Patho PrepU Chp 15

A student states, "It seems like helper T cells do a lot more than just 'help' the cellular immunity process". Which of the following responses listed below best conveys an aspect of the role of CD4+ helper T cells in immunity?

"Helper T cells play a major role in stimulating and regulating the whole process."

A patient with infectious mononucleosis asks the nurse why the lymph nodes are enlarged. Which of the following is the nurse's appropriate response?

"Your lymph nodes trap and destroy viruses."

Which of the following situations can best be characterized as an example of passive immunity?

A 6-week-old infant receives antibodies from his mother's breast milk.

The nurse is administering a measles, mumps, and rubella (MMR) vaccination to a pediatric client. When the nurse explains immunity to the mother, which type of immunity will she explain that this vaccination provides?

Active artificial immunity

A client is brought to the physician's office with a raised red macular rash on the trunk and arms accompanied by a fever. A diagnosis of measles is made. Which type of immunity does this disease process provide?

Active natural immunity

Substances foreign to the host that can stimulate an immune response are known as:

Antigens

Select the type of lymphocyte that matures in the bone marrow.

B lymphocytes

Which of the following statements are TRUE regarding humoral immunity? Select all that apply.

B lymphocytes (B cells) are vital to the functioning of this type of immunity. Two types of responses (primary and secondary) occur. The memory response occurs on subsequent exposures to the antigen.

Cell-mediated immunity is involved in resistance to infectious diseases caused by bacteria and some viruses. It is also involved in cell-mediated hypersensitivity reactions. Which of these does not cause a cell-mediated hypersensitivity reaction?

Blood transfusion

The nurse is caring for a patient who is receiving a bone marrow transplant. What does the nurse understand the patient may receive in order to increase the success rates of the transplantation?

Colony-stimulating factor

Cytokines that stimulate bone marrow pluripotent stem and progenitor or precursor cells to produce large numbers of platelets, erythrocytes, lymphocytes, neutrophils, and monocytes, eosinophils, basophils, and dendritic cells are known as:

Colony-stimulating factors (CSFs)

A lactation nurse visits a new mother after delivery of her first child and encourages the mother to breastfeed her infant, even for a short time. Which statement made by the nurse correctly explains the importance of breastfeeding?

Colostrum will provide the infant with passive immunity for several months to diseases to which the mother has immunity.

A nurse who works in a long-term care facility has observed the high incidence of infectious illnesses among the older adults who reside there. What is the best explanation for a diminished immune capacity in older adults?

Decreased numbers and responsiveness of T lymphocytes

The nurse knows high incidences of infectious illnesses among the older adults who reside in a long term care facility are most likely to have diminished immune capacity because of:

Decreased numbers and responsiveness of T lymphocytes

A clinical research study is evaluating cells that bridge both the innate and adaptive immune systems. A nurse has identified the dendritic cells (DCs) as a key component. Which of the following statements validates this finding?

Dendritic cells (DCs) directly sense pathogens, capture foreign agents, and transport them to secondary lymphoid tissues. Once activated, they undergo a maturation process and function as antigen-presenting cells (APCs) capable of initiating adaptive immunity.

During a blood transfusion, a client begins to have chills, back pain and develops a fever. The nurse determines the client is experiencing a transfusion reaction. The nurse educates the client about transfusion reactions. Which of the following statements indicates the cause of the reaction?

Each person has two HLA haplotypes that identify human cells. Blood typing involves the identification of these haplotypes (ABO compatibility). The closer the matching of HLA types, the greater is the probability of identical antigens and the lower the chance of rejection. A reaction occurs if the immune system views the HLA types as foreign.

Immunologically active sites on antigens are recognized as:

Epitopes

Select the statement that best describes the effectiveness of vaccination in the elderly population.

Experimental evidence suggests that vaccination is less successful in inducing immunization in older persons than in younger adults.

The laboratory finds IgA in a sample of cord blood from a newborn infant. This finding is important because it signifies what?

Fetal reaction to exposure to an intrauterine infection

A client diagnosed with sepsis has a critically low neutrophil count. The nurse expects which drug or drug class to be used to stimulate white blood cell production?

Granulocyte CSF (G-CSF) such as filgrastim (Neupogen)

A nurse is administering penicillin to a client diagnosed with a streptococcal infection. The client later develops a systemic rash. Which of the following is the cause of this allergic reaction? `

Hapten-carrier complexes

A 10 year old child with strep throat asks the nurse, "why are there large bumps [lymph nodes] on their neck when their throat gets sore?" The nurse replies that lymph nodes:

Help your body fight off infections by allowing special cells [lymphocytes and macrophages] move through the lymph chain and engulf and destroy germs.

A patient receives an interleukin-2 (IL-2) infusion to treat cancer. Which of the following responses explains how this cytokine will affect the growth of cancer cells?

IL-2 stimulates growth of cytotoxic T lymphocytes.

The nurse is assisting a new mother with breastfeeding. What does the nurse understand is a primary secretory Ig that is found in the colostrum?

IgA

A client experiences an allergic reaction. Select the immunoglobulin that would bind to mast cells and release histamine.

IgE

Which of the following immunoglobulins (Ig) is released in response to allergy or parasitic infections?

IgE

The nurse is aware that the only class of immunoglobulins to cross the placenta is:

IgG

Which of the following immunoglobulins (Ig) is the most abundant of circulating antibodies?

IgG

Three days ago, a mother delivered her full-term infant who had been identified as having an in utero infection. The infant is receiving antibiotic and phototherapy, and the mother is breastfeeding. Which of the following types of immunoglobulins could most reasonably be expected to predominate in the infant's immune system?

IgG, IgA, IgM

Which immunoglobulin is the first circulating immunoglobulin to appear in response to an antigen and is the first antibody type made by a newborn?

IgM

The nurse is reviewing the functions of immunoglobulins and determines which of the following as a correct action?

IgM/first to challenge the antigen

The most important function of the thymus is:

Immune cell production and maturation

A nurse is teaching a group of seniors about the decline of the immune system due to aging. Which of the following topics should be included in the teaching plan regarding the immune response of the elderly? Select all that apply.

Increase in susceptibility to infections Higher incidence of cancer Weakened response to vaccinations

Natural killer cells are specialized lymphocytes that are one of the major parts of which immunity?

Innate

A hospital client with a diagnosis of sepsis is in need of a specific response to microorganisms and a long-lasting immunity to the pathogens in question. Which component of the client's immune system is most able to meet these criteria?

Lymphocytes

An obstetrics nurse is counselling an expectant mother. The mother is concerned about letting people hold her baby once it's born, fearing that the baby will get sick. What should the nurse explain to the mother?

Maternal immunoglobulins cross the placenta and protect the newborn early in life.

A person has been exposed to a particular antigen and a now experiences a repeat exposure. What stimulates a quicker immune response?

Memory T cells

A blood smear is being examined and a stain has been added that will identify granulocytes. Which cell types will be visible with the stain? Select all that apply.

Neutrophil Eosinophil Basophil

A child has a congenital condition in which the thymus gland is absent. What should the nurse include in the education of care of this patient to the parents?

Observe and report signs and symptoms of infection.

The process by which microbes are coated to allow for more efficient recognition by phagocytes is known as:

Opsonization

A woman experiences a viral infection while pregnant. Which of the following types of immunity does an infant have at birth against this infection?

Passive

The nurse is planning care for a client with a diagnosis of primary immunodeficiency. Which of the following is a priority intervention to incorporate into the plan?

Protecting the client from infection

A client is being evaluated for atopic dermatitis possibly caused by a latex-related allergic reaction. The nurse will review which of the following labs to determine if an allergy is present?

Serum IgE

The first physical line of defense in innate immunity is:

Skin and mucous membranes

Which of the following is a secondary lymphoid structure located high in the left abdominal cavity?

Spleen

A client has immunity that was mediated by specific T lymphocytes and provides defense against intracellular microbes such as viruses. This immunity is recognized as:

T lymphocytes

Which of the following explains how T lymphocytes and B lymphocytes differ?

T lymphocytes mature in the thymus gland; B lymphocytes mature in the bone marrow.

The nurse knows the cells primarily programmed to remove the invading organisms and remember the antigen to respond rapidly during the next exposure are:

T-and B-lymphocytes.

A teenage client is exposed to a person infected with chicken pox. After two weeks, the client has not contracted the virus. How is this possible? Select all that apply.

The client was vaccinated for chicken pox. The client was previously exposed to chicken pox.

In an attempt to best explain the innate immune system to a class of first-year nursing students, the instructor should describe what characteristic?

The response of the innate immune system is rapid, usually within minutes to hours, and prevents the establishment of infection and deeper tissue penetration of microorganisms.

Stem cells in the bone marrow produce T lymphocytes or T cells and release them into the vascular system. The T cells then migrate where to mature?

Thymus

A patient seeks treatment in the clinic for exposure to poison ivy with a rash over the right arm and hand. The nurse is aware that what toxin is found in the oils on poison ivy that are responsible for eliciting an allergic reaction?

Urushiol

A mother is diagnosed with a bacterial infection and is worried that her newborn infant will also contract the infection. Which of the following statements should the nurse include in the teaching plan for the client?

Your newborn has maternal IgG antibodies that were transferred through the placenta before birth, providing some protection from infection.

The nurse is explaining the quality of pleiotropism that is possessed by many cytokines. The quality of pleiotropism implies that such cytokines:

are able to act on different types of cells.

The nurse knows a drug in a category identified as a colony-stimulating factor (CSF) helps:

to stimulate bone marrow to produce large numbers of mature cells such as platelets and erythrocytes.