Allergy/Immune Questions

During a 12-month well-baby visit, a mother reports that the baby has been breastfed since birth and has never been ill. The mother is trying to convince her sister, who is currently pregnant, to breastfeed also and asks the nurse about the benefits of breastfeeding. The nurse explains the immune benefits of breastfeeding and provides the mother with pamphlets. The nurse determines the mother understands the teaching based on which statement?

"Breastfeeding is beneficial because the dominant antibody IgA in breast milk acts by functioning as an antigen receptor in the mucosal membranes."

When obtaining a health history from a patient with possible abnormal immune function, what question would be a priority for the nurse to ask?

"Have you ever received a blood transfusion?"

A patient comes to the clinic with pruritus and nasal congestion after eating shrimp for lunch. The nurse is aware that the patient may be having an anaphylactic reaction to the shrimp. These symptoms typically occur within how many hours after exposure?

2 hours

The nurse is instructing clients about the importance of taking the shingles vaccine. Which client would benefit from this vaccine?

A 65-year-old client who had chicken pox when he was 12 years old

A client has been hospitalized for diagnostic testing. The client has just been diagnosed with multiple sclerosis, which the physician explains is an autoimmune disorder. How would the nurse explain an autoimmune disease to the client?

A disorder where killer T cells and autoantibodies attack or destroy natural cells—those cells that are "self.

A patient has been diagnosed with an allergy to peanuts. What is a priority for this patient to carry at all times?

An EpiPen

A client will be receiving a hepatitis B vaccination series prior to employment in a dialysis center. What type of immunity will this provide?

Artificially acquired active immunity

A client who has AIDS reports having diarrhea after every meal, and wants to know what can be done to stop this symptom. What should the nurse advise?

Avoid fibrous foods, lactose, fat, and caffeine.

What drug is a histamine antagonist?

Benadryl

A client with an allergic disorder calls the nurse and asks what treatment is available for allergic disorders. The nurse explains to the client that there is more than one treatment available. What treatments would the nurse tell the client about?

Desensitization

The nurse is preparing to administer a medication that has an affinity for H1 receptors. Which medication would the nurse administer?

Diphenhydramine (Benadryl)

A client calls the clinic and asks the nurse if using oxymetazoline nasal spray would be all right to relieve the nasal congestion the client is experiencing due to seasonal allergies. What instructions should the nurse provide to the client to avoid complications?

Do not overuse the medication as rebound congestion can occur

A school nurse is talking about infection with a high school health class. What would be the nurse's best explanation of the process of phagocytosis?

Engulfment and digestion of bacteria and foreign material

Which blood test confirms the presence of antibodies to HIV?

Enzyme immunoassay (EIA)

A client with lupus has had antineoplastic drugs prescribed. Why would the physician prescribe antineoplastic drugs for an autoimmune disorder?

For their immunosuppressant effects

After teaching a client how to self-administer epinephrine, the nurse determines that the teaching plan has been successful when the client demonstrates which action?

Jabs the autoinjector into the outer thigh at a 90-degree angle

A client has had a "stuffy nose" and obtained an oxymetazoline nasal spray. What education should the nurse provide to the client in order to prevent "rebound congestion"?

Only use the nasal spray for 3 to 4 days once every 12 hours.

A laboring mother asks the nurse if the baby will have immunity to some illnesses when born. What type of immunity does the nurse understand that the newborn will have?

Passive immunity transferred by the mother

The nurse is teaching a client about allergic rhinitis and its triggers. What is the most common trigger for the respiratory allergic response?

Plant pollen

A client with acquired immune deficiency syndrome (AIDS) is exhibiting shortness of breath, cough, and fever. What type of infection will the nurse most likely suspect?

Pneumocystis jiroveci

Which intervention is the single most important aspect for the client at risk for anaphylaxis?

Prevention

The nurse is taking the health history of a newly admitted client. Which condition would place the client at risk for impaired immune function?

Previous organ transplantation

A client has had skin testing and the results are inconclusive. The nurse would expect to prepare the client for which type of testing?

Radioallergosorbent test

The nurse is caring for a client recovering from a major burn. Burns affect the immune system by causing a loss of large amounts of which of the following?

Serum, which depletes the body's store of immunoglobulins

The nurse is working with a colleague who has a delayed hypersensitivity (type IV) allergic reaction to latex. Which statement describes the clinical manifestations of this reaction?

Symptoms are localized to the area of exposure, usually the back of the hands.

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

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

what type of reaction is anaphylaxis?

Type 1 hypersensitivity

A nurse is preparing a discharge teaching plan for a client with atopic dermatitis. Which instruction should the nurse include in the teaching plan?

Use a topical skin moisturizer daily

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

WBCs are produced in the bone marrow

The nurse knows the best strategy for latex allergy is

avoid latex based products

atopic dermatitis is also referred to as what?

eczema

what drug is given during anaphylaxis shock?

epinephrine

The nurse is reviewing various medications with a client that can be used to treat allergic disorders. What medication will the nurse identify as an intranasal corticosteroid?

fluticasone

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

infection because the spleen removes bacteria from the blood.

The nurse is working with a client with allergies. What will the nurse use to confirm allergies and decrease the risk of anaphylaxis?

intradermal testing

Tacrolimus can cause what?

lymphoma

The nurse is aware that the most prevalent cause of immunodeficiency worldwide is

malnutrition

what medication will decrease the inflammtory response?

methylprednisolone

A client has had a kidney transplant performed for end-stage kidney disease. What type of immune response that T-cell lymphocytes perform is related to this type of surgery?

a cell mediated response

What is atopic dermatitis?

a chronic inflammatory skin condition

A pt with allergies and prone to anaphlaxis should wear what?

a medical alert bracelet

A client is prescribed an oral corticosteroid for 2 weeks to relieve asthma symptoms. The nurse educates the client about side effects, which include

adrenal suppression

Cryptococcus meningitis is suspected in a client with HIV. Which manifestations would be consistent with cryptococcus meningitis? Select all that apply.

stiff neck and seizures

Tacrolimus

topical ointment -treats atopic dermatitis -commonly used for the face

The client asks the nurse how to determine a cause for rhinitis. What diagnostic test will the nurse explain to the client that will identify the cause of rhinitis?

total serum IgE test

In its attempt to suppress allergic responses, the body releases several chemicals which have a role in mediating physical reactions. Epinephrine, which interferes with vasoactive chemical release from mast cells, is instrumental in suppressing which type of hypersensitivity response?

type I

Which type of hypersensitivity reaction involves immune complexes forming when antigens bind to antibodies?

type III

What is ataxia?

uncoordinated movement

What types of cells are the primary targets of the healthy immune system? Select all that apply.

-infectious cells -foreign cells -cancerous cells

if your patient goes into respiratory arrest due to anaplyactic shock what should you prepare for?

-intubation or -tracheotomy

A nurse is reviewing the dietary history of a client who has experienced anaphylaxis. What would the nurse identify as a common cause of anaphylaxis? Select all that apply.

-milk -eggs -shrimp

what may a pt with atopic dermatitis present with?

-pruritic vesicles -skin rash -cheek rash

what is used to treat atopic dermatitis?

-tacrolimus -moistruzers -corticosteroids -phototherpay -antihistamines

what 2 conditions is atopic dermatitis associated with?

1. asthma and 2. allergic rhinitis

A client with AIDS has become forgetful with a limited attention span, decreased ability to concentrate, and delusional thinking. What condition is represented by these symptoms?

AIDS dementia complex (ADC)

When do most perinatal HIV infections occur?

After exposure during delivery

More than 50% of individuals with this disease develop pernicious anemia:

Common variable immunodeficiency (CVID)

While interviewing a client with an allergic disorder, the client tells the nurse about an allergy to animal dander. The nurse knows that animal dander is what type of substance?

Complete protein antigen

A client has begun sensitivity testing to determine the allergen which caused an anaphylactic reaction 3 weeks ago. In scratch testing, which part of the body is more sensitive to allergens?

back

Kaposi sarcoma (KS) is diagnosed through:

biopsy

The nurse is discussing sexual activity with a client recently diagnosed with human immunodeficiency virus (HIV). The client states, "As long as I have sex with another person who is already infected, I will be okay." What is the best response by the nurse?

"You should avoid having unprotected sex with a person who is HIV positive because you can increase the severity of the infection in both you and your partner."

A patient is experiencing an allergic reaction to a dose of penicillin. What should the nurse look for in the patient's initial assessment?

-Dyspnea -bronchospasms -laryngeal edema

A client is experiencing severe anaphylactic shock. What actions should the nurse take first? Select all that apply.

-administer diphenhydramine -ask the client if they are light headed -give intravaneous fluids -prepare for insertion of an endotracheal tube

what are some signs of anaphlaytic shock?

-dyspnea -wheezing -stridor

what are symptoms of anaphlaxis?

-systemic vasodilation - decreased CO -bronchoconstriction

A client arrives at the clinic and reports a very sore throat as well as a fever. A rapid strep test returns a positive result and the client is given a prescription for an antibiotic. How did the streptococcal organism gain access to the client to cause this infection?

via mucous membranes of the throat

What treatment option does the nurse anticipate for the patient with severe combined immunodeficiency disease (SCID)?

bone marrow transplant

A nurse is implementing appropriate infection control precautions for a client who is positive for human immunodeficiency virus (HIV). The nurse knows which body fluid is not a means of transmission?

urine

A client is given a dose of ketorolac, a nonsteroidal anti-inflammatory drug for complaints of abdominal pain. Ten minutes after receiving the medication, the client's eyes, lips, and face begin to swell, and the nurse hears stridor. What priority measure should the nurse prepare to do?

administer epinephrine

Which allergic reaction is potentially life threatening?

angioedema (swelling of the face, eyes, mouth)

what is your first intervention when your patient has anaphlaxis?

assess airway and oxygen needs -apply high oxygen via a non breather mask

Which condition is associated with impaired immunity relating to the aging client?

renal function decreases

what position will aid in perfusion and oxygenation for a patient experiencing anaphylaxis?

supine postion

Which assessment finding would the nurse expect to document for a client with ataxia-telangiectasis?

vascular lesions

what are pruritic vesicles?

vesicles that may ozze when scratched

if your patient is experincing anaphylaxis how will benadryl be adminstered?

via IV push -every 15 minutes until the pt responds

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

Impaired ciliary action as a result of exposure to environmental toxins

What does the nurse understand will result if the patient has a deficiency in the normal level of complement?

Increased susceptibility to infection

Which term refers to an incomplete antigen?

Hapten

The nurse is evaluating a client's complete blood cell count and differential along with the serum immunoglobulin E (IgE) concentration. Which result might indicate that the client has an allergic disorder?

High IgE concentration

Which is a primary chemical mediator of hypersensitivity?

Histamine

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

IgE

What type of immunoglobulin is most likely involved with allergic reactions?

IgE

During a routine checkup, a nurse assesses a client with acquired immunodeficiency syndrome (AIDS) for signs and symptoms of cancer. What is the most common AIDS-related cancer?

Kaposi's sarcoma

The nurse is caring for a client exposed to peanuts with a known allergy. What assessment is considered the most serious manifestation of angioneurotic edema?

Laryngeal swelling

A client has undergone diagnostic testing for human immunodeficiency virus (HIV) using the enzyme immunoassay (EIA) test. The results are positive and the nurse prepares the client for additional testing to confirm seropositivity. The nurse would prepare the client for which test?

Western blot assay

A client is diagnosed with multiple site cancers and has received whole-body irradiation. The nurse is concerned about a compromised immune system in this client for which reason?

radiation destroys lymphocytes

If your patient is having anaphlaxis and they have anxiety what should you do?

reassure them

Which immunity type becomes active as a result of infection by a specific microorganism?

naturally acquired active immunity

A 20-year-old client cut a hand while replacing a window. While reviewing the complete blood count (CBC) with differential, the nurse would expect which cell type to be elevated first in an attempt to prevent infection in the client's hand?

neutrophils

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

neutrophils and monocytes