Test 3- Immunity, Metabolism, and Cellular Regulation

The client with rheumatoid arthritis has a red blood cell count of 3.2 cells/cu mm. Which nursing diagnosis has the highest priority for the client?

Fatigue

A nurse is working in a support group for clients with acquired immunodeficiency syndrome (AIDS). Which point is most important for the nurse to stress?

Following safer-sex practices

Which condition is an early manifestation of HIV encephalopathy?

Headache

Which of the following indicates that a client with HIV has developed AIDS?

Herpes simplex ulcer persisting for 2 months

A client who is HIV positive is experiencing severe diarrhea. Which laboratory test result would the nurse expect to find?

Hypokalemia

A patient in the clinic states, "My boyfriend told me he went to the clinic and was treated for gonorrhea." While testing for the sexually transmitted infection (STI), what else should be done for this patient?

Inform the patient that it would be beneficial to test for HIV.

Which of the following is a center for immune cell proliferation?

Lymph node

What chemical is released by cytotoxic T cells?

Lymphokine

The nurse is discussing the new medication that a client will be taking for treatment of rheumatoid arthritis. Which disease-modifying antirheumatic drug (DMARD) will the nurse educate the client about?

Methotrexate (Rheumatrex)

The anatomy and physiology class is learning about antigens and antibodies. What should the instructor explain that antibodies are?

Natural killer cells

Which type of cell is capable of directly killing invading organisms and producing cytokines?

Natural killer cells

A client with AIDS is having a recurrence of 10 to 12 loose stools a day. What medication may help this client with controlling the chronic diarrhea?

Octreotide

A nurse is exposed to hepatitis C and receives a shot of gamma globulin. What type of immunity does this nurse have?

Passive immunity

A client with human immunodeficiency virus (HIV) develops a nonproductive cough, shortness of breath, a fever of 101°F and an O2 saturation of 92%. What infection caused by Pneumocystis jiroveci does the nurse know could occur with this client?

Pneumocystis pneumonia

A nurse is preparing an in-service presentation about human immunodeficiency virus (HIV) for a group of new graduate nurses. As part of the presentation, the nurse is planning to describe the events that occur once HIV enters the host cell. What would the nurse describe as the first step?

Attachment

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 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

An individual's exposure to an airborne pathogen has prompted an immune response that includes both cellular and humoral components. Which of the following activities is most closely associated with the humoral immune response?

B lymphocytes produce antibodies that are specific to the pathogen.

Which of the following tests determines initiation of antiretroviral treatment?

CD4/CD8 ratio

Which stage of HIV infection is indicated when the results are more than 500 CD4+ lymphocytes/mm?

CDC category A: HIV asymptomatic

A nurse is monitoring the client's progression of human immunodeficiency virus (HIV). What debilitating gastrointestinal condition found in up to 90% of all AIDS clients should the nurse be aware of?

Chronic diarrhea

This type of T lymphocyte is responsible for altering the cell membrane and initiating cellular lysis. Choose the T lymphocyte.

Cytotoxic T cell

A nurse is assesing a client with Kaposi's sarcoma. What initial sign does the nurse know to look for during assessment?

Deep purple cutaneous lesions

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?

Digestive enzymes destroy its protein structure.

Which adverse effect should the nurse closely monitor in a client who takes immunosuppressive drugs?

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 containing the genetic viral material?

Ribonucleic acid (RNA)

A client in a late stage of acquired immunodeficiency syndrome (AIDS) shows signs of AIDS-related dementia. Which nursing diagnosis takes highest priority?

Risk for injury

A client with acquired immune deficiency syndrome (AIDS) is experiencing pain secondary to Kaposi's sarcoma. How would the nurse most likely expect the client to describe the pain?

Sharp, throbbing pressure

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

T-cell deficiency occurs when which gland fails to develop normally during embryogenesis?

Thymus

The term used to define the amount of virus in the body after the initial immune response subsides is

Viral set point

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

In a client infected with human immunodeficiency virus (HIV), CD4+ levels are measured to determine the:

extent of immune system damage.

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

naturally acquired active immunity

A female client comes to the clinic and tells the nurse, "I think I have another vaginal infection and I also have some wartlike lesions on my vagina. This is happening quite often." What should the nurse consult with the physician regarding?

testing the client for the presence of HIV

A client who is HIV+ has been diagnosed with Pneumocystis pneumonia caused by P. jiroveci. What medication will the client take for the treatment of this infection?

trimethoprim-sulfamethoxazole

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?

Estrogen tends to enhance immunity.

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."

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

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?

interferons

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.

The nurse identifies a nursing diagnosis of ineffective airway clearance related to pneumocystis pneumonia and increased bronchial secretions for a client with AIDS. Which of the following would be appropriate for the nurse to include in the client's plan of care?

Assist with chest physiotherapy every 2 to 4 hours.

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.

The development of a positive HIV antibody test following initial infection generally occurs in which timeframe?

4 weeks

A client is beginning highly active antiretroviral therapy (HAART). The client demonstrates an understanding of the need for follow up when scheduling a return visit for viral load testing at which time?

6 weeks

A client who has developed kidney failure is discussing options with the health care provider for treatment. What does the nurse understand that kidney failure is associated with?

A deficiency in circulating lymphocytes

A client is diagnosed with rheumatoid arthritis. When teaching the client and family about rheumatoid arthritis, the nurse should provide which information?

Autoimmune disorders include connective tissue (collagen) disorders.

A nursing student asks the instructor how to identify rheumatoid nodules in a client with rheumatoid arthritis. Which of the following characteristics would the instructor include?

Located over bony prominence

The nurse is caring for a client with renal failure. Which factor indicates a compromised immune system?

A deficiency of circulating lymphocytes