Chapter 36 Problems Related to Immunologic Function
A client comes into the emergency department reporting difficulty walking and loss of muscle control in the arms. Once the nurse begins the physical examination, which assessment should be completed if an immune dysfunction in the neurosensory system is suspected? Assess for ataxia using the finger-to-nose test and heel-to-shin test Assess joint mobility using passive range of motion. Review the urinalysis report for hematuria Assess for hepatosplenomegaly by measuring abdominal girth
Assess for ataxia using the finger-to-nose test and heel-to-shin test
What chemical is released by cytotoxic T cells? Lymphokine Antigen Antibody Microphages
Lymphokine
Which type of immunity becomes active as a result of infection by a specific microorganism? Naturally acquired active immunity Artificially acquired active immunity Naturally acquired passive immunity Artificially acquired passive immunity
Naturally acquired active immunity
The nurse is caring for a client with a suspected immune system disorder. What test would be ordered if a deficiency or excess of immunoglobulins was suspected? Protein electrophoresis Enzyme-linked immunosorbent assay T-cell and B-cell assays Plasmapheresis
Protein electrophoresis When an immune system disorder is suspected, protein electrophoresis screens for diseases associated with a deficiency or excess of immunoglobulins may be ordered. The other options are incorrect tests to diagnose a deficiency or excess of immunoglobulins.
The nurse is administering a skin test for detection of exposure to tuberculosis. How would the nurse determine if the client was exposed to tuberculosis? The client will have a productive cough. The injection area swells if the client has developed antibodies against the antigen. The injection area will become painful with in duration if the client has antibodies against the antigen. The injection area will break out in a fine macular rash.
The injection area swells if the client has developed antibodies against the antigen.
Which statement accurately reflects current stem cell research? Stem cell transplantation cannot restore immune system functioning. Stem cell transplantation has been performed in the laboratory only. Clinical trials are underway only in clients with acquired immune deficiencies. The stem cell is known as a precursor cell that continually replenishes the body's entire supply of both red and white cells.
The stem cell is known as a precursor cell that continually replenishes the body's entire supply of both red and white cells.
A client has undergone a kidney transplant. The nurse is concerned about a compromised immune system in this client for which reason? Use of anti-rejection drugs Excess circulating lymphocytes Deficient circulating antibodies Excess circulating hemoglobin
Use of anti-rejection drugs
A client has a known allergy to peanuts, meaning that the client's immune system has identified peanuts as a foreign invader and has produced specific cells to attack if the client should come in contact with peanuts again. The formation of these specific cells is known as: humoral response. cell-mediated response. inflammatory response. memory response.
humoral response. The B-cell lymphocytes mature in the bone marrow and migrate to the spleen and other lymphoid tissues such as the lymph nodes. When stimulated by T cells, the B cells become either plasma or memory cells. Plasma cells produce antibodies. Formation of antibodies is called a humoral response.
Which immunity type becomes active as a result of infection by a specific microorganism? naturally acquired active immunity artificially acquired active immunity naturally acquired passive immunity artificially acquired passive immunity
naturally acquired active immunity Naturally acquired active immunity occurs as a direct result of an infection by a specific microorganism.
The nurse is instructing clients about the importance of taking the shingles vaccine. Which client would benefit from this vaccine? A 24-year-old client who is pregnant A 17-year-old client who will be attending college and living in a dormitory A 32-year-old client who has never had chickenpox A 65-year-old client who had chicken pox when he was 12 years old
A 65-year-old client who had chicken pox when he was 12 years old
The nurse is caring for a client with renal failure. Which factor indicates a compromised immune system? A deficiency of circulating lymphocytes An excess of circulating lymphocytes A deficiency of circulating antibodies An excess of circulating hemoglobin
A deficiency of circulating lymphocytes
The nurse is obtaining the medical history of a client with Crohn's disease. What medication would the nurse include when asking about what medications the client has taken for suppression of the inflammatory and immune response? Nonsteroidal anti-inflammatory Angiotensin-converting enzyme inhibitors (ACE-I) Diuretics Corticosteroids
Corticosteroids
An experiment is designed to determine specific cell types involved in cell-mediated immune response. The experimenter is interested in finding cells that attack the antigen directly by altering the cell membrane and causing cell lysis. Which cells should be isolated? Macrophages Helper T cells B cells Cytotoxic T cells
Cytotoxic T cells
A client who is being treated for complications related to acquired immunodeficiency disorder syndrome (AIDS) is receiving interferon parenterally as adjunctive therapy. Why does the nurse understand this route is being used? The taste of the medication is not palatable. The medication will work more rapidly parenterally. The medication, given orally, will cause diarrhea. Digestive enzymes destroy its protein structure.
Digestive enzymes destroy its protein structure.
A teenage boy is undergoing allergy testing and has had blood work drawn as part of the diagnostic workup. When reviewing the patient's laboratory results, the nurse should pay particular attention to the levels of what white blood cell (WBC) component? Neutrophils Eosinophils Lymphocytes Monocytes
Eosinophils
A client is informed of having a low white blood cell count and that the client is at risk for the development of infections. The client asks, "Where do I make new white blood cells?" What is the best response by the nurse? "White blood cells are produced in the plasma." "White blood cells are produced in the thymus gland." "White blood cells are produced in the lymphatic tissue." "White blood cells are produced in the bone marrow."
"White blood cells are produced in the bone marrow."
A gardener sustained a deep laceration while working and requires sutures. The patient is asked about the date of his last tetanus shot, which he tells the nurse was more than 10 years ago. Based on this information, the patient will receive a tetanus immunization. The tetanus injection will allow for the release of what? An antibody An antigen A bacteria A virus
An antibody
A client has breast cancer. The nurse is concerned about a compromised immune system in this client for which reason? Antineoplastic drug therapy Excess circulating lymphocytes Deficient circulating antibodies Excess circulating hemoglobin
Antineoplastic drug therapy
Activation of a natural immunity response is enhanced by physical and chemical barriers. Which of the following is a physical barrier, which the nurse knows can be altered by illness, nutrition, or lifestyle? Mucus Acidic gastric secretions Cilia of the respiratory tract Enzymes in saliva
Cilia of the respiratory tract
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? Release of chemicals to destroy bacteria and foreign material Engulfment and digestion of bacteria and foreign material Removal of bacteria and dead blood cells from circulation Conversion of memory cells to plasma cells
Engulfment and digestion of bacteria and foreign material
The nurse is caring for a female patient who has an exacerbation of lupus erythematosus. What does the nurse understand is the reason that females tend to develop autoimmune disorders more frequently than men? Androgen tends to enhance immunity. Estrogen tends to enhance immunity. Testosterone tends to enhance immunity. Leukocytes are increased in females.
Estrogen tends to enhance immunity. Autoimmune disorders tend to be more common in women because estrogen tends to enhance immunity. Androgen, on the other hand, tends to be immunosuppressive.
A patient with cystic fibrosis has received a double lung transplant and is now experiencing signs of rejection. What is the immune response that predominates in this situation? Humoral Nonspecific Cellular Mitigated
Humoral
What type of immunoglobulin does the nurse recognize that promotes the release of vasoactive chemicals such as histamine when a client is having an allergic reaction? IgG IgA IgM IgE
IgE
Which immunoglobulin assumes a major role in bloodborne and tissue infections? IgA IgG IgM IgD
IgG IgG assumes a major role in bloodborne and tissue infections. IgA protects against respiratory, gastrointestinal, and genitourinary infections. IgM appears as the first immunoglobulin produced in response to bacterial and viral infections. IgD possibly influences B-lymphocyte differentiation.
A woman who has experienced severe seasonal allergies in recent years has been referred for allergy skin testing. The nurse at the allergy clinic should be aware of the need to take precautions against the patient's risk of which of the following nursing diagnoses? Nausea Hopelessness Acute pain Impaired gas exchange
Impaired gas exchange
A client is diagnosed with human immunodeficiency virus (HIV). After recovering from the initial shock of the diagnosis, the client expresses a desire to learn as much as possible about HIV and acquired immunodeficiency syndrome (AIDS). When teaching the client about the immune system, the nurse states that humoral immunity is provided by which type of white blood cell? Neutrophil Basophil Monocyte Lymphocyte
Lymphocyte
The nursing students are learning about the immune system in their anatomy and physiology class. What would these students learn is a component of the immune system? Stem cells Cytokines Lymphoid tissues Red blood cells
Lymphoid tissues The immune system actually is a collection of specialized white blood cells and lymphoid tissues that cooperate to protect a person from external invaders and the body's own altered cells. The function of these structures is assisted and supported by the activities of natural killer cells, antibodies, and nonantibody proteins such as cytokines and the complement system. Red blood cells and stem cells are not part of the immune system.
A 25-year-old client receives a knife wound to the leg in a hunting accident. Which type of immunity was compromised? Specific immunity Passive immunity Adaptive immunity Natural immunity
Natural immunity Natural immunity, which is nonspecific, provides a broad spectrum of defense against and resistance to infection. It is considered the first line of host defense following antigen exposure, because it protects the host without remembering prior contact with an infectious agent.
Which type of cell is capable of directly killing invading organisms and producing cytokines? Null lymphocytes Natural killer cells Memory cells Cytotoxic T cells
Natural killer cells Natural killer cells defend against microorganisms and some types of malignant cells. Null lymphocytes also combat organisms, but they destroy antigens already coated with antibody. Memory cells are responsible for recognizing antigens from previous exposure and mounting an immune response. Cytotoxic T cells attack an antigen directly by altering the cell membrane and causing cell lysis and by releasing cytolytic enzymes and cytokines.
A child is brought to the clinic with a rash and is subsequently diagnosed with measles. The parent reports also having had measles as a young child. What type of immunity to measles develops after the initial infection? Naturally acquired active immunity Artificially acquired active immunity Naturally acquired passive immunity Artificially acquired passive immunity
Naturally acquired active immunity Immunity to measles that develops after the initial infection is an example of naturally acquired active immunity. Artificially acquired active immunity results from the administration of a killed or weakened microorganism or toxoid (attenuated toxin), whereas passive immunity develops when ready-made antibodies are given to a susceptible client.
Which type of immunity becomes active as a result of infection by a specific microorganism? Naturally acquired active immunity Artificially acquired active immunity Naturally acquired passive immunity Artificially acquired passive immunity
Naturally acquired active immunity Naturally acquired active immunity occurs as a result of an infection by a specific microorganism. Artificially acquired active immunity results from the administration of a killed or weakened microorganism or toxoid. Passive immunity develops when ready-made antibodies are given to a susceptible individual.
Which medication classification is known to inhibit prostaglandin synthesis or release? Nonsteroidal anti-inflammatory drugs (in large doses) Antibiotics (in large doses) Adrenal corticosteroids Antineoplastic agents
Nonsteroidal anti-inflammatory drugs (in large doses)
A 16-year-old has been brought to the emergency department by his parents after falling through the glass of a storm door. The fall resulted in a 6 cm laceration of the right antecubital. The nurse caring for this patient knows that the site of the injury will have an invasion of what? Interferon Phagocytic cells Apoptosis Cytokines
Phagocytic cells
A nurse is taking the health history of a newly admitted client. Which of the following conditions would NOT place the client at risk for impaired immune function? Previous organ transplantation Surgical removal of the appendix History of radiation therapy Surgical history of a splenectomy
Surgical removal of the appendix
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? Through the mucous membranes of the throat Through the skin Breathing in airborne dust From being outside in the cold weather and decreasing resistance
Through the mucous membranes of the throat
Which of the following protective responses begin with the B lymphocytes? Humoral Phagocytic Cellular Recognition
Humoral
A patient has enlarged lymph nodes in his neck and a sore throat. This inflammatory response is an example of a cellular immune response whereby: Antibodies reside in the plasma Antibodies are released into the bloodstream B-lymphocytes respond to a specific antigen Lymphocytes migrate to areas of the lymph node
Lymphocytes migrate to areas of the lymph node
Which stage of the immune response occurs when the differentiated lymphocytes function in either a humoral or a cellular capacity? Recognition stage Proliferation stage Response stage Effector stage
Response stage In the response stage, the differentiated lymphocytes function in either a humoral or a cellular capacity. Recognition of antigens as foreign or non-self by the immune system is the initiating event in any immune response. In the proliferation stage, the circulating lymphocytes containing the antigenic message return to the nearest lymph node. In the effector stage, either the antibody of the humoral response of the cytotoxic T cell of the cellular response reaches and connects with the antigen on the surface of the foreign invader.
An infant is born to a mother who had no prenatal care during her pregnancy. What type of hypersensitivity reaction does the nurse understand may have occurred? Bacterial endocarditis Rh-hemolytic disease Lupus erythematosus Rheumatoid arthritis
Rh-hemolytic disease
Lymphoid tissues, which perform a function within the immune response, are found throughout the body. While the thymus gland, tonsils and adenoids, spleen, and lymph nodes are lymphoid tissues, where else in the body can lymphoid tissues be found? Select all that apply. intestines lungs stomach kidneys
intestines lungs Lymphoid tissue also is found on alveolar membranes in the lungs, mucous membranes of the intestines, and in the lining of the sinusoids of the liver.
While taking the health history of a newly admitted client, the nurse asks for a list of the client's current medications. Which of the following medication classifications would place the client at risk for impaired immune function? Antimetabolites Antihypertensives Inotropics Pancreatic enzymes
Antimetabolites Antimetabolites can cause leukopenia, eosinoplilia, aplastic bone marrow, and pancytopenia. The other choices do not directly affect the immune system.
The nurse knows that a specific classification of drugs leads to immunosuppression. What classification of drugs is this? Antibiotics (in small doses) Nonsteroidal anti-inflammatory drugs (NSAIDs, in large doses) Antineoplastics Antithyroids
Antineoplastics
A nurse is taking health history from a new client, which includes asking about a history of blood transfusions. This is important for which reason? Exposure to foreign antigens may cause altered immune function. Blood products cause a high risk for exposure to HIV. Blood products cause a high risk for hepatitis B. Blood products cause lower antibody titers.
Exposure to foreign antigens may cause altered immune function.
A patient in the intensive care unit has a diagnosis of immune thrombocytopenia (ITP) and has been treated with an infusion of intravenous immunoglobulin (IVIG). The therapeutic effects of IVIG are an example of: Passive acquired immunity Active acquired immunity Innate immunity Inflammation
Passive acquired immunity Passive acquired immunity is temporary immunity transmitted from a source outside the body that has developed immunity through previous disease or immunization. The administration of IVIG is an example of this process, not innate immunity or inflammation. Active immunity prompts antibody production rather than depending on direct provision of antibodies.
A laboring mother asks the nurse if the baby will have immunity to some illnesses when born. What type of immunity does the nurse understand that the newborn will have? Naturally acquired active immunity Artificially acquired active immunity v There is no immunity passed down from mother to child.
Passive immunity transferred by the mother
A pediatric client is recovering from an anaphylactic reaction to an allergen which brought him to the ED. The client's mother is quite concerned with the potential reoccurrence of her child's reaction. In attempting to narrow down the possible allergen, it is important to consider that clinical manifestations generally correlate with: route of exposure. skin reactions. respiratory symptoms. systemic effects.
route of exposure.
An emergency department (ED) nurse has provided care for many patients who have primary and secondary diagnoses of immune dysfunction. Which of the following patients likely has the highest risk of a disruption to normal immune functioning? A woman who was motivated to come to the ED because of a severe migraine A woman who presented for care for a complaint of vertigo A child who has just been treated for a greenstick fracture to her radius A man who has recently completed medical treatment for prostate cancer
A man who has recently completed medical treatment for prostate cancer
Which of the following is accurate regarding acquired immunity? Select all that apply. An immunologic response acquired during life but not present at birth Usually develops as a result of exposure to an antigen through immunization Can develop by contracting a disease A nonspecific immunity present at birth Also know as innate immunity
An immunologic response acquired during life but not present at birth Usually develops as a result of exposure to an antigen through immunization Can develop by contracting a disease
Which type of hypersensitivity occurs when the system mistakenly identifies a normal constituent of the body as foreign? Anaphylactic Delayed Cytotoxic Immune complex
Cytotoxic Cytotoxic hypersensitivity occurs when the system mistakenly identifies a normal constituent of the body as foreign. Anaphylactic hypersensitivity is the most severe immune-mediated reaction. Delayed hypersensitivity occurs 24 to 72 hours after exposure to an allergen. Immune complex hypersensitivity involves immune complexes that are formed when antigens bind to antibodies.
An elderly client is diagnosed with cancer. While reviewing age-related changes in the immune system, what does the nurse identify as having contributed to this client's condition? Impaired ciliary action from exposure to environmental toxins Failure of immune system to differentiate "self" from "non-self" Failure of lymphocytes to recognize mutant cells Decreased sensation and slowing of reflexes
Failure of lymphocytes to recognize mutant cells
Which type of cells destroys antigens already coated with antibody? Null Natural killer (NK) Memory T-cell Suppressor T-cell
Null Null cells destroy antigens already coated with antibody. NK cells defend against microorganisms and some types of malignant cells. Memory T cells remember contact with an antigen and, on subsequent exposures, mount an immune response. Suppressor T-cells suppress the immune response.
T-cell and B-cell lymphocytes are the primary participants in the immune response. What do they do? T-cell and B-cell lymphocytes distinguish harmful substances and ignore those natural and unique to a person. T-cell and B-cell lymphocytes respond to the body's invasion by macrophages. T-cell and B-cell lymphocytes react to the body's lack of B12 . T-cell and B-cell lymphocytes distinguish harmful treatments from curative treatments.
T-cell and B-cell lymphocytes distinguish harmful substances and ignore those natural and unique to a person.
T-cell deficiency occurs when which gland fails to develop normally during embryogenesis? Thyroid Thymus Pituitary Adrenal
Thymus
A nursing instructor is giving a lecture on the immune system. The instructor's discussion on phagocytosis will include: neutrophils and monocytes. plasma cells and memory cells. regulator T cells and helper T cells. lymphokines and suppressor T cells.
neutrophils and monocytes. Neutrophils and monocytes are phagocytes, cells that perform phagocytosis.
While monitoring the patient's eosinophil level, the nurse suspects a definite allergic disorder when seeing an eosinophil value of what percentage of the total leukocyte count? 1% to 3% 3% to 4% 5% to 10% 15% to 40%
15% to 40%
Which of the following cell types are involved in humoral immunity? B lymphocytes Helper T lymphocyte Suppressor T lymphocyte Memory T lymphocyte
B lymphocytes
Which medication classification is known to inhibit prostaglandin synthesis or release? Nonsteroidal anti-inflammatory drugs (in large doses) Antibiotics (in large doses) Adrenal corticosteroids Antineoplastic agents
Nonsteroidal anti-inflammatory drugs (in large doses) Nonsteroidal anti-inflammatory drugs include aspirin and ibuprofen. Antibiotics in large doses are known to cause bone marrow suppression. Adrenal corticosteroids and antineoplastic agents are known to cause immunosuppression.
A patient in the intensive care unit has a diagnosis of immune thrombocytopenia (ITP) and has been treated with an infusion of intravenous immunoglobulin (IVIG). The therapeutic effects of IVIG are an example of: Passive acquired immunity Active acquired immunity Innate immunity Inflammation
Passive acquired immunity
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 been treated for a sexually transmitted infection?" "When was your last menstrual period?" "Do you have abdominal pain or discomfort?" "Have you ever received a blood transfusion?"
"Have you ever received a blood transfusion?"
A patient with cystic fibrosis has received a double lung transplant and is now experiencing signs of rejection. What is the immune response that predominates in this situation? Humoral Nonspecific Cellular Mitigated
Cellular Most immune responses to antigens involve both humoral and cellular responses, although only one predominates. For example, during transplantation rejection, the cellular response predominates, whereas in the bacterial pneumonias and sepsis, the humoral response plays the dominant role. Mitigated and nonspecific cell response is not noted in this situation.
A client with lupus has had antineoplastic drugs prescribed. Why would the physician prescribe antineoplastic drugs for an autoimmune disorder? To decrease the body's risk of infection Because an autoimmune disease is a neoplastic disease So the client has strong drug therapy For their immunosuppressant effects
For their immunosuppressant effects Drug therapy using anti-inflammatory and immunosuppressive agents is the mainstay for alleviating symptoms. Some antineoplastic (cancer) drugs also are used for their immunosuppressant effects. Antineoplastic drugs do not decrease the body's risk of infection; an autoimmune disease is not a neoplastic disease. Drugs are not ordered just so the client has strong drug therapy.
A woman has been diagnosed with breast cancer and is being treated aggressively with a chemotherapeutic regimen. As a result of this regimen, she has an inability to fight infection due to the fact her bone marrow is unable to produce a sufficient amount of what? Lymphocytes Cytoblasts Antibodies Capillaries
Lymphocytes
An adult client has had mumps when the client was a child. The client had a titer prior to entering nursing school and shows immunity. What type of immunity does this reflect? Artificially acquired active immunity Naturally acquired active immunity Passive immunity Natural passive immunity
Naturally acquired active immunity Naturally acquired active immunity occurs as a direct result of infection by a specific microorganism. An example is the immunity to measles that develops after the initial infection. Not all invading microorganisms produce a response that gives lifelong immunity. Artificially acquired immunity is obtained by receiving a killed or weakened microorganism or toxoid. Passive immunity is acquired when ready-made antibodies are given to a susceptible person.
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. bleeding because the spleen synthesizes vitamin K. acidosis because the spleen maintains acid-base balance. anemia because the spleen produces red blood cells.
infection because the spleen removes bacteria from the blood.
Ibuprofen affects the immune system by causing pancytopenia. neutropenia. hemolytic anemia. thrombocytopenia.
neutropenia. Ibuprofen causes leukopenia and neutropenia. Phenylbutazone causes pancytopenia. Cefuroxime sodium causes thrombocytopenia and hemolytic anemia.
A 38-year-old client has begun to suffer from rheumatoid arthritis and is being assessed for disorders of the immune system. The client works as an aide at a facility that cares for children infected with AIDS. Which is the most important factor related to the client's assessment? Age Diet Use of other drugs Home environment
Use of other drugs The nurse needs to review the client's drug history. These data will help her to assess the client's susceptibility to illness because certain past illnesses and drug use, such as corticosteroids, suppress the inflammatory and immune responses. The client's age, home environment, and diet do not have any major implications during assessment because they do not indicate the client's susceptibility to illness.
A patient is being treated in the intensive care unit for sepsis related to ventilator-associated pneumonia. The patient is on large doses of three different antibiotics. What severe outcome should the nurse monitor for in the lab studies? Leukocytosis Bone marrow suppression Oral thrush Rash
Bone marrow suppression
During an annual examination, an older client tells the nurse, "I don't understand why I need to have so many cancer screening tests now. I feel just fine!" Based on knowledge of neoplastic disease and the aging immune system, what teaching should the nurse include in the client's plan of care? Select all that apply. Tumor cells may possess special blocking factors that coat tumor cells and prevent their destruction by killer T lymphocytes; therefore the body may not recognize the tumor as foreign and fail to destroy the malignant cells. Routine screening increases the chance of finding and treating cancer early. Education about the importance of adhering to a recommended vaccine schedule should be initiated to boost the immune system function. The increase in occurrence of autoimmune diseases with aging strongly suggests a predisposition toward various types of cancer due to the body's inability to differentiate between self and nonself. Routine screening increases the chance of finding and treating cancer early. Nutritional intake to support a competent immune response plays an important role in reducing the incidence of cancer. A healthy diet including protein, vitamins, minerals, and some fats can alter the risk of cancer development. The immune system is integrated with other psychophysiological processes and is regulated by the brain. Aging of the brain can have immunologic consequences and can affect neural and endocrine function increasing the risk of cancer development.
Tumor cells may possess special blocking factors that coat tumor cells and prevent their destruction by killer T lymphocytes; therefore the body may not recognize the tumor as foreign and fail to destroy the malignant cells. Routine screening increases the chance of finding and treating cancer early. The increase in occurrence of autoimmune diseases with aging strongly suggests a predisposition toward various types of cancer due to the body's inability to differentiate between self and nonself. Routine screening increases the chance of finding and treating cancer early. Nutritional intake to support a competent immune response plays an important role in reducing the incidence of cancer. A healthy diet including protein, vitamins, minerals, and some fats can alter the risk of cancer development.
An older adult client, who leads a sedentary lifestyle, and a younger client, who has a very stressful and active lifestyle, require a vaccine against a particular viral disorder. The nurse knows that in one of these clients, the vaccine will be less effective. In which client is the vaccine more likely to be less effective and why? The older client because of age The older client because of lifestyle The younger client because of age The younger client because of lifestyle
The older client because of age Vaccines are less effective in an older adult than in a younger adult because the activity of the immune system declines with the aging process. The lifestyle or gender of the client does not have great implications on the effectiveness of a vaccine.
A 34-year-old client is diagnosed with chronic hepatitis C. Testing reveals that the client is a candidate for treatment. The nurse anticipates that which therapy could be used to treat the client's condition? Erythropoietin Interleukin-5 Monoclonal antibodies Interferon
Interferon Interferons are used to treat immune-related disorders (e.g., multiple sclerosis) and chronic inflammatory conditions (e.g., chronic hepatitis).
A community health nurse is aware that a comprehensive assessment of a patient's immune system addresses nearly every system of the body. Which of the following assessment questions should the nurse prioritize in an assessment of a new patient's immune system? "Have you had any recent unexplained weight loss or fatigue?" "Have you been consistent with taking your prescribed medications?" "Do you ever feel like your heart is racing or skips a beat?" "When was the last time that you visited your family doctor?"
Have you had any recent unexplained weight loss or fatigue?"
While taking the health history of a newly admitted client, the nurse reviews general lifestyle behaviors. What strategies would have a positive effect on the immune system? Humor, rigorous physical stress, and biofeedback Biofeedback, relaxation, and hypnosis Relaxation, intense competitive exercise, and humor Hypnosis, humor, and chronic illness
Biofeedback, relaxation, and hypnosis Growing evidence indicates that strategies such as relaxation, imagery techniques, biofeedback, humor, hypnosis, and conditioning can positively influence a measurable immune system response. Intense or rigorous competitive exercise can cause negative effects on the immune system, especially if the environment is stressful while undergoing exercise.
A nurse is explaining treatment options to a client diagnosed with an immune dysfunction. Which statement by the client accurately reflects the teaching about current stem cell research? "Stem cell transplantation has been discontinued based on concerns about safety, efficacy, resource allocation, and human cloning." "Currently, stem cell transplantation has only been performed in the laboratory, but future research with embryonic stem cell transplants for humans with immune dysfunction has been promising." "Stem cell clinical trials have only been attempted in clients with acquired immune deficiencies, but plans are underway to begin human cloning using embryonic stem cells." "Stem cell transplantation has been carried out in humans with certain types of immune dysfunction, and clinical trials using stem cells are underway in clients with a variety of disorders with an autoimmune component."
"Stem cell transplantation has been carried out in humans with certain types of immune dysfunction, and clinical trials using stem cells are underway in clients with a variety of disorders with an autoimmune component."
What types of cells are the primary targets of the healthy immune system? Select all that apply. infectious cells foreign cells cancerous cells typical cells
infectious cells foreign cells cancerous cells
A client is presenting an anaphylactic response to unknowingly ingesting nuts at a family celebration. What type of hypersensitivity did this client exhibit? type I type II type III type IV
type I
A parent has brought a child to the clinic for a wellness check. While talking with the nurse, the parent asks the nurse to suggest a diet that will maximize the immune function of growing children. What dietary pattern should the nurse suggest? Diet rich in iron, zinc, and vitamin E Diet rich in potassium, magnesium, and sodium Diet rich in amino acids and essential fatty acids Moderate diet that is balanced and varied
Moderate diet that is balanced and varied The best dietary advice to maximize immune function in healthy people is to eat a moderate diet that is balanced and varied, because the optimum amount and proportion of nutrients required are yet unknown. Recent studies indicate that the availability of one nutrient may impair or enhance the action of another nutrient in immune system functioning. Although it is necessary to include vitamins, amino acids, essential fatty acids, and electrolytes in the diet of growing children, excessive amounts are not advisable.
A client has begun to suffer from rheumatoid arthritis and is being assessed for disorders of the immune system. The client works as an aide at a facility that cares for children infected with AIDS. What is the most important factor related to the client's assessment? The client's use of other drugs The client's age The client's diet The client's home environment
The client's use of other drugs The nurse needs to review the client's drug history. This data will help to assess the client's susceptibility to illness because certain past illnesses and drugs, such as corticosteroids, suppress the inflammatory and immune responses. The client's age, home environment, and diet do not have any major implications during assessment because they do not indicate susceptibility to illness.
A client has been diagnosed with AIDS and tuberculosis (TB). A nursing student asks the nurse why the client's skin test for TB is negative if the client's physician has diagnosed TB. The nurse's correct reply is which of the following? The client's immune system cannot mount a response to the skin test. The client has only mild TB, which is not enough to cause a reaction. The solution used for the skin test was probably outdated. The skin test was improperly performed.
The client's immune system cannot mount a response to the skin test. The inflammatory response is a major function of the immune system that is elicited in response to invading foreign material. A person with AIDS has a poorly functioning or non-functioning immune system that will not respond to the injected skin test. Any TB organisms should cause a reaction to the skin test in people with intact immune systems. The nurse cannot accurately speculate on how the skin test was performed or that the solution was outdated.
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? Activation of the complement system Stimulation of colony-stimulating factors A cell-mediated response Naturally acquired active immunity
A cell-mediated response A cell-mediated response occurs when T cells survey proteins in the body, actively analyze the surface features, and respond to those that differ from the host by directly attacking the invading antigen. An example of a cell-mediated response is one that occurs when an organ is transplanted. The complement system cooperates with antibodies to attract phagocytes and coat antigens to make them more recognizable for phagocytosis and stimulate inflammation and is not related to the surgery. Colony-stimulating factors prompt the bone marrow to produce, mature, and promote the functions of blood cells. Naturally acquired active immunity is a direct result of infection by a specific microorganism.
A nurse is teaching a community group about healthy lifestyles. A participant asks about how to maintain a healthy immune system. The nurse informs the group that which factor will positively affect the immune system? Rigorous, competitive exercise Strong family and community connections Residential exposure to radiation Poor nutritional status
Strong family and community connections Strong family and community ties will have a positive effect on the immune system. Rigorous or competitive exercise, usually considered a positive lifestyle factor, can be a physiologic stressor and cause negative effects on immune response. Any form of radiation can have a negative effect on the immune system, as can poor nutritional status.
A nurse is aware of the important role that interferons (IFNs) perform in the normal function of the immune system. As well, the nurse has provided care for patients who have benefited from interferon therapy. IFN therapy is most likely to be effective in the treatment of which of the following patients? An 80-year-old man who is debilitated from Clostridium difficile-related diarrhea A 68-year-old woman who is being treated for chronic myeloid leukemia (CML) A 60-year-old man with motor and sensory deficits resulting from an ischemic stroke A 36-year-old woman who is in danger of developing sepsis after suffering full-thickness burns
A 68-year-old woman who is being treated for chronic myeloid leukemia (CML) IFNs are cytokines. They have antiviral and antitumor properties and can consequently be used in the treatment of neoplasms such as CML. Bacterial infections and neurological deficits are not responsive to interferon therapy.
The nurse is teaching a client who has been diagnosed with Hashimoto's thyroiditis. Which statement correctly describes the process of autoimmunity? The normal protective immune response attacks the body, damaging tissues. The body produces inappropriate or exaggerated responses to specific antigens. The body overproduces immunoglobulins. A deficiency results from improper development of immune cells or tissues.
The normal protective immune response attacks the body, damaging tissues. Autoimmunity happens when the normal protective immune response paradoxically turns against or attacks the body, leading to tissue damage. It is not an immune deficiency. An exaggerated immune response describes a hypersensitivity. An overproduction of immunoglobulins is the definition of gammopathies.
