Health Alt. Exam 1
The early management recommendations for an asymptomatic person confirmed to have HIV antibodies would consist of which intervention?
Baseline screening for viral load and CD4+ counts
A diagnosis of acquired immunodeficiency syndrome (AIDS) is identified when the CD4+ T cell count reaches which level?
Below 200 cells/μL
During a blood transfusion, a client begins to have chills, back pain, and develops a fever. The nurse determines the client is experiencing a transfusion reaction. The nurse educates the client about transfusion reactions. Which statement indicates the cause of the reaction?
Each person has two HLA haplotypes that identify human cells. Blood typing involves the identification of these haplotypes (ABO compatibility). The closer the matching of HLA types, the greater is the probability of identical antigens and the lower the chance of rejection. A reaction occurs if the immune system views the HLA types as foreign.
A 23-year-old HIV-positive woman in the United States with routinely low viral loads and robust CD4+ cell counts is planning to get pregnant. Which precaution would her health care provider eliminate from her care?
Give her single-dose perinatal nevirapine
The treatment of HIV/AIDS is complicated because different drugs act on different stages of the replication cycle of the virus. Therefore, treatment includes combinations of two, three, or more drugs. What is this treatment called?
HAART treatment
A client with common variable immunodeficiency (CVID) is admitted to the hospital for treatment. Which type of treatment will the nurse be administering to the client?
IV immunoglobulin
The nurse is assisting a new mother with breastfeeding. What does the nurse understand is a primary secretory immunoglobulin (Ig) that is found in the colostrum?
IgA
Which immunoglobulin is primarily found in secretions and has a primary function of providing local immunity on mucosal surfaces?
IgA
which immunoglobulin is primarily found in secretions and has a primary function of providing local immunity on mucosal surfaces?
IgA
a client is being treated for an anaphylactic reaction after eating shrimp. which class of antibodies mediates the anaphylaxis?
IgE
he nurse is providing care for a client whose abrupt-onset hypersensitivity reaction was stimulated by an antigen challenge. The nurse should understand that this reaction is:
IgE-mediated.
In a newborn, which antibody crosses the placenta to provide protection from infection?
IgG
a one day infant was exposed to an infectious microorganisms prior to discharge home from the hospital, but was able to affect a sufficient immune response in the hours and days following exposure. the nurse knows that which immunoglobulin assisted with this process?
IgG
the nurse is aware that the only class of immunoglobulins to cross the placenta is
IgG
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 have deficient immunity.
A client diagnosed with the autoimmune disorder Hashimoto's thyroiditis asks the nurse what he has done to cause this disorder. What knowledge by the nurse should the response be based upon?
It is a result of the loss of immunologic self-tolerance.
What is the main effect of HIV infection?
Poor helper T-cell function
A client with a diagnosis of cirrhosis has experienced an acute rejection of a donor liver. Which cell is most likely responsible for the rejection of the client's transplanted organ?
T cells
a client with a diagnosis of cirrhosis has experienced an acute rejection of a donor liver. which cell is most likely responsible of the client's transplanted organ?
T cells
which type of immunity provides a defense against intracellular microbes such as viruses?
T lymphocytes
A newborn has been lethargic and is not nursing well. testing of cord blood done at birth reveals the presence of IgM. How should the nurse interpret this finding?
The presence of IgM suggests the newborn has an infection
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 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.
A client in the primary or initial phase of a type I hypersensitivity reaction would most likely experience which physiologic response?
Vasodilation of the capillaries from the release of histamine
A client has begun HAART shortly after being diagnosed with HIV. When describing the potential benefits of this drug regimen, the nurse should describe:
a reduction in the replication rate of HIV.
which intervention 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 pregnant client asks the nurse when the fetus's immune system develops during gestation. the nurse will base the response on which information?
beginning at 5 to 6 weeks gestation the liver starts hematopoiesis
A client with end-stage renal disease received a kidney transplant with a kidney donated by a family member. The client has been carefully monitored for signs of rejection. The physician informs the client that there has been a gradual rise in the serum creatinine over the last 5 months. What type of rejection does this depict?
chronic rejection
of the pathways available to recognize microbes and activate the complement system, which one requires the presence of an antibody
classical
what is the term for a subset of cytokines that stimulate the production of large amounts of platelets, erythrocytes, lymphocytes, neutrophils, and monocytes, eosinophils, basophils, and dendritic cells?
colony- stimulating factors (CSFs)
Which regimen serves as the rationale for HIV/AIDS treatment with antiretroviral therapy?
combination therapy incorporating the five classes of antiretroviral drugs
once T helper cells are activated, they secrete which substance that activates and influences nearly all of the other cells of the immune system?
cytokines
Which cells block the entry of microbes and destroy them by secreting antimicrobial enzymes, proteins, and peptides within the mucous membrane linings of the gastrointestinal, respiratory, and urogenital tract?
epithelial
immunologically active sites on antigens are recognized as
epitopes
The laboratory finds IgA in a sample of cord blood from a newborn infant. This finding is important because it signifies what?
fetal reaction to exposure to an intrauterine infection
A lactation nurse visits a new mother after delivery of her first child and encourages the mother to breast-feed her infant, even for a short time. Which statement made by the nurse correctly explains the importance of breast-feeding?
for several months, colostrum will provide the infant with passive immunity to disease to which mother has immunity
The nurse is caring for a client who has lesions of Kaposi sarcoma (KS). The nurse understands that KS:
is a malignancy of the endothelial cells that line small blood vessels.
Manifestations of Kaposi sarcoma include:
lesions of the skin and in the oral cavity, gastrointestinal tract, and lungs.
A hospital client with a diagnosis of sepsis is in need of a specific response to microorganisms and a long-lasting immunity to the pathogens in question. Which component of the client's immune system is most able to meet these criteria?
lymphocytes
What is a common source of interleukin-1 (IL-1), interleukin-6 (IL-6), and interleukin-12 (IL-12)?
macrophages
A client has been exposed to a particular antigen and now experiences a repeat exposure. What stimulates a quicker immune response?
memory T cells
which disorder does the nurse know is considered to be an autoimmune disease?
myasthenia gravis
A teenager with an infected wound asks, "How does my body fight off the germs in my scraped arm?" Which response by the nurse correctly identifies the cells that play a central role to the innate immune response to an infectious microorganism?
neutrophils
which of the following helps the innate immune system differentiate between body cells and foreign substances?
pattern recognition receptors identify structures not shared by body tissues
Which medication is used in the treatment of HIV to prevent cleavage of the polyprotein chain into individual proteins?
protease inhibitor
A college student has received a tetanus booster shot. This immunization confers protection by way of what immune process?
secondary humoral response
a college student has received a tetanus booster shot. this immunization confers protection by way pf what immune process?
secondary humoral response
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
a client has been identified as having an excess of macrophages inhibitory factor, causing the client to have inhibited movement and activity of macrophages, which processes does the nurse expect to remain unaffected?
specify and memory of the immune response
The primary health care provider prescribes new medications to treat a client with an autoimmune disorder. Which order would the nurse question?
spironolactone
A nurse has just learned that her child has a life-threatening complement disorder known as hereditary angioneurotic edema (HAE). Due to deficiency in C1-INH, the nurse needs to be prepared for which possible life-threatening clinical manifestation?
swelling of the airway
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.
IgA
the primary secretory immunoglobulin found in the colostrum.
opsonization
the process by which microbes are coated to allow for more efficient recognition by phagocytes
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 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
One of the self-regulatory actions of the immune system is to identify self-antigens and be nonreactive to them. Which term best describes this process of the immune system?
tolerance
The type of hypersensitivity reaction that is dependent on IgE-mediated activation of mast cells and basophils and the subsequent release of chemical mediators of the inflammatory response is known as which of the following types of hypersensitivity reaction?
type I
Which manifestation is caused by a genetically determined hypersensitivity to common environmental allergens resulting in an atopic reaction?
urticaria
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
A client in the primary or initial phase of a type I hypersensitivity reaction would most likely experience which physiologic response?
vasodilation of the capillaries from the release of histamine
A 20-year-old male presents at the clinic complaining of severe fatigue, night sweats, and fever. While taking the client's history, he reports having multiple sexual partners and unprotected sex. HIV/AIDS is suspected. What diagnostic test would be ordered to confirm the diagnosis?
western blot assay
Helper T cells
when a client receives a pneumococcal vaccine and the client's B cells are consequently producing antibodies, what cell may help with the production of the antibodies?
Shortly after being diagnosed with HIV, a client has begun highly active antiretroviral therapy (HAART). The client asks, "My doctor tells me that my viral load is going down. What does that mean?" The nurse's best response is:
your HARRT medications are working to slow the progression of the disease
A client with infection mononucleosis asks the nurse why the lymph nodes are enlarged, what should the nurse say?
"your lymph nodes trap and destroy viruses."
A client recently diagnosed with leukocyte adhesion deficiency (LAD) asks, "Why am I always sick with an infection?" Which response by the nurse explains this rare autosomal recessive disorder?
"your white blood cells are not able to leave the blood vessels and move into the area of infection"
A nurse is teaching a group of seniors about the decline of the immune system due to aging. Which topic should be included in the teaching plan regarding the immune response of older adults? Select all that apply.
- increase in susceptibility to infections - higher incidence of cancer - weakened response to vaccinations
A nursing instructor is explaining the role of a macrophage to a group of nursing students. Which roles of the macrophage should be included in the teaching plan? Select all that apply.
-phagocytosis -antigen presentation -activation of lymphocytes -destruction of malignant cells
What is the length of time from infection with HIV to seroconversion?
1 to 3 months
Which client has the highest risk of contracting an opportunistic infection?
A client who has had HIV for 3 years and has a CD4+ count of 50 cells/μL
An infant is suspected of having a severe primary immunodeficiency disease. Which effect on the infant makes early detection a priority?
Administering live attenuated virus vaccines can be fatal.
When a client who has been newly diagnosed with HIV asks, "What are the chances that I can be cured?," what is the nurse's most therapeutic response?
"Although there is no current treatment that provides a possible cure, there are ones that have successfully managed the infection."
Which statement from a group of young adults demonstrates the need for further teaching related to HIV and prevention of the spread of HIV?
"Having oral sex is one way I can prevent passing on HIV to my partner."
A client describes himself as being "devastated" after hearing that his HIV test has come back positive. Which response by the nurse is most appropriate?
"It's entirely normal to feel that way. We are going to try our best to help you get all the support you need."
