Immunity Questions

Which of the following terms refers to an incomplete antigen? a) Hapten b) Allergen c) Antibody d) Antigen

a

Which type of contact dermatitis requires light exposure in addition to allergen contact? a) Photoallergic b) Allergic c) Irritant d) Phototoxic

a

Which of the following clinical manifestations would the nurse expect to find in a client with osteoarthritis? a) Small joint involvement b) Subcutaneous nodules c) Early morning stiffness d) Joint pain that diminishes with rest

c

Which of the following is a mast cell stabilizer used in the treatment of allergic rhinitis? a) Tetrahydrozoline hydrochloride (Visine) b) Pseudoephedrine hydrochloride (Sudafed) c) Intranasal cromolyn sodium (NasalCrom) d) Oxymetazoline hydrochloride (Afrin)

c

Which of the following is the leading cause of disability and pain in the elderly? a) Scleroderma b) Rheumatoid arthritis (RA) c) Osteoarthritis d) SLE

c

Which statement indicates the client with HIV needs further instruction about healthy eating? a. "Eating fat increases my chances of getting fat around my middle, so I am trying to choose all nonfat or low-fat food." b. "Eating carbs makes insulin resistance worse, so I am eating a very-low- carbohydrate diet." c. "Protein is the most important nutrient, so I am eating extra red meat at every meal." d. "Monounsaturated fats in olive oil, canola oil, nuts, and avocado are healthiest. I am eating more of them and less of other types of fats

a

The nurse is performing discharge teaching for a patient with rheumatoid arthritis. What teachings are priorities for the patient? Select all that apply. a) Assistive devices b) Medication dosages and side effects c) Narcotic safety d) Dressing changes e) Safe exercise

a, b, e

When describing the immunoglobulin most likely involved with allergic reactions, which of the following would the nurse address? a) IgM b) IgE c) IgA d) IgG

b

A nurse has developed irritant contact dermatitis from latex glove use. Which of the following would the nurse need to avoid? a) Applying silicone agents to the skin b) Using powder-free gloves whenever possible c) Using oil-based hand lotion before donning gloves d) Changing the brand of gloves used

c

Students are reviewing information about hypersensitivity disorders in preparation for class discussion the next day. The students demonstrate understanding of the material when they identify which of the following as a type IV hypersensitivity disorder? a) Anaphylaxis b) Allergic rhinitis c) Contact dermatitis d) Atopic dermatitis

c

The client with rheumatoid arthritis has a red blood cell count of 3.2 cells/cu mm. Which nursing diagnosis has the highest priority for the client? a) Self-care deficit: Bathing b) Risk for infection c) Fatigue d) Ineffective airway clearance

c

When assessing the skin of a client with allergic contact dermatitis, the nurse would most likley expect to find irritation at which area? a) Ankles b) Lower arms c) Plantar aspects of the feet d) Dorsal aspect of the hand

d

HIV selectively enters which of the following cells? B clones Helper T cells Suppressor T cells Cytotoxic T cells

Helper T cells

What should the nurse teach the patient about the diagnosis of osteoarthritis? a) "It is the most common and frequently disabling of joint disorders." b) "It affects young males." c) "It affects the cartilaginous joints of the spine and surrounding tissues." d) "It requires early treatment because most of the damage appears to occur early in the course of the disease."

a

When should nutrition become part of the care plan for a client with HIV? a. Before the onset of symptoms b. When the client begins to lose weight c. After an acute episode of illness d. When weight loss is more than 5% of initial weig

a

Which of the following allergies is responsible for most severe food allergy reactions? a) Peanuts b) Seeds c) Berries d) Seafood

a

A client is being treated for severe rheumatoid arthritis. The nurse could anticipate treatment with which of the following. a Etanercept—tumor necrosis factor b Gold therapy c Hylan G-F 20—hylans with elastic properties d Ketoprofen e Interferon beta-2a f Methotrexate

a, b, c, f

The immune abnormalities that characterize systemic lupus erythematosus (SLE) include which of the following? Select all that apply. a) Abnormal innate and adaptive immune responses b) Susceptibility c) Inflammation d) Damage e) Autoantibodies immune complexes

a,b,c,d,e

The nurse is preparing a client for skin testing. The client has been taking an over-the-counter allergy medication. The nurse would instruct the client to stop taking the medication at which time before the test? a) 5 to 7 days b) 2 to 4 days c) 7 to 10 days d) 1 to 2 days

b

The nurse observes diffuse swelling involving the deeper skin layers in a patient who has experienced an allergic reaction. The nurse would correctly document this finding as which of the following? a) Pitting edema b) Angioneurotic edema c) Contact dermatitis d) Urticaria

b

Which cells present the antigen to the T cells and initiate the immune response? a) Hapten b) Macrophages c) B cells d) Antigens

b

Which of the following is an appropriate nursing intervention in the care of the patient with osteoarthritis? a) Provide an analgesic after exercise. b) Encourage weight loss and an increase in aerobic activity. c) Avoid the use of topical analgesics. d) Assess for the gastrointestinal complications associated with COX-2 inhibitors.

b

Which of the following maybe the first and only physical sign of symptomatic osteoarthritis (OA)? a) Joint instability b) Limited passive movement c) Limb shortening d) Joint enlargement

b

Which of the following refers to fixation of a joint? a) Articulations b) Ankylosis c) Pannus d) Synovitis

b

Which of the following suggests to the nurse that the client with systemic lupus erythematous is having renal involvement? a) Behavioral changes b) Hypertension c) Chest pain d) Decreased cognitive ability

b

Which of the following classifications are considered antiarthritic drugs? Select all that apply. a) Muscle relaxants b) Anti-inflammatory c) Disease-modifying antirheumatics (DMARDs) d) Diuretics e) Glucocorticoids

b, c, e

A client with a history of allergic rhinitis comes to the clinic for an evaluation. The client is prescribed triamcinolone. Which of the following would the nurse include when teaching the client about this drug? a) Use ice chips to alleviate the symptoms of dry mouth. b) Take the drug orally before, with, or after meals. c) Be aware that some nasal burning and itching may occur. d) Place the prescribed number of drops into the conjunctiva.

c

Which of the following is a plasma protein associated with the immunologic reaction? a) Cytokines b) Prostaglandins c) Complement d) Leukotrienes

c

Which of the following would the nurse prioritize as the most important action for the patient to take to prevent anaphylaxis? a) Wear a medical alert bracelet b) Carry an emergency kit c) Avoid potential allergens d) Desensitization

c

The nurse is conducting discharge teaching for a patient who is being discharged from the ER after an anaphylactic reaction to peanuts. Which of the following should the nurse include in the teaching? Select all that apply. a) Desensitization to allergen b) Use of sedatives to treat reactions c) Wearing medical alert bracelet d) Avoiding allergens

c, d

Which intervention should the nurse implement to manage pain for the client with rheumatoid arthritis? Select all that apply. a) Provide assistive devices for self-feeding. b) Provide diversional activities. c) Support joints with splints and pillows. d) Provide opportunities for the client to express concerns. e) Assist the client to develop a sleep routine.

c, e

A client is scheduled to begin immunotherapy. The nurse would explain that the client will receive injections initially at which interval a) Bi-monthly b) Monthly c) Daily d) Weekly

d

A nurse comes to the employee health center for evaluation and is diagnosed with allergic contact dermatitis related to latex. Which of the following would the nurse most likely exhibit? a) Rhinitis b) Angioedema c) Laryngeal edema d) Blistering

d

After teaching a client how to self-administer epinephrine, the nurse determines that the teaching plan has been successful when the client demonstrates which of the following? a) Pushes down on the grey release cap to administer the medication b) Maintains pressure on the auto-injector for about 30 seconds after insertion c) Avoids massaging the injection site after administration d) Jabs the autoinjector into the outer thigh at a 90-degree angle

d

In teaching clients with osteoarthritis about their condition, it would be important for the nurse to focus on: a) Detection of systemic complications b) DMARDs therapy c) Prevention of joint deformity d) Strategies for remaining active

d

Which nursing diagnosis is least appropriate for the client with rheumatoid arthritis? a) Deficient knowledge: symptom management b) Impaired physical mobility c) Chronic pain d) Imbalanced nutrition: greater than body requirements

d

Which of the following disorders is characterized by an increased autoantibody production? a) Scleroderma b) Rheumatoid arthritis (RA) c) Polymyalgia rheumatic d) Systemic lupus erythematosus (SLE)

d

Which of the following is the most common cause for a patient to seek medical attention for arthritis? a) Stiffness b) Weakness c) Joint swelling d) Pain

d

Which of the following newer pharmacological therapies, used for the treatment of osteoarthritis, is thought to improve cartilage function and retard degradation as well as have some anti-inflammatory effects? a) Capsaicin b) Chondroitin c) Glucosamine d) Viscosupplementation

d

Which of the following statements is accurate regarding osteoarthritis? a) It is the most common inflammatory arthritic disorder. b) It is caused by an overproduction of uric acid. c) It affects young males. d) It is a noninflammatory disorder and the most common and frequently disabling of joint disorders.

d

While interviewing a client with an allergic disorder, the client tells the nurse that he is allergic to animal dander. The nurse interprets this substance as which of the following? a) Chemical mediator b) T-lymphocyte c) Immunoglobulin d) Complete protein antigen

d

Virus infections have proved difficult to treat because they have a protein coat. inject themselves into human cells to survive and to reproduce. are bits of RNA or DNA. easily resist drug therapy.

inject themselves into human cells to survive and to reproduce

Nursing interventions for the patient receiving antiviral drugs for the treatment of HIV probably would include monitoring renal and hepatic function periodically during therapy. administering the drugs just once a day to increase drug effectiveness. encouraging the patient to avoid eating if GI upset is severe. stopping the drugs and notifying the prescriber if severe rash occurs.

monitoring renal and hepatic function periodically during therapy.

A nurse might not see a salicylate used as an anti-inflammatory if a drug was needed for its antipyretic properties. analgesic properties. over the counter (OTC) availability. parenteral availability.

parenteral availability.

The nonsteroidal anti-inflammatory drugs (NSAIDs) affect the cyclooxygenase-1 (COX-1) and COX-2 enzymes. By blocking COX-2 enzymes, the NSAIDs block inflammation and the signs and symptoms of inflammation at the site of injury or trauma.By blocking COX-1 enzymes, these drugs block fever regulation. prostaglandins that protect the stomach lining. swelling in the periphery. liver function.

prostaglandins that protect the stomach lining.

A nurse is visiting the home of a client with atopic dermatitis. Which of the following suggestions for the client would be appropriate? Select all that apply. a) Keep the room temperature at approximately 70 degrees Farenheit. b) Humidify the home when the heat is on during the winter. c) Use a strong antibacterial detergent for the laundry. d) Apply topical moisturizers to the skin. e) Wear clothing made from synthetic fabrics.

a,b,d

Which of the following would be consistent with the diagnosis of rheumatoid arthritis? a) Decreased ESR b) Cloudy synovial fluid c) Increased C4 complement component d) Increased red blood cell count

b

Maximum intensity of histamine occurs within which time frame following antigen contact? a) 5 minutes b) 45 minutes c) 30 minutes d) 15 minutes

d

Which of the following body substances causes increased gastric secretion, dilation of capillaries, and constriction of the bronchial smooth muscle? a) Histamine b) Prostaglandin c) Bradykinin d) Serotonin

a

Which of the following disorders is characterized by a butterfly-shaped rash across the bridge of the nose and cheeks? a) Systemic lupus erythematous (SLE) b) Polymyositis c) Rheumatoid arthritis d) Scleroderma

a

Which of the following is a contraindication for immunotherapy? a) Use of a beta-blocker b) Conjunctivitis c) Allergic rhinitis d) Allergic asthma

a

The client with rheumatoid arthritis is seen in the clinic. Which assessment finding indicates the client is having difficulty implementing self-care? a) Shows a weight gain of 2 pounds b) Reports ability to perform ADLs c) Reports increased fatigue d) Reports decreased joint pain

c

The nurse is teaching a patient about her rheumatic disease. What statement best helps to explain "autoimmunity"? a) "You have antigens to the disease, but it they do not prevent the disease." b) "You have inherited your parent's immunity to the disease." c) "Your symptoms are a result of your body attacking itself." d) "You are not immune to the disease causing the symptoms."

c

The client asks the nurse about types of exercise that do not stress the joints. Which of the following would be an inappropriate type of exercise for the nurse to include in the teaching plan? a) Pilates b) Yoga c) T'ai chi d) Jogging

d

The nurse working in an allergy clinic is preparing to administer skin testing to a patient. Which of the following routes is the safest for the nurse to use to administer the solution? a) Subcutaneous b) Intravenous c) Intramuscular d) Intradermal

d

A client has had skin testing and the results are inconclusive. The nurse would expect to prepare the client for which type of testing? a) Serum immunoglobulin E levels b) Eosinophil count c) Complete blood count with differential d) Radioallergosorbent test

d

Naturally occurring substances that are released in the body in response to viral invasion are called antibodies. immunoglobulins. interferons. interleukins.

interferons.

The nurse is working with a colleague who has a delayed hypersensitivity (type IV) allergic reaction to latex. Which of the following statements describes the clinical manifestations of this reaction? a) Symptoms occur within minutes after exposure to latex. b) Symptoms worsen when hand lotion is applied before donning latex gloves. c) Symptoms are localized to the area of exposure, usually the back of the hands. d) Symptoms can be eliminated by changing glove brands.

c

Which nursing diagnosis is least appropriate for the client with rheumatoid arthritis? a) Chronic pain b) Impaired physical mobility c) Imbalanced nutrition: greater than body requirements d) Deficient knowledge: symptom management

c

Which of the following clinical manifestations would the nurse expect to find in a client who has had rheumatoid arthritis for several years? a) Bouchard's nodes b) Asymmetric joint involvement c) Small joint involvement d) Obesity

c

An antipyretic is a drug that can block pain. block swelling. block fever. block inflammation.

block fever

Which of the following aid in diagnosing the risk of anaphylaxis? a) Punch biopsy b) Nasal smear c) Peripheral blood smears d) Intradermal testing

d

Atopic dermatitis is considered which type of hypersensitivity disorder? a) I b) II c) IV d) III

a

A nurse is reviewing the dietary history of a client who has experienced anaphylaxis. Which of the following would the nurse identify as a common cause of anaplhylaxis? Select all that apply? a) Milk b) Shrimp c) Eggs d) Chicken e) Beef

a, b, c

A nurse is preparing a presentation to a local commununity group about allergic disorders. Which medication would the nurse include as the most common cause of anaphylaxis? a) Iodine contrast agent b) Penicillin c) Morphine d) Aspirin

b

The nurse is conducting an initial assessment of a hospitalized patient who states that he has a latex allergy. The nurse notes that the skin of the patient's hands is dry, thick, and cracked. The nurse documents the patient's reaction to latex as which of the following factors? a) Latex hyperplasia b) Irritant contact dermatitis c) Latex allergy d) Allergic contact dermatitis

b

Patients taking NSAIDs should be taught to avoid the use of OTC medications without checking with their prescriber because many of the OTC preparations contain NSAIDs, and inadvertent toxicity could occur. no one should take more than one type of pain reliever at a time. increased gastrointestinal upset could occur. there is a risk of Reye syndrome.

many of the OTC preparations contain NSAIDs, and inadvertent toxicity could occur.

A drug could be classified as an analgesic if it reduces fever. reduces swelling. reduces redness. reduces pain.

reduces pain.

Chronic or excessive activity by the inflammatory response can lead to loss of white blood cells. coagulation problems. release of lysosomal enzymes and tissue destruction. adrenal suppression.

release of lysosomal enzymes and tissue destruction

Your patient has been receiving ibuprofen for many years to relieve the pain of osteoarthritis. Assessment of the patient should include an electrocardiogram. complete blood count with differential. respiratory auscultation. renal evaluation.

renal evaluation.

A patient with rheumatoid arthritis who is on a fixed income and who is being treated with aspirin should be advised to use only brand-name aspirin. to use only enteric-coated aspirin. to use generic aspirin. to switch to one of the NSAIDs.

to use generic aspirin.

Which of the following points should be included in the medication-teaching plan for a patient taking adalimumab (Humira)? a) It is important to monitor for injection site reactions. b) The medication is administered IM. c) The medication is given at room temperature. d) The patient should continue taking the medication if fever occurs.

a

When explaining to a client the reasoning behind using combination therapy in the treatment of HIV, the nurse would include which of the following points? a The virus can remain dormant within the T cell for a very long time; they can mutate while in the T cell. b Adverse effects of many of the drugs used to treat this virus include immunosuppression, so the disease could become worse c The drugs are cheaper if used in combination. d The virus slowly mutates with each generation. e Attacking the virus at many points in its life cycle has been shown to be most effective. f Research has shown that using only one type of drug that targeted only one point in the virus life cycle led to more mutations and more difficulty in controlling the disease.

a, d, e, f

Appropriate nursing diagnoses related to the drug therapy for a patient receiving combination antiviral therapy for the treatment of HIV infection would include the following: a Disturbed Sensory Perception (Kinesthetic) related to the CNS effects of the drugs. b Imbalanced Nutrition: More Than Body Requirements related to appetite stimulation. c Heart Failure related to cardiac effects of the drugs. d Adrenal Insufficiency related to endocrine effects of the drugs. e Acute Pain related to GI, CNS, or dermatological effects of the drugs. f Deficient Knowledge regarding drug therapy.

a,e, f

The nurse working in the ED is asked to explain allergy testing to a patient who experienced an allergic reaction to an unknown allergen. Which test indicates the quantity of allergen necessary to evoke an allergic reaction? a) Provocative testing b) Radioallergosorbent testing (RAST) c) Intradermal test d) Scratch test

b

When evaluating a client's knowledge about use of antihistamines, which of the following statements made by the patient would indicate to the nurse a knowledge deficit? a) "I should be careful when driving." b) "If I am pregnant, I should take half the dose." c) "Hard candy will relieve my dry mouth." d) "This medication may be taken with food."

b

Which of the following interventions is the single most important aspect for the patient at risk for anaphylaxis? a) Desensitization b) Prevention c) Wearing of medical alert bracelet d) Use of antihistamines

b

A patient is having an anaphylactic reaction. The patient is hypotensive and does not respond to vasopressors. Which of the following medications may be given for its acute inotropic and chronotropic effects? a) Epinephrine b) Lasix c) Glucagon d) Albumin

c

The best treatment for latex allergy includes which of the following? a) Antihistamines b) Emergency kit with epinephrine c) Avoidance of latex-based products d) Corticosteroids

c

Which of the following are usually the first choice in the treatment of rheumatoid arthritis (RA)? a) Glucocorticoids b) Tumor necrosis factor (TNF) blockers c) Nonsteroidal anti-inflammatory drugs (NSAIDs) d) Disease-modifying antirheumatic drugs (DMARDS)

c

The nurse notes an order for oxaprozin (Daypro) for the treatment of arthritis. Before administering the drug, the nurse would assess the patient for which problems that could be cautions or contraindications? a Headaches b Dysmenorrhea c Active peptic ulcer disease d Chronic obstructive pulmonary disease e Renal impairment f Bleeding disorders

c, e, f

The client with osteoarthritis is seen in the clinic. Which assessment finding indicates the client is having difficulty implementing self-care? a) Reports ability to perform ADLs b) Shows increased joint flexibility c) Reports decreased joint pain d) Has a weight gain of 5 pounds

d

The nurse is evaluating a patient's complete blood cell count and differential (CBC and diff) along with the serum immunoglobulin E (IgE) level. Which of the following results might indicate that the patient has an allergic disorder? a) Low eosinophil level b) Low white blood cells c) High neutrophils d) High IgE level

d

The nurse is teaching the client newly diagnosed with systemic lupus erythematous about the condition. Which statement by the client indicates teaching was effective? a) "My energy level will gradually increase over time." b) "I do not need to make any changes in my diet." c) "My medications will ultimately correct my problem." d) "I should avoid prolonged sun exposure."

d