Nurs 107 Chapter 31 Assessment of Immune function

The nurse is obtaining a history from a patient with severe psoriasis. What question would be the most important to ask this patient to determine a genetic predisposition? "How many children do you have?" "Does your spouse or significant other have an autoimmune disease?" "How did you know you developed this disease?" "Does anyone in your family have more than one autoimmune disease?"

"Does anyone in your family have more than one autoimmune disease?"

When obtaining a health history from a patient with possible abnormal immune function, what question would be a priority for the nurse to ask? "Do you have abdominal pain or discomfort?" "Have you ever received a blood transfusion?" "Have you ever been treated for a sexually transmitted infection?" "When was your last menstrual period?"

"Have you ever received a blood transfusion?"

A nurse is teaching a client about the side effects of ibuprofen. The client's learning is determined to be effective based on which statement by the patient describing the drug's effect on the immune system? "Ibuprofen can cause pancytopenia, which is a decrease in all of my blood cells." "Ibuprofen can cause thrombocytopenia; I will need to watch for bruising and bleeding." "Ibuprofen can cause neutropenia, which can increase my risk of infection." "Ibuprofen can cause hemolytic anemia, which will make me feel tired and short of breath."

"Ibuprofen can cause neutropenia, which can increase my risk of infection."

A client presents at the clinic with an allergic disorder. The client asks the nurse what an "allergic disorder" means. What would be the nurse's best response? "It is a hyperimmune response to something in the environment that is usually harmless." "It means you are very sensitive to something inside of yourself." "It is a harmless reaction to something in the environment." "It is a muted response to something in the environment."

"It is a hyperimmune response to something in the environment that is usually harmless."

A client with an autoimmune disorder asks, "Why is autoimmune disease more prevalent in the women in my family?" Which response will the nurse make to this client? "Women have more stress than men and it weakens immunity." "There is not enough evidence to prove this." "It's because you take better care of your family than yourself." "It's believed to be caused by the differences in the sex hormones."

"It's believed to be caused by the differences in the sex hormones."

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? Relaxation, intense competitive exercise, and humor Biofeedback, relaxation, and hypnosis Hypnosis, humor, and chronic illness Humor, rigorous physical stress, and biofeedback

Biofeedback, relaxation, and hypnosis

A client is admitted to the hospital with a diagnosis of pneumonia. The client informs the nurse of having several drug allergies. The physician has ordered an antibiotic as well as several other medications for cough and fever. What should the nurse do prior to administering the medications? Consult drug references to make sure the medicines do not contain substances which the client is hypersensitive. Administer the medications that the physician ordered. Call the pharmacy and let them know the client has several drug allergies. Give the client one medicine at a time and observe for allergic reactions.

Consult drug references to make sure the medicines do not contain substances which the client is hypersensitive.

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? Cytotoxic T cells Macrophages Helper T cells B cells

Cytotoxic T cells

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? Conversion of memory cells to plasma cells 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

Engulfment and digestion of bacteria and foreign material

Which of the following protective responses begin with the B lymphocytes? Cellular Recognition Humoral Phagocytic

Humoral

Chronic illnesses may contribute to immune system impairment in various ways. Renal failure is associated with deficiency in circulating lymphocytes. decreased bone marrow function. increased incidence of infection. altered production of white blood cells.

deficiency in circulating lymphocytes.

The body has several mechanisms to fight disease, one of which is sending chemical messengers. The messengers released by lymphocytes, monocytes, and macrophages have differing roles in the immune response. Which messenger enables cells to resist viral replication and slow viral replication? colony-stimulating factor interleukins interferons tumor necrosis factor

interferons

Immunocompetence is the ability of the immune system to cooperatively protect a person from external invaders and the body's own altered cells. Immunocompetence is maintained by white blood cells and: antibodies. the compliment system. lymphoid tissue. cytokines.

lymphoid tissue.

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." "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." "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."

A parent of a child who has been having frequent bouts of tonsillitis brings the child back to the clinic for another sore throat. The parent asks the nurse, "What are tonsils good for anyway?" What is the best response by the nurse? "The tissue removes blood and bacteria." "They really do not have a function and should be removed." "The tissue acts as an emergency reservoir of blood." "These tissues filter bacteria from tissue fluid."

"These tissues filter bacteria from tissue fluid."

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 24-year-old client who is pregnant A 32-year-old client who has never had chickenpox A 17-year-old client who will be attending college and living in a dormitory

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

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 Activation of the complement system Naturally acquired active immunity Stimulation of colony-stimulating factors

A cell-mediated response

Which of the following cell types are involved in humoral immunity? Suppressor T lymphocyte Helper T lymphocyte Memory T lymphocyte B lymphocytes

B lymphocytes

A nurse is monitoring a client who developed facial edema after receiving a medication. Which white blood cells stimulated the edema? Monocytes Neutrophils Basophils Eosinophils

Basophils

Which immunoglobulin assumes a major role in bloodborne and tissue infections? IgM IgD IgA IgG

IgG

The nurse notes that an older adult was treated for a wound infection and pneumonia within the last 6 months. Which factor will the nurse attribute to this client's illnesses? Decline in self-care activities Immunosenescence Polypharmacy Reduced vitamin intake

Immunosenescence

A nurse is caring for a client undergoing evaluation for possible immune system disorders. Which intervention will best help support the client throughout the diagnostic process? Accompany the client to the diagnostic tests Assist the client with scheduling the procedures Encourage the client to ask the physician for information about treatment options for the possible diagnosis Educate the client about the diagnostic procedures and answer their questions about the possible diagnosis

Educate the client about the diagnostic procedures and answer their questions about the possible diagnosis

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? Blood products cause a high risk for exposure to HIV. Blood products cause lower antibody titers. Exposure to foreign antigens may cause altered immune function. Blood products cause a high risk for hepatitis B.

Exposure to foreign antigens may cause altered immune function.

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? Failure of the immune system to differentiate "self" from "non-self" Decreased phagocytosis by Kupffer cells Impaired ciliary action as a result of exposure to environmental toxins Decreased sensation and slowing of reflexes

Impaired ciliary action as a result of exposure to environmental toxins

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? Basophil Lymphocyte Monocyte Neutrophil

Lymphocyte

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 causes an excess of circulating lymphocytes. Radiation destroys lymphocytes. Radiation causes a deficiency of circulating hemoglobin. Radiation causes an excess of circulating hemoglobin.

Radiation destroys lymphocytes.

Which condition is associated with impaired immunity relating to the aging client? Incidence of autoimmune disease decreases Renal function decreases Antibody production increases Skin becomes thicker

Renal function decreases

A nursing instructor is giving a lecture on the immune system. The instructor's discussion on phagocytosis will include: regulator T cells and helper T cells. neutrophils and monocytes. lymphokines and suppressor T cells. plasma cells and memory cells.

neutrophils and monocytes.

A nurse is developing a teaching plan for a community presentation on smoking cessation. Based on current research regarding the effects of cigarette smoking on the immune system, which alterations in immune function can be attributed to smoking and should be included in the teaching presentation? Select all that apply. Increased risk of infection Increased white blood cell count Decreased natural killer cells Decreased T-cell function Decreased IgE antibody production

Increased risk of infection Increased white blood cell count Decreased natural killer cells Decreased T-cell function

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 are released into the bloodstream B-lymphocytes respond to a specific antigen Lymphocytes migrate to areas of the lymph node Antibodies reside in the plasma

Lymphocytes migrate to areas of the lymph node

The nurse is taking the health history of a newly admitted client. Which condition would place the client at risk for impaired immune function? Surgical history of a partial gastrectomy Negative history for radiation therapy Surgical removal of the appendix Previous organ transplantation

Previous organ transplantation

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? Red blood cells Cytokines Stem cells Lymphoid tissues

Lymphoid tissues

The nurse is aware that the phagocytic immune response, one of the body's responses to invasion, involves the ability of cells to ingest foreign particles. Which of the following engulfs and destroys invading agents? Macrophages Eosinophils Basophils Neutrophils

Macrophages

A 25-year-old client receives a knife wound to the leg in a hunting accident. Which type of immunity was compromised? Specific immunity Adaptive immunity Passive immunity Natural immunity

Natural immunity

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

Which type of immunity becomes active as a result of infection by a specific microorganism? Artificially acquired active immunity Naturally acquired active immunity Naturally acquired passive immunity Artificially acquired passive immunity

Naturally acquired active immunity

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 There is no immunity passed down from mother to child. Naturally acquired active immunity Artificially acquired active immunity

Passive immunity transferred by the mother

A client has undergone a kidney transplant. The nurse is concerned about a compromised immune system in this client for which reason? Excess circulating hemoglobin Excess circulating lymphocytes Deficient circulating antibodies Use of anti-rejection drugs

Use of anti-rejection drugs

What is the function of the thymus gland? Produce stem cells Programs B lymphocytes to become regulator or effector B cells. Develop the lymphatic system Programs T lymphocytes to become regulator or effector T cells.

Programs T lymphocytes to become regulator or effector T cells.

During which stage of the immune response does the circulating lymphocytes containing the antigenic message return to the nearest lymph node? Proliferation Response Effector Recognition

Proliferation

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 glucagon Plasma, which depletes the body's store of calcitonin Plasma, which depletes the body's store of catecholamines Serum, which depletes the body's store of immunoglobulins

Serum, which depletes the body's store of immunoglobulins

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? Surgical history of a splenectomy History of radiation therapy Surgical removal of the appendix Previous organ transplantation

Surgical removal of the appendix

The anatomy and physiology instructor is explaining a cell-mediated response to the pre-nursing students. What actions would the instructor explain occur in a cell-mediated response? The invading antigens precipitate. T-cell lymphocytes survey proteins in the body and attack the invading antigens. Toxins of invading antigens are neutralized. The invading antigens link together (agglutination).

T-cell lymphocytes survey proteins in the body and attack the invading antigens.

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 "self." The immune system recognizes one's own tissues as "foreign." Excess cytokines cause tissue damage. Regulatory mechanisms fail to halt the immune response.

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

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 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 client will have a productive cough. The injection area will break out in a fine macular rash.

The injection area swells if the client has developed antibodies against the antigen.

The nurse is teaching a client who has been diagnosed with Hashimoto's thyroiditis. Which statement correctly describes the process of autoimmunity? A deficiency results from improper development of immune cells or tissues. The body produces inappropriate or exaggerated responses to specific antigens. The body overproduces immunoglobulins. The normal protective immune response attacks the body, damaging tissues.

The normal protective immune response attacks the body, damaging tissues.

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 diet The client's age The client's use of other drugs The client's home environment

The client's use of other drugs