Pathophysiology Ch 8 EAQ Q's
A nurse is asked about the characteristics of natural killer cells. How does the nurse reply?
"NK cells can recognize protein changes on a cell's surface associated with viruses or cancer"
A laboratory test result indicates the patient has a decreased level of C8 cells. Which cells are decreased?
Cytotoxic T cells Cytotoxic T cells have CD8 proteins. B lymphocytes do not have CD8 proteins. T-helper type 1 and type 2 cells have CD4 proteins.
A patient's T-helper 1 cells are decreased. Which process will the nurse expect to occur?
Decreased inflammation Explanation: Th1 cells effect cellular immunity. Th2 cells effect humoral immunity. Th17 cells effect inflammation and macrophages.
Which laboratory test result indicates to the nurse that the patient had a secondary immune response?
Elevated IgG higher than IgM IgG production is increased considerably, making it the predominant antibody class. IgE is elevated in allergic responses. IgA is a secretory antibody.
A nurse teaches about the crytalline fragment (Fc) portion of the antibody. Which information does the nurse include in the teaching session? Select all that apply
Enhances phagocytosis Activates the complement system Through the Fc portion, antibodies activate components of innate resistance, including complement and phagocytes. The Fab portions contain the recognition sites (receptors) for antigens and confer the molecule's specificity toward a particular antigen, The two indentical fragments retain the ability to bind antigens and are termed antigen-binding fragments (Fab). Macrophages and dendritic cells are antigen-processing cells, not antibodies.
A patient has a parasite infestation. Which inflammatory cell or protein will substantially damage the parasite?
Eosinophil The only inflammatory cell that can adequately damage a parasite is the eosinophil, because of the special contents of its granules. Immunoglobulin E and other antibody classes such as IgG, IgM, and IgA are proteins that bind to the surface of parasites, activate complemetn, generate chemotactic factors for neutrophils and macrophages, and serve as opsonins for those phagocytic cells. This response, however, does not greatly damage parasites.
A patient is infected with a superantigen. Which pathophysiologic response does the nurse expect in the patient?
Excess T-helper cell activation and proliferation occurs. Superantigen binding is independent of antigen recognition and signal T-helper cell activation and proliferation and excessive cytokine production. Regulatory T cells control the immune response and are not affected by the superantigen. Interleukin 2 is excessively produced, not destroyed, with a superantigen. Th1 cells aid in developing cellular immunity. Lymphokine-producing cells secrete cytokines that activate other cells, and with a superantigen excessive production of cytokines occurs.
Which events induce active immunity in a patient? Select all that apply
Exposure to the flu virus and (antigen) Obtaining a pneumonia vaccine/immunization Active acquire immunity (active immunity: is produces by an individual either after natural exposure to antigens or after immunization. Passive acquire immunity (passive immunity) does not involve the host's immune response at all. Rather, passive immunity occurs when preformed antibodies or T cels are transferred from a donor to the recipient. This can occur naturally, as during pregnancy or breast-feedings, or artificially, as when immune globulins are given to an individual. Passive immunity has no memory response, PERSON DID NOT MAKE ANTIBODIES. Passive immunity is when antibodies are made in another person, animal or cell are injected into a human.
A patient is infected with a superantigen. Which clinical manifestations will the nurse expect to find upon assessment? Select all that apply
Fever, Fatal Shock, Hypotension The overproduction of inflammatory cytokines from superantigens results in symptoms of a systemic inflammatory reaction, including fever, low blood pressure, and potentially, fatal shock.
A patient has elevated levels of immunoglobulin E (IgE). Which conditions does the nurse suspect could be the cause of the elevated levels? Select all that apply
Has hay fever Got stung by a bee Infected with parasites IgE is a special class of antibody that protects the individual from infection with large parasitic worms. However, when IgE is produced against relatively innocuous environmental antigens, it is also the primary cause of common allergies (e.g. hay fever, dust allergies, bee stings). IgG accounts for most of the protective activity agains viral and bacterial infection.
Tetanus causes a patient's body to produce an immune response. Which term does the nurse use to describe the molecules of tetanus?
Immunogens Immunognes are molecules that induce an immune response. Memory cells, antibodies, and lymphocytes are part of the immune response; they do not induce the response.
A nurse teaches the primary difference between adaptive immunity and innate immunity. Which type of cell or protein is primarily involved in the adaptive response?
Immunoglobulins The third line of defense in the human body is adaptive (acquired) immunity, often called the immune response or immunity, and consists of lymphocytes and serum protein called antibodies. Therefore immunoglobulins (antibodies) are adaptive immune proteins. Neutrophils, macrophages, and dendritic cells are present in both innate and adaptive immune responses but are not the primary cells for an adaptive response. The primary cells of the adaptive immune response are B and T lymphocytes; plasma cells descend from B cells and produce proteins called immunoglobulins (antibodies)
A patient has an infection, and the patients body produces cytotoxic T lymphocytes. Which mechanism doe these cells use to kill infection?
Inducing apoptosis. After attachment of cytotoxic T lymphocytes to a target cell, killing occurs by induction of apoptosis. Cytotoxic T lymphocytes are not phagocytes (as macrophages and neutrophils are). Cytotoxic T lymphocytes do not produce antibodies (as plasma cells do), and they do not participate in opsonization (as complement does).
Before providing care for an older patient, the nurse washed their hands to decrease the chance of infection. Which age related factor supports the nurse's actions?
Involution of the thymus Involution of the thymus begins at puberty and continues through middle age. This change in thymus function contributes to decreased cell-mediated immunity in the older adult patient; handwashing will decrease the chance of infection. Bone marrow is the site of B-lymhopcyte maturation. Excitatory effects of sex hormone would not effect the immune system. Many vaccines confer long-lasting immunity and do not lose effectiveness.
A nurse teaches the principal antigen-processing cells. Which cells does the nurse include? Select all that apply
Macrophages and Dendritic cells Macrophages and dendritic cells are are the primary cells that engage in antigen processing and antigen presentation. Neutrophils are not a principal type of antigen-processing cell. Pluripotent cells are bone marrow stem cells and are not involved in antigen presentation. Plasma cells are mature B lymphocytes that release antibodies.
A nurse describes cells of the cell-mediated immune response. Which types of cells will the nurse include? Select all that apply
Memory cells T-cytotoxic cells T-regulatory cells There are several types of T cells: T-cytotoxic cells (Tc), T-helper cells (Th), T-regulaotry cells (Treg), and memory cells. T cells are responsible for the cell-mediated immune response. Plasma cells and antibodies are components of the humoral immune response.
A nurse describes the antigen-bonding site on an antibody. Which term does the nurse use?
Paratope The matching portion on the antibody to an antigen is sometimes referred to as the antigen-binding site, or paratope. The precise area of the molecule that is recognized by an antibody is called the antigenic determinant, or epitope. Monocytes are found in the blood and mature in the tissues into macrophages. Macrophages are antigen-processing cells and phagocytes.
A patient has an infection in the lungs resulting in an immune response. Which cells in the patient's body will produce antibodies?
Plasma cells Plasma cells are mature B lymphocytes that produce antibodies during an immune response. T cells do not produce antibodies. IgG is an antibody. T-helper cells stimulate B cells to produce antibodies.
A patient has an infection, and t-helper (Th2) cells are stimulated. The nurse expects which process to occur?
Stimulation of antibody production. Th2 cells provide more help for humoral immunity (B cells and antibodies). Th1 stimulates cell-mediated immunity, including cytotoxic cells. Th17 cells activate macrophages and help inflammation.
Which information indicates the nurse has a correct understanding of the function of activated T-helper 2 cells?
Support humoral immunity Th2 cells release cytokines that provide help for humoral immunity. Th1 cells provide help in developing cell-mediated immunity. Th2 cells, in addition to assisting B-cell clonal selection, secrete cytokine that activate M2 macrophages for healing and repair of damaged tissue. Th17 cells activate macrophages as part of inflammation. T reg cells release cytokines that suppress the immune response by suppressing antigen recognition.
A nurse teaches about cellular immunity. Which information does the nurse include in the teaching session?
T lymphocytes are the primary cell of cellular immunity. Explanation: T lymphocytes are the primary cells of cellular immunity. - The primary function of the B lymphocyte is release of antigen-specific antibodies, which is HUMORAL immunity. - Cytotoxic T lymphocytes destroy cancer cells through induction of apoptosis; plasma cells produce antibodies. - Humoral immunity protects against bacteria and viruses; wheres cellular immunity protects against cells infected by viruses and cancer.
A nurse is asked how an antibody can recognize an antigen. How does the nurse respond?
The Fab portions contain the receptors for antigens. The antigen-binding fragments (Fab) portions contain recognition sites for antigens and confer the molecule's specificity toward a particular antigen. They crystalline fragment (Fc) portion is responsible for most of the biological functions of antibodies. A self-antigen is one that is not foreign to the host. An immunogen is an antigen that induces an immune response.
Which information indicates the nurse has a correct understanding of major histocompatibility complex (MHC) class I molecules? Select all that apply
These molecules team up with T-cytotoxic cells These molecules present endogenous antigens These molecules present virus-infected and potentially malignant cells MHC class I molecules present antigens that are endogenous -- antigens originating within the cell. Examples of endogenous antigens include viruses that infect cells and cancerous cells. Antigens presented by MHC class I molecules are primarily recognized by T-cytotoxic cells. Because MHC class I molecules ae expressed on all cells except red blood cells, any change in a cell caused by viral infection or malignancy may result in foreign antigens being presented. CD1 presents lipid antigens derived from extracellular organisms.
A nurse teaches about major histocompatibility complex (MHC) molecules. Which information does the nurse include in the teaching session? Select all that apply
They are glycoproteins, They are antigen-presenting molecules, MHC class II molecules present exogenous antigens MHC molecules are glycoproteins found on the surface of all human cells except red blood cells. MHC are antigen-presenting molecules. MHC class II molecules present exogenous antigens-- that is, antigens that originate from outside the body. MHC class II molecules are primarily recognized by T-helper cells; MHC class I molecules recruit cytotoxic cells.
A nurse teaches how antibodies provide against infection through direct effects. Which direct effects does the nurse include? Select all that apply
- Neutralization of bacterial toxins -Agglutination of infectious agents The direct effects of antibodies against infection include neutralization, agglutination, and precipitation. Activation of complement, opsonization of parasites, and neutrophil chemotaxis are indirect effects of antibody activity.
What occurs during the second phase of the immune response in a patient?
Activation of clonal selection Activation of cellular and humoral immunity occurs during clonal selection, the second phase of the immune response. Migration of the lymphoid cells from the bone marrow to central lymphoid organs occurs during the first phase of the immune response (generation of clonal diversity). Also during this first phase, these cells undergo a series of cell division and differentiation that results in the formation of naive immunocompetent B cells and T cells. these cells enter the circulation and enter into the secondary lymphoid cells, like the spleen and the lymph node. The clonal selection phase is initiated by exposure to a foreign antigen.
A nurse provides care for an older adult patient. Which age-related factors affecting mechanisms of self-defense will the nurse consider when planning care for his patient?
Autoantibodies are increased. Explanation: Older adults tend to have increased levels of circulating autoantibodies (antibodies against self-antigens). Older persons are at risk for impaired wound healing, usually because of chronic illnesses. With age there is a decrease in thymic hormone production and the organ's ability to mediate T-cell differentiation.
When a patient is infected with a pathogen, which immune cells develop specificity for a specific antigen?
B and T lymphocytes In clonal selection, T or B lymphocytes proliferate and differentiate for a specidfic antigen. Thus, activation of the immune system produces a specific and long-lasting protection against specific antigens. Dendritic cells (antigen presenting cell type), natural killer cells, and macrophages respond to many different antigens
In which areas do the gut mucosal-associated lymphoid tissues (MALT) circulate in a patients body? Select all that apply
Blood, Thoracic duct, regional lymph nodes Lymphocytes from the mucosal-associated lymphoid tissues circulate throughout the body in a pattern separate from other lymphocytes. For example, lymphocytes from the gut-associated lymphoid tissue circulate through the regional lymph nodes, the thoracic duct, and the blood and return to other mucosal-associated lymphoid tissues rather than to lymphoid tissue of the systemic immune system. Thymus and bone marrow are central lymphoid organ where generation of clonal diversity occurs.
