Wk 7 immune system practice test

12. An older adultclient, who leads a sedentary lifestyle, and a younger client, who has a very stressful and active lifestyle, require a vaccine against a particular viral disorder. The nurse knows 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?

The male client because of his age

26. 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?

Passive immunity transferred by the mother

104. A client with AIDS is admitted to the hospital with severe diarrhea and dehydration. The physician suspects an infection with Cryptosporidium. What type of specimen should be collected to confirm this diagnosis?

Stool specimen for ova and parasites

103. A client with cytomegalovirus (CMV) infection tells the nurse at the clinic that he is starting to have difficulty seeing and his glasses don't seem to be working as they used to. The physician determines that the client is developing CMV retinitis. What medication does the nurse anticipate the client will receive for this?

Foscarnet

107. The nurse is preparing to start an V for a client who is combative. What precautionary measure should the nurse take in order to avoid a needlestick?

Ask for assistance.

101. The nurse is collecting objective data for a client with AIDS at the clinic. The nurse observes white plaques in the client's oral cavity, on the tongue, and buccal mucosa. What does the nurse understand this finding indicates?

Candidiasis

108. A client will be having a hysterectomy and wants her daughter to donate the blood for directed donor donation. What factor would eliminate her daughter from donating the blood?

The daughter is 15 years age.

106. The nurse has four clients who come to the clinic for healthcare. Which one of these clients has the highest risk factor for HIV infection?

26-year-old Inmate who receives tattoos in prison

105. A client tells the nurse, "You know I have AIDS. I still cannot afford to tell my employer because they will probably cancel my health insurance, then what would I do?" What is the best response by the nurse?

An employer cannot cancel your currently active health insurance on the basis of AIDS."

102. A client with AlIDS has been tested for cytomegalovirus (CMV) with positive titers. What severe complication should the nurse be alert for with cytomegalovirus?

Blindness

36. The nurse understands that which cells circulate throughout the body looking for virus- infected cells and cancer cells?

Natural killer cells

25. An adult client has had mumps when the client was a child. The client had a titer prior to entering nursing school and shows immunity. What type of immunity does this reflect?

Naturally acquired active immunity

21. 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?

cell-mediated response

30. 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?

determine if the client has practices that put him at risk for acquired immunodeficiency syndrome (AIDS)

29. The nurse is obtaining information froma 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?

Corticosteroids

6. The nurse is preparing to administer medications to a patient with rheumatoid arthritis (RA). The nurse should explain which goal of treatment to the patient?

Control inflammation

70. The nurse is instructing a client with chronic fatigue syndrome about what type of dietary sources are the best to eat to supply eicosapentaenoic acid (EPA). What statement by the client demonstrates the instruction is understood?

"Fresh salmon is one of my favorites, and I will eat it twice a week."

74. A client is taking the immunosuppressant medication, azathioprine (Imuran), for the treatment of Crohn's disease. What statement made by the client demonstrates an understanding of the side effects of this medication?

"I will notify the doctor if I have a fever or any other signs of infection."

48. A client with early-stage rheumatoid arthritis asks the nurse what he can do to help ease the symptoms of his disease. What would be the best response by the nurse?

"The doctor could prescribe anti-inflammatory drugs.

86. A female client informs the nurse that she is considering beginning sexual relations and wants to know the best way to protect herself from a sexually transmitted infection and HV. What is the best response by the nurse?

"Using a condom (latex) and spermicidal jelly is one of the most effective ways to decrease the risk of transmission of an STI and HIV."

19. 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?

"White blood cells are produced in the bone marrow."

38. The nurse is instructing client's about the importance taking the shingles vaccine. Which client would benefit from this vaccine?

65-year-old client who had chicken pox when he was 12 years old

46. A client has been hospitalized for diagnostic testing. The client has just been diagnosed with multiple sclerosis, which the physician explains is an autoimmune disorder. How would the nurse explain an autoimmune disease to the client?

A disorder whe re killer T cells and autoantibodies attack or destroy natural cells-those cells that are "self."

81. A public health nurse is giving an informational presentation on HIVIAIDS at a nearby college. How would the nurse best define AIDS?

Acquired immunodeficiency syndrome is a potentially life-threatening infection that profoundly weakens the immune system.

92. A client who had sexual contact with a partner who is HIV+ recently develops flulike symptoms such as a low-grade fever, headache, and muscle pain. What does the nurse suspect this client is experiencing?

Acute retroviral syndrome

58. The nurse is interviewing a client being admitted to the hospital and inquires about any allergies the client has. The client states he is allergic to aspirin and penicillin. What intervention should the nurse provide immediately to prevent complications related to allergies?

Apply an allergy bracelet and flag the chart.

16. When an attenuated toxin is administered to a client, the B-cell lymphocytes create memory cells that recognize the antigen if it invades the body at a future time. What kind of Points: immunity is this?

Artificially acquired active immunity

27. A client will be receiving a hepatitis B vaccination series prior to employment in a dialysis center. What type of immunity will this provide?

Artificially acquired active immunity

61. A client has been having joint pain and swelling in the left foot and is diagnosed with rheumatoid arthritis. The symptoms began suddenly without any identifiable cause, and the client has significant joint destruction. What type of disease is this considered?

Autoimmune

40. The client is about to have a skin test for an allergic disorder. What critical instruction should the nurse give this client?

Avoid antihistamines and cold preparations for 48 to 72 hours before the test.

89. A client is to have a hip replacement in 3 months and does not want a blood transfusion from random donors. What option can the nurse discuss with the client?

Bank autologous blood.

other general symptom complaints. Which client does the nurse determine is at most risk 67. The nurse has four clients who are scheduled to see the physician for "fatigue" and for having chronic fatigue syndrome?

Caucasian female, age 47 years

68. A client comes to the clinic and informs the nurse that he had a mild case of the flu a couple of months ago and "hasn't felt well since." The client tells the nurse that he is fatigued and it gets worse after any physical activity and a recurrent sore throat and joint pain. What does the nurse recognize these symptoms may indicate?

Chronic fatigue syndrome

17. A teenaged client has been brought to the clinic by his mother and is suspected of having an immune system disorder. What tests would the nurse expect to be ordered for this young client?

Complete blood count with differential

53. A client comes to the clinic to see the physician with the complaint of "I think I ate something that I am allergic to." What symptoms would be appropriate for the nurse to ask the questions aboul?

Diarrhea and abdominal cramping

23. A client who is being treated for complications related to acquired immunodeficiency disorder syndrome (AIDS) is receiving interferon parenterally as an adjunctive therapy. Why does the nurse understand this route is being used?

Digestive enzymes destroy its protein structure.

71. A client presents to the clinic with complaints that he began to itch and break out in hives after taking an aspirin this morning. What medication does the nurse anticipate administering that blocks histamine receptors?

Diphenhydramine

24. A client with chronic renal failure has begun treatment with a colony-stimulating factor. What medication does the nurse anticipate administering to the client that will promote the production of blood cells?

Epoetin alfa (Epogen)

have some erythema and edema at the incision site 12 to 24 hours post operation dependent on which condition? 3. The nurse is caring for a postoperative patient who had an open appendectomy. The nurse understands that this patient should

His immune system is functioning properly.

18. A client's immune system has the ability to protect itself from external invaders. What type of immune function is present when this occurs?

Immunocompetence

13. 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?

Lymphoid tissues

39. What type of cytokine will attract neutrophils and monocytes to remove debris?

Lymphokines

concerned that he will not be able to afford the therapy. What can the nurse inform the 96. A client is informed that he will have to start on antiretroviral therapy, and the client is client is the largest source of public funding for HIVIAIDS care?

Medicaid

41. The clinic nurse is caring for a client with an allergic disorder who has received the sensitizing dose of a new drug. What nursing action is most important at this point?

Monitor the client for reactions.

94. A client with suspected exposure to HIV has been tested with the enzyme-linked immunosorbent assay (ELISA) with positive results twice. What is the next step for the nurse to explain to the client for confirmation of the diagnosis?

Perform a Western blot test for confirmation of diagnosis.

14. What is the function of the thymus gland?

Programs T lymphocytes to become regulator or effector T cells

55. A client comes to the clinic and informs the nurse that he feels as though he has allergies. What laboratory test results will be a positive indicator for an allergic disorder?

Radioallergosorbent blood test (RAST)

63. A client with Crohn's disease, an autoimmune disorder, informs the nurse that he has not had any symptoms of the disease in 8 months. What does the nurse understand this asymptomatic period is referred to?

Remission

90. The nurse is administering an injection to a client with AIDS and, when finished, attempts to recap the needle and sustains a needlestick injury to the finger. What is the priority action by the nurse?

Report the incident to the supervisor

97. A client with HIV will be started on a medication regimen of three medications. Which medication will be given that will interfere with the virus's ability to make a genetic blueprint. What drug will the nurse instruct the client about?

Reverse transcriptase inhibitors

62. A client injured the left eye while playing basketball when another player hit him in the eye with his elbow. The client complained that although the right eye was not affected, he is having difficulty now with the vision in that eye too. What does the nurse understand this phenomenon is known as?

Sympathetic uveitis

88. A male client is having sexual relations with another male as well as using methamphetamine and has contracted HV. What concern does the nurse have for this client?

The client may develop AIDS in a shorter period of time.

32. 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?

The injection area swells if the client has developed antibodies against the antfigen.

20. A client is cutting vegetable for dinner and accidently cuts his finger. What response is desirable to destroy foreign agents such as microorganisms to prevent infection from developing in the finger?

The release of antibodies

56. A client is scheduled to have a prick test to determine what specific allergens are creating problems for the client. What should the nurse inform the client is involved with the testing?

The skin will be scratched, and applying a small amount of the liquid test antigen to the scratch, usually on the back.

59. A client has an allergic reaction to seafood with generalized edema and informs the nurse that he is unable to get his wedding ring off and it is too tight. The client was unable to remove it with soap and water. What action by the nurse can facilitate removal of the ring without damaging it?

Use twine to wrap the finger and, when the tissue is compressed, pull the free end of the twine and remove the ring.

44. A client presents at the clinic with an allergic disorder. The client asks the nurse what an "allergic disorder" means. What would be the nurse's best response?

a hyperimmune response to something in the environment that is usually harmless."

allergic reactions would the nursing instructor talk about? Select all that apply 45. The nursing instructor is discussing allergic reactions with her clinical group. What

atopic cytotoxic Immune complex

84. Which tests tell the physician what the viral load is in a client with HV/AIDS? Select all that apply.

p24 antigen test polymerase chain reaction

50. A client comes to the clinic and states he has "broken out in hives and itching since eating strawberries this morning." The client states he has never had problems strawberries before. What is the best response by the nurse?

possible to develop an allergic reaction to something you have had prior exposure to previously.

4. While caring for a patient preparing for a kidney transplant, the nurse knows that the patient understands teaching on immunosuppression when she makes which statement?

"The medications that I take will help prevent my body from attacking my new kidney." people."

83. A teenaged client with a diagnosis of HIV presents at the public health clinic complaining of pharyngitis, rash on the palms and soles of his feet, and diarrhea. What would the nurse suspect the client is suffering from?

Acute retroviral syndrome (ARS)

51. A client is given a dose of ketorolac, a nonsteroidal anti-inflammatory drug for complaints of abdominal pain. Ten minutes after receiving the medication, the client's eyes, lips, and face begin to swell, and the nurse hears stridor. What priority measure should the nurse prepare to do?

Administer epinephrine.

37. A client has not responded to chemotherapy and radiation therapy. What option may be available for treatment for this client?

Aldesleukin

98. A client has discussed therapy for his HIV-positive status. What does the nurse understand is the goal of antiretroviral therapy?

Bring the viral load to a virtually undetectable level.

33. 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?

Consult drug references to make sure the medicines do not contain substances which the client is hypersensitive.

72. A client calls the clinic and asks the nurse if using oxymetazoline nasal spray would be alright to relieve the nasal congestion he is experiencing due to seasonal allergies. What instructions should the nurse provide to the client to avoid complications?

Do not overuse the medication as rebound congestion can occur.

60. A client is scheduled for diagnostic skin testing in 1 week. What should the nurse be sure to instruct the client prior to the scheduled appointment?

Do not take prescribed or over-the-counter antihistamines or cold preparations for at least 72 hours before testing.

49. A client with an allergic disorder is in treatment for his disorder. What might the treatment be?

Drug therapy for symptoms

31. A client asks the nurse about the importance of taking supplements to maximize immune function. The client is healthy and does not have any medical problems. What is the best information to give to the client?

Eating a moderate diet that is balanced and varied will maximize immune function.

43. The nurse is caring for a client with chronic fatigue syndrome. What is a realistic nursing intervention when taking care of a client with this diagnosis?

Educate the client about the disease process.

10. 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?

Naturally acquired active immunity

baby following pre- 9. The nurse is caring for a client with a suspected diagnosis of HV. The nurse is test on this client. What is the most important action that the nurse should preparing to draw blood for a confirmatory diagnostic perform before testing a client for HIV?

Obtain a written consent from the client.

42. The nurse is caring for a client with an autoimmune disease. What is a characteristic of autoimmune disorders?

Progressive tissue damage without any verifiable etiology

15. The nurse is caring for a client with a suspected immune system disorder. What test would be ordered if a deficiency or excess of immunoglobulins was suspected?

Protein electrophoresis

8. 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?

T-cell lymphocytes survey proteins in the body and attack the invading antigens.

73. A client is taking oral corticosteroids after having an exacerbation of asthma. What should the nurse be sure to include when instructing the client how to take the medication?

Take the medication in the morning with food.

64. The nurse is collecting data from a client with the autoimmune disorder, endocarditis. What does the nurse recognize as symptom of an acute exacerbation?

Temperature of 100.9 "F

93. A female client comes to the clinic and tells the nurse, "I think I have another vaginal infection and I also have some wartlike lesions on my vagina. This is happening quite often." What should the nurse consult with the physician regarding?

Testing the client for the presence of HIV

28. The nurse is beginning the physical examination of a client with complaint fatigue. What documentation will the nurse provide to describe this general appraisal of the client's health?

The client appears mildly ill, listless, and disheveled.

91. The nurse is gathering data from laboratory studies for a client who has HIV. The clients T4-cell count is 200/mm, and the client has been diagnosed with Pneumocystis pneumonia. What does this indicate to the nurse?

The client has converted from HIV infection to AIDS.

100. A client that is HIV+ has been diagnosed with Pneumocystis pneumonia caused by P. jiroveci. What medication does the nurse expect that the client will take for the treatment of this infection?

Trimethoprim-sulfamethoxazole

95. A client has been diagnosed with HIV and has been placed on antiretroviral therapy. What does the nurse inform the client that will be required for determining the progression of the disease as well as guiding drug therapy?

Viral load and T4-cell counts will be performed every 2 to 3 months.

54. The nurse is talking with a client who was stung by a bee and began having difficulty breathing. What serious complication from injected venom should the nurse discuss with the client?

airway obstruction

22. A parent of a child who has been having frequent bouts of tonsillitis brings the child back to the clinic for another sore throat. The parent asks the nurse, "What are tonsils good for anyway?" What is the best response by the nurse?

and bacteria." "These tissues filter bacteria from tisue fluid."

87. A client requires a blood transfusion for anemia and informs the nurse that he refuses because he doesn't want to contract acquired immune deficiency syndrome (AIDS). What is the best response by the nurse?

blood is screened very carefully; the risk is approximately 1 in 2,000,000.

5. The nurse is caring for a patient who was started on intravenous antibiotic therapy earlier in the shift. As the second dose is being infused, the patient reports feeling dizzy and having difficulty breathing and talking. The nurse notes that the patient's respirations are 26 breaths/min with a weak pulse of 112 beats/min. The nurse suspects that the patient is experiencing which condition?

Anaphylactic reaction

7. The parents of a newborn question the nurse about the need for vaccinations: "Why does our baby need all those shots? He's so small, and they have to cause him pain." The nurse can explain to the parents that which of the following are true about vaccinations? (Select all that apply.)

Are part of primary prevention for system disorders Are recommended by the Centers for Disease Control and Prevention (CDC) Help protect individuals and communities

75. A client visits the nurse complaining of diarrhea every time he eats. The client has AIDS and wants to know what he can do to stop having diarrhea. What should the nurse advise?

Avoid fibrous foods, lactose, fat, and caffeine.

76. A woman infected with HIV comes into the clinic, What symptoms may be the focus of a medical complaint in women infected with HIV?

Gynecologic problems

82. When learning about HVIAIDS, the student should be able to differentiate the two subtypes of virus by

HIV-1 is more prevalent than HIV-2 subtypes

78. A client who is HIV positive is taking zidovudine. Which adverse effects should the nurse closely monitor for in this client?

Peripheral neuropathy

99. A client on antiretroviral drug therapy is discussing with the nurse that sometimes he "forgets to take his meds for a few days." What should the nurse inform the client can occur when the medications are not taken as prescribed?

The client is risking the development of drug resistance and drug failure.

34. 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?

The nurse ensures a written consent is obtained prior to testing.

11. The nurse is caring for a client on tube feedings. The physician has ordered Osmolite HN as the feeding formula for the client. The family asks why the physician has ordered Osmolite HN instead of another formula to feed their family member. What is an important reason that tube-feeding formulas, such as Impact, Immun-Aid, or Perative, be recommended to clients?

To enhance the production of T-cell lymphocytes and NK cells

79. A client who is HIVIAIDS positive has orders for laboratory tests to be performed. What precautions should the nurse observe whenever there is a risk of exposure to the blood and body fluids of an infected client?

Transport the specimens of body fluids in leak-proof containers.

80. A client with AIDS is brought to the clinic by his family. The family tells the nurse the client has become forgetful, with a limited attention span, decreased ability to concentrate, and delusional thinking. What condition is represented by these symptoms?

AIDS dementia complex (ADC)

1. The nurse is caring for a patient who is being discharged home after a splenectomy. What information on immune function needs to be included in this patient's discharge planning?

Basic infection control techniques

66. A client is taking a corticosteroid for the treatment of systemic lupus erythematosus. When the nurse is providing instructions about the medication to the client, what priority information should be included?

Be alert for signs and symptoms of infection and report them immediately to the physician.

57. A client informs the nurse that he is very allergic to poison ivy but loves to go camping and has several camping trips planned for the summer months. What suggestions can be made to protect against poison ivy?

Bentoquatam 5% applied 15 minutes prior to exposure and every 4 hours

85. The nurse is talking with a group of teens about transmission of human immunodeficiency virus (HV). What body fluids does the nurse inform them will transmit the virus? Select all that apply.

Blood Vaginal secretions Breast milk

52. A client received 2 units of packed red blood cells while in the hospital with rectal bleeding. Three days after discharge, the client experienced an allergic response and began to itch and break out with hives. What type of reaction does the nurse understand could be occurring?

Delayed hypersensitivity response

35. What type of immunoglobulin does the nurse recognize that promotes the release of vasoactive chemicals such as histamine when a client is having an allergic reaction?

IgE

69. The client is scheduled for a tilt-table test to assist in the diagnosis of chronic fatigue syndrome (CFS). What is the nurse's responsibility while the client is having the test?

Position the client while monitoring blood pressure and pulse.

2. An 18-month-old female patient is diagnosed with her fifth ear infection in the past 10 months. The physician notes that the child's growth rate has decreased from the 60th percentile for height and weight to the 15th percentile over that same time period. The child has been treated for thrush consistently since the third ear infection. The nurse understands that the patient is at risk for which condition?

Primary immunodeficiency

65. A client with rheumatoid arthritis informs the nurse that since he has been in remission and not having any symptoms, he doesn't need to take his medication any longer. What is the best response by the nurse?

important that you continue to take your medication to avoid an acute exacerbation."

77. A healthcare worker has been exposed to the blood of an HIV-positive client and is awaiting the results of an HIV test. In the meantime, what precautions must the healthcare worker take to prevent the spread of infection?

Follow the same sexual precautions as someone who has been diagnosed with AIDS.

47. A client with lupus has had antineoplastic drugs prescribed. Why would the physician prescribe antineoplastic drugs for an autoimmune disorder?

For their immunosuppressant effects