PrepU misc 1
The nurse working at a community clinic is caring for a young male client. The client asks the nurse if he could get AIDS from being sprayed in the face with breast milk. Select the best response by the nurse.
"Breast milk can contain the virus that causes AIDS, but to be infected, the milk needs to be in contact with your mucous membranes or an open sore."
A client has been diagnosed with Coxiella burnetii infection. She asked the health care provider how she could have gotten this disease. The health care provider's best response is:
"Drinking contaminated milk."
Which of the following statements from a group of young adults demonstrates the need for further teaching related to HIV and prevention of the spread?
"Having oral sex is one way I can prevent passing on HIV to my partner."
In the context of a workshop on rheumatoid arthritis, a clinical educator is teaching a group of nurses about autoimmune diseases. Which of the following statements by an attendee would the educator most likely want to follow up with further teaching?
"Introduction of a foreign antigen can sometimes induce a cascade of immune response that is not self-limiting"
A nurse is teaching a group of clients about health promotion activities and lifestyle changes. A client tells the nurse he has smoked 2 packs of cigarettes a day for the last 4 years and has been told he is at risk for developing respiratory infections. The best response would be:
"Smoking can increase the risk of inhalation-acquired diseases."
A pregnant client who has HIV asks the nurse if her baby will have the disease. The best response would be:
"The baby will test positive for the HIV antibody test result, although the child may not necessarily be infected with the virus."
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."
Place the following in the sequence of the progression of HIV/AIDS on a cellular level. 1)The HIV virus is uncoded. 2)HIV attaches to the receptors on the CD4+ cell. 3)DNA synthesis occurs by reverse transcription. 4)Transcription of the DNA to form a single-strand messenger RNA.
2,1,3,4
Which of the following types of viral hepatitis is not associated with transmission through contact with infected blood?
A
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.
A client has been diagnosed with an abscess. Upon assessment of the client, the nurse would expect to find:
A localized pocket of infection composed of devitalized tissue, microorganisms, and the host's phagocytic white blood cells
The nurse is teaching a client infected with the flu about viruses. Which of the following would the nurse use to describe a viral infection?
A parasitic relationship between an organism and host is present.
A client comes to the physician's office after being bitten by a tic, with symptoms of headache, fatigue, joint pain and swelling. The physician determines which of the following as the mode of transmission for the infection?
A vector
Which of the following is a known trigger for many autoimmune disorders?
A viral infection
Sometimes the host's white blood cells are unable to eliminate the microorganism, but the body is able to contain the dissemination of the pathogen. What is this called?
Abscess
Which of the following statements about HIV/AIDS is true?
Accidental stick with a needle used on an HIV-infected patient carries little risk of infection.
Which of the following phenomena would be least likely to result in activation of the complement system?
Activation of toll-like receptors (TLRs) on complement proteins.
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
A client who has undergone a liver transplant 7 weeks ago has developed the following assessment data: ALT/AST elevation; jaundice of skin and sclera; weight gain with increase in abdominal circumference; and low-grade fever. The nurse suspects:
Acute graft rejection
An 81-year-old female patient in a subacute medical unit of a hospital has developed an oral Candida albicans infection. Which of the following phenomena would the patient's nurse suspect as a key contributing factor to her infection?
Antibiotic therapy that eliminated normal bacterial flora.
The cells that mediate humoral immunity do so because they are capable of producing:
Antibodies
The nurse is caring for a client with an infection of candida albicans. Which type of antimicrobial agent will the nurse plan to administer to effectively treat this disease?
Antifungal
Substances foreign to the host that can stimulate an immune response are known as:
Antigens
A child has experienced a "bee-sting" while at the park. The health care provider is walking by and notices the child has swelling around the eyes, lips, and face in general. What priority assessment should the nurse make at this time?
Assess and establish an open airway.
Select the type of lymphocyte that matures in the bone marrow.
B lymphocytes
Which of the following types of pneumonia listed below is best characterized by an infective agent that produces sputum samples with a peptidoglycan cell wall, expresses endotoxins, replicates readily in broth and on agar, grows in clusters, has pili, and does not stain when exposed to crystal violet?
Bacteria
Which one of the following statements about acquired immunodeficiency syndrome (AIDS) is true?
Both B-cell and T-cell function are affected.
A patient is brought to the emergency room with complaints of facial muscle paralysis and increasing upper extremity weakness several hours after eating canned peppers. Histologic examination reveals a bacterial infection and further testing reveals a decrease in the release of the neurotransmitter acetylcholine from cholinergic neurons. The nurse explains to the patient that which of the following is the most likely cause of this illness?
Botulism exotoxin
The human immunodeficiency virus (HIV) acts on which of the following types of cells?
CD4+ T lymphocytes
Which one of the following is an AIDS-defining condition?
CD4+ count less than 200 cells/microliter of blood
In providing education to a sexually active 22-year-old female, which of the following would be most beneficial to discuss to decrease her risk for contracting HIV?
Consistent use of latex condoms with sexual activity
Which of the following best describes the structure of a virus?
Consists of a capsid that surrounds a nucleic acid core
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
The nurse is caring for a pregnant woman who is infected with HIV. What is an important nursing intervention for this client?
Education about medication compliance
Which one of the following is found in the cell wall of gram negative bacteria?
Endotoxin
Which of the following is a cost-effective diagnostic method that is used as a screening test for HIV antibodies?
Enzyme-linked immunosorbent assay (ELISA)
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?
Epithelial
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.
A home health nurse is visiting an elderly client, who is exhibiting signs of an upper respiratory infection but denies contact with an infected person. The nurse evaluates the home and recommends air conditioner duct cleaning as a precautionary measure against which of the following pathogens?
Fungi
One week after a client received a transplant the nurse notes that the skin shows a maculopapular rash on the hands and feet. The client reports itching and nausea. What is the likely cause of these manifestations?
Graft versus host disease
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.
Escherichia coli (E. coli) produces an exotoxin called Shiga toxin that enters the body when you eat undercooked hamburger meat and fruit juices that are not pasteurized. What can E. coli infection cause?
Hemorrhagic colitis
A nurse, educating a client about disease transmission, learns that the client has received weekly manicures and pedicures in various commercial salons for many years. Which of the following diseases is the client at risk for due to improper sterilization of equipment used in the salons?
Hepatitis B
When explaining what is occurring when their child has an acute bronchial asthma attack, the nurse will emphasize that which mediator is primarily responsible for the bronchial constriction?
Histamine.
Which of the following immunoglobulins (Ig) is released in response to allergy or parasitic infections?
IgE
In a newborn, which antibody crosses the placenta to provide protection from infection?
IgG
Infants are born with a passive immunity that occurs when immunoglobulin antibodies cross the placenta from the maternal circulation prior to birth. Which immunoglobulin is capable of crossing the placenta?
IgG
Health care team members know recently an increased incidence of infections such as West Nile virus and SARS do not match previously established patterns. Which of the following phenomena constitutes the most significant contributor to the spread of new diseases in the United States?
Individual and group increased ease and speed of travel
The nurse is teaching a new mother about caring for her baby and reducing the risk for infection. On which of the following does the nurse base the knowledge of passive immunity?
Infants are protected at birth from infection by maternal IgG.
A fomite is which one of the following?
Infection transfer agent
For HIV to reproduce in the human body, which of the following processes must occur?
It must change its RNA into DNA.
Which of the following is a characteristic finding in AIDS?
Kaposi sarcoma
A 36-year-old male who is positive for HIV antibodies notices purplish spots on his upper body. Which of the following terms is used to identify these areas as an opportunistic infection?
Kaposi's sarcoma
Which one of the following is often found in a patient with AIDS?
Kaposi's sarcoma
Which of the following is a characteristic indicator that an individual is in the latent phase of HIV?
Lack of symptoms
Manifestations of Kaposi sarcoma include which of the following?
Lesions of the skin and in the oral cavity, gastrointestinal tract, and lungs
A nurse is teaching a prenatal group about the benefits of breastfeeding. The nurse determines teaching has been effective based on which of the following statements?
Maternal IgA from colostrum provides immunity through the mucosal membranes for the intestinal system.
A client has developed a type 1 hypersensitivity reaction. The nurse recognizes that a secondary or late-phase response:
May occur 2 to 8 hours after the primary or initial-phase response and lasts for several days
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 nurse is caring for an adult patient who had the thymus gland removed. Which of the following immune responses is expected to be activated?
No change in immunity
Typical symptoms seen in the latent period of HIV infection include which of the following?
No signs or symptoms
A entry on a client's health record documents that she has a subclinical infection. Which of the following assessments would the nurse expect to find?
No systemic manifestations of disease
Which one of the following is a common opportunistic infection in patients who have AIDS?
Pneumocystis jiroveci
The results of recent research suggest that a key role in the origin of some diseases is played by inflammation. For which of these diseases is it thought that inflammation has a role in its beginnings?
Rheumatoid arthritis
The infectious agents that cause Rocky Mountain spotted fever and epidemic typhus are transmitted to the human body via vector such as a tick. What are these infectious agents?
Rickettsiae
What instruction will the nurse provide to a client with a new diagnosis of anaphylactic reaction to peanuts?
Routinely wear medical alert identification.
The mother of an infant born with profound mental retardation and hearing loss tells the nurse that she had a viral infection in the first trimester of her pregnancy. The nurse identifies which of the following congenital infections as the cause of the fetal defects?
Rubella
A health care provider is providing information to a client about ectoparasites. The most prominent human ectoparasite would be:
Scabies
Which is a complication of infection in which pathogens gain access to the blood?
Septicemia
A systemic immune complex disorder that is caused by insoluble antigen-antibody complexes being deposited in blood vessels, the joints, the heart, or kidney tissue is called what?
Serum sickness
The first physical line of defense in innate immunity is:
Skin and mucous membranes
Antinuclear antibodies are characteristic of which one of the following?
Systemic lupus erythematosus
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 client is ordered to receive a quinolone, ciprofloxacin (Cipro), to treat a bacterial infection. The nurse instructs the client to monitor for which potentially dangerous side effect associated with quinolone therapy?
Tendon rupture
Which of the following distinguishes a primary immunodeficiency disorder versus another disorder?
The are inherited abnormalities of immune function that render a person susceptible to diseases normally prevented by an intact immune system.
The treatment prescribed for an autoimmune disorder is primarily dependent upon what?
The current manifestations of the disease and the mechanisms that cause the disease process
Which HIV test is the most accurate in determining the presence of HIV antibodies and is the least expensive?
The enzyme-linked immunosorbent assay (ELISA)
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
One of the self-regulatory actions of the immune system is to identify self-antigens and be nonreactive to them. What is this ability of the immune system defined as?
Tolerance
In the United States, the most common opportunistic infection in people with HIV/AIDS infections is respiratory infection. When the CD4+ level drops below 200 cells/μL, it is time to start prophylaxis. What is the drug of choice for prophylaxis?
Trimethoprim-sulfamethoxazole
What is the leading cause of death for persons with HIV infection worldwide?
Tuberculosis
The type of hypersensitivity reaction that is dependent on IgE-mediated activation of mast cells and basophils and the subsequent release of chemical mediators of the inflammatory response is known as which of the following types of hypersensitivity reaction?
Type I
The type of hypersensitivity reaction that is mediated by IgG or IgM antibodies directed against target antigens on specific host cell surfaces or tissues is also known as which of the following types of hypersensitivity reaction?
Type II
A client has developed a hypersensitivity reaction resulting in the formation and deposition of insoluble antigen-antibody complexes that cause serum sickness and acute glomerulonephritis. The nurse would document this as:
Type III hypersensitivity reaction
Global infectious diseases are now being recognized. These diseases, known as endemic to one part of the world, are now being found in other parts of the world because of international travel and a global marketplace. Which of the following is considered a global infectious disease?
West Nile virus
The nurse is caring for a client who has lesions of Kaposi sarcoma (KS). The nurse understands that KS:
is a malignancy of the endothelial cells that line small blood vessels.
The bacteria that line the gut of a human help maintain normal gut health and provide essential nutrients. This type of relationship is:
mutualistic
The nurse knows which of the following statements listed below relative to a client with malignant melanoma treated with Alpha interferon (IFN-α) is accurate? Alpha interferon (IFN-α):
plays an important role in the modulation of the inflammatory response.
The nurse is reviewing the client's medical record for the results of a Western blot test with the understanding that:
the Western blot is used to confirm a diagnosis of HIV infection.
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.
The nurse understands that the best way for a health care worker to protect against the transmission of HIV is to:
use universal precautions on all clients.
The nurse is caring for a client who has just been diagnosed with AIDS. The client asks the nurse, "How long will I live?" Which of the following is an appropriate response by the nurse?
"AIDS is considered to be a chronic illness today."
The nurse is preparing to administer a unit of blood to a client. The client says that he is not sure he wants to give consent to receive the blood transfusion because he does not want to get AIDS from the blood. Select the best response from the nurse.
"All blood is now tested for the AIDS virus, so the risk of getting AIDS from a blood transfusion is extremely low."
When a patient who has been newly diagnosed with HIV asks, "What are the chances that I can be cured," which of the following is the nurse's most therapeutic response?
"Although there is no current treatment that provides a possible cure, there are ones that have successfully managed the infection."
A mother brings her 5-month-old infant to the pediatrician for recurrent colds. The mother has never breastfed and the infant is fed iron-fortified formula. The mother asks, "My baby has been perfectly healthy up until last month--now it seems like she has been sick constantly. Why?" How should the physician respond?
"An infant gets immunity from the mother at birth and from breast milk; this provides protection from infection but wears off in approximately 3 to 6 months. An infant still needs time for his own immune system to mature."
Members of an AIDS support group who have more advanced cases are sharing some of their recent health problems with a member who has just been diagnosed. Which of the members' statements is most accurate?
"As people with HIV live longer, more of us are eventually succumbing to the cancers that are associated with HIV"
A nurse is instructing a client on the long-term use of antibiotics and antibiotic resistance. Which of the following statements by the client indicates that the teaching has been successful?
"Bacterial resistance to antibiotics can occur due to genetic mutations."
A patient diagnosed with H pylori asks the nurse, "How an infection can occur in their stomach since it is an acid environment?" The nurse responds:
"H. pylori produces an enzyme called urease that converts gastric juices into ammonia which neutralizes the acidic stomach environment."
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."
The employee health nurse is working with a nursing student who has just sustained a needlestick injury and has received a dose of hepatitis B immune globulin. The nurse is counseling the student about vaccination against hepatitis B. Which statement by the student indicates understanding?
"I need to start the hepatitis B vaccination series as soon as possible."
A nurse is teaching parents of a child with scarlet fever. Which of the following statements indicates that the parents understand the treatment for the child?
"I will give the antibiotic for the full 10 days."
A nurse is teaching a parent group about the importance of regular childhood vaccines. The nurse evaluates that the teaching is successful based on which of the following statements?
"I will have my baby vaccinated as scheduled to reduce the senseless spread of vaccine-preventable illnesses."
The nurse is teaching a group of college students about reducing the risk of HIV transmission during sexual relations. The nurse makes which of the following appropriate teaching points?
"If a person has a sexually transmitted disease (STD), there is an increased risk for HIV infection."
The nurse is caring for a client who has been told that he is HIV infected. The client asks the nurse, "Can my partner and I ever have sex again?" Which of the following is an appropriate response by the nurse?
"If you use latex condoms with water-soluble lubricant consistently, sex is safer, but not completely risk free."
The nurse is administering a childhood vaccine to a pediatric client. The mother asks the nurse why the child needs so many vaccinations. How should the nurse respond?
"Immunization is an important means of inhibiting the spread of infection by decreasing your child's susceptibility to the infection."
A 60-year-old male client with an acute viral infection is receiving interferon therapy. The physician is teaching the family of the client about the diverse actions of the treatment and the ways that it differs from other anti-infective therapies. Which of the following teaching points listed below should the physician least likely include?
"Interferon can bolster your father's immune system through the stimulation of natural killer cells that attack viruses."
As part of her prenatal education, a 29 year-old woman who is pregnant with her first child is receiving teaching from her primary care provider. Which of the following statements by the woman reflects an accurate understanding of HIV transmission?
"It's discouraging to know that my breast milk can pass on HIV to my baby."
A nurse is teaching a new mother diagnosed with HIV about the transfer of the infection to her newborn. The mother begins to cry and states, "It's too late, the lab tests on my baby are already positive for HIV." How should the nurse respond?
"Just because the test is positive for HIV does not mean your baby is infected with the virus."
The physician knows the client, G1P0 has correctly understood the prenatal education regarding sexually transmitted infection as evidenced by which of the following statements listed below?
"My baby could become infected either across the placenta or during the birth itself."
A client who was exposed to hepatitis A at a local restaurant has recovered from the disease. At her annual physical, the client asks the health care provider if she should go to her health department and get the hepatitis A "shot." The best response, based on the concepts of adaptive immunity, by the health care provider would be:
"No, since having an active case, you have already developed antigens against hepatitis A."
A client is very much concerned about the harmful effect that all microorganisms may have. The best response by the nurse would be:
"Not all interactions between microorganisms and humans are detrimental."
An 8-week-old boy has been recently diagnosed with a severe combined immunodeficiency (SCID). His parents have performed a significant amount of research on the Internet and have brought a large amount of material to discuss with their care provider. Which of the following statements best reflects an accurate understanding of their son's health situation?
"Our son likely has a deficiency of B-lymphocytes and can't produce antibodies."
A patient who was tested for HIV received a positive result from the enzyme-linked immunosorbent assay (ELISA) followed by a negative Western blot test asks the nurse what this means. Which of the following is the nurse's best response?
"The ELISA test gives some false positives, but the Western blot confirms you don't have HIV."
A college student has been called into the student health office because she tested positive for HIV on the enzyme-linked immunosorbent assay (ELISA). The student asks, "What is this Western blot assay going to tell you?" The best response by the health care provider is:
"The Western blot is a more sensitive assay that looks for the presence of antibodies to specific viral antigens."
A client stepped on a nail at work. The emergency room physician prescribes a tetanus "booster" shot. The client asks the nurse, "If I have already been vaccinated for tetanus why do I need to have another shot?" How should the nurse respond?
"The booster shot will stimulate your immune system's memory, causing an immediate rise in antibodies to protect you from an infection."
The nurse knows which of the following statements below is appropriate to be included in an education session for a 21-year-old male with a diagnosis of malaria?
"The infectious organisms are considered tiny, single-celled animals, given their complete eukaryotic machinery."
A patient was recently diagnosed with acquired immunodeficiency syndrome (AIDS) and started on antiviral therapy. The nurse evaluates the patient's understanding of the antiviral drug when the patient correctly identifies which of the following as the pharmacological mechanism of action?
"The primary target of most antiviral compounds is viral RNA or DNA synthesis."
A potential donor is angry at the personal nature of the questions about HIV risk factors that he is required to answer at a blood collection center, and states that simple blood testing should suffice. How can the nurse at the center best respond?
"There's a period shortly after someone is infected with HIV when blood tests might still be negative."
A sixth grade science teacher asks the students to explain the role of cilia in the lower respiratory tract. Which student response is the best?
"These little hairs move germs trapped in mucous toward the throat so the body can cough them out."
A school nurse is teaching high school students about HIV and AIDS in the context of the school's sexual health curriculum. Which of the students' following statements would the nurse most likely want to correct or clarify?
"They have to take a blood sample from you in order to test you for AIDS."
A 5-year-old child is experiencing itchy, watery eyes and an increased respiratory rate with some inspiratory wheezes. He has been outside playing in the yard and trees. The mother asks, "Why does he get like this?" The health care worker's best response is:
"This is what we call a type I hypersensitivity reaction and usually occurs a few minutes after exposure to his allergen. It is primarily caused by mast cells in his body."
A client has been diagnosed with herpes simplex virus. The client states that, "modern medicine produces more and more antivirals every year and so the treatment should be simple." Which of the following statements listed below is the best response?
"Treatment options for viruses are often limited because what destroys viruses often damages your own body cells."
A client tells the health care provider he has heard several myths about viruses. The most appropriate information for the nurse to provide would be:
"Viruses can produce symptoms of disease months to years later."
The nurse is caring for a client who has just learned that he is HIV positive. The client asks the nurse how long he has been able to infect others. Select the best response by the nurse.
"You can infect others before the HIV antibody is detectable in your blood."
A client called the physician's office with symptoms of the common cold. The nurse educates the client on supportive treatment for symptoms and explains that the body's immune system is fighting the virus but will take approximately how long for a response?
1-2 weeks
What is the minimum number of antiretroviral medications used in highly active antiretroviral therapy (HAART) (also known as combined antiretroviral therapy (CAR)?
3
The nurse observes dark, foul-smelling, blood-tinged urine from a client who recently had a bowel resection. The client is diagnosed with a urinary tract infection. The nurse explains that this infection most likely caused by which of the following?
A nosocomial infection
Which of the following patients has the highest risk of contracting an opportunistic infection?
A patient who has had HIV for 3 years and has a CD4+ count of 50 cells/μL
When counseling a male patient with suspected HIV, the nurse informs him that if the enzyme-linked immunosorbent assay (ELISA) come back positive, then:
A second test known as the Western blot assay will be ordered to confirm positive HIV status.
An immunocompromised client is exposed to varicella (chicken pox virus). The client has not had the varicella vaccine and has never had the disease. What intervention should the nurse anticipate to prevent this client from developing varicella?
Administer varicella zoster immune globulin (VZIG).
An infant is suspected of having a severe combined T- and B-cell immunodeficiency disorder. Which of the following effects on the infant makes early detection a priority?
Administering live attenuated virus vaccines can be fatal.
Which of the following would be the best treatment option to prevent perinatal transmission of HIV antibodies to a fetus from the HIV-positive mother?
Administration of zidovudine to the mother during pregnancy, labor, and delivery
In reference to infectious disease, a patient cannot be which one of the following?
Agent
A client presents to the Urgent Care with erythematous, papular, and vesicular lesions associated with intense pruritus and weeping. The client states he was in the woods and thinks he may have come in contact with poison ivy .The reaction may be classified as:
Allergic contact dermatitis
A patient will be receiving a bone graft from an unrelated individual. Which of the following types of graft does the nurse inform the patient that he or she will be receiving?
Allograft
Which one of the following is a protozoan infection?
Amebic dysentery
Which of the following clients is at the greatest risk for developing an intracellular pathogen infection?
An AIDS client with a decreased CD4+ TH1 count
The ingestion of a Shiga toxin produced by Escherichia coli O157:H7 can cause a sometimes fatal illness called hemolytic-uremic syndrome (HUS). Select the client at highest risk.
An individual who consumed undercooked hamburger during a backyard barbecue
Which is not correct about an opportunistic infection?
An opportunistic infection primarily affects a host with a normal immunity.
Some members of the population are so sensitive to certain antigens that they react within minutes by developing itching, hives, and skin erythema, followed shortly thereafter by bronchospasm and respiratory distress. What is this near immediate reaction commonly known as?
Anaphylactic reaction
A patient with common variable immunodeficiency (CVID) who is also deficient in IgA is being treated with IV immunoglobulin (IV Ig) in the hospital. For which of the following should the nurse closely monitor the client during treatment?
Anaphylaxis
Select the statement that best describes autoimmune disease.
Autoimmune diseases represent a disruption in self-tolerance that results in damage to body tissues by the immune system.
Which of the following types of a hypersensitivity reaction involves failure of the development of self-tolerance?
Autoimmune reaction
A client is taking a vacation in a foreign country. The nurse teaches the client about giardiasis, a common traveler's infection. Which of the following statements should be included in the teaching plan?
Avoid eating food and drinking beverages that might be contaminated.
Select the statement that best describes the cause of antibiotic resistance.
Bacteria that harbor plasmids increase their resistance to antibiotics.
Staphylococcus aureus commonly found in the skin, nares, and other body sites of patients without any signs and symptoms of infection is known as which of the following conditions listed below?
Bacterial colonization.
Which of the following statements about opportunistic pathogen infection in AIDS is true?
Becoming infected with an opportunistic pathogen is one requirement for the diagnosis of AIDS.
A diagnosis of acquired immunodeficiency syndrome (AIDS) is identified when the CD4+ T cell count reaches which level?
Below 200 cells/μL
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
An infectious disease nurse is researching T cells to determine which cells control replication of intracellular bacteria. Which of the following cells should the nurse begin investigating?
CD8 cells
A patient has been diagnosed with Hodgkin's disease after a series of diagnostic tests. This condition would be related to which of the following immunodeficiencies?
Cellular (T cell)
The nurse will most likely assess which of the following clinical manifestations in a client was diagnosed with Creutzfeldt-Jakob disease?
Change in behavior and memory, loss of coordination leading to encephalopathy.
A patient tells the nurse that the primary care provider prescribed an antibiotic. The patient was instructed to take the antibiotic three times a day for ten days. After the 4th day, the patient was feeling much better and decided to stop taking the medication. What complication could result from stopping the antibiotic early?
Chronic infection
A client with end-stage renal disease received a kidney transplant with a kidney donated by a family member. The client has been carefully monitored for signs of rejection. The physician informs the client that there has been a gradual rise in the serum creatinine over the last 5 months. What type of rejection does this depict?
Chronic rejection
A client develops a ruptured tendon after taking an antibiotic for an infection. Which antibiotic prescription would the nurse checking the history expect to find?
Ciprofloxacin (Cipro)
Of the pathways available to recognize microbes and activate the complement system, which one requires the presence of an antibody?
Classical
All antiretroviral medications interfere with some stage of the HIV life cycle. What stage do protease inhibitors prevent?
Cleavage of the polyprotein chain into the individual proteins that will be used to make new virus
Which description does the nurse recognize fits a client in the prodromal stage of an infection?
Client is experiencing vague symptoms of fatigue and low grade fever.
A patient is suspected of having a T-cell immunodeficiency. Which of the following procedures will help diagnose this disorder?
Clinical presentation and family history
Which one of the following relates to bacterial shape?
Cocci
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
A patient receiving chemotherapy has a leukopenia. Which of the following types of medication would promote long-term improvement in the patient's immune response?
Colony-stimulating factor (CSF)
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 is providing care for a 17-year-old boy who has experienced recurrent sinus and chest infections throughout his life and presently has enlarged tonsils and lymph nodes. Blood work indicated normal levels of B cells and free immunoglobins but a lack of differentiation into normal plasma cells. The boy is currently receiving intravenous immunoglobulin (IVIG) therapy. What is the boy's most likely diagnosis?
Common variable immunodeficiency
A client suspects they may have developed an allergic response to latex. What most common allergic response would the nurse expect to find?
Contact dermatitis
A hospitalized client's progress has been noted as the convalescent stage. Select the statement that best describes this stage.
Containment of infection, progressive elimination of the pathogen, repair of damaged tissue, and resolution of associated symptoms
A patient is diagnosed with a mild case of an autoimmune disorder and is beginning a treatment regimen. Which of the following is the mainstay of treatment with an autoimmune disorder?
Corticosteroids and immunosuppressants
Which cells bind with MHC class I molecules?
Cytotoxic T cells
Which of the types of T cells is responsible for destroying pathogens by punching holes in their cell membrane and by secreting cytokines/lymphokines?
Cytotoxic T cells
The nurse has just administered a Mantoux test to a client. Select the reaction that best describes the anticipated response.
Delayed-type hypersensitivity
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.
A number of fungi, such as ringworm, athlete's foot, and jock itch, are incapable of growing at a core body temperature. Hence, their infection is limited to cooler cutaneous surfaces. What are these pathogens known as?
Dermatophytes
A woman complains to the nurse that she has developed a yeast infection. The woman does not understand how she could get a yeast infection since she has been on antibiotics for a urinary tract infection. What is the rationale for this patient's complaint?
Destroying one type of resident flora (bacteria) can allow over proliferation of another competing type (yeast).
Primary cell-mediated disorders of the immune system cause severe problems with infections. Children with these disorders rarely survive beyond childhood without a bone marrow transplant. Which of the following is a disease that involves primary cell-mediated disorders of the immune system?
DiGeorge syndrome
The spirochete, leptospires is primarily transmitted to farmers by:
Direct contact with infected animals.
A public health nurse notes an increase in regional throat cancer cases. Upon epidemiological studies, many of the throat cancer clients also had oral exposure to human papillomavirus (HPV). This exposure to HPV would be considered by:
Direct contact with infected secretions
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.
A nurse is providing care for a client who is immunocompromised following chemotherapy. The nurse knows which of the following characterizations of the adaptive immune system listed below is responsible for the client's disruption in their normal immune function?
Epitopes on antigens are recognized by immunoglobulin receptors following presentation by accessory cells.
A family consumed some undercooked hamburger at a picnic and has since developed bloody diarrhea. The nurse knows which of the following statements listed below is correct regarding the infectious process?
Exotoxins that damage vascular endothelial causing bleeding and low platelet counts.
Elderly persons who are immunized have the same effective response in immunity as younger persons do.
False
The nurse is teaching a male client who has been diagnosed as HIV positive. The client asks what precautions he should take to prevent his family members from contracting HIV. Which of the following statements will the nurse include in teaching this client?
Family members should not come in contact with your blood.
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 specific type of gram-negative bacteria contains endotoxin in the bacterial cell envelope. What is the likely clinical manifestation if these bacteria become pathogenic?
Fever
The nurse is assessing a client diagnosed with varicella. The nurse is aware that nonspecific manifestations may include:
Fever
After several months on a waiting list, a 44-year-old male received a liver transplant 5 days ago. In the last 36 hours, he has developed a rash beginning on his palms and soles, along with abdominal pain and nausea. It has been determined by his care team that the immune response that is causing his symptoms originates not with his own compromised immune components but with those introduced with his new organ. This man's most likely medical diagnosis is:
Graft-versus-host-disease (GVHD)
The bacteriologist is staining the slides of a client diagnosed with scarlet fever and rheumatic fever. The slide identifies S. pyogenes and stains purple by crystal violet dye. The result would indicate:
Gram-positive organism
A client is experiencing a decrease in the number of circulating neutrophils (neutropenia) during an active bacterial infection. The nurse examines the client's lab results looking for which of the following cytokines, that is responsible for promoting growth and maturation of neutrophils during inflammatory reactions?
Granulocyte CSF (G-CSF)
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)
While explaining evasive factors by microbes to evade various components of the host's immune system, the instructor uses which of the following examples?
H. Pylori being able to survive in an acidic environment
The treatment of HIV/AIDS is complicated because different drugs act on different stages of the replication cycle of the virus. Therefore, treatment includes combinations of two, three, or more drugs. What is this treatment called?
HAART treatment
Which of the following would be considered an example of transmitting an infection from person-to-person through shared inanimate objects (fomites)?
HIV from a contaminated IV drug user needle
While teaching about HIV/AIDS to a group of high school seniors, the school health nurse will begin by explaining the basic facts which will likely include which of the following information?
HIV is different from other viruses since it is a retrovirus that selectively attacks the body's immune cells.
Which of the following serves as recognition markers to aid in self-tolerance?
HLA antigens encoded by MHC genes
A male elementary school student has a severe allergy to peanuts and is displaying the signs of anaphylactic shock after inadvertently eating a peanut-containing candy bar. Which of the following statements best captures the boy's current status and preferred treatment?
He is approaching vascular shock and developing edema due to actions of IgE antibodies, situations that can be reversed by administration of epinephrine.
Which one of the following organisms causes peptic ulcers?
Helicobacter pylori
Which of the following infectious agents listed below would be a site-specific pathogen and not spread throughout the body via the circulatory system? Patient diagnosed with:
Helicobacter pylori diagnosed after an endoscopic procedure.
A 39 year-old female with has been characterized as a typical progressor by her care team, and is experiencing an increase in her manifestations and health complaints as her CD4+ count declines. Which of the following health problems would her care team most likely attribute to a cause other than her HIV?
Her decreased bone density and recent fractures.
A patient has symptoms of an atopic reaction. Which of the following clinical manifestations would the nurse expect the patient to display? (Select all that apply.)
Hives Allergic rhinitis Atopic dermatitis
A patient with end-stage kidney disease is receiving a kidney donated by a family member. When caring for this patient, what does the nurse know is the major target involved in organ transplant rejection?
Human leukocyte antigens (HLAs)
An essential property of the immune system is self-regulation. An immune response that is not adequate can lead to immunodeficiency, while an immune response that is excessive can lead to conditions from allergic responses all the way to autoimmune diseases. Which of these is not an example of a breakdown of the self-regulation of the immune system?
Huntington disease
A client is suffering from the effects of the opportunistic infection, Cryptosporidium parvum. An important nursing intervention would be to encourage which of the following?
Hydration
The surgeon is performing a kidney transplant on a client. The surgeon attaches the kidney and immediately notes that the kidney takes on a cyanotic, mottled appearance. The surgeon would interpret this as:
Hyperacute rejection
While undergoing a kidney transplant from a non-family member, the patients' transplanted kidney has just had the arterial clamps removed. The OR staff notice that the organ is turning purple with no urine output. When explaining to the family why they had to remove the donor kidney, the nurse will anticipate that the surgeon would likely include which statement?
Hyperacute rejection occurs because antibodies against HLA antigens are deposited in vessels causing necrosis.
The immune system typically responds to invaders of all types in our body. However, it can also cause tissue injury and disease. What is this effect called?
Hypersensitivity action
An anaphylactic reaction could include all of the following signs/symptoms except which of the following?
Hypertension
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.
A client comes to the clinic with reports of runny nose, itchy eyes and congestion due to seasonal allergies. The nurse teaches the client about the allergic reaction. The nurse knows that teaching has been effective when the client identifies which CD4 helper T-cell cytokine as the cause of this Type I hypersensitivity reaction?
IL-4
A patient with common variable immunodeficiency (CVID) is admitted to the hospital for treatment. Which of the following types of treatment will the nurse be administering to the patient?
IV immunoglobulin
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
A patient is being treated for an anaphylactic reaction after eating shrimp. Which of the following classes of antibodies mediates the anaphylaxis?
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
A nurse is evaluating lab results of a patient newly diagnosed with bacterial pneumonia. Which of the following immunoglobulins will elevate during the early stage of the infection?
IgM
A nurse is reviewing labs for a client newly diagnosed with a bacterial infection. In determining if the client is experiencing a primary immune response, the nurse looks for which type of antibody produced from activated immature B cells?
IgM
A pregnant client is in labor. The physician suspects that the fetus has developed an infection in utero and orders blood tests. If an infection was present, which of the following labs would be elevated in the fetus at birth?
IgM
A premature neonate in the ICU suspected of having an infection has blood drawn for class specific antibodies. Which of the following confirms that the neonate has developed a congenital infection?
IgM antibodies are elevated.
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 client is brought to the emergency department after being bitten by a stray dog. To prevent rabies infection the nurse anticipates administering which of the following?
Immunoglobulins (IgG)
Varicella, the virus that causes chicken pox, is an enveloped virus. Based on this knowledge, a nurse correctly identifies that this virus is located in which part of the host cell?
In a lipoprotein envelope derived from the cytoplasmic membrane
When discussing colony-stimulating factors (CSFs), the nurse explains that recombinant CSF is currently used to:
Increase the success rate of bone marrow transplantation
Which of the following sequences accurately describes the stages of a disease?
Incubation, prodromal, acute, convalescent, and resolution.
A client tells the nurse she is at risk to prematurely deliver her baby and is concerned that the baby does not have a developed immune system. The best response would be:
Infants born prematurely may be deficient immunity.
The nurse is caring for a child who has a defect in humoral immunity. The nurse is aware that the child is at risk for:
Infections with S. pneumonia, Haemophilus influenza, Staphylococcus aureus, and gram-negative organisms such as Pseudomonas species
What is the term for parasitic relationships between microorganisms and the human body in which the human body is harmed?
Infectious disease
A patient with a history of cancer and recent chemotherapy was hospitalized with fever, weakness, shortness of breath and productive cough. A bronchoscopy with transbronchial biopsy showed granulomas containing the fungus Histoplasma. Based on patient history and the biopsy results, a nurse can conclude that the most likely cause of this infection was due to which of the following?
Inhalation of fungi and decreased host defenses permitting an opportunistic infection.
A school age child with a history of asthma has brought a note home from school stating there has been one case of meningitis (Neisseria meningitides) in the school. Since the mother is a nurse, she is very concerned since she knows the portal of entry of this pathogen is:
Inhalation via the respiratory tract such as through breathing or yawning.
Select the phases that makeup the reaction of the complement system.
Initial activation, amplification of inflammation, and membrane attack response
A 40-year-old woman who experiences severe seasonal allergies has been referred by her family physician to an allergist for weekly allergy injections. The woman is confused as to why repeated exposure to substances that set off her allergies would ultimately benefit her. Which of the following phenomena best captures the rationale for allergy desensitization therapy?
Injections of allergens simulate production of IgG, combining with the antigens to prevent activation of IgE antibodies.
Natural killer cells are specialized lymphocytes that are one of the major parts of which immunity?
Innate
The nurse is teaching a client who has HIV infection about complications associated with HAART therapy, including which of the following?
Insulin resistance
A client being treated for a bacterial infection is improving and preparing for discharge. The nurse explains the disease process and functioning of the immune system to the client. Which of the following cytokines is identified as responsible for decreasing the inflammatory immune response?
Interleukin-10 (IL-10)
A client has a suspected infection by a particular microorganism in question cannot be cultured. Which of the following processes listed below is most likely to result in an accurate diagnosis for the client?
Introduce cultured, marked antibodies to the client and observe for a reaction with antigens in the client.
Antibiotics target bacteria. If an antibiotic is bactericidal, how does it affect the bacteria?
It causes irreversible and lethal damage to the bacterial pathogen.
A new client presents at the clinic with the following history: a CD4+ cell count of 400 cells/μL, generalized lymphadenopathy, and a positive HIV test 8 years ago. Based on this information, the nurse would know that the client is in what phase of the HIV infection?
Latent phase
A nurse is working on a community project that will teach first responders how to be prepared for a pandemic flu. Select the priority intervention from the following statements.
Limit person-to-person transmission.
A teenage male develops a severe case of "athlete's foot." He asks, "How did I get this?" The health care worker explains that certain fungi become infectious (called dermatophytes) and exhibit which of the following characteristics?
Limited to cooler cutaneous surfaces
A person who has been diagnosed with HIV infection 12 years ago and still has a CD4+cell count of 800 cells/µL and a low viral load are considered clinical to be a:
Long-term nonprogressor.
The nurse knows which of the following components listed below is needed for long lasting immunity in a client with a diagnosis of sepsis without the causative agent identified?
Lymphocytes
A 53-year-old female hospital patient has received a kidney transplant following renal failure secondary to hypertension. As part of the teaching while she was on the organ wait list, she was made aware that she would need to take anti-rejection drugs for the rest of her life. Which aspect of the immune system underlies this necessity?
MHC molecules will never develop in the cells of the donor organ and effector cells will be continually stimulated.
A theory that has been postulated to describe the mechanisms by which infectious agents or other foreign substances trigger an immune response against autoantigens is known as what?
Molecular mimicry
Which of the following is least likely to contribute to the spread of HIV infection?
Mosquitoes
Systemic lupus erythematosus is best characterized by which one of the following?
Most patients have antinuclear antibodies present in their blood.
The nurse in the emergency department knows clients exposed to Clostridium botulinum, an agent of bioterrorism, would likely be exhibiting which of the following clinical manifestations listed below?
Muscle weakness in extremities eventually leading to paralysis of respiratory muscles.
Which disorder does the nurse know is considered to be an autoimmune disease?
Myasthenia gravis
While caring for a pediatric client admitted with a viral infection, the nurse knows that which type of cell will be the child's primary defense against the virus?
Natural killer (NK) cells
Which of the following types of immunity is achieved by an infant from its mother through antibodies transferred in utero or in breast milk
Naturally acquired passive immunity
A 37 year-old male with HIV who has recently become symptomatic has begun highly active antiretroviral therapy (HAART). Among the numerous medications that the man now regularly takes are several that inhibit the change of HIV RNA to DNA in a CD4+ cell. Which of the following classes of medications address this component of the HIV replication cycle?
Non-nucleoside reverse transcriptase inhibitors
The nurse is caring for a client who has AIDS and suffers from wasting syndrome. Which of the following is the priority nursing consideration for this client?
Nutrition
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.
A 21-year-old woman diagnosed with HIV/AIDS 4 years ago now presents with cytomegalovirus. The nurse explains to the woman that the infection is caused by a common organism that normally does not cause infection in someone with a healthy immune system. This type of infection is called what?
Opportunistic infection
The process by which microbes are coated to allow for more efficient recognition by phagocytes is known as:
Opsonization
The C3b subcomponent of the complement system does which of the following?
Opsonizes microbes to facilitate phagocytosis
Following a knee replacement, a client develops an infection at the site. After months of unsuccessful anti-infective therapy, the surgeon removed the implant. What explanation can the nurse provide when the client asks why the anti-infective therapy did not work?
Organisms on a colonized implant produce a self-protecting biofilm.
While explaining immunity to a client, the nurse responds, "The body's internal organs are protected from pathogens because:
Our mucosal tissue contains all the necessary cell components to fight a pathogen with an immune response."
Which of the following is an example of how international travel has contributed to increased prevalence and incidence of nonindigenous diseases?
Outbreak of hemolytic-uremic syndrome related to contaminated salad being shipped to various regions
A physician orders a real-time PCR (polymerase chain reaction) DNA detection test on a client experiencing severe diarrhea following IV antibiotic administration. Which of the following statements is the reason for this diagnostic test?
PCR is effective in determining the diagnosis of Clostridium difficile.
The nurse is caring for an infant wih DiGeorge syndrome. Which of the following organs does the nurse know will be underdeveloped or absent?
Parathyroid and thymus glands
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 administering Imovax Rabies, a rabies vaccine, to a client who was bitten by a wild squirrel. The nurse explains the mechanism of action of the medication to the client. Which type of immunity does the nurse say this vaccination provides?
Passive artificial immunity
A client asks the nurse what happens when a pathogen enters the body. Select the best response.
Pathogens that enter the intestinal mucosa can cause diseases in the lungs or liver.
Which of the following patients would be diagnosed with wasting syndrome?
Patient with HIV, fever, diarrhea, and significant involuntary weight loss
A client who has a diagnosis of an autoimmune disease asks his nurse why it is that their immune system does not attack all of the cells that make up his body. Which of the following aspects of pathogen recognition in the innate immune system listed below would underlie the nurse's response?
Pattern recognition receptors (PRRs) ensure cells are correctly identified.
Which of the following helps the innate immune system differentiate between body cells and foreign substances?
Pattern recognition receptors identify structures not shared by body tissues.
Transmission of the rabies virus from a dog bite would be best described by which of the following mechanisms of entry?
Penetration
Both innate and adaptive immunity have cells that produce cytokines. Cytokines mediate the actions of many cells in both innate and adaptive immunity. How are the actions of cytokines described?
Pleiotropic and redundant
Which one of the following is a common opportunistic infection in AIDS patients?
Pneumocystis jiroveci pneumonia (PCP)
Which of the following is the main effect of HIV infection?
Poor helper T-cell function
Which one of the following is the main effect of HIV infection?
Poor helper T-cell function
Which of the following best describes the number of active disease cases at any given time?
Prevalence
A nurse is caring for a child who has had a history of recurrent severe infections that have been resistant to treatment with antibiotics. Which of the following disorders should be suspected in this child?
Primary immunodeficiency disorder (PID)
Transmissible neurodegenerative diseases such as Creutzfeldt-Jakob disease are associated with:
Prion
Which statement about prion diseases is correct?
Prion disease's method of replications is not clearly understood.
Which one of the following infective agents contains no DNA or RNA?
Prions
A client newly diagnosed with the neurodegenerative disease Creutzfeldt-Jakob disease (CJD) asks why antibiotics are not part of the treatment plan. How should the nurse respond?
Prions are not affected by antibiotics.
In the usual course (stages) after a pathogen has entered the host body, the stage when the host initially develops the appearance of signs/symptoms like a mild fever and body aches is:
Prodromal
Select the statement that best describes the major difference between prokaryotes and eukaryotes.
Prokaryotes lack an organized nucleus.
Which of the following is the priority intervention for a nurse caring for a patient with wasting syndrome from HIV?
Promote nutritional intake
Which of the following medications is used in the treatment of HIV to prevent cleavage of the polyprotein chain into individual proteins?
Protease inhibitor
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
Which one of the following agents is the cause of malaria?
Protozoan parasite
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
A pregnant female client in her third trimester visits her gynecologist for a prenatal checkup. The physician is concerned that the fetus has developed an infection in utero. Which test can be used to diagnose the infection in the neonate at birth?
Serum measurement of IgM
Which of the following statements is an accurate descriptor of the role of viruses in human infections?
Some viruses are capable of transforming normal host cells into malignant cells.
A client has developed an infection from an exogenous source. The nurse recognizes this as acquired from:
Sources in the external environment, such as the water, food, soil, or air
A client has been identified as having an excess of macrophage inhibitory factor, causing the client to have inhibited movement and activity of macrophages. Which of the following processes listed below would the health care team member expect to remain unaffected?
Specificity and memory of the immune response
Which of the following is a secondary lymphoid structure located high in the left abdominal cavity?
Spleen
A client is suspected of having a parasitic infection with roundworms. For what laboratory testing will the nurse prepare the client to most rapidly identify this infection?
Stool exam for ova
The clinical picture, or presentation of a disease in the body, is called what?
Symptomatology of the disease
While working in the newborn nursery, a nurse is assessing a new admission. The nurse notes the infant has an increased distance between his eyes, a very small jaw, and a split uvula. Thinking this infant might have DiGeorge syndrome, the nurse should be assessing this infant for which of the following electrolyte imbalances?
Tetany due to hypocalcemia
The nurse understands that a positive ELISA test reported in a baby born to a woman who is HIV positive indicates which of the following?
The baby has antibodies from the mother and it is uncertain whether the baby is infected with HIV.
A student asks, "What does cell-mediated immunity mean to the client?" The instructor responds. "This means:
The body is trying to defend itself against intracellular microbe invasion by engulfing and destroying the microbe."
A 2-year-old girl has had repeated ear and upper respiratory infections since she was born. A pediatrician has determined a diagnosis of transient hypogammaglobulinemia of infancy. What is the physiological origin of the child's recurrent infections?
The child's immune system is unable to synthesize adequate immunoglobulin on its own.
A client experiencing severe neck pain and fever comes to the emergency room and is diagnosed with bacterial meningitis. Knowing that the client's immune system is fighting the infection, the infectious disease nurse correctly identifies which of the following pathways as the activation of the complement system?
The classical
A client seen in the clinic has an immune deficiency involving the T-lymphocytes (T cells). The nurse should educate the client about which of the following risks associated with this deficiency?
The client has an increased risk of contracting a viral infection; wear a mask during flu season.
Following delivery, the parents have chosen to have their infant's cord blood frozen. A blood test is performed on the cord blood and found to contain IgM antibodies. The nurse interprets this to mean:
The infant has been exposed to an intrauterine infection.
A newborn has been lethargic, is not nursing well, and is basically looking ill. Following lab tests, it has been found that the newborn has IgM present in his blood. How should the nurse interpret this finding?
The presence of IgM suggests the infant has a current infection.
Question: A 30-year-old male knows that he contracted HIV a month ago. Place the following steps in the order of the progression of the disease, starting with what he could expect first if he does not receive treatment.
There is a rapid increase in viral replication, which leads to very high viral loads. Viral symptoms such as fatigue, lymphadenopathy, headaches, and gastrointestinal distrubances and the CD4+ T-cell count begins to fall. There is a period (up to 10 years) of being symptoms free as CD4+ T cells decrease. CD4+ T-cell count is 200 cells/&muL;confirming the diagnosis of AIDS. The risk of opportunist infection is highest. Death
A client with otitis media is ordered to receive amoxicillin (Amoxil). The client questions the nurse on how the drug works. Which of the following statements describes how penicillin works?
This drug causes interference with a specific step in bacterial cell wall synthesis.
A patient with AIDS has recently developed a temperature of 101.1°F along with headaches, visual disturbances, and confusion. Magnetic resonance imaging is ordered and neurologic lesions are present. Which of the following opportunistic infections is most likely contributing to these symptoms?
Toxoplasmosis gondii
A 1-year-old child who has experienced low platelet counts and bacterial susceptibility has been admitted to a pediatric medical unit of a hospital for treatment of Wiskott-Aldrich syndrome. The nurse who has admitted the child to the unit would anticipate which of the following short-term and longer-term treatment plans?
Treatment of eczema; management of bleeding; bone marrow transplant
Which of the following serves as the rationale for AIDS treatment with antiretroviral therapy?
Triple therapy with reverse transcriptase, protease, and fusion inhibitors
Children born to mothers who are infected with HIV are considered uninfected if the children become HIV antibody negative after 18 months of age, have no other laboratory evidence of HIV infection, and have not met the surveillance case definition criteria for AIDS in children.
True
What is the length of time from infection with the AIDS virus to seroconversion?
Up to six months
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
Which of the following is the most common mode of transmission of HIV?
Vaginal and anal intercourse
A patient in the primary or initial phase of a type I hypersensitivity reaction would most likely experience which of the following?
Vasodilation of the capillaries from the release of histamine
An HIV-positive mother passes the virus to her infant during delivery. This type of transmission is known as:
Vertical transmission
A client presents at the clinic complaining of unplanned weight loss of up to 10% of her body weight. She states that she has had diarrhea, more than twice a day. She goes on to say the she has fever and weakness that "just won't go away." After a complete history and physical, an enzyme-linked immunosorbent assay test is ordered. This order is based on what suspected diagnosis?
Wasting syndrome
The nurse is administering an intramuscular medication to a client who has AIDS. Which of the following precautions will the nurse take when administering the medication?
Wear gloves
A nursing student is assigned to care for a client who has AIDS. The student is unsure of what personal protective equipment should be worn while caring for this client. Which of the following statements is appropriate direction from the student's nursing instructor?
Wear gloves if there is a chance you will come in contact with the client's blood or body fluids.
What type of precautions should the nurse take when caring for a client with Rocky Mountain spotted fever?
Wearing gloves for contact with secretions
Which of the following procedures reduces the potential for infection primarily by addressing the portal of entry?
Wearing gloves when contact with blood or body fluids is anticipated.
A 20-year-old male presents at the clinic complaining of severe fatigue, night sweats, and fever. While taking the client's history, he reports having multiple sexual partners and unprotected sex. HIV/AIDS is suspected. What diagnostic test would be ordered to confirm the diagnosis?
Western blot assay
A client comes to the clinic with the following cardinal signs of inflammation: redness, heat, pain and swelling, following a laceration to the thigh. Which of the following statements correctly explains the cause of swelling at the laceration site?
When activated, the complement protein C3 breaks into two fragments. The larger 3b fragment acts as an enzyme to cleave C5 into two components the C5a fragment produces vasodilation and increases vascular permeability causing edema.
Select the option that best describes a single-celled organism that reproduces by a budding process.
Yeast
Which is a single celled organism that is about the size of a red blood cell and reproduces by a budding process?
Yeast
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.
Infections that are passed from animals to humans are known as:
Zoonotic
HIV is considered to be a retrovirus because:
it carries its genetic information in ribonucleic acid (RNA) rather than deoxyribonucleic acid (DNA).
The nurse is caring for a client who recently had a positive ELISA test for HIV. The client states, "How did I become HIV positive? I have never had sex with anyone!" Which of the following responses are appropriate? Select all that apply.
• "Have you ever had a blood transfusion?" • "Do you use IV drugs?" • "Do you consider oral sex as having sex?" • "Sometimes this test gives false positive results. To confirm the diagnosis, another test will be performed."
The nurse knows that further teaching is needed when a client who is HIV positive makes which of the following statements? The client is aware that his blood work reflects a CD4+ cell count of 800. Select all that apply.
• "Since my CD4+ count is 800, I understand that I am of little risk of infecting my sexual partner." • "I am disappointed that I am not yet cured of HIV."
It has been postulated that an autoimmune disease needs a "trigger event" for it to clinically manifest itself in a body. What are these "trigger events" thought to be? (Select all that apply.)
• A microorganism or virus • A self-antigen from a previously sequestered body tissue • A chemical substance
The school nurse is teaching a health class to a group of high school students. She is preparing a lecture on HIV/AIDS. The nurse would know to include what information about the transmission of AIDS in her lecture? (Select all that apply.)
• AIDS is transmitted from the mother to her unborn baby. • AIDS is transmitted through sexual contact. • AIDS is transmitted through blood-to-blood contact.
Chlamydiaceae have characteristics of both viruses and bacteria and are a rather common sexually transmitted infectious organism. After entry into the host, they transform into a reticulate body. The health care provider should monitor which of the following clients for this possible infection? Select all that apply.
• An adult male who raises a number of exotic birds in his home • A drug abuser looking to share needles/syringes • A newborn with a noticeable eye infection
Which of the following outpatients are at a greater risk for developing Treponema pallidum, the cause of syphilis? Select all that apply.
• An older adult female living in a condominium who regularly has sex with three to four different men/week • A male who frequents clubs catering to exotic dancers and sexual favors • A homeless adolescent female performing oral sex for money
A nurse is caring for several patients with disorders with inflammatory responses. Which patient conditions arise from hyperresponsive adaptive immunity? Select all that apply.
• Atherosclerosis • Bronchial asthma • Multiple sclerosis
A nurse is developing a teaching plan for a senior citizens group on the importance of chronic disease management. The nurse knows that inflammation plays a key role in the pathogenesis of many common pathophysiologic states. Which of the following diseases should be included in the teaching plan? Select all that apply.
• Atherosclerosis • Coronary artery disease • Non-insulin-dependent diabetes mellitus (NIDDM)
Kaposi sarcoma is an opportunistic malignancy that is found on the skin, in the oral cavity, in the gastrointestinal tract, and in the lungs of immunocompromised people. Many people with skin lesions caused by Kaposi sarcoma also have gastrointestinal involvement. What are the presenting symptoms of Kaposi sarcoma in the gastrointestinal tract? (Select all that apply.)
• Bleeding • Pain • Obstruction
Select the infectious disease that may be acquired from protein particles, such as prions. Select all that apply
• Bovine spongiform encephalopathy • Chronic wasting disease • Creutzfeldt-Jakob disease Correct
Evasive factors, one type of virulence factor, are factors produced by infectious microorganisms to keep the host's immune system from destroying the microorganism. Which of these are evasive factors? (Select all that apply.)
• Capsules • Slime • Mucous layers
In both the innate and adaptive immune systems, cells communicate information about invading organisms by the secretion of chemical mediators. Which are these mediators? (Select all that apply.)
• Chemokines • Colony-stimulating factors
Which statements best describe communicable disease? Select all that apply.
• Communicable diseases are spread from person to person. • Blood is a common carrier for communicable diseases. • Communicable diseases are caused by infections that live and reproduce in a human host
The nurse is caring for a client who is HIV positive and is newly diagnosed with Mycobacterium tuberculosis (TB). Which of the following symptoms does the nurse associate with TB? Select all that apply.
• Cough • Fever • Night sweats
Which of the following findings are considered part of normal aging? Select all that apply.
• Decreased IL-2 level • Decrease in CD4+ count
A nursing instructor is explaining the role of a macrophage to a group of nursing students. Which of the following roles of the macrophage should be included in the teaching plan? Select all that apply.
• Destruction of malignant cells • Antigen presentation • Phagocytosis • Activation of lymphocytes
Which are mechanisms by which pathogens cause disease in humans? Select all that apply.
• Direct destruction of the host cell • Interference with the host cell's metabolic function • Exposure of the host cell to toxins
The nurse is reviewing the medical record for laboratory blood work that would indicate if a client is HIV infected. The nurse reviews which lab test?
• ELISA enzyme-linked immunoassay
A client is in the emergency department with a severe type I IgE-mediated hypersensitivity reaction. What pharmacologic treatment should the nurse prepare to administer in this acute phase? (Select all that apply)
• Epinephrine • An antihistamine • Systemic corticosteroids
An adolescent is diagnosed with Epstein-Barr virus. What information should the nurse provide to the parents? Select all that apply.
• Epstein-Barr virus can cause infectious mononucleosis. • Epstein-Barr virus can be spread by saliva. • The Epstein-Barr virus invades and replicates within the salivary glands.
When assessing a patient, the nurse recognizes that which of the following symptoms are nonspecific and can be shared by a number of diverse infectious diseases? Select all that apply.
• Fever • Myalgia • Headache • Lethargy
Some viruses have the ability to transform host cells into cancer cells. For which of the following viruses should the client be assessed regularly for the potential development of cancer? Select all that apply.
• Hepatitis B • Human papillomavirus
The clinic nurse suspects the client is having a genetically determined hypersensitivity to common environmental allergens since the client is experiencing which of the following clinical manifestations? Select all that apply.
• Hives • Runny nose • Wheezes
The nurse is caring for a client experiencing a systemic anaphylactic reaction. The nurse would assess the client for: Select all that apply.
• Hypotension • Bronchospasm and respiratory distress • Vomiting and abdominal cramps • Laryngeal edema and obstruction
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
A client comes to the emergency room concerned about infection after being cut on the hand by a piece of glass; the skin surrounding the wound is red, warm and painful. After assisting with suture insertion, the nurse develops a plan of care for discharge. Which information on the body's natural defenses should be included in the plan of care? Select all that apply.
• Innate immunity is the body's first line of defense. • The epithelial layers of the skin provide innate immunity. • Redness, heat, pain and swelling are part of the normal inflammatory process. • Initiation of the inflammatory process does not mean an infection is present.
Infectious agents produce products or substances called virulence factors that make it easier for them to cause disease. Which of these are virulence factors? (Select all that apply.)
• Invasive factors • Adhesion factors • Toxins • Evasive factors
Select the assessment data that place a client most at risk for the development of an opportunistic infection. A client with/who: Select all that apply.
• Is currently receiving chemotherapy • Has a diagnosis of malnutrition • Has a compromised immune system • Just completed 6 weeks of radiation therapy
A nurse is reviewing the process required for the development of a healthy innate immune response. Which of the following components need to be included in the review? Select all that apply.
• Leukocytes • Opsonins • Cytokines • Complement
An infection control nurse is conducting research on the activation of the immune system and is identifying anatomical locations where primary immune responses are initiated. Which of the following locations should be included in the research study? Select all that apply.
• Lymph nodes • Spleen • Tonsils • Peyer patches
The nurse is teaching a group of parents about foods that commonly cause allergic reactions in children. The most important information to provide would be: Select all that apply.
• Milk • Eggs • Peanuts • Shellfish
Which of the following is correct regarding the diagnosis of an autoimmune disorder? Select all that apply.
• Overlapping presentation of symptoms is common among this type of disorder. • Non-autoimmune diseases can present with autoimmune like symptoms. • Effective history taking is vital to the diagnosis of autoimmune disorders. • Laboratory diagnostic testing aids in the diagnosis of auto immune disorders.
The CDC recommends routine testing for HIV of which groups of people? Select all that apply.
• People who inject illicit drugs • People who exchange sex for money • People who have more than one sex partner
When treating a patient with antibiotics, a nurse recognizes that which of the following can cause bacterial resistance? Select all that apply.
• Production of enzymes that inactivate antibiotics • Genetic mutations • Creation of alternative metabolic pathways that bypass antibiotic activity • Changes in the filtration qualities of the bacterial cell
A newly diagnosed HIV positive adolescent has blood work drawn which includes a CD8 T cell count. The nurse knows which of the following functions of CD8 T cells listed below will assist the adolescent's immune system in fighting off the viral attack? Select all that apply.
• Release of destructive enzymes. • Trigger intracellular programmed death.
A patient has been diagnosed with B-cell immunodeficiency disorder. Which of the following bacteria would the nurse likely see associated with this disorder? (Select all that apply.)
• Streptococcus pneumoniae • Staphylococcus aureus
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.
The nurse accidentally has been stuck with a needle that was used to administer an intramuscular injection to a client who has AIDS. Which of the following statements related to this event are true? Select all that apply.
• The stage of illness of the client diagnosed with AIDS impacts the risk of transmission of HIV to the nurse from the client. • The viral load of the client diagnosed with AIDS impacts the risk of transmission of HIV to the nurse from the client. • The depth of the needle puncture of the client diagnosed with AIDS impacts the risk of transmission of HIV to the nurse from the client. • The amount of blood on the needle of the client diagnosed with AIDS impacts the risk of transmission of HIV to the nurse from the client.
Which of the following statements are TRUE regarding the effects of aging on the immune system? Select all that apply.
• Vaccinations are less effective as we age. • The incidence of cancer increases as we age. • The elderly tend to have more evidence of autoimmune disorders as we age.