Review questions Immune dysfunction
A 10-year-old male is stung by a bee while playing in the yard. He begins itching and develops pain, swelling, redness, and respiratory difficulties. He is suffering from: A. immunodeficiency. B. autoimmunity. C. anaphylaxis. D. tissue-specific hypersensitivity.
C. anaphylaxis.
When a patient presents at the emergency department for an allergic reaction, the nurse recognizes the most severe consequence of a type I hypersensitivity reaction is: A. urticaria. B. hives. C. anaphylaxis. D. antibody-dependent cell-mediated cytotoxicity (ADCC).
C. anaphylaxis.
Which information indicates a good understanding of bacterial vaccines? Most bacterial vaccines contain: A. fully active bacteria. B. synthetic bacteria. C. dead bacteria. D. bacterial toxins.
C. dead bacteria.
A patient presents with poison ivy on the extremities, face, and buttocks after an initial exposure 48 hours ago. This condition is an example of: A. anaphylaxis. B. serum sickness. C. delayed hypersensitivity. D. viral disease.
C. delayed hypersensitivity.
When the immunologist says that pathogens possess infectivity, what is the immunologist explaining? Infectivity allows pathogens to: A. spread from one individual to others and cause disease. B. induce an immune response. C. invade and multiply in the host. D. damage tissue.
C. invade and multiply in the host.
After studying about viruses, which information indicates the student has a good understanding of viruses? Viruses: A. contain no DNA or RNA. B. are capable of independent reproduction. C. replicate their genetic material inside host cells. D. are easily killed by antimicrobials.
C. replicate their genetic material inside host cells.
An infant is experiencing hemolytic disease of the newborn. Which of the following would the nurse expect to find in the infant's history and physical? A. The mother was exposed to measles. B. The father was exposed to Agent Orange. C. The baby is Rh positive. D. The baby was born 6 weeks prematurely.
C. The baby is Rh positive.
You are working in an employee health clinic. One of the employees comes in to have their TB test read, and you notice a dermal reaction that looks reddened, indurated and inflamed. Which of the following is true? A. This means the person has experienced a Type IV Hypersensitivity reaction that mimics a positive TB test B. The person has not been exposed to TB in the past, but has had a severe reaction to the TB serum in the test C. The person has been exposed to TB in the past and is now reacting to the TB antigen in the test D. People only experience severe reactions like tissue necrosis to this test if they have never been exposed to TB in the past
C. The person has been exposed to TB in the past and is now reacting to the TB antigen in the test
When a patient asks the nurse what hypersensitivity is, how should the nurse respond? Hypersensitivity is best defined as: A. a reduced immune response found in most pathologic states. B. a normal immune response to an infectious agent. C. an excessive or inappropriate response of the immune system to a sensitizing antigen. D. antigenic desensitization.
C. an excessive or inappropriate response of the immune system to a sensitizing antigen.
A 22-year-old was recently diagnosed with acquired immunodeficiency syndrome (AIDS). Which decreased lab finding would be expected to accompany this virus? A. CD4+ T-helper B. CD8 T-helper C. CDC cells D. CDC10 cells
A. CD4+ T-helper
Which disorders are a result of a type II hypersensitivity? (select all that apply) A. Hyperacute graft rejection B. Serum sickness C. Type 1 diabetes D. Alloimmune reactions such as a blood transfusion reaction E. Arthus reaction
A. Hyperacute graft rejection C. Type 1 diabetes D. Alloimmune reactions such as a blood transfusion reaction
Which of the following statements regarding diagnosis of HIV infection is true? (select all that apply) A. Seroconversion in HIV infection is defined when HIV antibodies are noted B. Parenteral transmission delays seroconversion in HIV infection C. A positive Enzyme-linked Immunosorbent Assay (ELISA) for HIV antibodies should be confirmed by a Western Blot test before reporting a positive infection. D. False positive results for HIV infection can result after receiving certain immunizations.
A. Seroconversion in HIV infection is defined when HIV antibodies are noted C. A positive Enzyme-linked Immunosorbent Assay (ELISA) for HIV antibodies should be confirmed by a Western Blot test before reporting a positive infection. D. False positive results for HIV infection can result after receiving certain immunizations.
A person is given an attenuated antigen as a vaccine. When the person asks what was given in the vaccine, how should the nurse respond? The antigen is: A. alive, but less infectious. B. mutated, but highly infectious. C. normal, but not infectious. D. inactive, but infectious.
A. alive, but less infectious.
When a nurse cares for a patient with systemic lupus erythematosus (SLE), the nurse remembers this disease is an example of: A. autoimmunity. B. alloimmunity. C. homoimmunity. D. alleimmunity.
A. autoimmunity.
R.V. is a 28-year-old HIV-positive man recently hospitalized for evaluation of symptoms of progressive weakness, dyspnea, weight loss, and low-grade fever. His CD4+ count is 190 cells/ul. A biopsy of R.V.'s lung tissue reveals Pneumocystis carinii pneumonia. These findings indicate that R.V. A. has AIDS. B. has less than 2 years to live. C. cannot be treated. D. was an intravenous drug abuser.
A. has AIDS.
A 30-year-old female complains of fatigue, arthritis, rash, and changes in urine color. Laboratory testing reveals anemia, lymphopenia, and kidney inflammation. Assuming a diagnosis of SLE, which of the following is also likely to be present? A. Anti-LE antibodies B. Autoantibodies C. Antiherpes antibodies D. Anti-CMV antibodies
B. Autoantibodies
A 5-year-old male becomes ill with a severe cough. Histologic examination reveals a bacterial infection, and further laboratory testing reveals cell membrane damage and decreased protein synthesis. Which of the following is the most likely cause of this illness? A. Endotoxin B. Exotoxin C. Hemolysis D. Septicemia
B. Exotoxin
Which of the following is a characteristic of the human immunodeficiency virus (HIV), which causes AIDS? A. HIV only infects B cells. B. HIV is a retrovirus. C. Infection does not require a host cell receptor. D. After infection, cell death is immediate.
B. HIV is a retrovirus.
Severe type I hypersensitivity reactions are: A. Common, especially in hospitals where IV antibiotics are given frequently B. Rare, and most commonly involve contact with medications, peanuts, seafood and beestings C. Common even among those who only are mildly allergic D. All of the above
B. Rare, and most commonly involve contact with medications, peanuts, seafood and beestings
What common symptom should be assessed in individuals with immunodeficiency? A. Anemia B. Recurrent infections C. Hypersensitivity D. Autoantibody production
B. Recurrent infections
In addition to matching ABO antigens, a blood transfusion must also be matched for: A. HLA type. B. Rh antigen. C. immunoglobulins. D. platelet compatibility.
B. Rh antigen.
Which information indicates a correct understanding of viral vaccines? Most viral vaccines contain: A. active viruses. B. attenuated viruses. C. killed viruses. D. viral toxins.
B. attenuated viruses.
When a nurse notices that a patient has type O blood, the nurse realizes that anti-_____ antibodies are present in the patient's body. A. A only B. B only C. A and B D. O
C. A and B
When the maternal immune system becomes sensitized against antigens expressed by the fetus, what type of immune reaction occurs? A. Autoimmune B. Anaphylaxis C. Alloimmune D. Allergic
C. Alloimmune
Your patient has a primary immunodeficiency disorder. Which of the following is true of these disorders? A. Like secondary immunodeficiency disorders, they involve functional decreases in one or more component of the immune system B. They are the result of a pathology in the immune system itself, rather than (as in secondary deficiencies) being the result of a cause outside of the immune system C. Both A and B D. Neither A nor B
C. Both A and B
When the immunologist says that pathogens possess virulence, what does virulence mean? A. Spreads from one individual to others and causes disease. B. Induces an immune response. C. Causes disease. D. Damages tissue.
C. Causes disease.
A 50-year-old female experiences decreased blood pressure, decreased oxygen delivery, cardiovascular shock, and subsequent death. A complication of endotoxic shock is suspected. Which of the following is the most likely cause? A. Gram-positive bacteria B. Fungi C. Gram-negative bacteria D. Virus
C. Gram-negative bacteria
A child with a history of recent strep throat infection develops glomerulonephritis. This is most likely to be a type _____ hypersensitivity reaction. A. I B. II C. III D. IV
C. III
Hepatitis B Immune globulin (HBIG) is given to a newborn born to a mother who tests positive for Hepatitis B surface antigen (HBsAG). What type of immunity does HBIG provide for the child? A. Active acquired, natural B. Passive acquired, natural C. Passive acquired, artificial D. Active acquired, artificial
C. Passive acquired, artificial
Autoimmune diseases A. are due to increased T suppressor cell activity associated with aging. B. occur only when lymphocytes are in close contact with body cells during embryogenesis. C. result from failure of the immune system to differentiate self and nonself molecules. D. are often communicable to others by direct contact.
C. result from failure of the immune system to differentiate self and nonself molecules.
A nurse recalls that an example of an immune-complex-mediated disease is: A. bronchial asthma. B. contact dermatitis. C. serum sickness. D. rheumatoid arthritis.
C. serum sickness.
What is the chance that two siblings share both HLA haplotypes, making them a good match for an organ transplant from one to the other? A. 100% B. 75% C. 50% D. 25%
D. 25%
A 15-year-old male suffers from severe hemorrhage following a motor vehicle accident. He is given a blood transfusion, but shortly afterward the red blood cells are destroyed by agglutination and lysis. Which of the following blood type transfusion type matches would cause this? A. A-A B. B-O C. AB-O D. A-AB
D. A-AB
Which of the following would be considered secondary immunodeficiencies? A. Malnutrition B. Stress C. Chemotherapy D. All of the above
D. All of the above
You are working in a post-pardum floor of an OB hospital. Your patient is a young mother whose child has hemolytic disease of the newborn. Which of the following contributed to this condition? A. A Type II hypersensitivity B. The fact that the mother was Rh-negative and the child Rh-positive C. An antigen-antibody reaction when the blood of the mother and child co-mingled such as during birth. D. All of the above
D. All of the above
Your patient is receiving chemotherapy and requires a blood transfusion. A few minutes into this reaction, she has a transfusion reaction. Which of the following reactions in a transfusion are typical of Type II Hypersensitivity? A. In this type of reaction, antibodies attack antigens on the surface of cells or tissues B. Immediate or near immediate reaction symptoms (15-30 minutes after exposure) C. Resulting cell injury and death D. All of the above
D. All of the above
A 30-year-old male was diagnosed with HIV. Which of the following treatments would be most effective? A. Reverse transcriptase inhibitors B. Protease inhibitors C. Entrance inhibitors D. Antiretroviral therapy (ART)
D. Antiretroviral therapy (ART)
A 30-year-old male is having difficulty breathing and has been spitting blood. He reports that he began experiencing this reaction after cleaning his pigeons' cages. Testing reveals he is suffering from allergic alveolitis. Which of the following is he experiencing? A. Serum sickness B. Raynaud phenomenon C. Antibody-dependent cytotoxicity D. Arthus reaction
D. Arthus reaction
Congenital forms of primary immunodeficiency diseases include all the following EXCEPT A. Selective IgA deficiency B. DiGeorge syndrome C. Severe combined immunodeficiency (SCID) D. HIV/AIDS
D. HIV/AIDS
Which information would indicate more teaching is needed regarding hypersensitivity reactions? Type _______ hypersensitivity reactions involve an antibody response. A. I B. II C. III D. IV
D. IV
A 40-year-old female is diagnosed with SLE. Which of the following findings would be considered a symptom of this disease? A. Gastrointestinal ulcers B. Decreased glomerular filtration rate C. Rash on trunk and extremities D. Photosensitivity
D. Photosensitivity
The nurse would correctly respond that the etiology of a congenital immune deficiency is due to a(n): A. negative response to an immunization. B. adverse response to a medication. C. renal failure. D. genetic defect.
D. genetic defect.
A nurse recalls bacteria become resistant to antimicrobials by: A. proliferation. B. attenuation. C. specialization. D. mutation.
D. mutation.
A young female student comes to your clinic for follow from a diagnosis of SLE. A biology student at UH, she has lots of questions about the autoimmunity underlying this disease. Which of the following will be included in your answer to her? A. autoimmunity results when the immune system mistakes "self" cells as non-self cells B. autoimmunity is a poorly understood phenomena that may involve any or all of the following: abnormal immune cells, viral stimuli, and/or a genetic component C. autoimmunity is more common among women D. Type II-Type III hypersensitivity reactions may cause cellular injury leading to autoimmunity E. all of the above
E. all of the above