NURB 3050 Test 2: Infections

A client asks, "Why do people who have AIDS get Kaposi sarcoma but not people who have normal immune systems?" What is the best response from the nurse?

A healthy immune system can destroy abnormal cells that can develop into cancers, but the suppressed immune system in a person who has AIDS is not able to do so as effectively.

A nurse administers an attenuated vaccination. Which type of vaccine did the nurse give to the client?

A live, weakened microorganism

A nurse is caring for a client with mycosis. The nurse is caring for which client?

A man with a fungal infection

A client has to be treated for an infection that produces endotoxins. The nurse is caring for which client?

A man with an Escherichia coli infection

The nurse is caring for a client who has undergone bone marrow transplantation. After assessing the client, the nurse suspects that the client is at risk for graft-versus-host disease (GVHD). Which client statement supports the nurse's conclusion?

"I always feel thirsty."

The nurse is assessing a child who has wide-set eyes, low-set ears, and a shortened structure of the upper lip. The child's laboratory reports indicate a decrease in the number of T cells. Which instruction should the nurse give to the child's parents to prevent further complications?

"Provide calcium-rich food to your child."

A client has type A blood. Which type of blood can the nurse administer to this client?

A & O

Which client is most at risk for developing systemic lupus erythematosus ( SLE)?

A 35-year-old black woman

Which intervention will the nurse question for a client with immunodeficiencies?

Administer attenuated vaccine

A client has an inappropriate, exaggerated response against a noninfectious environmental substance. Which term should the nurse use when reporting this condition to another healthcare professional?

Allergy

A client has an organ transplant from another person. The client's body mounts an aggressive response against the organ transplanted. Which type of reaction did the client experience?

Alloimmune

A client has a reaction to a liver transplant. Which term will the nurse use to describe this event?

Alloimmunity

A nurse is caring for a client with an alloimmune disease. The nurse is caring for which client?

An infant with hemolytic disease of the newborn

A child who has a congenital immunodeficiency that impairs B lymphocyte function will have primarily a deficiency of which immune component?

Antibodies

Which information indicates the nurse has a correct understanding of the causes for type II hypersensitivity tissue injury?

Antibody opsonization of cells leads to subsequent phagocytosis. Neutrophils attach to cell receptors, causing release of granules into cells. Antibodies activate complement, and subsequent lysis of target cells occurs.

A nurse is teaching about HIV. Which area (see diagram) should the nurse choose to illustrate the structure that incorporates viral DNA into the client's cell DNA?

Area 2

A nurse is teaching the staff about the human immunodeficiency virus (HIV). Which area (see diagram) should the nurse choose to illustrate the substance that combines with the CD4 molecule?

Area 2

Which assessment findings will the nurse expect to observe in a client with systemic lupus erythematosus ( SLE)?

Arthralgias, mouth ulcers, and facial rash

A nurse hears that a client is sensitized and is predisposed to a type I hypersensitivity reaction. How should the nurse interpret this finding?

Attachment of large amounts of IgE to mast cell membranes has occurred.

A nurse is caring for a client that has no antigen presentation because of a lack of major histocompatibility complex (MHC) class I molecules. Which diagnosis will the nurse observe written in the client's medical record?

Bare lymphocyte syndrome

A nurse is teaching about the mechanisms of action for antibiotics. Which information should the nurse include?

Block DNA replication Inhibit protein synthesis Inhibit synthesis of cell wall Interfere with folic acid metabolism

A client who is HIV positive receives a reverse transcriptase inhibitor drug. The drug produces a therapeutic effect by which action?

Blocks the conversion of viral RNA into double-stranded DNA

While reviewing the laboratory reports of a client with otitis media, the nurse finds that the client has no circulating B cells and a normal number of T cells. Which condition will the nurse expect to see written in the client's medical record?

Bruton agammaglobulinemia

After reviewing the laboratory reports of a client with a T cell deficiency, the nurse suspects that the client has acquired immunodeficiency syndrome. Which laboratory finding is consistent with this condition?

CD4+ cell levels are 150/mm^3

The nurse is caring for a client who is receiving antibiotic therapy. The laboratory reports indicate the presence of pyrogenic bacteria and cytokines in the client's blood. Which conditions should the nurse suspect in the client?

Cardiovascular shock Intravascular coagulation

The nurse is monitoring four clients who require blood transfusions. Which client will receive safe and effective treatment?

Client A: Client's blood group - A positive Blood group transfusion to client - O positive

The nurse is assessing clients who have symptoms of hypersensitivity reactions. Which client has an immune complex-mediated hypersensitivity reaction?

Client A: Client developed an allergic reaction after eating wheat products

The nurse is reviewing the blood reports of four pregnant clients and their fetuses. Which client requires an immediate administration of RhoGAM?

Client C: Client's blood group - B negative Fetal blood group - O positive

A client has an Arthus reaction after an injection. What will the nurse observe upon assessment of this client?

Clotting problems

During the assessment, the nurse discovers a client has recurrent Neisseria menigitides Infection. Which deficiency does the nurse suspect?

Complement

A nurse is preparing a teaching poster about routes of transmission for human immunodeficiency virus (HIV). Which routes should be included?

Contact with infected blood Breast-feeding by an infected mother Sexual intercourse with an infected partner

A client with arthritis has a malar rash, oral ulcers, seizures, and a discoid rash. Which class of medication should be included in the client's prescriptions to provide effective treatment?

Corticosteroids

A nurse is caring for a client with systemic lupus erythematosus (SLE). Which pathophysiologic process should the nurse consider when planning care for this client?

Deposition of immune complexes in the kidneys and many other body tissues

A client has an immune deficiency. While the nurse is taking the history, which finding will be typical?

Frequent, severe Infection

A client, who has acquired immune deficiency syndrome (AIDS), receives treatment for prevention of Pneumocystis pneumonia. The client states, "I don't understand why I'm getting treatment for an infection I don't have yet." The best response by the nurse is that people with immunosuppression get Pneumocystis pneumonia under which conditions?

From microorganisms that usually are harmless

Which action by the new nurse will cause the charge nurse to intervene?

Giving type AB blood to a person with type O blood

A client is admitted to the hospital with an infection producing endotoxins. When the nurse checks the culture and sensitivity test, which type of microorganism will the nurse observe?

Gram-negative bacteria

The nurse teaches a group of clients with acquired immunodeficiency syndrome (AIDS) about ways to protect themselves from infection. What is the rationale for the nurse's behavior?

HIV primarily infects and destroys T helper cells.

While reviewing the medical history of a client with X-linked immunodeficiency disorder, the nurse finds that the client has low immunoglobulin M (IgM) antibodies. Which complication should the nurse assess for in the client?

Hemorrhage

A client requires a transplant. Which cells become a priority for the nurse to check?

Human leukocyte antigens (HLAs)

The nurse is assessing a client who has entered anaphylactic shock. Which physiologic condition does the nurse expect to see in the client?

Hypotension

The nurse is teaching safety measures to a client with systemic lupus erythematosus (SLE). Which client statement indicates effective learning?

I should avoid sun exposure." "I should take nonsteroidal antiinflammatory drugs."

A client has an Arthus reaction. Which type of hypersensitivity reaction did the client experience?

III

A client has an allergic response. When the nurse is checking the laboratory values, which antibody level will be most elevated?

IgE

After a client has a type 1 hypersensitivity response, which laboratory test result will the nurse find the most elevated?

IgE

A client has a type III hypersensitivity reaction. Which pathophysiologic process should the nurse consider when planning care for this client?

Immune complexes activate the complement system and damage tissues.

How should the nurse explain to the staff the process of human immunodeficiency virus (HIV) replication?

Insertion of viral RNA into helper T cells leads to conversion to viral DNA and provides genetic instructions to make new virions.

When a nurse is asked which microorganism causes AIDS, how should the nurse answer?

It is a retrovirus.

Which information indicates the nurse has an accurate understanding of the function of viral protease in an HIV virus?

It processes newly synthesized viral proteins.

A child developed hives soon after eating homemade strawberry jam. The child's mother states, "I don't understand what happened. He didn't break out last month when I made this jam." Which information should the nurse consider before answering?

Last month, antibodies against antigens normally in strawberries bound to mast cells, making the child sensitized. More jam today caused these mast cells to degranulate and release mast cell products.

A client has a type I hypersensitivity reaction. Which cells release the chemical mediators of inflammation in the immediate phase?

Mast cells

A nurse is caring for a client with Dengue fever. Which route of transmission will the nurse consider when planning care?

Mosquito vector

What is a similarity between a type I hypersensitivity reaction in a male client and a type IV hypersensitivity reaction in a female client?

Neither involves the participation of complement.

A client recently tested positive for human immunodeficiency virus (HIV). The client's fever, muscle aches, and swollen nodes have gone away. Which assessment findings should the nurse expect to see over time before the client develops any acquired immunodeficiency syndrome (AIDS) indicator conditions?

No signs and symptoms

The client in early-stage human immunodeficiceny virus (HIV) infection will exhibit which clinical manifestations upon assessment?

Nonspecific flu-like symptoms including fever, headache, and fatigue

A client inhales a microorganism that causes an infection. Which term should the nurse use to describe the inhalation of the microorganism?

Portal of entry

A client has chronic granulomatous disease. Which goal is priority for this client?

Prevent pneumonia

Which information from the nurse indicates a correct understanding of the difference between primary and secondary immunodeficiency disorders?

Primary immunodeficiencies are congenital, whereas secondary immunodeficiencies are acquired.

A client has Wiskott-Aldrich syndrome. Which nursing goal takes priority?

Protection from IgM deficiency Infection

A client presents to the healthcare clinic with a malar rash, oral ulcers, photosensitivity, and pleurisy. Which complications should the nurse expect to find in the client?

Proteinuria Thrombocytopenia

Which finding in the history will indicate to the nurse that the client may have a deficiency of humoral immune cells?

Recurrent bacterial Infection

The primary healthcare provider prescribes bone marrow transplantation to a client with a leukocyte adhesion defect. Which treatment strategy will the nurse prepare the client for before surgery can be performed?

Removing mature T cells

Which manifestations will the nurse expect to find when assessing a client who is experiencing a type I hypersensitivity reaction?

Rhinitis, urticaria, and wheezing

The parents of an infant with which condition will need the most complex teaching about protecting their infant from infection?

Severe combined immunodeficiencies (SCIDs)

Which laboratory finding should the nurse use to evaluate the effectiveness of protease inhibitors prescribed for a client with a viral infection?

T helper cells = 800/mm^3

A client has type AB+ blood. How should the nurse interpret this finding?

The client has D antigens The client has the DD genotype. The client has A and B antigens.

A client with acquired immunodeficiency syndrome (AIDS) has a decreasing CD4 + count. How should the nurse interpret this finding?

The number of helper T cells is decreasing.

A nurse is caring for a client with an infection that produces endotoxins. Which piece of equipment will the nurse obtain to monitor for the clinical manifestation of this type of disease?

Thermometer

A nurse is teaching about parasitic diseases. Which information should the nurse include in the teaching session?

They are rarely transmitted from human to human.

Which treatment should the nurse expect to be prescribed for a client with adenosine deaminase deficiency and low levels of IgM and IgA?

Transplantation of bone marrow Transfusions of glycerol frozen-packed erythrocytes

The nurse is assessing a client with low-set ears, a fish-shaped mouth, and shortened structure of the upper lip. The client's laboratory reports indicate the presence of low circulating T cell levels. Which treatment strategy will be most beneficial for the client?

Transplantation of fetal thymus tissue

A nurse is discussing ART with the oncoming nurse for the next shift. What is the nurse describing?

Treatment for AIDS

A person who has an allergic reaction to a bee sting comes to the clinic. The nurse will monitor the client for which type of hypersensitivity reaction?

Type I

For a client with Graves disease, which type of hypersensitivity reaction should guide nursing care?

Type II

A client has a hypersensitivity reaction that is mediated primarily by T lymphocytes. Which type of reaction did the client experience?

Type IV

A client has poison ivy. Which type of reaction did the client experience?

Type IV

A nurse administers a skin test for tuberculosis. The nurse reads the results of the skin test based on which type of hypersensitivity reaction?

Type IV

A client has gastroenteritis from eating spinach contaminated with E. coli. While planning care, the nurse should remember that the severity of the client's illness is determined by which characteristic of the bacteria?

Virulence

A nurse is describing a type of microorganism that must depend on the permissive host to replicate. Which type of microorganism is the nurse discussing?

Viruses

Which terms can a nurse use to describe urticaria to another health professional?

Wheal/flare Dermal reaction Hives

Which assessment finding will indicate to the nurse that the client is having a life-threatening type I hypersensitivity reaction?

Wheezing, difficulty breathing, and hypotension

A client says, "I have been learning about human immunodeficiency virus (HIV) replication. I know that integrase puts the HIV DNA into the host cell DNA, but I don't understand where integrase comes from in the first place." What is the nurse's best response?

When HIV enters a host cell, it brings integrase with it.

A nurse is caring for a client that had an organ transplant rejection. Which information indicates the nurse has a correct understanding of transplant rejection?

White graft indicates hyperacute rejection. Acute rejection is a type IV hypersensitivity reaction.

Which term will the nurse use to describe the time between infection and the appearance of antibodies to human immunodeficiency virus (HIV)?

Window period

A client has an X-linked recessive immunodeficiency disease characterized by decreased immunoglobulin M (IgM) production. Which medical diagnosis will the nurse observe written in the chart?

Wiskott-Aldrich syndrome

A camp nurse meets with a young male camper who states that he touched poison ivy accidentally but is perfectly fine. The camper seems to think that he is not allergic to poison ivy. What is the nurse's best response?

You will likely get an itchy blistering rash in the next few days. Let me check your hand every day this week.

A client with a B-cell deficiency is receiving intravenous immune globulin. When the client asks about the drug therapy, how should the nurse respond?

You will need repeated treatments.

"My doctor said I have an autoimmune disease. What does that mean?" asks a client. How should the nurse respond?

Your immune system is creating antibodies that are destroying your own cells.