Pre lecture quiz 31/32
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
HIV ________________ is a clinical syndrome that is characterized by a progressive decline in cognitive, behavioral, and motor functions as a direct result of HIV infection.
Encephalopathy
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
9 ______________ are the first cells to arrive at the site in the body where inflammation occurs.
Neutrophils
Temporary immunity, transmitted from a source outside the body that has developed immunity through previous disease or immunization, is called ___________ acquired immunity.
Passive
A patient had unprotected sex with an HIV-infected person and arrives in the clinic requesting HIV testing. Results determine a negative HIV antibody test and an increased viral load. What stage does the nurse determine the patient is in?
Primary infection
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
To assess an enlarged spleen, the nurse would palpate the area of the: You Selected:
Upper left quadrant of the abdomen
Which of the following is a center for immune cell proliferation?
lymph node
Ibuprofen affects the immune system by causing
neutropenia
engulfing, ingesting, and destroying greater numbers and quantities of foreign bodies or toxins
phagocytic cells,
The inflammatory response needs to be balanced so that what is helpful does not become harmful if mediators are secreted in excess. Which of the following are the primary mediators in an inflammatory response?
T cells and cytokines
The body, when invaded by bacteria, viruses, or other pathogens, has three types of immune responses: phagocytic, humoral or antibody, and _____________.
Cellular
Modes of transmission for HIV include blood, semen, saliva, and casual contact.
False
Which of the following is a lack of one or more of the five immunoglobulins?
Hypogammaglobulinemia
The majority of primary immune deficiency disorders are diagnosed during infancy.
TRUE
What treatment option does the nurse anticipate for the patient with severe combined immunodeficiency disease (SCID)?
Bone marrow transplantation
This type of T lymphocyte is responsible for altering the cell membrane and initiating cellular lysis. Choose the T lymphocyte.
Cytotoxic T cell
The incidence of autoimmune diseases decreases with age, possibly due to the increased ability of antibodies to differentiate between self and non-self.
False
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?
Lymphoid tissues
The nurse is aware that the most prevalent cause of immunodeficiency worldwide is
Malnutrition
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.
B lymphocytes mature in the bone marrow and T lymphocytes mature in the __________
Thymus
The T lymphocytes are primarily responsible for cellular immunity.
True
A common complication of stage 3 HIV infection, __________syndrome, is defined as a loss of more than 10% of one's body weight over a 30-day timeframe.
Wasting
A nurse is caring for a client with human immunodeficiency virus (HIV). What would the nurse expect the health care provider to order to determine the effectiveness of treatment?
quantification of T-lymphocytes
The nurse receives a phone call at the clinic from the family of a client with AIDS. They state that the client started "acting funny" and reported headache, tiredness, and a stiff neck. Checking the temperature resulted in a fever of 103.2°F. What should the nurse inform the family member?
"The client may have cryptococcal meningitis and will need to be evaluated by the health care provider."
A patient is on highly active antiretroviral therapy (HAART) for the treatment of HIV. What does the nurse know would be an adequate CD4 count to determine the effectiveness of treatment for a patient per year?
50 mm3 to 150 mm3
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)
develops after birth.
Acquired or specific immunity
A client has been diagnosed with acquired immune deficiency syndrome (AIDS). Which statement correctly describes a secondary immune deficiency?
An interference develops in an already developed immune system
A client receiving antiretroviral therapy reports "not urinating enough." What is the nurse's best action?
Assess blood urea nitrogen and creatinine.
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.
A client who is HIV positive is receiving highly active antiretroviral therapy (HAART) that includes a protease inhibitor (PI). The client comes to the clinic for a follow-up visit. Assessment reveals lipoatrophy of the face and arms. The client states, "I'm thinking the side effects of the drug are worse than the disease. Look what's happening to me." The nurse would most likely identify which nursing diagnosis as the priority?
Disturbed body image related to loss of fat in the face and arms
Which of the following is the first barrier method that can be controlled by the woman?
Female condom
A nurse is preparing to give a client an infusion of gamma globulin. The nurse knows to stop the infusion if the client experiences which symptoms? Select all that apply.
Flank pain Shaking chills Tightness in the chest
Which condition is an early manifestation of HIV encephalopathy?
Headache
Which of the following protective responses begin with the B lymphocytes?
Humoral
______________ refers to the body's specific protective response to an invading foreign agent or organism.
Immunity
A client with severe combined immunodeficiency is to receive a hematopoietic stem cell transplant. What would the nurse expect to be started?
Immunosuppressive agents
is present at birth
Natural immunity or nonspecific immunity
The nurse understands that which cells circulate throughout the body looking for virus-infected cells and cancer cells?
Natural killer cells
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
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?
Naturally acquired active immunity
A client with common variable immunodeficiency disease (CVID) has an order for an IVIG infusion. What actions should the nurse perform before beginning the infusion? Select all that apply
Premedicate with acetaminophen and diphenhydramine. Assess baseline vital signs. Measure the client's height and weight. Assess for history of migraine headaches.
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
Which adverse effect(s) should the nurse closely monitor in a client who has secondary immunodeficiencies due to immunosuppressive therapy?
Respiratory or urinary system infections
Nursing students are reviewing the pathophysiology of human immunodeficiency virus (HIV). They demonstrate understanding of the information when they state which of the following as the form of the genetic viral material?
Ribonucleic acid (RNA)
Nursing management of a patient who requires immunosuppression must include use of __________ precautions when providing care to prevent infection.
Standard
A client with AIDS is admitted to the hospital with severe diarrhea and dehydration. The physician suspects an infection with Cryptosporidium. What type of specimen should be collected to confirm this diagnosis?
Stool specimen for ova and parasites
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 removal of the appendix
The structural part of the invading or attacking organism that is responsible for stimulating antibody production is called an antigen.
TRUE
A client taking fosamprenavir reports "getting fat." What is the nurse's best action?
Teach the client about medication side effects.
What are the characteristics of a B-cell deficiency, such as common variable immune deficiency (CVID)? Select all that apply.
There is a disappearance of germinal centers from lymphatic tissue. There is complete lack of antibody production. Disease onset occurs most often in the second decade of life
Lupus erythematosus, rheumatoid arthritis, multiple sclerosis, and psoriasis are examples of autoimmune disorders.
True
Nurses need to be nonjudgmental in order to be effective in educating LGBT population about HIV/AIDS prevention methods.
True
Nursing management of patients with HIV include educating the patient to recognize the signs and symptoms of infection.
True
The majority of lymphocytes in the blood, which play a major role in cell-mediated immune responses, are T cells.
True
Immune deficiency disorders may be caused by a defect in, or a deficiency of, phagocytic cells, B lymphocytes, T lymphocytes, or the ______________ system.
complement
A pediatric client is recovering from an anaphylactic reaction to an allergen. In the first assessment, the client presents with a periorbital accumulation of blood, a common occurrence in children. What type of allergic reaction presents "allergic shiners"?
type I
usually develops due to prior exposure to an antigen through immunization (vaccination) or by contracting a disease, both of which generate a protective immune response. Weeks or months after exposure to a disease or vaccine, the body produces an immune response that is sufficient to defend against the disease on re-exposure.
Acquired (adaptive) immunity
Which of the following are actions of chemical mediators? Select all that apply.
Activating phagocytes, Minimize blood loss Promoting formation of fibrous scar tissue
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?
Educate the client about the diagnostic procedures and answer their questions about the possible diagnosis
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?
Strong family and community connections
Many patients with PIDDs have comorbid autoimmune disorders, such as thyroid disease, rheumatoid arthritis, cytopenias, and inflammatory bowel disease.
TRUE
The nurse is admitting a client to the unit with a diagnosis of ataxia-telangiectasia. The nurse would recognize that the client is exhibiting telangiectasia when assessing the presence of what?
Vascular lesions caused by dilated blood vessels
Antiretroviral medications as post-exposure prophylaxis for health care workers are started within ______________ hours of exposure.
72
A client with AIDS develops pneumocystis pneumonia. The nurse would most likely expect to include administration of which agent in the client's plan of care?
TMP-SMZ
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?
Lymphocyte
