Chapter 35, 36, 37, 38 Immune test

A man with chronic mucocutaneous candidiasis , an autosomal recessive disorder, asks the nurse, "will my children have this disease?" Which response by the nurse is appropriate? a) "All of your children will be carriers of the recessive gene but may not develop the disease." b) "All of your children will develop the disease" c) "Only your male children are at risk for developing this disease" d) "Your female children will be carriers for disease, but only male children will develop the disease"

a) "All of your children will be carriers of the recessive gene but may not develop the disease."

During a third trimester transabdominal utlrasound, cardiac anomoly and facial abnormalities are noted on the fetus. Further testing reveals that the thymus gland has failed to develop normally and the fetus is diagnosed with thymic hypoplasia. Based on this diagnosis, the nurse anticipates careful monitoring for which common manifestation during the first 24 hours of life? a) Hypocalcemia b) Thrombocytopenia c) Hyperkalemia d) Hypoglycemia

a) Hypocalcemia

Which of the following immunoglobulins assumes a major role in blood-borne and tissue infections? a) IgG b) IgA c) IgM d) IgD

a) IgG

During a 12-month well-baby visit, a mother reports that the baby has been breast-fed since birth and has never been ill. She is trying to convince her sister who is currently pregnant to breast-feed also and asks the nurse about the benefits of breast-feeding. The nurse explains the immune benefits of breast-feeding and provides the mother with pamphlets. The nurse determines the patient understands the teaching based on which of the following patient statements? a) "Breast-feeding is beneficial because the dominant antibody IgA in breast milk acts by functioning as an antigen receptor in the mucosal membranes." b) "Breast-feeding is beneficial because the dominant antibody IgM in breast milk is the first immunoglobulin produced in response to bacterial and viral infections." c) "Breast-feeding is beneficial because T lymphocytes found in breast milk are primarily responsible for cellular immunity." d) "Breastfeeding is beneficial because the dominant antibody IgG in breast milk assumes a major role in bloodborne and tissue infections."

a) "Breast-feeding is beneficial because the dominant antibody IgA in breast milk acts by functioning as an antigen receptor in the mucosal membranes."

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

a) "Have you ever received a blood transfusion?"

A nurse is teaching a client who has a new diagnosis of rheumatoid arthritis. Which of the following statements should the nurse include in the teaching? a) "You can experience morning stiffness when you get out of bed" b) "You can experience abdominal pain" c) "You can experience weight gain" d) "You can experience low blood sugar"

a) "You can experience morning stiffness when you get out of bed"

The nurse is instructing client's about the importance of taking the shingles vaccine. Which client would benefit from this vaccine? a) A 65-year-old client who had chicken pox when he was 12 years old b) A 32-year-old client who has never had chickenpox c) A 24-year-old client who is pregnant d) A 17-year-old client who will be attending college and living in a dormitory

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

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? a) A cell-mediated response b) Naturally acquired active immunity c) Activation of the complement system d) Stimulation of colony-stimulating factors

a) A cell-mediated response

While taking the health history of a newly admitted client, the nurse asks for a list of the client's current medications. Which of the following medication classifications would place the client at risk for impaired immune function? a) Antimetabolites b) Inotropics c) Antihypertensives d) Pancreatic enzymes

a) Antimetabolites

A client is diagnosed with rheumatoid arthritis, an autoimmune disorder. When teaching the client and family about autoimmune disorders, the nurse should provide which information? a) Autoimmune disorders include connective tissue (collagen) disorders. b) Autoimmune disorders are distinctive, aiding differential diagnosis. c) Clients with autoimmune disorders may have false-negative but not false-positive serologic tests. d) Advanced medical intervention can cure most autoimmune disorders.

a) Autoimmune disorders include connective tissue (collagen) disorders.

While taking the health history of a newly admitted client, the nurse reviews general lifestyle behaviors. Which of the following would have a positive effect on the immune system? a) Biofeedback, relaxation, and hypnosis b) Relaxation, intense competitive exercise, and humor c) Humor, rigorous physical stress, and biofeedback d) Hypnosis, humor, and chronic illness

a) Biofeedback, relaxation, and hypnosis

A patient is being treated in the intensive care unit for sepsis related to ventilator-associated pneumonia. The patient is on large doses of three different antibiotics. What severe outcome should the nurse monitor for in the lab studies? a) Bone marrow suppression b) Leukocytosis c) Rash d) Oral thrush

a) Bone marrow suppression

Which of the following is associated with impaired immunity relating to the aging patient? a) Breakdown and thinning of the skin b) Decrease in inflammatory cytokines c) Increase in humoral immunity d) Increase in peripheral circulation

a) Breakdown and thinning of the skin

The nurse is obtaining information from a 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? a) Corticosteroids b) Ibuprofen (Advil) c) Diuretics d) Angiotensin-converting enzyme inhibitors (ACE-I)

a) Corticosteroids

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? a) Cytotoxic T cells b) Macrophages c) B cells d) Helper T cells

a) Cytotoxic T cells

Which of the following is a age-related change associated with the immune system? a) Decreased antibody production b) Increased antibody production c) Elevated phagocytic immune response d) Ability to differentiate "self" from "nonself"

a) Decreased antibody production

A nurse is discussing gout with a client who is concerned about developing the disorder. which of the following findings should the nurse identify as risk factors for this disease? (select all that apply) a) Diuretic use b) Obesity c) Deep sleep deprivation d) Depression e) Cardiovascular disease

a) Diuretic use b) Obesity e) Cardiovascular disease

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? a) Estrogen tends to enhance immunity. b) Testosterone tends to enhance immunity. c) Leukocytes are increased in females. d) Androgen tends to enhance immunity.

a) Estrogen tends to enhance immunity.

T-cells can be either regulator T cells or effector T cells. Regulator T cells are made up of helper and suppressor cells. What function are helper T-cells important in? a) Fighting infection b) Activating lymphokines c) Producing antibodies d) Turning off the immune response

a) Fighting infection

As a nursing instructor, you realize the importance of your students understanding how the immune system works and its role to protect and defend the body from potential harm. What type of cells are the primary targets of the healthy immune system? Select all that apply. a) Infectious cells b) Cancerous cells c) Foreign cells d) Typical cells

a) Infectious cells b) Cancerous cells c) Foreign cells

A client is diagnosed with human immunodeficiency virus (HIV). After recovering from the initial shock of the diagnosis, the client expresses a desire to learn as much as possible about HIV and acquired immunodeficiency syndrome (AIDS). When teaching the client about the immune system, the nurse states that humoral immunity is provided by which type of white blood cell? a) Lymphocyte b) Monocyte c) Basophil d) Neutrophil

a) Lymphocyte

What chemical is released by cytotoxic T cells? a) Lymphokine b) Antigen c) Antibody d) Microphages

a) Lymphokine

A patient with combined immunodeficiency disease is receiving immunosuppression therapy to ensure engraftment of depleted bone marrow during transplantation procedures. What is the priority nursing care for this patient? a) Meticulous infection control precautions b) Daily oral assessment and oral care every 4 hours c) Continuous monitoring of cardiac status d) Daily weights and strict monitoring of intake and output

a) Meticulous infection control precautions

Which type of cells is capable of recognizing and killing infected or stressed cells and producing cytokines? a) Natural killer cells b) Null lymphocytes c) Cytotoxic T cells d) Memory cells

a) Natural killer cells

Which type of cells is capable of recognizing and killing infected or stressed cells and producing cytokines? a) Natural killer cells b) Cytotoxic T cells c) Null lymphocytes d) Memory cells

a) Natural killer cells

Which type of immunity becomes active as a result of the infection of a specific microorganism? a) Naturally acquired active immunity b) Artificially acquired active immunity c) Artificially acquired passive immunity d) Naturally acquired passive immunity

a) Naturally acquired active immunity

A 20 year old male patient cut his hand while replacing a window. While reviewing the complete blood count with differential, the nurse would expect which of the following cell types to be elevated first in order to prevent an infection in the patient's hand? a) Neurtrophils b) Eosinophils c) B cells d) Monocytes

a) Neurtrophils

A nursing instructor is giving a lecture on the immune system. Which of the following cells will the instructor include in her discussion on phagocytosis? a) Neutrophils and monocytes b) Regulator T cells and Helper T cells c) Lymphokines and Suppressor T cells d) Plasma cells and memory cells

a) Neutrophils and monocytes

An older adult has developed a sacral pressure ulcer. What should the nurse assess in order to ensure adequate wound healing and prevent poor outcomes for this patient? (Select all that apply.) a) Nutritional status b) The amount of carbohydrates the patient ingests c) Quality of food ingested d) Caloric intake e) The patient's ability to perform her own wound care

a) Nutritional status d) Caloric intake c) Quality of food ingested

A patient with common variable immunodeficiency disease (CIVD) has an order for an IVIG infusion. What actions should the nurse perform prior to the beginning of the infusion? (select all that apply) a) Obtain the patient's height and weight b) Premedicate with acetaminophen and diphenhydramine c) Schedule peaks and trough blood draws with the laboratory d) Assess for history of migraine headaches e) Assess baseline vital signs

a) Obtain the patient's height and weight b) Premedicate with acetaminophen and diphenhydramine d) Assess for history of migraine headaches e) Assess baseline vital signs

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? a) Passive immunity transferred by the mother b) Artificially acquired active immunity c) Naturally acquired active immunity d) There is no immunity passed down from mother to child.

a) Passive immunity transferred by the mother

A nurse in an outpatient clinic is assessing a client who reports night sweats and fatigue. He states he has had a cough along with nausea and diarrhea. His temperature is 38.1 C. Which of the following actions should the nurse take? (select all that apply) a) Perform a physical assessment b) Determine when the manifestations began c) Teach the client about HIV transmission d) Draw blood for HIV testing e) Obtain a sexual history

a) Perform a physical assessment b) Determine when the manifestations began e) Obtain a sexual history

A nurse is assessing a client for HIV. The nurse should identify that which of the following are risk factors associated with this virus? (select all that apply) a) Perinatal exposure b) Pregnancy c) Monogamous sex partner d) Older adult women e) occupational exposure

a) Perinatal exposure d) Older adult women e) occupational exposure

A patient with common variable immunodeficiency comes to the ED with complaints of tingling and numbness in the hands and feet, muscle weakness, fatigue, and chronic diarrhea. An assessment reveals abdominal tenderness, weight loss, and loss of reflexes. A gastric biopsy shows lymphoid hyperplasia of the small intestine and spleen as well as gastric atrophy. Based on these findings, what common secondary problem has this patient developed? a) Pernicious anemia b) Gastric ulcer c) Sickle cell anemia d) Hyperthyroidism

a) Pernicious anemia

A nurse is reviewing the plan of care for a client who has systemic lupus erythematosus (SLE). The client reports fatigue, joint tenderness, swelling, and difficulty urinating. Which of the following laboratory findings should the nurse anticipate? (select all that apply) a) Positive ANA titer b) Increased hemoglobin c) 2 + urine protein d) Increased serum C3 and C4 e) Elevated BUN

a) Positive ANA titer c) 2 + urine protein e) Elevated BUN

During which stage of the immune response does the circulating lymphocyte containing the antigenic message return to the nearest lymph node? a) Proliferation b) Recognition c) Response d) Effector

a) Proliferation

You are caring for a client with a suspected immune system disorder. What test would be ordered if a deficiency or excess of immuneglobulins was suspected? a) Protein electrophoresis b) Plasmapheresis c) T-cell and B-cell assays d) Enzyme-linked immunosorbent assay

a) Protein electrophoresis

A nurse working in an outpatient clinic is assessing a client who has rheumatoid arthritis (RA). The client reports increased joint tenderness and swelling. Which of the following findings should the nurse expect? (select all that apply) a) Recent influenza b) Decreased range of motion c) Hypersalivation d) Increased blood pressure e) Pain at rest

a) Recent influenza b) Decreased range of motion e) Pain at rest

Which of the following adverse effects should the nurse closely monitor in a patient who has secondary immunodeficiencies due to immunosuppressive therapy? a) Respiratory or Urinary system infections b) Depression, memory impairment, and coma c) Rheumatoid arthritis d) Cardiac dysrhythmias and heart failure

a) Respiratory or Urinary system infections

Which stage of the immune response occurs when the differentiated lymphocytes function in either a humoral or a cellular capacity? a) Response stage b) Recognition stage c) Proliferation stage d) Effector stage

a) Response stage

The nurse is performing a physical assessment for a patient at the clinic and palpates enlarged inguinal lymph nodes on the left. What should the nurse document? (Select all that apply.) a) Size b) Temperature c) Consistency d) Reports of tenderness e) Location

a) Size c) Consistency d) Reports of tenderness e) Location

T-cell and B-cell lymphocytes are the primary participants in the immune response. What do they do? a) T-cell and B-cell lymphocytes distinguish harmful substances and ignore those natural and unique to a person. b) T-cell and B-cell lymphocytes respond to the body's invasion by macrophages. c) T-cell and B-cell lymphocytes react to the body's lack of B12 . d) T-cell and B-cell lymphocytes distinguish harmful treatments from curative treatments.

a) T-cell and B-cell lymphocytes distinguish harmful substances and ignore those natural and unique to a person.

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? a) T-cell lymphocytes survey proteins in the body and attack the invading antigens. b) Toxins of invading antigens are neutralized. c) The invading antigens precipitate. d) The invading antigens link together (agglutination).

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

The nurse is teaching the patient with HIV about therapy. What is essential for the nurse to include in the teaching plan? (Select all that apply) a) The CD4 count is the major indicator of immune function and guides therapy b) The goal of antiretroviral therapy is to prevent opportunistic infections c) medication therapy is rarely effective d) anti-retroviral therapy targets different stages of the HIV life cycle e) patients rarely respond to medication therapy

a) The CD4 count is the major indicator of immune function and guides therapy d) anti-retroviral therapy targets different stages of the HIV life cycle

A nurse is reviewing the causes of genetic disease with parents of an infant born with severe combined immunodeficiency disease. Which of the following would be inaccurate information pertaining to SCID? a) The inheritance of SCID can be autosomal dominant b) This illness occurs in all racial groups and both genders c) The incidence is unknown d) This is a rare disease in most population groups, but is one of the most common causes of primary immunodefciencies

a) The inheritance of SCID can be autosomal dominant

The nurse is teaching a client who has been diagnosed with Hashimoto's thyroiditis. Which of the following statements correctly describes the process of autoimmunity? a) The normal protective immune response attacks the body, damaging tissues. b) The body overproduces immunoglobulins. c) The body produces inappropriate or exaggerated responses to specific antigens. d) A deficiency results from improper development of immune cells or tissues.

a) The normal protective immune response attacks the body, damaging tissues.

Which of the following statements accurately reflects current stem cell research? a) The stem cell is known as a precursor cell that continually replenishes the body's entire supply of both red and white cells. b) Stem cell transplantation cannot restore immune system functioning. c) Clinical trials are underway in patients with acquired immune deficiencies only. d) Stem cell transplantation has been performed in the laboratory only.

a) The stem cell is known as a precursor cell that continually replenishes the body's entire supply of both red and white cells.

The nursing instructor is discussing the development of human immunodeficiency disease (HIV) with the students. What should the instructor inform the class about helper T cells? a) They are activated on recognition of antigens and stimulate the rest of the immune system. b) They have the ability to decrease B-cell production. c) They are responsible for recognizing antigens from previous exposure and mounting an immune response. d) They attack the antigen directly by altering the cell membrane and causing cell lysis.

a) They are activated on recognition of antigens and stimulate the rest of the immune system.

Decades ago, a typical childhood surgery, after repeated bouts with tonsillitis, was to have a tonsillectomy and adenoidectomy. That was before the role of the tonsils and adenoids were better understood. As it is understood today, what are the roles of the tonsils and adenoids? a) They are lymphoid tissues that filter bacteria from tissue fluid. b) They are lymphoid tissues that increase the efficacy of antibiotics. c) They are lymphoid tissues that program T lymphocytes. d) They are lymphoid tissues that eliminate cancer cells.

a) They are lymphoid tissues that filter bacteria from tissue fluid.

A client has undergone a kidney transplant. The nurse is concerned about a compromised immune system in this client for which of the following reasons? a) Use of anti-rejection drugs b) Deficient circulating antibodies c) Excess circulating lymphocytes d) Excess circulating hemoglobin

a) Use of anti-rejection drugs

The nurse is caring for a patient in the hospital who is receiving a vitamin D supplement. What does the nurse understand is the importance of supplementation with this vitamin? (Select all that apply.) a) Vitamin D deficiency is associated with increased risk of inflammatory disorders. b) Vitamin D deficiency is associated with increased risk of congenital anomalies. c) Vitamin D deficiency is associated with increased risk of common cancers. d) Vitamin D deficiency is associated with increased risk of autoimmune disease. e) Vitamin D deficiency is associated with increased risk of celiac disease.

a) Vitamin D deficiency is associated with increased risk of inflammatory disorders. c) Vitamin D deficiency is associated with increased risk of common cancers. d) Vitamin D deficiency is associated with increased risk of autoimmune disease.

A nurse is caring for a client who is suspected of having HIV. The following diagnostic tests and laboratory values are used to confirm HIV infection? (select all that apply) a) Western Blot b) Indirect immunofluorescence assay c) CD4+ T-lymphocyte count d) HIV RNA quantification test e) Cerebrospinal fluid analysis

a) Western Blot b) Indirect immunofluorescence assay

A client taking abacavir has developed fever and a rash. What is the priority nursing action? a) call the healthcare provider to report. b) Edminister lidocaine cream for the rash c) administer acetaminophen d) document the information

a) call the healthcare provider to report

Which assessment finding is not likely to cause noncompliance with antiretroviral treatment? a) past substance abuse b) lack of social support c) Active substance abuse d) depression

a) past substance abuse

What stage of HIV infection is indicated when the results are more than 500 CD4+ lymphocytes/mm? a) primary infection (acute HIV infection or acute HIV syndrome) b) stage one c) stage two d) stage three

a) primary infection (acute HIV infection or acute HIV syndrome)

What intervention is appropriate before the patient starts on efavirenz (Sustiva) therapy? a) testing for Stevens Johnson syndrome potential b) administering Benadryl c) teaching the patient about restricted foods d) assessing renal function

a) testing for Stevens Johnson syndrome potential

The nurse is obtaining a history from a patient with severe psoriasis. What question would be the most important to ask this patient to determine a genetic predisposition? a) "How did you know you developed this disease?" b) "Does anyone in your family have more than one autoimmune disease?" c) "How many children do you have?" d) "Does your spouse or significant other have an autoimmune disease?"

b) "Does anyone in your family have more than one autoimmune disease?"

A 34-year-old man is diagnosed with chronic hepatitis C. Testing reveals that he is a candidate for treatment. The nurse anticipates that which of the following could be used to treat his condition? a) Monoclonal antibodies b) Interferon c) Erythropoietin d) Interleukin-5

b) Interferon

The nurse is teaching the patient who has an immunodeficiency disorder how to avoid infection at home. Which statement indicates that additional teaching is needed? a) "I will wash my hands whenever I get home from work" b) "I will be sure to eat lots of fresh fruits and vegetables everyday c) "I will avoid contact with people who are sick or who have recently been vaccinated" d) "I will make sure to have my own toothbrush and tube of toothpaste at hom"

b) "I will be sure to eat lots of fresh fruits and vegetables everyday

The nurse is obtaining an assessment and health history from the parents of a 6 month old infant with an elevated temperature. Which statements by the parents will alert will alert the nurse to a possible immunodeficiency disorder? a) "I had a good prenatal care and vaginal delivery, although they had to use forceps" b) "This is the third infection with a high fever the baby has had in the past month" c) "I usually feed the baby a bottle every 4-6 hours during the day" d) "My husband's family has a history of hemophilia; can this be the problem?"

b) "This is the third infection with a high fever the baby has had in the past month"

Which of the following is a humoral immune response? a) Intracellular infections b) Anaphylaxis c) Transplant rejection d) Delayed hypersensitivity

b) Anaphylaxis

The immune system is a complicated and intricate system that contains specialized cells and tissues that protect us from external invaders and our own altered cells. Which of the following is the term used to define any substance capable of inducing a specific immune response and of reacting with the products of that response? a) Antibodies b) Antigens c) Lymphocytes d) Lymphokines

b) Antigens

A nurse is reviewing strategies to promote comfort with a client who received an immunization. Which of the following information should the nurse include? (select all that apply) a) Massage the injection site b) Apply a cool compress the injection site c) Take acetaminophen or ibuprofen d) Use the affected extremity e) Apply an antimicrobial ointment to the injection site

b) Apply a cool compress the injection site c) Take acetaminophen or ibuprofen d) Use the affected extremity

A nurse is preparing to administer a scratch test to a client who has possible food and environmental allergies. Which of the following actions should the nurse perform prior to the procedure? (select all that apply) a) Cleanse the client's skin with povidone-iodine b) Ask the client about previous reactions to allergens c) Ask the client about medications she took over the past several days d) Inform the client to expect itching at one site. e) Obtain emergency resuscitation equipment.

b) Ask the client about previous reactions to allergens c) Ask the client about medications she took over the past several days d) Inform the client to expect itching at one site. e) Obtain emergency resuscitation equipment.

A patient comes into the emergency department with complaints of difficulty walking and loss of muscle control in the arms. As the nurse begins the physical examination, which of the following assessment should be completed if an immune dysfunction in the neurosensory system is suspected? a) Assess for hepatosplenomegaly by measuring abdominal girth b) Assess for ataxia using the finger-to-nose test and heel-to-shin test c) Review the urinalysis report for hematuria d) Assess joint mobility using passive range of motion.

b) Assess for ataxia using the finger-to-nose test and heel-to-shin test

An infant diagnosed with agammaglobulinemia. The nurse reviews the family history for a male relative with this disorder, which the nurse knows is also known by which of the following names? a) Common variable immunodeficiency b) Brunton's disease c) Nezelof Syndrome d) Wiskott-Aldrich syndrome

b) Brunton's disease

Which of the following micro organisms is known to cause retinitis in people with HIV/AIDS? a) Cryptococcus neoformans b) cytomegalovirus c) Pneumocytis carinii d) Mycobacterium avium

b) Cytomegalovirus

Chronic illnesses may contribute to immune system impairment in various ways. Renal failure is associated with which of the following? a) Decreased bone marrow function b) Deficiency in circulating lymphocytes c) Altered production of white blood cells d) Increased incidence of infection

b) Deficiency in circulating lymphocytes

A nurse is caring for a patient undergoing evaluation for possible immune system disorders. Which of the following interventions will best help support the patient throughout the diagnostic process? a) Accompanying the patient to the diagnostic tests b) Educating the patient about the diagnostic procedures and answer questions they may have about the possible diagnosis c) Encouraging the patient to ask their physician for information about the treatment options for the possible diagnosis. d) Assisting the patient with the scheduling of the procedures.

b) Educating the patient about the diagnostic procedures and answer questions they may have about the possible diagnosis

A patient is administered foscarnet to treat a case of cytomegalovirus retinitis. Which of the following adverse effects should the nurse closely monitor in the patient? a) Anemia b) Electrolyte imbalances c) Peripheral neuropathy d) Hypotension

b) Electrolyte imbalances

A nurse is caring for a client who has rheumatoid arthritis. Which of the following laboratory tests are used to diagnose this disease? a) Urinalysis b) Erythrocyte sedimentation rate (ESR) c) BUN d) Antinuclear antibody (ANA) titer e) WBC count

b) Erythrocyte sedimentation rate (ESR) d) Antinuclear antibody (ANA) titer e) WBC count

Infants with DiGeorge syndrome have which type of endocrine disorder? a) Hyperthyroidsim b) Hypoparathyroidism c) Hyperparathyroidism d) Hypothyroidism

b) Hypoparathyroidism

What type of immunoglobulin does the nurse recognize that promotes the release of vasoa ctive chemicals such as histamine when a client is having an allergic reaction? a) IgM b) IgE c) IgA d) IgG

b) IgE

At 39 weeks' gestation, a pregnant female, visits her physician for a scheduled prenatal checkup. The physician determines that the fetus has developed an infection in utero and sends the patient for an emergency C section. The patient is very concerned about the health of her unborn child. Based on the knowledge of the immune system, the delivery room nurse explains about which of the following immunoglobulins that will be increased in the fetus at the time of birth and actively fighting the infection? a) IgA b) IgG c) IgM d) IgD

b) IgG

Which of the following immunoglobulins assumes a major role in blood-borne and tissue infections? a) IgA b) IgG c) IgM d) IgD

b) IgG

A 6 year old patient is diagnosed with a viral infection of the respiratory system. Which of the following will most likely be trying to fight the antigen? a) Self-antigens b) Interferons c) B cells d) Complements

b) Interferons

A nurse caring for a client who has a WBC count of 20,000/mm3. The nurse should conclude that the patient has which of the following? a) Neutropenia b) Leukocytosis c) Left shift d) Leukopenia

b) Leukocytosis

Matt Carson, a 20-year-old college student, was riding his motorcycle home from class when he lost control of the bike and sustained serious internal injuries, including a ruptured spleen. Matt has been taken to the OR to remove his spleen and the ED nurse is meeting with Matt's parents to answer some of their additional questions. Which of the following will be included in the nurse's discussion regarding special considerations following the removal of Matt's spleen? a) Matt will be susceptible to bleeding because the spleen synthesizes vitamin K. b) Matt will be susceptible to infection because the spleen removes bacteria from the blood. c) Matt will be susceptible to anemia because the spleen produces red blood cells. d) Matt will be susceptible to acidosis because the spleen maintains acid-base balance.

b) Matt will be susceptible to infection because the spleen removes bacteria from the blood.

A nurse is preparing to document administration of a meningococcal vaccine to a client. Which of the following information should the nurse include in the documentation? (select all that apply) a) Age of client receiving the vaccine b) Name of vaccine manufacturer c) Vaccine expiration date d) Date of administration e) Serial number of the vaccine

b) Name of vaccine manufacturer c) Vaccine expiration date d) Date of administration

The nurse understands that which cells circulate throughout the body looking for virus-infected cells and cancer cells? a) Interferons b) Natural killer cells c) Cytokines d) Interleukins

b) Natural killer cells

A 20-year-old male patient cut his hand while replacing a window. While reviewing the complete blood count (CBC) with differential, the nurse would expect which of the following cell types to be elevated first in order to prevent an infection in the patient's hand? a) Monocytes b) Neutrophils c) Eosinophils d) B cells

b) Neutrophils

Which type of cells destroys antigens already coated with antibody? a) Suppressor T-cell b) Null c) Memory T-cell d) Natural killer (NK)

b) Null

Which of the following nursing actions is essential before an EIA test performed? a) Performing polymerase chain reaction test b) Obtaining a general consent for medical care from the patient c) Obtaining a written consent from the patient d) Performing a Western blot test

b) Obtaining a general consent for medical care from the patient

Which is the following is a process in which the antigen-antibody molecule is coated with a sticky substance that facilitates phagocytosis? a) Immunoregulation b) Opsonization c) Agglutination d) Apoptosis

b) Opsonization

A nurse is caring for a client who has SLE and is experiencing an episode of Raynaud's phenomenon. Which of the following findings should the nurse anticipate? a) Swelling of joint of the fingers b) Pallor of the toes with cold exposure c) Feet that become reddened with ambulation d) Client report of intense feeling of heat in the fingers

b) Pallor of the toes with cold exposure

Which type of disorder produces recurrent and persistant infection of the soft tissue, lungs, and other organs? a) B-cell deficiency b) Primary phagocytic disorder c) Complement deficiency d) T-cell deficiency

b) Primary phagocytic disorder

Which of the following adverse effects should the nurse closely monitor in a patient who takes immunosuppressive drugs? a) Depression, memory impairment, and coma b) Respiratory or urinary system infections c) Heart failure, infusion reactions, and life-threatening infections d) Rheumatoid arthritis

b) Respiratory or urinary system infections

What stage of the immune response occurs when the differentiated lymphocytes function in either a humoral or a cellular capacity? a) Recognition stage b) Response stage c) Proliferation stage d) Effector stage

b) Response stage

The nurse is caring for a client recovering from a major burn. Burns affect the immune system by causing a loss of large amounts of which of the following? a) Plasma, which depletes the body's store of catecholamines b) Serum, which depletes the body's store of immunoglobulins c) Plasma, which depletes the body's store of calcitonin d) Serum, which depletes the body's store of glucagon

b) Serum, which depletes the body's store of immunoglobulins.

What organ is considered lymphoid tissue? a) Pancreas b) Spleen c) Intestines d) Liver

b) Spleen

What are the primary participants in the immune system? a) Lymphoblasts and gamma globulins b) T- and B- cell lymphocytes c) Macrophages and memory cells d) Stem cells and monocytes

b) T- and B- cell lymphocytes

A patient arrives at the clinic and informs the nurse that she has a very sore throat as well as a fever. A rapid strep test returns a positive result and the patient is given a prescription for an antibiotic. How did the streptococcal organism gain access to the patient to cause this infection? a) Breathing in airborne dust b) Through the mucous membranes of the throat c) Through the skin d) From being outside in the cold weather and decreasing resistance

b) Through the mucous membranes of the throat

Which of the following responses identifies a role of T lymphocytes? a) Anaphylaxis b) Transplant rejection c) Bacterial phagocytosis and lysis d) Allergic hay fever and asthma

b) Transplant rejection

During an annual examination, an older patient tells the nurse, "I don't understand why I need to have so many cancer screening tests now. I feel just fine!" Based on the knowledge of neoplastic disease and the aging immune system, what teaching should the nurse include in the patient's plan of care? Select all that apply. a) The immune system is integrated with other psychophysiologic processes and is regulated by the brain. Aging of the brain can have immunologic consequences and can affect neural and endocrine function increasing the risk of cancer development. b) Tumor cells may possess special blocking factors that coat tumor cells and prevent their destruction by killer T lymphocytes; therefore, the body may not recognize the tumor as foreign and fail to destroy the malignant cells. Routine screening increases the chance of finding and treating cancer early. c) Education about the importance of adhering to a recommended vaccine schedule should be initiated to boost the immune system function. d) Nutritional intake to support a competent immune response plays an important role in reducing the incidence of cancer. A healthy diet including protein, vitamins, minerals, and some fats can alter the risk of cancer development. e) The increase in occurrence of autoimmune diseases due to aging strongly suggests a predisposition to various types of cancer due to the body's inability to differentiate between self and nonself. Routine screening increases the chance of finding and treating cancer early.

b) Tumor cells may possess special blocking factors that coat tumor cells and prevent their destruction by killer T lymphocytes; therefore, the body may not recognize the tumor as foreign and fail to destroy the malignant cells. Routine screening increases the chance of finding and treating cancer early. e) The increase in occurrence of autoimmune diseases due to aging strongly suggests a predisposition to various types of cancer due to the body's inability to differentiate between self and nonself. Routine screening increases the chance of finding and treating cancer early. d) Nutritional intake to support a competent immune response plays an important role in reducing the incidence of cancer. A healthy diet including protein, vitamins, minerals, and some fats can alter the risk of cancer development.

When do most perinatal HIV infections occur? a) through casual contact b) after exposure during delivery c) in utero d) through breast-feeding

b) after exposure during delivery

A patient comes into the emergency room with complaints of difficulty walking and loss of muscle control in the arms. As the nurse begins the physical examination, which of the following assessment should be completed if an immune dysfunction in the neurosensory system is suspected? a) Assess joint mobility using passive range of motion b) assess for ataxia using the finger to nose test and heel to shin test c) Review the urinalysis report for hematuria d) Assess for hepatosplenomegaly by measuring abdominal girth

b) assess for ataxia using the finger to nose test and heel to shin test

What intervention is a priority when treating a patient with HIV/AIDS? a) monitoring psychological status b) assessing fluid and electrolyte balance c) monitoring skin integrity d) assessing neurologic status

b) assessing fluid and electrolyte balance

Diagnosis of Kaposi's sarcoma is made by which of the following? a) skin scraping b) biopsy c) Visual assessment d) CT scan

b) biopsy

When assisting the patient to interpret a negative HIV test result, what does the nurse tell the patient this result means? a) antibodies to the aids virus are in his blood. b) his body has not produced antibodies to the aids virus. c) he is immune to the aids virus. d) he has not been infected with HIV.

b) his body has not produced and our bodies to the AIDS virus

Proteins formed when cells are exposed to viral or foreign agents that are capable of activating other components of the immune system are referred to as a) antigens. b) interferons. c) antibodies. d) complements.

b) interferons.

Patient taking amprenavir (Agenerase) complains of "getting fat." What's the nurses best action? a) assess the patient's diet b) teach the patient about medication side effects c) arrange for a psychological counseling d) have a patient increase exercise

b) teach the patient about medication side effects

The term used to define the balance between the amount of HIV in the body and the immune response is which of the following? a) viral clearance rate b) viral set point c) primary infection stage d) window period

b) viral set point

A nurse is preparing to administer a varicella immunization to a client. Which of the following questions by the nurse is appropriate? a) "Are you allergic to eggs?" b) "Are you allergic to baker's yeast?" c) "Are you pregnant?" d) "Do you have a history of Guillain-Barre syndrome?"

c) "Are you pregnant?"

A nurse is teaching a client who has SLE about self-care. Which of the following statements by the client indicates an understanding of the teaching? a) "I should limit my time to 10 minutes in the tanning bed" b) "I will apply powder to any skin rash" c) "I should us a mild shampoo" d) "I will inspect my skin once a month for rashes"

c) "I should us a mild shampoo"

A nurse is teaching a patient about the side effects of ibuprofen. The patient's teaching is determined to be effective based on which of the following patient statements explaining the drugs effect on the immune system? a) "Motrin can cause hemolytic anemia, which will make me feel tired and short of breath." b) "Motrin can cause pancytopenia, which is a decrease in all of my blood cells" c) "Motrin can cause neutropenia, which can increase my risk of infection" d) "Motrin can cause thrombocytopenia; I will need to watch for bruising and bleeding"

c) "Motrin can cause neutropenia, which can increase my risk of infection"

A nurse is teaching a patient about the side effects of ibuprofen (Motrin). The patient's teaching is determined to be effective based on which of the following patient statements explaining the drugs effect on the immune system? a) "Motrin can cause hemolytic anemia, which will make me feel tired and short of breath." b) "Motrin can cause pancytopenia, which is a decrease in all of my blood cells." c) "Motrin can cause neutropenia, which can increase my risk of infection." d) "Motrin can cause thrombocytopenia; I will need to watch for bruising and bleeding."

c) "Motrin can cause neutropenia, which can increase my risk of infection."

A nurse is explaining treatment options to a patient diagnosed with an immune dysfunction. Which of the following statements made by the patient accurately reflects the teaching about current stem cell research? a) "Currently stem cell transplantation has only been performed in the laboratory, but future research with embryonic stem cell transplants for humans with immune dysfunction has been promising" b) "Stem cell transplantation has been discontinued based on concerns about safety, efficacy, resource allocation, and human cloning" c) "Stem cell transplantation has been carried out in humans with certain types of immune dysfunction and clinical trials using stem cells underway in patients with a variety of disorders having an autoimmune component" d) "Stem cell clinical trials have only been attempted in patients with acquired immune deficiencies but plans are underway to begin human cloning using embryonic stem cells"

c) "Stem cell transplantation has been carried out in humans with certain types of immune dysfunction and clinical trials using stem cells underway in patients with a variety of disorders having an autoimmune component"

A nurse is preparing to administer an IM injection of immune globulin to a client who has been exposed to hepatitis A. Which of the following statements by the nurse is appropriate? a) "This medication offers permanent immunity to hepatitis A" b) This medication involves three injections over several months." c) "This medication provides you with an immune response more quickly than your body can produce it." d) "This medication provides an attenuated virus to help your body create antibodies."

c) "This medication provides you with an immune response more quickly than your body can produce it."

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? a) "White blood cells are produced in the lymphatic tissue." b) "White blood cells are produced in the plasma." c) "White blood cells are produced in the bone marrow." d) "White blood cells are produced in the thymus gland."

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

The nurse is working with a mother whose child has just been diagnosed with selective immunoglobulin A deficiency. The mother asks the nurse, "Does this mean that my child is going to die?" How will the nurse respond? a) "Selective immunoglobulin A deficiency can cause uncontrolled muscle movements with progressive neurologic deterioration if left untreated" b) "Your child may die without proper medication and treatment" c) "Your child has a mild genetic immune deficiency caused by a lack of immunoglobulin A (IgA), a type of antibody that protects against infections of the lining in the mouth and digestive tract" d) "Selective immunoglobulin A deficiency is the term used to describe the early stages of the AIDS infection"

c) "Your child has a mild genetic immune deficiency caused by a lack of immunoglobulin A (IgA), a type of antibody that protects against infections of the lining in the mouth and digestive tract"

Which of the following is a humoral immune response? a) Intracellular infections b) Delayed hypersensitivity c) Anaphylaxis d) Transplant rejection

c) Anaphylaxis

Which of the following is associated with impaired immunity relating to the aging patient? a) Increase in humoral immunity b) Decrease in inflammatory cytokines c) Breakdown and thinning of the skin d) Increase in peripheral circulation

c) Breakdown and thinning of the skin

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? a) Administer the medications that the physician ordered. b) Call the pharmacy and let them know the client has several drug allergies. c) Consult drug references to make sure the medicines do not contain substances which the client is hypersensitive. d) Give the client one medicine at a time and observe for allergic reactions.

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

Which of the following is associated with impaired immunity in the aging patient? a) Incidence of autoimmune disease decreases with age b) Skin becomes thicker c) Decreased renal function d) Increased antibody production

c) Decreased renal function

A client who is being treated for complications related to acquired immunodeficiency disorder syndrome (AIDS) is receiving interferon parenterally as adjunctive therapy. Why does the nurse understand this route is being used? a) The taste of the medication is not palatable. b) The medication, given orally, will cause diarrhea. c) Digestive enzymes destroy its protein structure. d) The medication will work more rapidly parenterally.

c) Digestive enzymes destroy its protein structure.

A nurse is caring for a patient undergoing evaluation for possible immune system disorders. Which of the following interventions will best help support the patient throughout the diagnostic process? a) Assisting the patient with the scheduling of the procedures b) Encouraging the patient to ask their physician for information about the treatment options for the possible diagnosis c) Educating the patient about the diagnostic procedures and answer questions they may have about the possible diagnosis d) Accompanying the patient to the diagnostic tests

c) Educating the patient about the diagnostic procedures and answer questions they may have about the possible diagnosis

A school nurse is talking about infection with a high school health class. What would be the nurse's best explanation of the process of phagocytosis? a) Removal of bacteria and dead blood cells from circulation b) Release of chemicals to destroy bacteria and foreign material c) Engulfment and digestion of bacteria and foreign material d) Conversion of memory cells to plasma cells

c) Engulfment and digestion of bacteria and foreign material

An elderly client is diagnosed with cancer. While reviewing age-related changes in the immune system, the nurse identifies which of the following as having contributed to this client's condition? a) Impaired ciliary action from exposure to environmental toxins b) Decreased sensation and slowing of reflexes c) Failure of lymphocytes to recognize mutant cells d) Failure of immune system to differentiate "self" from "non-self"

c) Failure of lymphocytes to recognize mutant cells

A 38-year old female has recently been diagnosed with rheumatoid arthritis. She is also receiving further testing for disorders of the immune system. She works as an aide at a facility which cares for children infected with AIDS. Which of the following factors will hold the greatest implications during the client's assessment? Select all that apply. a) Her diet b) Her age c) Her work environment d) Her home environment e) Her history of immunizations and allergies f) Her use of other drugs

c) Her work environment e) Her history of immunizations and allergies f) Her use of other drugs

Which of the following protective responses begin with the B lymphocytes? a) Recognition b) Phagocytic c) Humoral d) Cellular

c) Humoral

At 39 weeks gestation, a pregnant female, visits her physician determines that the fetus has developed an infection in utero and sends the patient for an emergency c-section. The patient is very concerned about the health of her unborn child. Based on the knowledge of the immune system, the delivery room nurse explains about which of the following immunoglobulins that will be increased in the fetus at the time of birth and actively fighting the infection? a) IgA b) IgD c) IgG d) IgM

c) IgG

An elderly client is diagnosed with a respiratory infection. While reviewing age-related changes in the immune system, the nurse identifies which of the following as having contributed to this client's infection? a) Decreased phagocytosis by Kupffer cells b) Decreased sensation and slowing of reflexes c) Impaired ciliary action from exposure to environmental toxins d) Failure of the immune system to differentiate "self" from "non-self"

c) Impaired ciliary action from exposure to environmental toxins

A nurse is taking the health history of a newly admitted client and asks for a list of the client's current medications. Which of the following medication classifications would NOT place the client at risk for impaired immune function? a) Antineoplastic agents b) Antimetabolites c) Inotropics d) Adrenal corticosteroids

c) Inotropics

A nurse is reviewing the laboratory findings of a patient who has measles. The nurse should expect to find an increase in which of the following types of WBCs? a) Neutrophils b) Basophils c) Lymphocytes d) Eosinophils

c) Lymphocytes

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? a) Red blood cells b) Stem cells c) Lymphoid tissues d) Cytokines

c) Lymphoid tissues

Which type of cells is capable of directly killing invading organisms and producing cytokines? a) Null lymphocytes b) Cytotoxic T cells c) Natural killer cells d) Memory cells

c) Natural killer cells

A client has had mumps when he was 9 years old. He had a titer prior to entering nursing school and shows immunity. What type of immunity does this reflect? a) Passive immunity b) Artificially acquired active immunity c) Naturally acquired active immunity d) Natural passive immunity

c) Naturally acquired active immunity

The nurse is caring for an older adult patient hospitalized with cellulitis of the right lower extremity. Why is it imperative that the nurse continually assess the physical and emotional status of this patient? a) Older patients are at risk of developing dementia. b) The patient will not respond to the antibiotic treatment as well as a younger patient would. c) Older adult patients develop depression and suicidal tendencies when they are faced with chronic illness. d) Early recognition and management of factors influencing immune response may decrease morbidity and mortality.

c) Older adult patients develop depression and suicidal tendencies when they are faced with chronic illness.

Which of the following is a process in which the antigen-antibody molecule is coated with a sticky substance that facilitates phagocytosis? a) Immunoregulation b) Agglutination c) Opsonization d) Apoptosis

c) Opsonization

A client will be taking the tumor necrosis factor inhibitor, infliximab (Remicade), for the treatment of rheumatoid arthritis. Prior to beginning this therapeutic regimen, what screening should the client have? a) Screening for syphilis b) Screening for peptic ulcer disease c) Screening for tuberculosis d) Screening for rubella

c) Screening for tuberculosis

A nurse is taking the health history of a newly admitted client. Which of the following conditions would NOT place the client at risk for impaired immune function? a) History of radiation therapy b) Previous organ transplantation c) Surgical removal of the appendix d) Surgical history of a splenectomy

c) Surgical removal of the appendix

The nurse is beginning the physical examination of a client with a complaint of fatigue. What documentation will the nurse provide to describe this general appraisal of the client's health? a) The client is alert and oriented to all spheres. b) The client has palpable peripheral pulses in the upperextremities. c) The client appears mildly ill, listless, and disheveled. d) The client has a blood pressure of 120/72 mm Hg.

c) The client appears mildly ill, listless, and disheveled.

A client has been diagnosed with AIDS and tuberculosis (TB). A nursing student asks the nurse why the client's skin test for TB is negative if the client's physician has diagnosed TB. The nurse's correct reply is which of the following? a) The client has only mild TB, which is not enough to cause a reaction. b) The solution used for the skin test was probably outdated. c) The client's immune system cannot mount a response to the skin test. d) The skin test was improperly performed.

c) The client's immune system cannot mount a response to the skin test.

A 64-year-old male client, who leads a sedentary lifestyle, and a 31-year-old female client, who has a very stressful and active lifestyle, require a vaccine against a particular viral disorder. As the nurse, you would know 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? a) The female client because of her age b) The male client because of his lifestyle c) The male client because of his age d) The female client because of her lifestyle

c) The male client because of his age

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? a) The nurse will call the client with the results of the test. b) The nurse will inform the client that the results will have to be reported to the Centers for Disease Control and Prevention (CDC). c) The nurse ensures a written consent is obtained prior to testing. d) The nurse should send the client to have the blood drawn without informing him about the specific screening test.

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

When the nurse administers intravenous gamma-globulin infusion, she recognizes that which of the following complaints, if reported by the patient, may indicate an adverse effect of the infusion? a) Burning urination b) Nasal stuffiness c) Tightness in the chest d) Increased thirst

c) Tightness in the chest

Which of the following responses identifies a role of T lymphocytes? a) Bacterial phagocytosis and lysis b) Allergic hay fever and asthma c) Transplant rejection d) Anaphylaxis

c) Transplant rejection

Which blood test confirms the presence of antibodies to HIV? a) p24 antigen b) reverse transcriptase c) enzyme linked immunosorbent assay (ELISA) d) erythrocyte sedimentation rate (ESR)

c) enzyme linked immunosorbent assay

Which of the following is an early manifestation of HIV encephalopathy? a) vacant stare b) Hyperreflexia c) headache d) hallucinations

c) headache

What test will the nurse assessed to determine the patient's response to antiretroviral therapy? a) Western blot b) EIA enzyme immunoassay c) viral load d) CBC

c) viral load

The nurse is caring for a young patient who has agammaglobulinemia. The nurse is teaching the family how to avoid infection at home. Which statement by the family indicates additional teaching is needed? a) "I will apply lotion following every bath to prevent dry skin" b) "I will avoid letting my child drink any juice that has been sitting out for more than an hour" c) "I will let my neighbor have my pet iguana" d) "I can take my child to the beach, as long as we play in the sand rather than swim in the water"

d) "I can take my child to the beach, as long as we play in the sand rather than swim in the water"

A nurse is providing teaching for a client who has stage 2 HIV disease and is having difficulty maintaining a normal weight. Which of the following statements by the client should indicate to the nurse an understanding of the teaching? a) "I will choose a diet high in fat to help gain weight" b) "I will be sure to eat three large meals daily" c) "I will drink 1 liter of liquid each day" d) "I will add high-protein foods to my diet"

d) "I will add high-protein foods to my diet"

A nurse is providing teaching for a client who has stage 3 HIV disease. Which of the following statements by the client should indicate to the nurse an understanding of the teaching? a) "I will wear gloves when changing the pet litter box" b) "I will rinse raw fruits with water before eating them" c) "I will wear a mask when around family members" d) "I will cook vegetables before eating them"

d) "I will cook vegetables before eating them"

A nurse is explaining treatment options to a patient diagnosed with an immune dysfunction. Which of the following statements made by the patient accurately reflects the teaching about current stem cell research? a) "Currently stem cell transplantation has only been performed in the laboratory, but future research with embryonic stem cell transplants for humans with immune dysfunction has been promising." b) "Stem cell transplantation has been discontinued based on concerns about safety, efficacy, resource allocation, and human cloning." c) "Stem cell clinical trials have only been attempted in patients with acquired immune deficiencies but plans are underway to begin human cloning using embryonic stem cells." d) "Stem cell transplantation has been carried out in humans with certain types of immune dysfunction and clinical trials using stem cells are underway in patients with a variety of disorders having an autoimmune component."

d) "Stem cell transplantation has been carried out in humans with certain types of immune dysfunction and clinical trials using stem cells are underway in patients with a variety of disorders having an autoimmune component."

A nurse is teaching the parents of an infant about primary immunodeficiencies. which of the following statements verifies that the parents understand the teaching? a) "My baby cannot survive into childhood with a diagnosis of primary immunodeficiency." b) "Girls are diagnosed with primary immunodeficiencies more often than boys." c) "The primary immunodeficiency will disappear with age." d) "The majority of primary immmunodeficiencies are diagnosed in infancy"

d) "The majority of primary immmunodeficiencies are diagnosed in infancy"

A nurse is reviewing treatment options with sever combined immunodeficiency disease. The nurse recognizes that the parents understand the teaching based on which of the following statements? a) "The only treatment option is thymus gland transplantation" b) "Hematopoietic stem cell transplantation cannot be performed until the age of 5 years" c) "We can ask our family members to donate blood for stem cell harvesting" d) "We could have our 10 year old daughter tested, as the ideal stem cell donor is a human leukocyte antigen (HLA)-identical sibling"

d) "We could have our 10 year old daughter tested, as the ideal stem cell donor is a human leukocyte antigen (HLA)-identical sibling"

A nurse in a clinic is caring for a client who is to receive an immunization. The client asks about contraindications to immunizations. Which of the following is an appropriate response by the nurse? a) "The use of insulin is a contraindication" b) "An anaphylactic reaction is a contraindication for administration of any type of immunization" c) "The common cold is a contraindication for receiving an immunization" d) "Your provider will weigh the risks if you have experienced any adverse effects"

d) "Your provider will weigh the risks if you have experienced any adverse effects"

Which term means a lack of one or more of the five immunoglobulins? a) Panhypoglobulinemia b) Telegiectasia c) Agammaglobulinemia d) Hypogammaglobulinemia

d) Hypogammaglobulinemia

A nurse is working in a pediatric clinic. After giving a hepatitis B immunization to an infant, the mother asks what kind of protection this provides for her child. The correct response is which of the following? a) Active acquired immunity, which is temporary b) Passive acquired immunity, which is temporary c) Passive acquired immunity, which lasts many years or a lifetime d) Active acquired immunity, which lasts many years or a lifetime

d) Active acquired immunity, which lasts many years or a lifetime

A nurse is assessing a client who has a new diagnosis of SLE. Which of the following findings should the nurse expect? a) Weight gain b) Petechiae on thighs c) Systolic murmur d) Alopecia

d) Alopecia

Which of the following is accurate regarding acquired immunity? Select all that apply. a) Usually develops as a result of exposure to an antigen through immunization b) A nonspecific immunity present at birth c) Also know as innate immunity d) An immunologic response acquired during life but not present at birth e) Can develop by contracting a disease

d) An immunologic response acquired during life but not present at birth a) Usually develops as a result of exposure to an antigen through immunization e) Can develop by contracting a disease

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

d) Assure the patient that this is a normal reaction

Which of the following cell types are involved in humoral immunity? a) Memory T lymphocyte b) Helper T lymphocyte c) Suppressor T lymphocyte d) B lymphocytes

d) B lymphocytes

During a 12 month well-baby visit, a mother reports that the baby has been breast fed since birth and has never been ill. She is trying to convince her sister who is currently pregnant to breast feed also and asks the nurse about the benefits of breast feeding. The nurse explains the immune benefits of breast-feeding and provides the mother with pamphlets. The nurse determines the patient understands the teaching based on which of the following patient statements? a) "Breast feeding is beneficial because T lymphocytes found in breast milk are primarily responsible for cellular immunity" b) "Breast feeding is beneficial because the dominant antibody IgM in breast milk is the first immunoglobulin produced in response to bacterial and viral infections'" c) "Breast feeding is beneficial because the dominant antibody IgG in breast milk assumes a major role in bloodborne and tissue infections" d) Breast-feeding is beneficial because the dominant antibody IgA in breast milk acts by functioning as an antigen receptor in the mucosal membranes"

d) Breast-feeding is beneficial because the dominant antibody IgA in breast milk acts by functioning as an antigen receptor in the mucosal membranes"

Which of the following is usually the most important consideration and decisions to initiate antiretroviral therapy? a) HIV RNA b) ELISA c) Western blot assay d) CD4 counts

d) CD4 counts

A patient with paroxysmal hemoglobinuria, a deficiency of complement proteins, is complaining of headache and weakness of the right arm and leg. Based on these symptoms, for which complication should the nurse assess with this patient? a) Bacterial meningitis b) Rheumatoid arthritis c) Edema formation in the subcutaneous tissues of the extremities d) Cerebral venous thrombosis

d) Cerebral venous thrombosis

A client has dilated cardiomyopathy and has just found out he will be receiving a heart. What medication does the client understand that he will have to take for the duration of his life to help suppress the immune system to prevent rejection of the new heart? a) Etanercept (Enbrel) b) Adalimumab (Humira) c) Infliximab (Remicade) d) Cyclosporine (Sandimmune)

d) Cyclosporine (Sandimmune)

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? a) B cells b) Helper T cells c) Macrophages d) Cytotoxic T cells

d) Cytotoxic T cells

Chronic illnesses may contribute to immune system impairment in various ways. Renal failure is associated with which of the following? a) Altered production of white blood cells b) Increased incidence of infection c) Decreased bone marrow d) Deficiency in circulating lymphocytes

d) Deficiency in circulating lymphocytes

During the immune response, cytotoxic cells bind to invading cells, destroy the targeted invader, and release lymphokines to remove the debris. Which type of T-cell lymphocyte is cytotoxic? a) Suppressor T cells b) Helper T cells c) Regulator T cells d) Effector T cells

d) Effector T cells

A nurse is taking health history from a new client, which includes asking about a history of blood transfusions. This is important for which of the following reasons? a) Blood products cause lower antibody titers. b) Blood products cause a high risk for exposure to HIV. c) Blood products cause a high risk for hepatitis B. d) Exposure to foreign antigens may cause altered immune function.

d) Exposure to foreign antigens may cause altered immune function.

A 38 year old female has been diagnosed with RA, and autoimmune disease. As the nurse completes the health history assessment she learns that the patient works as an aide at a facility that cares for children infected with AIDS, does moderate cardiovascular exercise every other day, takes no medications, has no allergies, and eats mainly a vegetarian diet with fish and chicken one to two times a week. Which of the following factors is the most important consideration in determining the status of the patient's immune system? a) Environment b) Age c) Diet d) Gender

d) Gender

A 38-year-old female patient has begun to suffer from rheumatoid arthritis. She is also being assessed for disorders of the immune system. She works as an aide at a facility that cares for children infected with AIDS. Which of the following is the most important factor related to the patient's assessment? a) Her age b) Her home environment c) Her diet d) Her use of other drugs

d) Her use of other drugs

Which type of phagocytic disorder occurs when white blood cells cannot initiate an inflammatory response to infectious organisms? a) Telangiectasia b) Panhypoglobulkinemia c) Agammaglobulinemia d) Hyperimmunoglobulinemia

d) Hyperimmunoglobulinemia

A 34 year old man is diagnosed with chronic hepatitis C. Testing reveals that he is a candidate for treatment. The nurse anticipates that which of the following could be used to treat his condition? a) Monoclonal antibodies b) Interleukin-5 c) Erythropoietin d) Interferon

d) Interferon

A 6-year-old patient is diagnosed with a viral infection of the respiratory system. Which of the following will most likely be trying to fight the antigen? a) Self-antigens b) B cells c) Complements d) Interferons

d) Interferons

The body has several mechanisms to fight disease, one of which is sending chemical messengers. Specifically, 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? a) Colony-stimulating factor b) Tumor necrosis factor c) Interleukins d) Interferons

d) Interferons

Which of the following is a center for immune cell proliferation? a) Liver b) Spleen c) Pancreas d) Lymph node

d) Lymph node

Which of the following is an action of cytotoxic T cells? a) Decrease B cell activity to a level at which the immune system is compatible with life b) Attack of foreign invaders (antigens) directly c) Production of circulating antibodies d) Lyse cells infected with virus

d) Lyse cells infected with virus

A patient seen in the outpatient clinic has common variable immunodeficiency. It is important for the nurse to teach the patient about the need for more frequent screening for which of the following complications? a) Allergies b) Human immunosuppressive virus (HIV) c) Autoimmune disorders d) Malignancy

d) Malignancy

A mother has brought her child to the clinic for a wellness check. While talking with the nurse, the mother asks the nurse to suggest a diet that will maximize the immune function of her growing children. What dietary pattern should the nurse suggest? a) Diet rich in amino acids and essential fatty acids b) Diet rich in iron, zinc, and vitamin E c) Diet rich in potassium, magnesium, and sodium d) Moderate diet that is balanced and varied

d) Moderate diet that is balanced and varied

A 25 year old man receives a knife wound to the leg in a hunting accident. Which of the following types of immunity was compromised? a) Passive immunity b) Specific immunity c) Adaptive immunity d) Natural immunity

d) Natural immunity

A 25-year-old man receives a knife wound to the leg in a hunting accident. Which of the following types of immunity was compromised? a) Adaptive immunity b) Passive immunity c) Specific immunity d) Natural immunity

d) Natural immunity

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? a) Naturally acquired passive immunity b) Artificially acquired active immunity c) Artificially acquired passive immunity d) Naturally acquired active immunity

d) Naturally acquired active immunity

Which of the following immunity types becomes active as a result of infection by a specific microorganism? a) Artificially acquired passive immunity b) Artificially acquired active immunity c) Naturally acquired passive immunity d) Naturally acquired active immunity

d) Naturally acquired active immunity

Which of the following medication classifications are known to inhibit prostaglandin synthesis or release? a) Antibiotics in large doses b) Antineoplastic agents c) Adrenal corticosteroids d) Nonsteroidal anti-inflammatory drugs (NSAIDs) in large doses

d) Nonsteroidal anti-inflammatory drugs (NSAIDs) in large doses

Which of the following medication classifications are known to inhibit prostaglandin synthesis or release? a) Antibiotics in large doses b) Adrenal corticosteroids c) Antineoplastic agents d) Nonsteroidal anti-inflammatory drugs in large doses

d) Nonsteroidal anti-inflammatory drugs in large doses

You are the clinic nurse caring for a client with a suspected diagnosis of HIV. You are preparing to draw blood for a confirmatory diagnostic test on this client. What is the most important action that the nurse should perform before testing a client for HIV? a) Advise the client to take off any ornaments and metallic objects. b) Advise the client to avoid excess fluid intake. c) Advise the client to abstain from having intercourse. d) Obtain a written consent from the client.

d) Obtain a written consent from the client.

What is the function of the thymus gland? a) Produce stem cells b) Programs B lymphocytes to become regulator or effector Bcells. c) Develop the lymphatic system d) Programs T lymphocytes to become regulator or effector T cells.

d) Programs T lymphocytes to become regulator or effector T cells.

During which stage of the immune response does the circulating lymphocyte containing the antigenic message return to the nearest lymph node? a) Recognition b) Response c) Effector d) Proliferation

d) Proliferation

Thirty minutes after the nurse begins an intravenous immunoglobulin infusion, the patient complains of itching at the site and a lump in the throat. Which is the first action the nurse should take? a) Administer subcutaneous epinephrine b) Apply a tourniquet above the infusion site c) Notify the physician d) Stop the infusion

d) Stop the infusion

A nurse is teaching a community group about healthy lifestyles. A participant asks about how to maintain a healthy immune system. The nurse informs the group that which of the following factors will positively affect the immune system? a) Poor nutritional status b) Residential exposure to radiation c) Rigorous, competitive exercise d) Strong family and community connections

d) Strong family and community connections

A nurse is caring for a client with multiple sclerosis. Client education about the disease process includes which of the following explanations about the cause of the disorder? a) Regulatory mechanisms fail to halt the immune response. b) The immune system recognizes one's own tissues as "self." c) Excess cytokines cause tissue damage. d) The immune system recognizes one's own tissues as "foreign."

d) The immune system recognizes one's own tissues as "foreign."

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? a) The client will have a productive cough. b) The injection area will become painful with in duration if the client has antibodies against the antigen. c) The injection area will break out in a fine macular rash. d) The injection area swells if the client has developed antibodies against the antigen.

d) The injection area swells if the client has developed antibodies against the antigen.

A nurse assessing a patient with a primary immunodeficiency. Afterward she documents that the patient displayed ataxia. Which of the following statements explains the documentation? a) The patient has difficulty swallowing b) The patient has an inability to understand the spoken word c) The patient has vascular lesions caused by dilated blood vessels d) The patient has uncoordinated muscle movements.

d) The patient has uncoordinated muscle movements

A major manifestation of Wiskott-Aldrich syndrome includes which of the following? a) Episodes of edema b) Bacterial infection c) Ataxia d) Thrombocytopenia

d) Thrombocytopenia

A patient is scheduled to receive an intravenous immunoglobulin infusion. He asks the nurse about the infusion's administration and it's adverse effects. Which of the following choices should the nurse instruct this patient to report immediately? a) Sneezing b) Constipation c) Mouth sores d) Tickle in the throat

d) Tickle in the throat

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? a) To determine if the client needs a referral to counseling services b) To determine what type of personality the client has c) To find out if the client will be compliant with therapeutic treatments d) To determine if the client has practices that put him at risk for acquired immunodeficiency syndrome (AIDS)

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

The nurse teaches the patient that lowering his or her viral load will have what effect? a) A longer immunity b) A shorter time to AIDS diagnosis c) A shorter survival time d) A longer survival time

d) a longer survival time

A patient being treated for HIV/AIDS has a decreased appetite, almost to the point of anorexia. What is the nurses best action? a) talk to the patient about his unwillingness to eat b) ask his family to bring in food that he enjoys c) ask the dietitian to repair his favorite meals d) administer megastrol acetate Megace

d) administer megastrol acetate Megace

Patient receiving antiretroviral therapy is complaining of "not urinating enough." What's the nurses best action? a) encourage the patient to drink more fluids b) assess liver function tests c) administer fluids 100 mLs per hour via IV therapy d) assess the BUN and creatinine

d) assess the BUN and creatinine

A patient receiving atazanavir (ATV, Reyataz) requires what priority intervention? a) increase fluids b) renal function tests c) diet modification d) cardiac assessment

d) cardiac assessment

Other than abstinence, what is the only proven method of decreasing the risk for sexual transmission of HIV infection? a) spermicides b) vaginal lubricants c) birth control pills d) consistent and correct use of condoms

d) consistent and correct use of condoms

Which of the following statements reflects the treatment of HIV infection? a) treatment should be offered to individuals with plasma HIV RNA levels less than 55,000 copies/mL (RT-PCR assay) b) treatment should be offered only to select patients once they reach CDC category B: HIV symptomatic c) treatment should be offered to all patients once they reach CDC category B: HIV symptomatic d) treatment of HIV infection for an individual patient is based on the clinical condition of the patient, CD4 T cell count level, and HIV RNA (viral load)

d) treatment of HIV infection for an individual patient is based on the clinical condition of the patient, CD4 T cell count level, and HIV RNA (viral load)

What diagnostic test measures HIV RNA in the plasma? a) ELISA b) enzyme immunoassay c) Western blot assay d) viral load

d) viral load