testing for disorders of the immune system. She works as an aide at a facility which cares for children infected with AIDS. Which of the following factors will hold the greatest implications during the client's assessment? Select all that apply. a) Her diet b) Her age c) Her work environment d) Her home environment e) Her history of immunizations and allergies f) Her use of other drugs
c) Her work environment e) Her history of immunizations and allergies f) Her use of other drugs
The nurse is caring for an older adult patient hospitalized with cellulitis of the right lower extremity. Why is it imperative that the nurse continually assess the physical and emotional status of this patient? a) Older patients are at risk of developing dementia. b) The patient will not respond to the antibiotic treatment as well as a younger patient would. c) Older adult patients develop depression and suicidal tendencies when they are faced with chronic illness. d) Early recognition and management of factors influencing immune response may decrease morbidity and mortality.
c) Older adult patients develop depression and suicidal tendencies when they are faced with chronic illness.
A client will be taking the tumor necrosis factor inhibitor, infliximab (Remicade), for the treatment of rheumatoid arthritis. Prior to beginning this therapeutic regimen, what screening should the client have? a) Screening for syphilis b) Screening for peptic ulcer disease c) Screening for tuberculosis d) Screening for rubella
c) Screening for tuberculosis
A client has dilated cardiomyopathy and has just found out he will be receiving a heart. What medication does the client understand that he will have to take for the duration of his life to help suppress the immune system to prevent rejection of the new heart? a) Etanercept (Enbrel) b) Adalimumab (Humira) c) Infliximab (Remicade) d) Cyclosporine (Sandimmune)
d) Cyclosporine (Sandimmune)
The body has several mechanisms to fight disease, one of which is sending chemical messengers. Specifically, the messengers released by lymphocytes, monocytes, and macrophages have differing roles in the immune response. Which messenger enables cells to resist viral replication and slow viral replication? a) Colony-stimulating factor b) Tumor necrosis factor c) Interleukins d) Interferons
d) Interferons
Which of the following is an action of cytotoxic T cells? a) Decrease B cell activity to a level at which the immune system is compatible with life b) Attack of foreign invaders (antigens) directly c) Production of circulating antibodies d) Lyse cells infected with virus
d) Lyse cells infected with virus
A child is brought to the clinic with a rash. The child is diagnosed with measles. The mother tells the nurse that she had the measles when she was a little girl. What immunity to measles develops after the initial infection? a) Naturally acquired passive immunity b) Artificially acquired active immunity c) Artificially acquired passive immunity d) Naturally acquired active immunity
d) Naturally acquired active immunity
During a 12-month well-baby visit, a mother reports that the baby has been breast-fed since birth and has never been ill. She is trying to convince her sister who is currently pregnant to breast-feed also and asks the nurse about the benefits of breast-feeding. The nurse explains the immune benefits of breast-feeding and provides the mother with pamphlets. The nurse determines the patient understands the teaching based on which of the following patient statements? a) "Breast-feeding is beneficial because the dominant antibody IgA in breast milk acts by functioning as an antigen receptor in the mucosal membranes." b) "Breast-feeding is beneficial because the dominant antibody IgM in breast milk is the first immunoglobulin produced in response to bacterial and viral infections." c) "Breast-feeding is beneficial because T lymphocytes found in breast milk are primarily responsible for cellular immunity." d) "Breastfeeding is beneficial because the dominant antibody IgG in breast milk assumes a major role in bloodborne and tissue infections."
a) "Breast-feeding is beneficial because the dominant antibody IgA in breast milk acts by functioning as an antigen receptor in the mucosal membranes."
The nurse is instructing client's about the importance of taking the shingles vaccine. Which client would benefit from this vaccine? a) A 65-year-old client who had chicken pox when he was 12 years old b) A 32-year-old client who has never had chickenpox c) A 24-year-old client who is pregnant d) A 17-year-old client who will be attending college and living in a dormitory
a) A 65-year-old client who had chicken pox when he was 12 years old
A client has had a kidney transplant performed for end-stage kidney disease. What type of immune response that T-cell lymphocytes perform is related to this type of surgery? a) A cell-mediated response b) Naturally acquired active immunity c) Activation of the complement system d) Stimulation of colony-stimulating factors
a) A cell-mediated response
While taking the health history of a newly admitted client, the nurse asks for a list of the client's current medications. Which of the following medication classifications would place the client at risk for impaired immune function? a) Antimetabolites b) Inotropics c) Antihypertensives d) Pancreatic enzymes
a) Antimetabolites
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? a) Bone marrow suppression b) Leukocytosis c) Rash d) Oral thrush
a) Bone marrow suppression
The nurse is obtaining information from a client with Crohn's disease about his medication history. What medication would the nurse include when asking about what medications the client has taken for suppression of the inflammatory and immune response? a) Corticosteroids b) Ibuprofen (Advil) c) Diuretics d) Angiotensin-converting enzyme inhibitors (ACE-I)
a) Corticosteroids
As a nursing instructor, you realize the importance of your students understanding how the immune system works and its role to protect and defend the body from potential harm. What type of cells are the primary targets of the healthy immune system? Select all that apply. a) Infectious cells b) Cancerous cells c) Foreign cells d) Typical cells
a) Infectious cells b) Cancerous cells c) Foreign cells
A nursing instructor is giving a lecture on the immune system. Which of the following cells will the instructor include in her discussion on phagocytosis? a) Neutrophils and monocytes b) Regulator T cells and Helper T cells c) Lymphokines and Suppressor T cells d) Plasma cells and memory cells
a) Neutrophils and monocytes
An older adult has developed a sacral pressure ulcer. What should the nurse assess in order to ensure adequate wound healing and prevent poor outcomes for this patient? (Select all that apply.) a) Nutritional status b) The amount of carbohydrates the patient ingests c) Quality of food ingested d) Caloric intake e) The patient's ability to perform her own wound care
a) Nutritional status d) Caloric intake c) Quality of food ingested
A laboring mother asks the nurse if the baby will have immunity to some illnesses when born. What type of immunity does the nurse understand that the newborn will have? a) Passive immunity transferred by the mother b) Artificially acquired active immunity c) Naturally acquired active immunity d) There is no immunity passed down from mother to child.
a) Passive immunity transferred by the mother
You are caring for a client with a suspected immune system disorder. What test would be ordered if a deficiency or excess of immuneglobulins was suspected? a) Protein electrophoresis b) Plasmapheresis c) T-cell and B-cell assays d) Enzyme-linked immunosorbent assay
a) Protein electrophoresis
T-cell and B-cell lymphocytes are the primary participants in the immune response. What do they do? a) T-cell and B-cell lymphocytes distinguish harmful substances and ignore those natural and unique to a person. b) T-cell and B-cell lymphocytes respond to the body's invasion by macrophages. c) T-cell and B-cell lymphocytes react to the body's lack of B12 . d) T-cell and B-cell lymphocytes distinguish harmful treatments from curative treatments.
a) T-cell and B-cell lymphocytes distinguish harmful substances and ignore those natural and unique to a person.
The nurse is teaching a client who has been diagnosed with Hashimoto's thyroiditis. Which of the following statements correctly describes the process of autoimmunity? a) The normal protective immune response attacks the body, damaging tissues. b) The body overproduces immunoglobulins. c) The body produces inappropriate or exaggerated responses to specific antigens. d) A deficiency results from improper development of immune cells or tissues.
a) The normal protective immune response attacks the body, damaging tissues.
Which of the following statements accurately reflects current stem cell research? a) The stem cell is known as a precursor cell that continually replenishes the body's entire supply of both red and white cells. b) Stem cell transplantation cannot restore immune system functioning. c) Clinical trials are underway in patients with acquired immune deficiencies only. d) Stem cell transplantation has been performed in the laboratory only.
a) The stem cell is known as a precursor cell that continually replenishes the body's entire supply of both red and white cells.
Decades ago, a typical childhood surgery, after repeated bouts with tonsillitis, was to have a tonsillectomy and adenoidectomy. That was before the role of the tonsils and adenoids were better understood. As it is understood today, what are the roles of the tonsils and adenoids? a) They are lymphoid tissues that filter bacteria from tissue fluid. b) They are lymphoid tissues that increase the efficacy of antibiotics. c) They are lymphoid tissues that program T lymphocytes. d) They are lymphoid tissues that eliminate cancer cells.
a) They are lymphoid tissues that filter bacteria from tissue fluid.
A 20-year-old male patient cut his hand while replacing a window. While reviewing the complete blood count (CBC) with differential, the nurse would expect which of the following cell types to be elevated first in order to prevent an infection in the patient's hand? a) Monocytes b) Neutrophils c) Eosinophils d) B cells
b) Neutrophils
A patient arrives at the clinic and informs the nurse that she has a very sore throat as well as a fever. A rapid strep test returns a positive result and the patient is given a prescription for an antibiotic. How did the streptococcal organism gain access to the patient to cause this infection? a) Breathing in airborne dust b) Through the mucous membranes of the throat c) Through the skin d) From being outside in the cold weather and decreasing resistance
b) Through the mucous membranes of the throat
A school nurse is talking about infection with a high school health class. What would be the nurse's best explanation of the process of phagocytosis? a) Removal of bacteria and dead blood cells from circulation b) Release of chemicals to destroy bacteria and foreign material c) Engulfment and digestion of bacteria and foreign material d) Conversion of memory cells to plasma cells
c) Engulfment and digestion of bacteria and foreign material
An elderly client is diagnosed with a respiratory infection. While reviewing age-related changes in the immune system, the nurse identifies which of the following as having contributed to this client's infection? a) Decreased phagocytosis by Kupffer cells b) Decreased sensation and slowing of reflexes c) Impaired ciliary action from exposure to environmental toxins d) Failure of the immune system to differentiate "self" from "non-self"
c) Impaired ciliary action from exposure to environmental toxins
A nurse is taking the health history of a newly admitted client and asks for a list of the client's current medications. Which of the following medication classifications would NOT place the client at risk for impaired immune function? a) Antineoplastic agents b) Antimetabolites c) Inotropics d) Adrenal corticosteroids
c) Inotropics
A client has been diagnosed with AIDS and tuberculosis (TB). A nursing student asks the nurse why the client's skin test for TB is negative if the client's physician has diagnosed TB. The nurse's correct reply is which of the following? a) The client has only mild TB, which is not enough to cause a reaction. b) The solution used for the skin test was probably outdated. c) The client's immune system cannot mount a response to the skin test. d) The skin test was improperly performed.
c) The client's immune system cannot mount a response to the skin test.
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? a) B cells b) Helper T cells c) Macrophages d) Cytotoxic T cells
d) Cytotoxic T cells
During the immune response, cytotoxic cells bind to invading cells, destroy the targeted invader, and release lymphokines to remove the debris. Which type of T-cell lymphocyte is cytotoxic? a) Suppressor T cells b) Helper T cells c) Regulator T cells d) Effector T cells
d) Effector T cells
A mother has brought her child to the clinic for a wellness check. While talking with the nurse, the mother asks the nurse to suggest a diet that will maximize the immune function of her growing children. What dietary pattern should the nurse suggest? a) Diet rich in amino acids and essential fatty acids b) Diet rich in iron, zinc, and vitamin E c) Diet rich in potassium, magnesium, and sodium d) Moderate diet that is balanced and varied
d) Moderate diet that is balanced and varied
You are the clinic nurse caring for a client with a suspected diagnosis of HIV. You are preparing to draw blood for a confirmatory diagnostic test on this client. What is the most important action that the nurse should perform before testing a client for HIV? a) Advise the client to take off any ornaments and metallic objects. b) Advise the client to avoid excess fluid intake. c) Advise the client to abstain from having intercourse. d) Obtain a written consent from the client.
d) Obtain a written consent from the client.
A nurse is teaching a community group about healthy lifestyles. A participant asks about how to maintain a healthy immune system. The nurse informs the group that which of the following factors will positively affect the immune system? a) Poor nutritional status b) Residential exposure to radiation c) Rigorous, competitive exercise d) Strong family and community connections
d) Strong family and community connections
While taking the health history of a newly admitted client, the nurse reviews general lifestyle behaviors. Which of the following would have a positive effect on the immune system? a) Biofeedback, relaxation, and hypnosis b) Relaxation, intense competitive exercise, and humor c) Humor, rigorous physical stress, and biofeedback d) Hypnosis, humor, and chronic illness
a) Biofeedback, relaxation, and hypnosis
The nurse is administering a skin test for detection of exposure to tuberculosis. How would the nurse determine if the client was exposed to tuberculosis? a) The client will have a productive cough. b) The injection area will become painful with in duration if the client has antibodies against the antigen. c) The injection area will break out in a fine macular rash. d) The injection area swells if the client has developed antibodies against the antigen.
d) The injection area swells if the client has developed antibodies against the antigen.
What organ is considered lymphoid tissue? a) Pancreas b) Spleen c) Intestines d) Liver
b) Spleen
What are the primary participants in the immune system? a) Lymphoblasts and gamma globulins b) T- and B- cell lymphocytes c) Macrophages and memory cells d) Stem cells and monocytes
b) T- and B- cell lymphocytes
A client is diagnosed with rheumatoid arthritis, an autoimmune disorder. When teaching the client and family about autoimmune disorders, the nurse should provide which information? a) Autoimmune disorders include connective tissue (collagen) disorders. b) Autoimmune disorders are distinctive, aiding differential diagnosis. c) Clients with autoimmune disorders may have false-negative but not false-positive serologic tests. d) Advanced medical intervention can cure most autoimmune disorders.
a) Autoimmune disorders include connective tissue (collagen) disorders.
T-cells can be either regulator T cells or effector T cells. Regulator T cells are made up of helper and suppressor cells. What function are helper T-cells important in? a) Fighting infection b) Activating lymphokines c) Producing antibodies d) Turning off the immune response
a) Fighting infection
The nurse is caring for a client recovering from a major burn. Burns affect the immune system by causing a loss of large amounts of which of the following? a) Plasma, which depletes the body's store of catecholamines b) Serum, which depletes the body's store of immunoglobulins c) Plasma, which depletes the body's store of calcitonin d) Serum, which depletes the body's store of glucagon
b) Serum, which depletes the body's store of immunoglobulins.
A client is diagnosed with human immunodeficiency virus (HIV). After recovering from the initial shock of the diagnosis, the client expresses a desire to learn as much as possible about HIV and acquired immunodeficiency syndrome (AIDS). When teaching the client about the immune system, the nurse states that humoral immunity is provided by which type of white blood cell? a) Lymphocyte b) Monocyte c) Basophil d) Neutrophil
a) Lymphocyte
A nurse is caring for a patient undergoing evaluation for possible immune system disorders. Which of the following interventions will best help support the patient throughout the diagnostic process? a) Assisting the patient with the scheduling of the procedures b) Encouraging the patient to ask their physician for information about the treatment options for the possible diagnosis c) Educating the patient about the diagnostic procedures and answer questions they may have about the possible diagnosis d) Accompanying the patient to the diagnostic tests
c) Educating the patient about the diagnostic procedures and answer questions they may have about the possible diagnosis
Which of the following responses identifies a role of T lymphocytes? a) Bacterial phagocytosis and lysis b) Allergic hay fever and asthma c) Transplant rejection d) Anaphylaxis
c) Transplant rejection
Which of the following is a center for immune cell proliferation? a) Liver b) Spleen c) Pancreas d) Lymph node
d) Lymph node
The nurse is caring for a female patient who has an exacerbation of lupus erythematosus. What does the nurse understand is the reason that females tend to develop autoimmune disorders more frequently than men? a) Estrogen tends to enhance immunity. b) Testosterone tends to enhance immunity. c) Leukocytes are increased in females. d) Androgen tends to enhance immunity.
a) Estrogen tends to enhance immunity.
Which of the following medication classifications are known to inhibit prostaglandin synthesis or release? a) Antibiotics in large doses b) Antineoplastic agents c) Adrenal corticosteroids d) Nonsteroidal anti-inflammatory drugs (NSAIDs) in large doses
d) Nonsteroidal anti-inflammatory drugs (NSAIDs) in large doses
What is the function of the thymus gland? a) Produce stem cells b) Programs B lymphocytes to become regulator or effector Bcells. c) Develop the lymphatic system d) Programs T lymphocytes to become regulator or effector T cells.
d) Programs T lymphocytes to become regulator or effector T cells.
Matt Carson, a 20-year-old college student, was riding his motorcycle home from class when he lost control of the bike and sustained serious internal injuries, including a ruptured spleen. Matt has been taken to the OR to remove his spleen and the ED nurse is meeting with Matt's parents to answer some of their additional questions. Which of the following will be included in the nurse's discussion regarding special considerations following the removal of Matt's spleen? a) Matt will be susceptible to bleeding because the spleen synthesizes vitamin K. b) Matt will be susceptible to infection because the spleen removes bacteria from the blood. c) Matt will be susceptible to anemia because the spleen produces red blood cells. d) Matt will be susceptible to acidosis because the spleen maintains acid-base balance.
b) Matt will be susceptible to infection because the spleen removes bacteria from the blood.
Which of the following is a age-related change associated with the immune system? a) Decreased antibody production b) Increased antibody production c) Elevated phagocytic immune response d) Ability to differentiate "self" from "nonself"
a) Decreased antibody production
Which of the following is associated with impaired immunity relating to the aging patient? a) Increase in humoral immunity b) Decrease in inflammatory cytokines c) Breakdown and thinning of the skin d) Increase in peripheral circulation
c) Breakdown and thinning of the skin
An elderly client is diagnosed with cancer. While reviewing age-related changes in the immune system, the nurse identifies which of the following as having contributed to this client's condition? a) Impaired ciliary action from exposure to environmental toxins b) Decreased sensation and slowing of reflexes c) Failure of lymphocytes to recognize mutant cells d) Failure of immune system to differentiate "self" from "non-self"
c) Failure of lymphocytes to recognize mutant cells
Which of the following immunity types becomes active as a result of infection by a specific microorganism? a) Artificially acquired passive immunity b) Artificially acquired active immunity c) Naturally acquired passive immunity d) Naturally acquired active immunity
d) Naturally acquired active immunity
During an annual examination, an older patient tells the nurse, "I don't understand why I need to have so many cancer screening tests now. I feel just fine!" Based on the knowledge of neoplastic disease and the aging immune system, what teaching should the nurse include in the patient's plan of care? Select all that apply. a) The immune system is integrated with other psychophysiologic processes and is regulated by the brain. Aging of the brain can have immunologic consequences and can affect neural and endocrine function increasing the risk of cancer development. b) Tumor cells may possess special blocking factors that coat tumor cells and prevent their destruction by killer T lymphocytes; therefore, the body may not recognize the tumor as foreign and fail to destroy the malignant cells. Routine screening increases the chance of finding and treating cancer early. c) Education about the importance of adhering to a recommended vaccine schedule should be initiated to boost the immune system function. d) Nutritional intake to support a competent immune response plays an important role in reducing the incidence of cancer. A healthy diet including protein, vitamins, minerals, and some fats can alter the risk of cancer development. e) The increase in occurrence of autoimmune diseases due to aging strongly suggests a predisposition to various types of cancer due to the body's inability to differentiate between self and nonself. Routine screening increases the chance of finding and treating cancer early.
b) Tumor cells may possess special blocking factors that coat tumor cells and prevent their destruction by killer T lymphocytes; therefore, the body may not recognize the tumor as foreign and fail to destroy the malignant cells. Routine screening increases the chance of finding and treating cancer early. e) The increase in occurrence of autoimmune diseases due to aging strongly suggests a predisposition to various types of cancer due to the body's inability to differentiate between self and nonself. Routine screening increases the chance of finding and treating cancer early. d) Nutritional intake to support a competent immune response plays an important role in reducing the incidence of cancer. A healthy diet including protein, vitamins, minerals, and some fats can alter the risk of cancer development.
A nurse is caring for a client with multiple sclerosis. Client education about the disease process includes which of the following explanations about the cause of the disorder? a) Regulatory mechanisms fail to halt the immune response. b) The immune system recognizes one's own tissues as "self." c) Excess cytokines cause tissue damage. d) The immune system recognizes one's own tissues as "foreign."
d) The immune system recognizes one's own tissues as "foreign."
