CH33: Intro to Immune

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When obtaining a health history from a patient with possible abnormal immune function, what question would be a priority for the nurse to ask? 1) "Do you have abdominal pain or discomfort?" 2) "Have you ever received a blood transfusion?" 3) "Have you ever been treated for a sexually transmitted infection?" 4) "When was your last menstrual period?"

"Have you ever received a blood transfusion?" Explanation: A history of blood transfusions is obtained, because previous exposure to foreign antigens through transfusion may be associated with abnormal immune function.

A client with an autoimmune disorder asks, "Why is autoimmune disease more prevalent in the women in my family?" Which response will the nurse make to this client? 1) "Women have more stress than men and it weakens immunity." 2) "It's believed to be caused by the differences in the sex hormones." 3) "It's because you take better care of your family than yourself." 4) "There is not enough evidence to prove this."

"It's believed to be caused by the differences in the sex hormones." Explanation: There are differences in the immune system functions of men and women. Research has revealed that sex hormones are integral signaling modulators of the immune system and the presence of autoimmune disease. Sex hormones play definitive roles in lymphocyte maturation, activation, and synthesis of antibodies and cytokines. Even though some autoimmune diseases are genetically linked, overall men do not have stronger genes than women. There is no evidence that the client relinquishes self-care for family care. Even though stress influences immunity, there is no evidence that women have more stress than men.

During a mumps outbreak at a local school, a patient, who is a school teacher, is exposed. She has previously been immunized for mumps. What type of immunity does she possess? 1) Phagocytic immunity 2) Natural immunity 3) Acquired immunity 4) Humoral immunity

Acquired immunity Explanation: Acquired immunity usually develops as a result of prior exposure to an antigen through immunization. When the body is attacked by bacteria, viruses, or other pathogens, it has three means of defense. The first line of defense, the phagocytic immune response, involves the white blood cells (WBCs), which have the ability to ingest foreign particles. A second protective response is the humoral immune response, which begins when the B lymphocytes transform themselves into plasma cells that manufacture antibodies. The natural immune response system is rapid, nonspecific immunity present at birth.

A client's current immune response involves the direct destruction of foreign microorganisms. This aspect of the immune response may be performed by which cells? 1) Cytotoxic T cells 2) Complement T cells 3) Memory T cells 4) Suppressor T cells

Cytotoxic T cells Explanation: Cytotoxic T cells (also called CD8 + cells) participate in the destruction of foreign organisms, attacking the antigen directly by altering the cell membrane, causing cell lysis (disintegration), and releasing cytolytic enzymes and cytokines. Memory T cells are responsible for recognizing antigens from previous exposure and mounting an immune response; however, they do not participate in the direct destruction of foreign microorganisms. Suppressor T cells have the ability to decrease B-cell production, thereby keeping the immune response at a level that is compatible with health; however, they do not participate in the direct destruction of foreign microorganisms. The complement system does not exist as a type of T cell.

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?

Cytotoxic T cells Explanation: Cytotoxic T cells (killer T cells) attack the antigen directly by altering the cell membrane and causing cell lysis (disintegration) and by releasing cytolytic enzymes and cytokines. Lymphokines can recruit, activate, and regulate other lymphocytes and white blood cells. These cells then assist in destroying the invading organism.

A gardener sustained a deep laceration while working and requires sutures. The date of the client's last tetanus shot was over 10 years ago. Based on this information, the client will receive a tetanus immunization, which will allow for the release of which type of substance?

Antibodies Explanation: Immunizations activate the humoral immune response, culminating in antibody production. Antigens are the substances that induce the production of antibodies. Cytokines are nonantibody proteins secreted by helper T cells that act as intercellular mediators, as in the generation of immune response. They attract and activate B cells, cytotoxic T cells, natural killer cells, macrophages, and other cells of the immune system. Phagocytes are white blood cells that engulf, ingest, and destroy foreign bodies or toxins. Immunizations do not prompt cytokine or phagocyte production.

A nurse is reviewing the immune system before planning an immunocompromised client's care. How should the nurse characterize the humoral immune response? 1) T lymphocytes are assisted by cytokines to fight infection. 2) Antibodies are made by B lymphocytes in response to a specific antigen. 3) Specialized cells recognize and ingest cells that are recognized as foreign. 4) Lymphocytes are stimulated to become cells that attack microbes directly.

Antibodies are made by B lymphocytes in response to a specific antigen. Explanation: The humoral response is characterized by the production of antibodies by B lymphocytes in response to a specific antigen. Phagocytosis and direct attack on microbes occur in the context of the cellular immune response.

A client undergoing a skin test has been intradermally injected with a disease-specific antigen on the inner forearm. The client becomes anxious because the area begins to swell. Which technique may be used to decrease anxiety in this client? 1) Gently rub the swollen area to accelerate blood flow 2) Assure the client that this is a normal reaction 3) Advise the client to use prescribed analgesics 4) Apply ice packs to reduce the swelling

Assure the client that this is a normal reaction Explanation: The nurse should assure the client that this is a normal reaction. When disease-specific antigens are injected, the injection area swells as a result of the client developing antibodies against the antigen that is introduced. The nurse should also keep in mind that the client is not necessarily actively infectious if the test result is positive. Rubbing the area gently or even applying ice packs may only aggravate the swelling. The swollen area should be left open to heal by itself. The nurse should await the physician's instructions before advising the client to use any prescribed analgesics.

Which of the following protective responses begin with the B lymphocytes? 1) Recognition 2) Cellular 3) Phagocytic 4) Humoral

Humoral Explanation: A second protective response, the humoral immune response, begins with the B lymphocytes, which can transform themselves into plasma cells that manufacture antibodies. The first line of defense, the phagocytic immune response, involves the white blood cells (WBCs; granulocytes and macrophages), which have the ability to ingest foreign particles. The third mechanism of defense, the cellular immune response, also involves T lymphocytes, which can turn into special cytotoxic (or killer) T cells that can attack the pathogens. Recognition of antigens as foreign, or nonself, by the immune system is the initiating even in any immune response.

When the body is in contact with an allergen, this lymphocyte, located in the respiratory and intestinal mucosa, triggers the release of histamine. Choose that lymphocyte 1) Ig A 2) Ig D 3) Ig E 4) Ig G

Ig E Explanation: IgE lymphocytes bind together to an allergen and trigger basophils to release chemical mediators such as histamine and leukotrienes.

The thymus gland, a lymphoid tissue, programs T lymphocytes to become regulator or effector T cells. In which part of the life cycle does the thymus gland produce lymphocytes? 1) adolescence 2) fetal development 3) after birth 4) adulthood

fetal development Explanation: The thymus gland produces lymphocytes during fetal development. It may be the embryonic origin of other lymphoid structures such as the spleen and lymph nodes. After birth, the thymus gland programs T lymphocytes to become regulator or effector T cells. The thymus gland becomes smaller during adolescence but retains some activity throughout the life cycle.

Decades ago, before the role of the tonsils and adenoids was better understood, it was typical after repeated bouts with tonsillitis to have a tonsillectomy and adenoidectomy. Today it is understood that the tonsils and adenoids are lymphoid tissues that: 1) filter bacteria from tissue fluid. 2) eliminate cancer cells. 3) increase the efficacy of antibiotics. 4) program T lymphocytes.

filter bacteria from tissue fluid. Explanation: The tonsils and adenoids filter bacteria from tissue fluid. Because they are exposed to pathogens in the oral and nasal passages, they can become infected and locally inflamed.

Which immunity type becomes active as a result of infection by a specific microorganism? 1) naturally acquired passive immunity 2) artificially acquired passive immunity 3) artificially acquired active immunity 4) naturally acquired active immunity

naturally acquired active immunity Explanation: Naturally acquired active immunity occurs as a direct result of an infection by a specific microorganism.

A nursing instructor is giving a lecture on the immune system. The instructor's discussion on phagocytosis will include: 1) regulator T cells and helper T cells. 2) plasma cells and memory cells. 3) lymphokines and suppressor T cells. 4) neutrophils and monocytes.

neutrophils and monocytes. Explanation: Neutrophils and monocytes are phagocytes, cells that perform phagocytosis.

A client is taking immunosuppressive medications to prevent the rejection of a transplanted kidney. Which adverse effect(s) should the nurse closely monitor in this client? 1) depression, memory impairment, and coma 2) rheumatoid arthritis 3) heart failure 4) respiratory or urinary system infections

respiratory or urinary system infections Explanation: When taking medications to suppress the immune system, clients have an increased risk of infection, especially in the respiratory or the urinary system.

A nurse is aware of the important role that interferons (IFNs) perform in the normal function of the immune system. As well, the nurse has provided care for patients who have benefited from interferon therapy. IFN therapy is most likely to be effective in the treatment of which of the following patients? 1) An 80-year-old man who is debilitated from Clostridium difficile-related diarrhea 2) A 68-year-old woman who is being treated for chronic myeloid leukemia (CML) 3) A 60-year-old man with motor and sensory deficits resulting from an ischemic stroke 4) A 36-year-old woman who is in danger of developing sepsis after suffering full-thickness burns

A 68-year-old woman who is being treated for chronic myeloid leukemia (CML) Explanation: IFNs are cytokines. They have antiviral and antitumor properties and can consequently be used in the treatment of neoplasms such as CML. Bacterial infections and neurological deficits are not responsive to interferon therapy.

A client who has developed kidney failure is discussing options with the health care provider for treatment. What does the nurse understand that kidney failure is associated with? 1) A deficiency in phosphorus 2) A deficiency in circulating lymphocytes 3) Decreased amount of WBCs 4) Increased amount of macrophages

A deficiency in circulating lymphocytes Explanation: Renal failure is associated with a deficiency in circulating lymphocytes.

A client requires ongoing treatment and infection-control precautions because of an inherited deficit in immune function. The nurse should recognize that this client most likely has which type of immune disorder? 1) An autoimmune disorder 2) A gammopathy 3) A rheumatic disorder 4) A primary immune deficiency

A primary immune deficiency Explanation: Primary immune deficiency results from improper development of immune cells or tissues. These disorders are usually congenital or inherited. Autoimmune disorders are less likely to have a genetic component, though some have a genetic component. Overproduction of immunoglobulins is the hallmark of gammopathies. Rheumatic disorders do not normally involve impaired immune function.

A client requires ongoing treatment and infection-control precautions because of an inherited deficit in immune function. The nurse should recognize that this client most likely has which type of immune disorder?

A primary immune deficiency Explanation: Primary immune deficiency results from improper development of immune cells or tissues. These disorders are usually congenital or inherited. Autoimmune disorders are less likely to have a genetic component, though some have a genetic component. Overproduction of immunoglobulins is the hallmark of gammopathies. Rheumatic disorders do not normally involve impaired immune function.

A nurse is monitoring a client who developed facial edema after receiving a medication. Which white blood cells stimulated the edema? 1) Neutrophils 2) Eosinophils 3) Monocytes 4) Basophils

Basophils Explanation: The client's edema is related to an allergic reaction to the medication. Basophils are responsible for releasing histamine during an allergic reaction. Eosinophils' major function is phagocytosis of antigen-antibody complexes that are formed in allergic reactions. Monocytes and neutrophils are predominately phagocytic.

A client has undergone treatment for urosepsis and received high doses of numerous antibiotics during the course of treatment. When planning the client's subsequent care, the nurse should be aware of which potential effect on the client's immune function? 1) Prostaglandin synthesis inhibition 2) Uncontrolled apoptosis 3) Immunosuppression 4) Bone marrow suppression

Bone marrow suppression Explanation: Large doses of antibiotics can precipitate bone marrow suppression, affecting immune function. Uncontrolled apoptosis, or programmed cell death, is not known to be an effect of antibiotic therapy. Inhibition of prostaglandin synthesis or release can be an effect of nonsteroidal anti-inflammatory drugs but is not typically an effect of antibiotic therapy. Immunosuppression can be an effect of adrenal corticosteroids, antineoplastic agents, and antimetabolites, but is not typically an effect of antibiotic therapy.

Which condition is associated with impaired immunity relating to the aging client? 1) Decrease in inflammatory cytokines 2) Breakdown and thinning of the skin 3) Increase in peripheral circulation 4) Increase in humoral immunity

Breakdown and thinning of the skin Explanation: The aging process stimulates changes in the immune system. Age-related changes in many body systems also contribute to impaired immunity. Changes such as poor circulation, as well as the breakdown of natural mechanical barriers such as the skin, place the aging immune system at even greater disadvantage against infection. As the immune system undergoes age-associated alterations, its response to infections progressively deteriorates. Humoral immunity declines and the number of inflammatory cytokines increase with age.

This type of T lymphocyte is responsible for altering the cell membrane and initiating cellular lysis. Choose the T lymphocyte. 1) Cytotoxic T cell 2) Helper T cell 3) Memory T cell 4) Suppressor T cell

Cytotoxic T cell Explanation: The cytotoxic T cells (also known as killer T cells) attack the antigen directly and release cytotoxic enzymes and cytokines.

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? 1) Estrogen tends to enhance immunity. 2) Leukocytes are increased in females. 3) Testosterone tends to enhance immunity. 4) Androgen tends to enhance immunity.

Estrogen tends to enhance immunity Explanation: Autoimmune disorders tend to be more common in women because estrogen tends to enhance immunity. Androgen, on the other hand, tends to be immunosuppressive.

A client's injury has initiated an immune response that involves inflammation. What are the first cells to arrive at this client's site of inflammation?

Neutrophils Explanation: Neutrophils are the first cells to arrive at the site where inflammation occurs. Eosinophils increase in number during allergic reactions and stress responses, but are not always present during inflammation. RBCs do not migrate during an immune response. Lymphocytes become active but do not migrate to the site of inflammation.

A client has been brought to the emergency department by the parents after falling through the glass of a patio door, sustaining a laceration. The nurse caring for this client knows that the site of the injury will have an invasion of which type of cell?

Phagocytic cells Explanation: Monocytes migrate to injury sites and function as phagocytic cells, engulfing, ingesting, and destroying greater numbers and quantities of foreign bodies or toxins than granulocytes. This occurs in response to the foreign bodies that have invaded the laceration from the dirt on the broken glass. Interferon, one type of biologic response modifier, is a nonspecific viricidal protein that is naturally produced by the body and is capable of activating other components of the immune system. Helper T cells are activated on recognition of antigens and stimulate the rest of the immune system. When activated, helper T cells secrete cytokines, which attract and activate B cells, cytotoxic T cells, NK cells, macrophages, and other cells of the immune system. Cytokines are the various proteins that mediate the immune response. These do not migrate to injury sites.

The nurse is taking the health history of a newly admitted client. Which condition would place the client at risk for impaired immune function? 1) Negative history for radiation therapy 2) Surgical history of a partial gastrectomy 3) Previous organ transplantation 4) Surgical removal of the appendix

Previous organ transplantation Explanation: Organ transplantation requires immunosuppressive drugs, which cause impaired immune function. Removal of the appendix or stomach would have no effect on the immune system. A positive history for radiation therapy would affect the immune system, but not a negative history.

A client was recently exposed to infectious microorganisms and many T lymphocytes are now differentiating into killer T cells. This process characterizes what stage of the immune response? 1) Proliferation 2) Response 3) Effector 4) Recognition

Proliferation Explanation: In the proliferation stage, T lymphocytes differentiate into cytotoxic (or killer) T cells, whereas B lymphocytes produce and release antibodies. This does not occur in the response, recognition, or effector stages.

The nurse should recognize a client's risk for impaired immune function if the client has undergone surgical removal of which of the following? 1) Pancreas 2) Spleen 3) Thyroid gland 4) Kidney

Spleen Explanation: A history of surgical removal of the spleen, lymph nodes, or thymus may place the client at risk for impaired immune function. Removal of the thyroid, kidney, or pancreas would not directly lead to impairment of the immune system.

A nurse is explaining how the humoral and cellular immune responses should be seen as interacting parts of the broader immune system rather than as independent and unrelated processes. What aspect of immune function best demonstrates this? 1) The movement of B cells in and out of lymph nodes 2) The universal role of the complement system 3) The differentiation between different types of T cells 4) The interactions that occur between T cells and B cells

The interactions that occur between T cells and B cells Explanation: T cells interact closely with B cells, indicating that humoral and cellular immune responses are not separate, unrelated processes, but rather branches of the immune response that interact. Movement of B cells does not clearly show the presence of a unified immune system. The differentiation between types of T cells and the role of the complement system does not directly suggest a single immune system.

A client arrives at the clinic and reports a very sore throat as well as a fever. A rapid strep test returns a positive result and the client is given a prescription for an antibiotic. How did the streptococcal organism gain access to the client to cause this infection? 1) Through the mucous membranes of the throat 2) Breathing in airborne dust 3) From being outside in the cold weather and decreasing resistance 4) Through the skin

Through the mucous membranes of the throat Explanation: In a streptococcal throat infection, the streptococcal organism gains access to the mucous membranes of the throat.

An infection control nurse is presenting an in-service reviewing the immune response. The nurse describes the clumping effect that occurs when an antibody acts like a cross-link between two antigens. What process is the nurse explaining? 1) Agglutination 2) Phagocytic immune response 3) Humoral response 4) Cellular immune response

Agglutination Explanation: Agglutination refers to the clumping effect occurring when an antibody acts as a cross-link between two antigens. This takes place within the context of the humoral immune response, but is not synonymous with it. Cellular immune response, the immune system's third line of defense, involves the attack of pathogens by T-cells. The phagocytic immune response, or immune response, is the system's first line of defense, involving white blood cells that have the ability to ingest foreign particles.

Immunoglobulins (also known as antibodies) promote the destruction of invading cells in various ways, using different mechanisms. Which mechanism is used by immunoglobulins to destroy pathogenic antigens? 1) agglutination 2) All options are correct. 3) neutralization 4) precipitation

All options are correct. Explanation: Immunoglobulins bind with antigens and promote the destruction of invading cells in one of two ways. First, immunoglobulins may hinder antigens physically by (1) neutralizing their toxins; (2) linking them together in a process called agglutination and (3) causing them to precipitate, or become solid. Second, antibodies can facilitate the destruction of antigens with other mechanisms; for example, those performed by nonantibody proteins such as the complement system and cytokines.

A gardener sustained a deep laceration while working and requires sutures. The date of the client's last tetanus shot was over 10 years ago. Based on this information, the client will receive a tetanus immunization, which will allow for the release of which type of substance? 1) Cytokines 2) Phagocytes 3) Antibodies 4) Antigens

Antibodies Explanation: Immunizations activate the humoral immune response, culminating in antibody production. Antigens are the substances that induce the production of antibodies. Cytokines are nonantibody proteins secreted by helper T cells that act as intercellular mediators, as in the generation of immune response. They attract and activate B cells, cytotoxic T cells, natural killer cells, macrophages, and other cells of the immune system. Phagocytes are white blood cells that engulf, ingest, and destroy foreign bodies or toxins. Immunizations do not prompt cytokine or phagocyte production.

An individual's exposure to an airborne pathogen has prompted an immune response that includes both cellular and humoral components. Which of the following activities is most closely associated with the humoral immune response? 1) A circulating lymphocyte containing an antigenic message returns to the nearest lymph node. 2) T cells directly attack the foreign pathogen. 3) Granulocytes and macrophages engulf and destroy the invading agents. 4) B lymphocytes produce antibodies that are specific to the pathogen.

B lymphocytes produce antibodies that are specific to the pathogen. Explanation: The humoral response is characterized by the production of antibodies by B lymphocytes in response to a specific antigen. T cells are more closely associated with cellular immunity, and the action of circulating lymphocytes containing antigenic messages is associated with the proliferation stage that precedes the humoral and cellular response. Phagocytic immunity is associated with the actions of granulocytes and macrophages.

A client is being treated for cancer and the nurse has identified the nursing diagnosis of Risk for Infection Due to Protein Losses. Protein losses inhibit immune response in which way? 1) Causing apoptosis of cytokines 2) Increasing interferon production 3) Causing CD4+ cells to mutate 4) Depressing antibody response

Depressing antibody response Explanation: Depletion of protein reserves results in atrophy of lymphoid tissues, depression of antibody response, reduction in the number of circulating T cells, and impaired phagocytic function. This specific nutritional deficit does not cause T-cell mutation, an increase in the production of interferons, or apoptosis of cytokines.

Which is the most important guideline for a nurse caring for immunosuppressed clients? 1) Ensure a balanced and varied diet. 2) Maintain a serene atmosphere. 3) Follow the guidelines of the agency for controlling infections. 4) Uplift the morale of such clients.

Follow the guidelines of the agency for controlling infections. Explanation: The nurse should follow agency guidelines for controlling infectious diseases or protecting the client who is immunosuppressed.

What immunoglobulin is present in small amounts and is thought to be related to allergic responses? 1) IgG 2) IgE 3) IgA 4) IgM

IgE Explanation: Five different types of immunoglobulins have been identified: IgE is present in small amounts and seems to be related to allergic responses and to the activation of mast cells. The first immunoglobulin released is M (IgM), and it contains the antibodies produced at the first exposure to the antigen. IgG, another form of immunoglobulin, contains antibodies made by the memory cells that circulate and enter the tissue; most of the immunoglobulin found in the serum is IgG. IgA is found in tears, saliva, sweat, mucus, and bile. It is secreted by plasma cells in the GI and respiratory tracts and in epithelial cells. These antibodies react with specific pathogens that are encountered in exposed areas of the body.

The nurse notes that an older adult was treated for a wound infection and pneumonia within the last 6 months. Which factor will the nurse attribute to this client's illnesses? 1) Reduced vitamin intake 2) Polypharmacy 3) Decline in self-care activities 4) Immunosenescence

Immunosenescence Explanation: Immunosenescence is the term for age-related changes in the immune system. These changes have been linked to the increased rates of illness and mortality in older adults, and an increased incidence of infections. There is no evidence that polypharmacy has caused an increase in infections in the older adult. The development of infections is not directly linked to vitamin intake or self-care activities

A client with a history of dermatitis takes corticosteroids on a regular basis. The nurse should assess the client for which complication of therapy? 1) Anemia 2) Thrombocytopenia 3) Immunosuppression 4) Agranulocytosis

Immunosuppression Explanation: Corticosteroids, such as prednisone, can cause immunosuppression. Corticosteroids do not typically cause agranulocytosis, anemia, or low platelet counts. Agranulocytosis, which is a decrease in granulocytes, a type of white blood cell, may be caused by antibiotics, antithyroid drugs, or nonsteroidal anti-inflammatory drugs. Anemia, which is a decrease in red blood cells, may be caused by antibiotics or nonsteroidal anti-inflammatory drugs. Thrombocytopenia, which is a decrease in platelets, may be caused by antibiotics.

A woman has been diagnosed with breast cancer and is being treated aggressively with a chemotherapeutic regimen. As a result of this regimen, she has an inability to fight infection due to the fact her bone marrow is unable to produce a sufficient amount of what? 1) Lymphocytes 2) Antibodies 3) Cytoblasts 4) Capillaries

Lymphocytes Explanation: The white blood cells involved in immunity are produced in the bone marrow. Like other blood cells, lymphocytes are generated from stem cells, which are undifferentiated cells. Descendants of stem cells become lymphocytes, the B lymphocytes and the T lymphocytes. B lymphocytes mature in the bone marrow and then enter the circulation. T lymphocytes move from the bone marrow to the thymus, where they mature into several kinds of cells with different functions. Cytoblasts are the protoplasm of the cell outside the nucleus. Capillaries are small blood vessels. Antibodies are protein substances that respond to the presence of an antigen. Antibodies are found in normal circulation.

A patient has enlarged lymph nodes in his neck and a sore throat. This inflammatory response is an example of a cellular immune response whereby: 1) B-lymphocytes respond to a specific antigen 2) Antibodies are released into the bloodstream 3) Lymphocytes migrate to areas of the lymph node 4) Antibodies reside in the plasma

Lymphocytes migrate to areas of the lymph node Explanation: Recognition of antigens as foreign, or non-self, by the immune system is the initiating event in any immune response. Recognition involves the use of lymph nodes and lymphocytes for surveillance. Lymph nodes are widely distributed internally throughout the body and in the circulating blood, as well as externally near the body's surfaces. They continuously discharge small lymphocytes into the bloodstream. These lymphocytes patrol the tissues and vessels that drain the areas served by that node.

A client is responding to a microbial invasion and the client's differentiated lymphocytes have begun to function in either a humoral or a cellular capacity. During what stage of the immune response does this occur? 1) The response stage 2) The effector stage 3) The recognition stage 4) The proliferation stage

The response stage Explanation: In the response stage, the differentiated lymphocytes function in either a humoral or a cellular capacity. In the effector stage, either the antibody of the humoral response or the cytotoxic (killer) T cell of the cellular response reaches and connects with the antigen on the surface of the foreign invader. In the recognition stage, the recognition of antigens as foreign, or nonself, by the immune system is the initiating event in any immune response. During the proliferation stage the circulating lymphocytes containing the antigenic message return to the nearest lymph node

A client is vigilant in self-care but is frustrated by a recent history of upper respiratory infections and influenza. Which aspects of the client's lifestyle may have a negative effect on immune response? Select all that apply.

Works as a medical researcher Exercises at the gym twice a day Explanation: Rigorous or competitive exercise—usually considered a positive lifestyle factor—can be a physiologic stressor and cause negative effects on immune response. Occupational or residential exposure to environmental radiation and pollutants has been associated with impaired immune function. Research jobs are among those with a higher risk of workplace pollution. Taking a multivitamin daily and not eating red meat are generally positive steps as long as the client does not rely solely on the vitamin to provide all nutrients and has the appropriate level of protein intake. Seven to nine hours of sleep daily are the general recommendations for good health and an effective immune system.

A client has had a splenectomy after sustaining serious internal injuries in a motorcycle accident, including a ruptured spleen. Following removal of the spleen, the client will be susceptible to: 1) acidosis because the spleen maintains acid-base balance. 2) anemia because the spleen produces red blood cells. 3) infection because the spleen removes bacteria from the blood. 4) bleeding because the spleen synthesizes vitamin K.

infection because the spleen removes bacteria from the blood. Explanation: One function of the spleen is to remove bacteria from circulation; therefore, the client will be more susceptible to infection.

What types of cells are the primary targets of the healthy immune system? Select all that apply. 1) foreign cells 2) typical cells 3) infectious cells 4) cancerous cells

infectious cells foreign cells cancerous cells Explanation: The immune system's primary targets are infectious, foreign, or cancerous cells.

What types of cells are the primary targets of the healthy immune system? Select all that apply.

infectious cells foreign cells cancerous cells Explanation: The immune system's primary targets are infectious, foreign, or cancerous cells.

The body has several mechanisms to fight disease, one of which is sending chemical messengers. 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? 1) interferons 2) colony-stimulating factor 3) tumor necrosis factor 4) interleukins

interferons Explanation: Interferons are chemicals that primarily protect cells from viral invasion. They enable cells to resist viral infection and slow viral replication. They have been used as adjunctive therapy in the treatment of AIDS. Interferons also have been used to treat some forms of cancer such as leukemia because they stimulate NK cell activity. Interferon is administered parenterally because digestive enzymes destroy its protein structure.

A client has been diagnosed with breast cancer and is being treated aggressively with a chemotherapeutic regimen. As a result of this regimen, the client has an inability to fight infection because bone marrow is unable to produce a sufficient amount of:

lymphocytes. Explanation: The white blood cells involved in immunity (including lymphocytes) are produced in the bone marrow. Cytoblasts are the protoplasm of the cell outside the nucleus. Antibodies are produced by lymphocytes, but not in the bone marrow. Capillaries are small blood vessels


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