Inflammation and Immunity

Which patient would benefit most from receiving a detailed explanation about human leukocyte antigens (HLAs)? a.patient has anorexia nervosa and is refusing to eat b. patient has an identical twin who needs a kidney transplant c. patient has strong family history of breast cancer d. patient is refusing to take antibiotics because of the side effects

b. patient has an identical twin who needs a kidney transplant

A patient who had a kidney transplant 5 years ago is experiencing progressively reduced function of the organ. Which intervention is appropriate for this patient? a. patient should be admitted to intensive care for observation and possible dialysis b. patient should be educated about retransplantation; related living donor should be sought c. Drug management may limit the damage and allow the graft to be maintained. d. Patient should be immediately prepped for surgical removal of the organ

b. patient should be educated about retransplantation; related living donor should be sought

What is the clinical significance of the absolute neutrophil count (ANC)? a. high numbers of mature neutrophils are seen only in patients with severe sepsis b. the higher the number of mature circulating neutrophils, the greater the resistance to infection c. low ANC suggests that the infection is resolving because total number is depleted d. low ANC occurs when antibiotic therapy successfully takes over the neutrophils

b. the higher the number of mature circulating neutrophils, the greater the resistance to infection

The action of which cell types must be suppressed to prevent acute rejection of transplanted organs? Select all that apply. a. Eosinophils b. Suppressor T-cells c. Natural killer cells d. Cytotoxic/Cytolytic T-cells e. Helper/inducer T-cells f. neutrophils

c. Natural Killer Cells d. Cytotoxic/Cytolytic T-Cells

The nurse assesses a patient who sustained a scalding burn to the left dorsal surface of the hands and fingers that occurred one day ago. There is redness, swelling, and warmth The patient has pain, decreased fine motor movements, and limited range of motion. What do these findings indicate? a. stage II of inflammation b. serious infection that should be reported c. cardinal signs of inflammation d. probable inappropriate first-aid treatment

c. cardinal signs of inflammation

How does the immune system respond to a graft when a transplant rejection occurs? a. collateral circulation develops and the transplanted organ becomes engorged b. opportunistic infections develop because the body is immunosuppressed c. host's immune system starts inflammation and immunologic actions to destroy nonself cells d. systemic tissue destruction occurs because of inability to differentiate self from nonself cells

c. host's immune system starts inflammation and immunologic actions to destroy nonself cells

An older patient reports that he has been treated for tuberculosis in the distant past. He currently has a negative tuberculosis skin test. How does the nurse interpret the test results? a. patient does not currently have tuberculosis b. patient has incorrectly remembered being treated for tuberculosis c. in older patients, false negative tuberculosis results are a possibility d. test results are documented, and patient is to be retested annually

c. in older patients, false negative tuberculosis results are a possibility

The patient is receiving erythropoietin. If the therapy is successful in correctly stimulating stem cells, which laboratory results would the nurse expect to see? a. increase in t-lymphocytes b. increase in leukocytes c. increase in erythrocytes d. increase in platelets

c. increase in erthrocytes

Which circumstance poses the greatest risk to good health via exposure to living organisms? a. a healthy adult nurse takes care of a patient with a bacterial infection of the leg b. a sanitation worker forgets to wear gloves when picking up a garbage can c. infant children in a daycare play together and share toys and food d. an animal care technician gives vaccinations and draws blood from cats and dogs

c. infant children in a daycare play together and share toys and food

Which type of white blood cell does the body produce most? a. macrophages b. eosinophils c. neutrophils d. band neutrophils

c. neutrophils

Based on the nurse's knowledge of the concept of immunity, what is an example of self-tolerance? a. patient is given chemotherapy to eradicate the cancer cells b. antibiotic medication cures the patient's urinary tract infection c. skin from the patient's thigh is successfully grafted to a burn wound d. patient receives an uneventful blood transfusion during surgery

c. skin from the patient's thigh is successfully grafted to a burn wound

Why do older adults have an increased risk for autoimmune diseases? a. the number of neutrophils and macrophages are increased, as are their functions b. memory cells are damaged by age and they fail to react to antigens c. there is loss of recognition of self and an increase in circulating autoantibodies d. the white blood cell count is markedly decreased or absent

c. there is loss of recognition of self and an increase in circulating autoantibodies

When an injury or invasion occurs, phagocytosis involves seven steps. Degradation is the final (7th) step. Place the first six steps that precede degradation in the correct order. a. Adherence b. exposure and invasion c. phagosome formation d. cellular ingestion e. attraction f. recognition

1-b. exposure and invasion 2-e. attraction 3-a. adherence 4-f. recognition 5-d. cellular injestion 6-c. phagosome formation

To combat rejection of a transplanted kidney, the patient is prescribed intravenous daclizumab. Which question if the nurse most likely to ask to assess for side effects of this medication? a. "Are you having any nausea, vomiting, or abdominal discomfort?" b. "Have you noticed bruising or bleeding when brushing your teeth?" c. "Do you notice unusual fatigue or feelings of lightheadness?" d. "Have you experienced any tremors or muscular weakness?"

A. "Are you having any nausea, vomiting, or abdominal discomfort?"

During surgery, a patient undergoing a heart transplant experiences rejection of the organ. What type of rejection is this? a. Acute b. Chronic c. Hyperacute d. Transplant

C. Hyperacute

The nurse is instructing a patient who has undergone an organ transplant about immunosuppressant medications. What information does the nurse include? a. all immunosuppressive medications increase the risk of infection and cancer b. these medications will be gradually discontinued c. these medications prevent infection in the transplanted organ d. intravenous forms are more effective than oral medications

a. all immunosuppressive medications increase the risk of infection and cancer

Which cells interact in the presence of an antigen to start antibody production? Select all that apply a. b-lymphocytes b. macrophages c. neutrophils d. t-helper/inducer cells e. t-suppressor cells f. red blood cells

a. b-lymphocytes b. macrophages d. t-helper/inducer cells

A patient who is in good health is naturally assisted in cancer prevention by which type of immunity? a. cell-mediated b. innate c. lymphokine d. humoral

a. cell-mediated

In which conditions might the nurse observe inflammation without infection? Select all that apply a. joint sprains b. myocardial infarction c. otitis media d. blister formation e. allergic rhinitis f. contact dermatitis

a. joint sprains b. myocardial infarction d. blister formation e. allergic rhinitis f. contact dermatitis

What precaution or intervention has the highest priority for a patient going home on maintenance drugs after receiving a kidney transplant? a. monitoring for bacterial and fungal infections b. avoiding he use of table salts c. measuring abdominal girth daily d. avoiding blood donation

a. monitoring for bacterial and fungal infections

An older resident living in a long-term care facility asks for help to go to the bathroom more frequently than usual. The nurse suspects a urinary tract infection. What changes in the immune system of an older adult should the nurse keep in mind? Select all that apply a. older adults are more at risk for bacterial and fungal infections in the genitourinary tract b. older adults may have an infection but not show expected changes in white blood cell counts c. older adults may not have a fever during inflammatory or infectious episodes d. urinalysis results for older patients are more likely to show false negative results e. older patients are less likely to become septic because of history of antibody-antigen activity f. neutrophil counts may be normal, but activity is reduced, increasing the risk for infection

a. older adults are more at risk for bacterial and fungal infections in the genitourinary tract b. older adults may have an infection but not show expected changes in white blood cell counts c. older adults may not have a fever during inflammatory or infectious episodes f. neutrophil counts may be normal, but activity is reduced, increasing the risk for infection

Which patients have factors that may affect the function of the immune system? SELECT ALL THAT APPLY a. patient has been on a severely limited diet for several weeks to quickly lose weight. b. patient is homeless and is continuously seeking shelter for cold weather conditions c. patient is on multiple medications including corticosteroids, and a nonsteroidal anti inflammatory d. patient is a 30 year old adult with a family history of hypertension and high cholestrol e. patient is 84 years old and lives alone in her own home f. patient has type 2 diabetes mellitus that is well controlled with oral antidiabetic medication

a. patient has been on a severely limited diet for several weeks to quickly lose weight. b. patient is homeless and is continuously seeking shelter for cold weather conditions c. patient is on multiple medications including corticosteroids, and a nonsteroidal anti inflammatory e. patient is 84 years old and lives alone in her own home f. patient has type 2 diabetes mellitus that is well controlled with oral antidiabetic medication

Under what circumstance are the tissue mast cells most likely to be involved in the immune response? a. person has an allergic reaction to peanuts b. person cuts hand while chopping vegetables c. person is sitting by someone who is coughing d. person has a flare up of rheumatoid arthritis

a. person has an allergic reaction to peanuts

What is an example fo the clinical significance of the anamnestic response? a. person who had childhood measles is re-exposed as an adult but does not develop measles b. person had influenza last year and therefore decides that this year's immunization is unnecessary c. person had cancer that is in remission; response to therapy was better than expected d. person is very healthy, has a few infectious illnesses, and always recovers quickly

a. person who had childhood measles is re-exposed as an adult but does not develop measles

The actions of leukocytes provide the body protection against invading organisms. What are actions of leukocytes? Select all that apply. a. phagocytic destruction of foreign invaders and unhealthy cells b. lytic destruction of foreign invaders and unhealthy cells c. stimulate maturational pathway of stem cells d. production of antibodies directed against invaders e. Production of cytokines that decrease specific leukocyte growth and activity f. increase growth and differentiation of platelets

a. phagocytic destruction of foreign invaders and unhealthy cells b. lytic destruction of foreign invaders and unhealthy cells d. production of antibodies directed against invaders

The patient reports a sore throat. The nurse notes that the throat is red and the tissues look swollen and inflamed. Based on the concepts of general immunity and inflammatory response, what should the nurse tell the patient about immune protection? a. protection is immediate but short term and does not provide true immunity b. protection will occur with any future exposure to the same organisms c. inflammation is a specific response that protects only the throat area d. inflammation provides some protection against passing the infection to others

a. protection is immediate but short term and does not provide true immunity

In which conditions is the inflammatory response present? Select all that apply a. sprain injuries to joints b. apendicitis c. hypothyroidism d. myocardial infarction e. contact dermatitis f. allergic rhinitis

a. sprain injuries to joints b. apendicitis d. myocardial infarction e. contact dermatitis f. allergic rhinitis

The patients leg wound has increased blood flow (hyperemia) and swelling. The nurse recognizes this as stage I in the sequence of inflammation process. What would be considered a normal outcome for this stage? a. symptoms usually subside within 24 to 72 hours b. symptoms will resolve after antibiotic therapy c. symptoms are not normal and should be reported d. symptoms will disappear if the leg is elevated

a. symptoms usually subside within 24 to 72 hours

The nurse is caring for a patient prescribed a new oral antibiotic. Eosinophil and basophil levels are elevated. What is the nurse's best interpretation of this laboratory report? a. the patient may be having an allergic reaction b. the patients body is fighting off an infection c. the patients white blood cells are phagocytizing the invasive organisms d. the patient is at high risk for pneumonia and other respiratory infections

a. the patient may be having an allergic reaction

The patient is experienced a myocardial infarction 6 months ago during which 25% of his left ventricle was damaged and replaced by scar tissue. Which is the most likely outcome? a. the patient will lose 25% of the effectiveness of his left ventricular contraction b. the patient will lose 50% of his ejection fraction c. The patient will regain 25% of the effectiveness of his left ventricle after healing d. the patient will lose 75% of his activity tolerance

a. the patient will lose 25% of the effectiveness of his left ventricular contraction

The nurse is caring for a patient after a kidney transplant. Which finding prompts the nurse to quickly alert the health care provider about a probable hyperacute rejection? a. there is no urine output and problems occur immediately b. blood urea nitrogen and creatinine show trend for elevation c. patient reports some tenderness at the incision site d. patient has an allergic reaction to the transplant medications

a. there is no urine output and problems occur immediately

A patient is admitted with pneumonia and has developed sepsis. What can the findings from a differential white blood cell count reveal about this patient? a. whether an infection is bacterial or viral b. whether the patient has active immunity c. the tissue type from the human leukocyte antigen d. the type of antibody response occuring

a. whether an infection is bacterial or viral

The nurse is reviewing the patient's medication administration record and sees that the patient takes muromanab-CD3. What question is the nurse most likely to ask? a. "When were you first diagnosed with cancer?" b. "when was your organ transplant performed?" c. "Is the medication controlling your allergy symptoms?" d. "Are you still having symptoms of infection?"

b. "when was your organ transplant performed"

In what way is antibody-mediated immunity (AMI) different from cell-mediated immunity (CMI)? a. AMI is more powerful than CMI b. AMI can be transferred from one person to another, CMI cannot c. CMI requires constant re-exposure for "boosting"; AMI does not d. CMI requires inflammatory actions; AMI is independent of inflammatory actions

b. AMI can be transferred form one person to another, CMI cannot

A babysitter is caring for a child who is in the presymptomatic stage of influenza A. The babysitter has never had influenza A and develops symptoms several days after caring for the child. What type of immunity will the babysitter have as a result of antibody-antigen actions? a. B cells will be sensitized to influenza A and B b. B cells will be sensitized only to influenza A c. immunity is short term because B cell action is nontransferable from child to adult

b. B cells will be sensitized only to influenza A

What is the significance of toll-like receptors (TRLs) in helping the body to fight infection? a. research shows that diseases are spread by flies spread by flies through the TRLs b. TRLs interact with the surface of an organism and allow recognition of nonself. c .persons who have more TRLs are more likely to develop infections. d. older people and immunocompromised persons will not produce TRLs

b. TRLs interact with the surface of an organism and allow recognition of nonself

The health care provider writes a prescription for the patient to be immunized with the flu vaccine. Which type of immunity does the nurse provide the patient by injecting this vaccine? a. natural active immunity b. artificial active immunity c. adaptive immunity d. passive immunity

b. artificial active immunity

The nurse is performing a physical assessment on an adult with no known health problems. Which assessment finding poses the greatest potential threat to the patients immune system? a. has an old scar formation related to an appendectomy b. has poor oral hygiene and numerous dental caries c. displays occasional skipped heartbeats during auscultation d. displays orthostatic hypotension and is mildly dehydrated

b. has poor oral hygiene and numerous dental caries

The nurse is reviewing the patient's laboratory results and sees that there is a left shift (bandemia). Which assessment is the nurse most likely to perform? a. look for signs of bleeding, such as petechiae b. look for signs of infection and check temperature and pulse c. check for signs of anemia, such as pallor or tachycardia d. check for signs and symptoms of inflammatory response

b. look for signs of infection and check temperature and pulse

Which cell types associated with the inflammatory response participate in phagocytosis? a. neutrophils and eosinophils b. macrophages and neutrophils c. macrophages and eosinophils d. eosinophils and basophils

b. macrophages and neutrophils

Which person is most likely to be immunocompetent? a. 79 year old male who lives independently, exercises daily, and eats balanced meals b. 25 year old female who drinks alcohol and who stays out late every night with her friends c. 6 year old male who is energetic but frequently has minor upper respiratory infections d. 45 year old female who works daily in her garden and eats a vegetarian diet

d. 45 year old female who works daily in her garden and eats a vegetarian diet

Which type of infection is most likely to result in a left shift (bandemia) that indicates an increased number of immature neutrophils? a. viral infection b. parasitic infection c. fungal infection d. bacterial infection

d. bacterial infection

What is an example of innate-native immunity? a. nurse obtains hepatitis b series before starting a new job abroad b. patient, bitten by wild rabid animal, receives four doses of rabies vaccine c. new mother decides to breastfeed her infant for first several months d. nurse has intact healthy skin on hands and healthy mucous membranes

d. nurse has intact healthy skin on hands and healthy mucous membranes

A patient is admitted to the hospital for acute rejection of a kidney transplant that was preformed 2 months ago. Which intervention is appropriate for this patient? a. immediate removal of the transplanted kidney b. grief and loss counseling to prepare for loss of organ c. magnetic resonance imaging of organ d. organ biopsy to diagnose impaired function

d. organ biopsy to diagnose impaired function

Production of immune cells will be most jeopardized by which event? a. patient's thymus gland atrophies because of the aging process b. patient's spleen is removed because of a serious car accident c. patient has liver failure secondary to alcohol abuse d. patient develops bone marrow disorder

d. patient develops a bone marrow disorder

What feature of stem cells has made them valuable to research and therapy? a. found only in the fetus tissue b. posses long life span c. resistant to cancer d. pluripotency

d. pluripotency

Which findings are most likely to manifest in a patient who is experiencing the release of histamine and kinins by basophils? a. fever and tachycardia b. foul odor and pus c. shortness of breath d. swelling and edema

d. swelling and edema

A patient has sustained a severe right ankle sprain, and the nurse explaining the process of inflammation to the patient and family. Which information does the nurse include in this teaching? a. because inflammation is present, treatment for infection is advised b. the inflammation response is painful but provides long term protection c. inflammation is a specific body defense in response to the ankle injury d. symptoms of inflammation depend on the intensity and severity of the injury

d. symptoms of inflammation depend on the intensity and severity of the injury

A nurse is exposed to a viral infection at work. After several days, the nurse full recovers and returns to work. What is the role of the memory cell in relation to the nurse's viral illness? a. the memory cell reminds the nurse's healthy cells to function after recovery b. if the nurse develops other viral infections, the memory cell seeks out an antigen match c. the memory cell prevents viral shedding from the nurse to patients who are immunocompromised d. when the nurse is reexposed to the same antigen, the memory cell will produce antibodies

d. when the nurse is re-exposed to the same antigen, the memory cell will produce antibodies