IMMUNITY

Which type of cells form a network to bind and process antigens in the epidermis? Merkel cells Reticular dermis Langerhans cells Dermal dendrocytes

Langerhans cells

An intensive care nurse is caring for a client who has been admitted for a deep-vein thrombus and who has a history of immune-mediated heparin-induced thrombocytopenia (HIT). The nurse would expect the client to be discharged with a prescription for which medication? Tissue plasminogen activator Low-molecular-weight heparin High-molecular-weight heparin Nonsteroidal anti-inflammatory drugs

Low-molecular-weight heparin Low-molecular-weight heparin has been found to be effective in avoiding HIT and preventing the recurrence of thrombosis.

A client develops bone marrow suppression related to a drug's effects. What would be most important for the nurse to do? Monitor laboratory blood values. Place the client on protective isolation. Facilitate cardiac monitoring. Prepare the client for dialysis.

Monitor laboratory blood values.

The granulocyte cell lines are derived from: Myeloid stem cells Lymphoid stem cells Metamyelocytes Monoblasts

Myeloid stem cells

A client is scheduled for a renal arteriogram. When the nurse checks the chart for allergies to shellfish or iodine, she finds no allergies recorded. The client is unable to provide the information. During the procedure, the nurse should be alert for which finding that may indicate an allergic reaction to the dye used during the arteriogram? Increased alertness Hypoventilation Pruritus Unusually smooth skin

Pruritus

A client had been exposed to a particular antigen and now experiences a repeat exposure. What stimulates a quicker immune response? memory T cells immunity macrophages antibodies

memory T cells

The obstetric nurse is caring for a woman in the delivery room who has tested positive for the HBsAg. Which intervention does the nurse recognize is indicated? Vaccination of the mother for hepatitis A Vaccination of the newborn with immunoglobulin Vaccination of the mother with hepatitis C vaccine Vaccination of the newborn for hepatitis A

Vaccination of the newborn with immunoglobulin The CDC also recommends that infants born to HBsAg positive mothers receive appropriate doses of hepatitis B immunoglobulin (HBIG) and hepatitis B vaccine.

The nurse explains to a client that immunotherapy initially starts with injections at which interval? Daily Weekly Bi-monthly Monthly

Weekly

A client with hypertension is given an IV medication and has an anaphylactic reaction. This is considered to be: a complication. a sequelae. a syndrome. a subacute presentation.

a complication.

A potential complication for the mother and fetus is Rh incompatibility; therefore, assessment should include blood typing. If the mother is Rh negative, her antibody titer should be evaluated. If treatment with Rho(D) immune globulin is indicated, the nurse would expect to administer it at which time? at 28 weeks at 32 weeks at 36 weeks only at birth

at 28 weeks

The nurse is explaining patterns of incidence and transmission of HIV to a group of adolescent girls. She explains that the risks for this population are much higher because of the possibility of both vertical and horizontal transmission. Horizontal transmission refers to transmission of the disease during: sexual contact. feeding with breast milk. the birthing process. pregnancy.

sexual contact.

The nurse is caring for an infant exposed to HIV. The polymerase chain reaction (PCR) test was negative at birth. The nurse tells the mother that the child should be tested again at what age? 4 to 7 weeks 8 to 10 weeks 2 to 3 months 12 months

4 to 7 weeks

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? Eosinophils Macrophages Basophils Neutrophils Basophils Neutrophils

Macrophages Macrophages move toward the antigen and destroy it.

A client has developed pericarditis following an episode of acute glomerulonephritis, developments that may be attributable to the presence of similar epitopes on group A beta-hemolytic streptococci and the antigens in the client's heart tissue. Which has most likely accounted for this client's autoimmune response? Breakdown of T-cell anergy Release of sequestered antigens Superantigens Molecular mimicry

Molecular mimicry

A nurse reading a chart notes that the client had a Mantoux skin test result with no induration and a 1-mm area of ecchymosis. How does the nurse interpret this result? Negative Positive Borderline Uncertain

Negative

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 Macrophage Basophil Monocytes

Neutrophil Eosinophil Basophil

The nurse is caring for a client with a suspected diagnosis of HIV. The nurse is 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? Advise the client to avoid excess fluid intake. Advise the client to abstain from having intercourse. Advise the client to take off any ornaments and metallic objects. Obtain a written consent from the client.

Obtain a written consent from the client.

A client is receiving auranofin as treatment for rheumatoid arthritis. The nurse should expect this drug to be given by which route? Oral Subcutaneous Intramuscular Intravenous

Oral

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

Passive immunity transferred by the mother

A 32-year-old female client is taking tizanidine (Zanaflex) for spasticity related to her multiple sclerosis. The nurse will inform the client and her husband that the adverse effect that poses the greatest safety risk to the client is: constipation. dry mouth. fatigue. hypotension.

hypotension.

The nurse is caring for a client who reports having recurrent yeast infections. The nurse will assess for evidence of which underlying condition based on this client's health history? immunocompromise fluid volume deficit peripheral hypoperfusion xeroderma (dry skin)

immunocompromise

The nurse is preparing to administer oprelvekin to a client diagnosed with a chemotherapy-induced bleeding disorder. The nurse is explaining to the client the reason for administering this drug? Which explanation is best? "The drug is used only after unsuccessful removal of the spleen." "The drug is used if treatment with romiplostim does not work." "The drug is used to increase platelet count during chemotherapy." "The drug is used to prevent fluid retention."

"The drug is used to increase platelet count during chemotherapy."

A client develops an immunodeficiency disorder after receiving chemotherapy for the treatment of lung cancer. The client asks the nurse if he was born with this deficiency. What is the nurse's best response? "You were probably born with an immunodeficiency disorder and it remained dormant until you began receiving chemotherapy." "You have developed a secondary immunodeficiency disorder as a result of your chemotherapy." "The immunodeficiency disorder is a result of your body's rejection of the chemotherapy." "You must have caught this disorder from another person."

"You have developed a secondary immunodeficiency disorder as a result of your chemotherapy."

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 natural immunity Active artificial immunity Passive natural immunity Passive artificial immunity

Active artificial immunity

The nurse is completing a care plan for a child who has recently had a bone marrow transplant. Which nursing interventions should the nurse include in the care plan? Select all that apply. Administer immunosuppressive medications as ordered. Maintain contact transmission-based precautions for the first 2 weeks of care. Monitor the client for signs and symptoms of graft versus host disease. Provide oral care at least every shift, but more often as needed. Perform meticulous hand hygiene and ensure all visitors follow these precautions.

Administer immunosuppressive medications as ordered. Monitor the client for signs and symptoms of graft versus host disease. Provide oral care at least every shift, but more often as needed. Perform meticulous hand hygiene and ensure all visitors follow these precautions.

The administration of immunizations to a client is a form of what type of immunity? Artificial active immunity Naturally active immunity Passive active immunity Attenuated active immunity

Artificial active immunity Immunizations are a form of artificial active immunity.

The nurse is administering the prescribed intravenous immunoglobulin to a 10-year-old boy. What step would be most important for the nurse to do? Have epinephrine available. Monitor urine for glucose. Administer with food. Monitor for signs of Cushing syndrome.

Have epinephrine available.

The perinatal nurse recognizes that what vaccine can be safely given to a neonate? Hepatitis B Varicella Measles, mumps and rubella (MMR) Hepatitis A

Hepatitis B

A client is administered methotrexate for the treatment of severe rheumatoid arthritis. Administration of this drug should be performed with particular care because of the associated high risk of what condition? Intracapsular bleeding Thrombophlebitis Hepatotoxicity Myocardial infarction or CVA

Hepatotoxicity

Which of the following sexually transmitted infections (STIs) could be transmitted perinatally? Herpes simplex Chlamydia Gonorrhea Trichomoniasis

Herpes simplex

What is the most common cause of drug fever? Increased heat production from PTU Hypersensitivity reaction to medication Impaired peripheral heat dissipation by atropine Serotonin syndrome

Hypersensitivity reaction to medication

The parent of a child with allergies has been told the child will have a blood test done for immunoglobulin measurement. The nurse should tell the parent that which immunoglobulin will be tested? IgG IgE IgA IgM

IgE

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

IgE

A 16-year-old boy has been diagnosed with ankylosing spondylitis. Which etiology is responsible for his health problem? Infection Friction between bones Immune response Inappropriate bone remodeling

Immune response

A client who has multiple sclerosis has experienced a fall and requires open reduction and internal fixation of a femoral fracture. The anesthesiologist has informed the perioperative nurse that the client will be given a neuromuscular junction (NMJ) blocker to facilitate anesthesia. What is the nurse's best action? Monitor the client's status before, during, and after surgery as per usual protocol. Question the anesthesiologist about the use of an NMJ blocker with this client. Inform the surgeon of the anesthesiologist's statement and document in the client's health record. Document this statement and inform the perioperative nurse manager.

Monitor the client's status before, during, and after surgery as per usual protocol.

The general adaptation syndrome is what occurs in the body in response to stressors. When the body's defenses are depleted, signs of "wear and tear" or systemic damage appear. Which diseases have been linked to stress and are thought to be encouraged by the body itself when it can no longer adapt to the stress in a healthy manner? Psychotic disorders Osteogenesis sarcomas Rheumatic disorders Infections of the head and neck

Rheumatic disorders

Which statement explains how T lymphocytes and B lymphocytes differ? T lymphocytes mature in the thymus gland; B lymphocytes mature in the bone marrow. T lymphocytes secrete antibodies; B lymphocytes provide cellular response to antigens. T lymphocytes are helpers that assist B lymphocytes to amplify the lysis of antigens. T lymphocytes recognize bacteria; B lymphocytes recognize viruses and cancer.

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

A 51-year-old male has been diagnosed with alcohol-induced liver disease. He admits to the nurse he does not understand what the liver does in the body. Which of these statements best explains the liver's function? The liver is responsible for the absorption of most dietary nutrients as well as the production of growth hormones. The liver contributes to the metabolism of ingested food and provides the fluids that the GI tract requires. The liver metabolizes most components of food and also cleans the blood of bacteria and drugs. The liver maintains a balanced level of electrolytes and pH in the body and stores glucose, minerals and vitamins.

The liver metabolizes most components of food and also cleans the blood of bacteria and drugs.

The nurse is assessing a child who is experiencing renal complications as a result of lupus. Which finding is of greatest concern? elevated temperature elevated blood pressure hypotension reduced body temperature

elevated blood pressure

Administration of which medication reverses the histamine release and hypotension that are seen in anaphylaxis? diphenhydramine atropine epinephrine cimetidine

epinephrine

The nurse is caring for a pediatric client with idiopathic celiac disease. Which meal will the nurse select for this client? Ham and cheese sandwich, orange slices, chips, and whole milk Whole wheat pasta, meatballs, carrot sticks, apple, and water Baked salmon, potato slices, vanilla ice cream, and apple juice Meatloaf, green beans, peanut butter cookie, and fat-free milk

Baked salmon, potato slices, vanilla ice cream, and apple juice

Which cells block the entry of microbes and destroy them by secreting antimicrobial enzymes, proteins, and peptides within the mucous membrane linings of the gastrointestinal, respiratory, and urogenital tract? Immune Lymphatic Leukocytes Epithelial

Epithelial

The nurse is administering chrysotherapy to a patient with rheumatoid arthritis. What drug will the nurse be administering? Hydroxychloroquine Humira Gold salts Azathioprine

Gold salts The administration of gold salts is called chrysotherapy. Gold is an anti-inflammatory agent that interferes with cells and substances in the immune system

Adult strabismus is almost always of the paralytic variety. What is a cause of adult strabismus? Huntington disease Parkinson disease Graves disease Addison disease

Graves disease

A middle-aged female client complains of anxiety, insomnia, weight loss, the inability to concentrate, and eyes feeling "gritty." Thyroid function tests reveal the following: thyroid-stimulating hormone (TSH) 0.02 U/ml, thyroxine 20 g/dl, and triiodothyronine 253 ng/dl. A 6-hour radioactive iodine uptake test showed a diffuse uptake of 85%. Based on these assessment findings, the nurse should suspect: thyroiditis. Graves' disease. Hashimoto's thyroiditis. multinodular goiter.

Graves' disease.

A school nurse is gathering registration data for a child entering first grade. Which immunizations would the school nurse verify that the child has had? Select all that apply. influenza vaccine diphtheria-tetanus-pertussis series Haemophilus influenzae type b series varicella vaccine pneumonia vaccine oral polio series

Haemophilus influenzae type b series diphtheria-tetanus-pertussis series varicella vaccine

A client is receiving anakinra for treatment of rheumatoid arthritis. The client is scheduled to have arthroscopic evaluation of the right knee. What is the priority nursing diagnosis for this client after the procedure? Risk for infection Risk for injury Impaired skin integrity Acute pain

Risk for infection the priority would be risk for infection because the client is receiving anakinra, which suppresses the immune system and places the client at higher risk for infection following an invasive procedure.