Quiz 8

A client who has developed kidney failure is discussing options with the health care provider for treatment. What does the nurse understand that kidney failure is associated with?

A deficiency in circulating lymphocytes

The nurse is caring for a client with renal failure. Which factor indicates a compromised immune system?

A deficiency of circulating lymphocytes

A nurse is working in a pediatric clinic. After the nurse gives a hepatitis B immunization to an infant, the parent asks what kind of protection this provides for the child. What is the nurse's best response?

Active acquired immunity, which lasts many years or a lifetime

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?

Antimetabolites

A client has breast cancer. The nurse is concerned about a compromised immune system in this client for which reason?

Antineoplastic drug therapy

A client comes into the emergency department reporting difficulty walking and loss of muscle control in the arms. Once the nurse begins the physical examination, which assessment should be completed if an immune dysfunction in the neurosensory system is suspected?

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

Which assessment should be completed if immune dysfunction is suspected in the neurosensory system?

Ataxia

A client is diagnosed with rheumatoid arthritis. When teaching the client and family about rheumatoid arthritis, the nurse should provide which information?

Autoimmune disorders include connective tissue (collagen) disorders.

While taking the health history of a newly admitted client, the nurse reviews general lifestyle behaviors. What strategies would have a positive effect on the immune system?

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?

Bone marrow suppression

Activation of a natural immunity response is enhanced by physical and chemical barriers. Which of the following is a physical barrier, which the nurse knows can be altered by illness, nutrition, or lifestyle?

Cilia of the respiratory tract

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?

Digestive enzymes destroy its protein structure.

A nurse is caring for a client undergoing evaluation for possible immune system disorders. Which intervention will best help support the client throughout the diagnostic process?

Educate the client about the diagnostic procedures and answer their questions about the possible diagnosis

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?

Estrogen tends to enhance immunity.

At 39 weeks' gestation, a pregnant client visits the physician for a scheduled prenatal checkup. The physician determines that the fetus has developed an infection in utero and sends the client for an emergency cesarean delivery. The client is very concerned about the health of her unborn child. Based on knowledge of the immune system, the delivery room nurse explains about which immunoglobulin that will be increased in the fetus at the time of birth and will be actively fighting the infection?

IgG

A nurse is taking the health history of a newly admitted client and asks for a list of the client's current medications. Which medication classification would NOT place the client at risk for impaired immune function?

Inotropics

Which of the following is a center for immune cell proliferation?

Lymph node

The nurse is aware that the phagocytic immune response, one of the body's responses to invasion, involves the ability of cells to ingest foreign particles. Which of the following engulfs and destroys invading agents?

Macrophages

A parent has brought a child to the clinic for a wellness check. While talking with the nurse, the parent asks the nurse to suggest a diet that will maximize the immune function of growing children. What dietary pattern should the nurse suggest?

Moderate diet that is balanced and varied

Which type of cell is capable of directly killing invading organisms and producing cytokines?

Natural killer cells

Which medication classification is known to inhibit prostaglandin synthesis or release?

Nonsteroidal anti-inflammatory drugs (in large doses)

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

Opsonization

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

Radioallergosorbent blood test (RAST) of 3

Which adverse effect should the nurse closely monitor in a client who takes immunosuppressive drugs?

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?

Response stage

T-cell and B-cell lymphocytes are the primary participants in the immune response. What do they do?

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

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

The client appears mildly ill, listless, and disheveled.

A client has begun to suffer from rheumatoid arthritis and is being assessed for disorders of the immune system. The client works as an aide at a facility that cares for children infected with AIDS. What is the most important factor related to the client's assessment?

The client's use of other drugs

A nurse is caring for a client with multiple sclerosis. Client education about the disease process includes which explanation about the cause of the disorder?

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

An older adult client, who leads a sedentary lifestyle, and a younger client, who has a very stressful and active lifestyle, require a vaccine against a particular viral disorder. The nurse knows that in one of these clients, the vaccine will be less effective. In which client is the vaccine more likely to be less effective and why?

The older client because of age

A client is cutting vegetables for dinner and accidentally cuts a finger. What response is desirable to destroy foreign agents such as microorganisms to prevent infection from developing in the finger?

The release of antibodies

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?

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

In which response do T lymphocytes have a role?

Transplant rejection

A client has undergone a kidney transplant. The nurse is concerned about a compromised immune system in this client for which reason?

Use of anti-rejection drugs

A 38-year-old client has begun to suffer from rheumatoid arthritis and is being assessed for disorders of the immune system. The client works as an aide at a facility that cares for children infected with AIDS. Which is the most important factor related to the client's assessment?

Use of other drugs

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 term is used to define any substances capable of inducing a specific immune response and of reacting with the products of that response?

antigens

Decades ago, before the role of the tonsils and adenoids was better understood, it was typical after repeated bouts with tonsillitis to have a tonsillectomy and adenoidectomy. Today it is understood that the tonsils and adenoids are lymphoid tissues that:

filter bacteria from tissue fluid.

A client has had a splenectomy after sustaining serious internal injuries in a motorcycle accident, including a ruptured spleen. Following removal of the spleen, the client will be susceptible to:

infection because the spleen removes bacteria from the blood.

The body has several mechanisms to fight disease, one of which is sending chemical messengers. The messengers released by lymphocytes, monocytes, and macrophages have differing roles in the immune response. Which messenger enables cells to resist viral replication and slow viral replication?

interferons

A nursing instructor is giving a lecture on the immune system. The instructor's discussion on phagocytosis will include:

neutrophils and monocytes.

A client is diagnosed with an immune system disorder caused by a congenital alteration in the proper development of immune cells. The nurse is aware that this immune system disorder is classified as which type?

primary immune deficiency

Which of the following occurs when the antigen-antibody molecule is coated with a sticky substance what also facilitates phagocytosis?

Opsonization

A nurse is exposed to hepatitis C and receives a shot of gamma globulin. What type of immunity does this nurse have?

Passive immunity

An elderly client is diagnosed with cancer. While reviewing age-related changes in the immune system, what does the nurse identify as having contributed to this client's condition?

Failure of lymphocytes to recognize mutant cells

A client is informed of having a low white blood cell count and that the client is at risk for the development of infections. The client asks, "Where do I make new white blood cells?" What is the best response by the nurse?

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

A client is admitted to the hospital with a diagnosis of pneumonia. The client informs the nurse of having several drug allergies. The physician has ordered an antibiotic as well as several other medications for cough and fever. What should the nurse do prior to administering the medications?

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

The nurse is caring for an elderly client with a respiratory infection. While reviewing age-related changes in the immune system, the nurse identifies which factor as having contributed to this client's infection?

Impaired ciliary action as a result of exposure to environmental toxins

An elderly client is diagnosed with a respiratory infection. While reviewing age-related changes in the immune system, what would the nurse identify as having contributed to this client's infection?

Impaired ciliary action from exposure to environmental toxins

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

Naturally acquired active immunity