Deck 15: Care of the Patient with an Immune Disorder

Question 1

What should the nurse include to assess for in the plan of care for a patient undergoing plasmapheresis?

A) Hypotension
B) Hypersensitivity
C) Urticaria
D) Flank pain

Answer 1

Hypotension

Question 2

The nurse explains that when the patient received tetanus antitoxin with the antibodies in it,the patient received a ___________ type of immunity.

A) Active natural
B) Passive natural
C) Active artificial
D) Passive artificial

Answer 2

Passive artificial

Question 3

What is the substance released by the T cells that stimulates the lymphocytes to attack an inflammation?

A) Lymphokine
B) Epinephrine
C) B cells
D) Histamine

Answer 3

Lymphokine

Question 4

An anxious patient enters the emergency room with angioedema of the lips and tongue,dyspnea,urticaria,and wheezing after having eaten a peanut butter sandwich.What should be the nurse's first intervention?

A) Apply cool compresses to urticaria
B) Provide oxygen per non-rebreathing mask
C) Cover patient with a warm blanket
D) Prepare for venipuncture for the delivery of IV medication

Question 5

A patient is admitted with a secondary immunodeficiency from chemotherapy.The nursing plan of care should include provisions for:

A) infection control.
B) supporting self-care.
C) nutritional education.
D) maintaining high fluid intake.

Question 6

The nurse takes into consideration that when the antigen and antibody react,the complement system is activated which:

A) toughens the cell wall.
B) generates more T cells.
C) attracts phagocytes.
D) makes the antigen resistant.

Question 7

A patient is undergoing immunotherapy on a perennial basis.With this form of treatment,what should the patient receive?

A) Larger doses each week
B) Higher concentrations each week
C) Increased amounts and concentrations in 6-week cycles
D) The same amount and concentration each visit

Question 8

What is the term for transplantation of tissue between members of the same species?

A) Allograft
B) Autograft
C) Isograft
D) Homograft

Question 9

What is the purpose of plasmapheresis in the treatment of rheumatoid arthritis?

A) To add corticosteroids to relieve pain
B) To remove pathologic substances present in the plasma
C) To remove waste products such as urea and albumin
D) To add antinuclear antibodies

Question 10

Which person is most at risk for a hypersensitivity reaction?

A) 26-year-old receiving his second desensitization injection
B) 35-year-old starting back on birth control tablets
C) The 52-year-old started on a new series of Pyridium for cystitis
D) The 84-year-old receiving penicillin for an annually recurring respiratory infection

Question 11

Which of the following is an example of immunocompetence?

A) A child that is immune to measles because of an inoculation
B) A person who has seasonal allergies every fall
C) When the symptoms of a common cold disappear in 1 day
D) A neonate having a natural immunity from maternal antibodies

Question 12

Health care facilities have reduced the incidence of serious latex reactions by:

A) Having local and injectable corticosteroids on hand for employees
B) Desensitizing staff who are allergic
C) Supplying extra handwashing stations in the halls
D) Using only powder-free gloves

Question 13

The nurse recommends to the busy mother of three that the antihistamine fexofenadine (Allegra)would be more beneficial than diphenhydramine (Benadryl)because Allegra:

A) is inexpensive.
B) contains a stimulant for an energy boost.
C) does not dry out the mucous membranes.
D) does not induce drowsiness.

Question 14

In which patient should the nurse be most concerned about immunodeficiency disorder?

A) The patient taking desensitization injections (immunotherapy)
B) The patient on long-term radiation therapy for cancer
C) The overweight patient
D) The patient recently diagnosed with lupus erythematosus

Question 15

How does normal aging change the immune system?

A) Depresses bone marrow
B) T cells become hyperactive
C) B cells show deficiencies in activity
D) Increase in the size of the thymus

Question 16

The patient who had an asthma-like reaction to a desensitization shot was medicated with a subcutaneous injection of epinephrine.What effect should the nurse assure the anxious patient this will have?

A) Cause vasodilation
B) Produce bronchodilation
C) Cause productive coughing
D) Reduction of pulse rate

Question 17

Immediately after the nurse administers an intradermal injection of a suspected antigen during allergy testing,the patient complains of itching at the site,weakness,and dizziness.Which action by the nurse is most appropriate initially?

A) Elevate the arm above the shoulder
B) Administer subcutaneous epinephrine
C) Apply a warm compress to area
D) Apply a local anti-inflammatory cream to the site

Question 18

What would the nurse recommend for a 94-year-old home health patient with deteriorated cell-mediated immunity?

A) Avoiding the influenza vaccine
B) Getting pneumonia vaccine
C) Having skin tests for all antigens
D) Taking large doses of beta-carotene

Question 19

What is the etiology of autoimmune diseases based on?

A) Reaction to a "superantigen"
B) Immune system producing no antibodies at all
C) T cells destroying B cells
D) B and T cells producing autoantibodies

Question 20

A patient who works in a plant nursery and has suffered an allergic reaction to a bee sting is stabilized and prepared for discharge from the clinic.During discussion of prevention and management of further allergic reactions,the nurse identifies a need for additional teaching based on which comment?

A) "I need to think about a change in my occupation."
B) "I will learn to administer epinephrine so that I will be prepared if I am stung again."
C) "I should wear a Medic-Alert bracelet indicating my allergy to insect stings."
D) "I will need to take maintenance doses of corticosteroids to prevent reactions to further stings."

Question 21

The LPN/LVN has arrived at the patient's bedside with a unit of packed cells to be connected to an IV that is infusing.When the RN arrives,what is the first thing the nurses must do?

A) Check to ensure that the donor and recipient numbers match according to policy
B) Request the patient to sign the card on the packed cells
C) Immediately administer the packed cells
D) Check the patient's ID bracelet and then administer the packed cells

Question 22

A transfusion using blood from one's own blood is a(n)___________ transfusion,which is the best defense against a transfusion reaction.

Question 23

What should the nurse do because of the increasing strength of the dose in the injections for immunotherapy?

A) Observe the patient for at least 20 minutes after administration
B) Take the vital signs every 10 minutes for an hour
C) Have the patient lie down quietly for an hour
D) Place a warm compress on the area to speed its absorption

Question 24

The nurse outlines the functions of the immune system as those actions which: (Select all that apply. )

A) Prevention of hemorrhage
B) Protection of the body's internal environment
C) Maintenance of hemoglobin level
D) Maintenance of homeostasis by removing damaged cells
E) Destruction of growth of abnormal cells

Question 25

The nurse stresses that when a person produces his own antibodies against a specific antigen,that process of immunity is ______________ ________________ immunity

Question 26

Which of the following are diseases which result from one's own immune system attacking the body? (Select all that apply. )

A) Lupus erythematosus
B) Glomerulonephritis
C) Polio
D) Rheumatoid arthritis
E) Thrombocytopenic purpura
F) Osteoarthritis

Question 27

The nurse outlines for a patient who has asthma attacks from pollen that the process from exposure to symptoms follows a systematic sequence.Place the physiologic responses of an allergic asthma attack in sequence.(Separate letters by a comma and space as follows: A,B,C,D)

A) Release of histamine
B) Edema
C) Vasodilation
D) Activation of mast cells
E) Bronchospasm
F) Exposure to pollen

Question 28

To provide examples of an active acquired immunity,the nurse uses the example of a person who has acquired immunity from measles because that person has had: (Select all that apply. )

A) Chickenpox and mumps
B) Measles
C) An extremely healthy immune system
D) An inoculation against measles
E) Maternal antibodies against measles

Question 29

What is humoral immunity based on? (Select all that apply. )

A) Production of antibodies by B cells
B) T cells are activated by an antigen
C) The body's response to an antigen
D) Sensitized T cells destroy the antigen
E) Helper T cells activate phagocytosis

Question 30

The nurse arrives at the bedside of a patient who has had a unit of packed cells infusing in his right arm for 35 minutes.He is complaining of chills,itching,and shortness of breath.What should be the nurse's initial action?

A) Cover with a warm blanket
B) Take the patient's temperature
C) Elevate the head of the bed
D) Stop the transfusion and continue with saline

Question 31

Which symptom would be classified as a mild transfusion reaction?

A) Orthopnea
B) Tachycardia
C) Hypotension
D) Wheezing

Question 32

Because the older adult has decreased production of saliva and gastric secretions,they are at risk for:

A) mouth ulcers.
B) fissures in corners of the mouth.
C) gastrointestinal infections.
D) bloating.

Question 33

The transfer of tissue between genetically identical individual (twins)is a(n)________.

Question 34

A type IV latex allergy is characterized by________ _______.

Question 35

What is the major negative effect of cell-mediated immunity?

A) Depression of bone marrow
B) Rejection of transplanted tissue
C) Activation of the T cells
D) Stimulation of the B cells

Question 36

If a nurse is sensitive to latex gloves,what potential food sensitivities might the nurse develop? (Select all that apply. )

A) Peanuts
B) Avocados
C) Milk
D) Bananas
E) Tomatoes
F) Potatoes

Question 37

What timeframe must blood be transfused within once it has been removed from refrigeration?

A) 2 hours
B) 4 hours
C) 6 hours
D) 3 hours

Question 38

The process of immunity through a controlled exposure to an attenuated organism to stimulate the production of antibodies is _______________.

Question 39

Which of the following provide the body with innate immunity? (Select all that apply. )

A) Skin and mucous membranes
B) Lungs
C) Heart
D) Tears and saliva
E) Natural intestinal and vaginal flora
F) Stomach acid

Question 40

What is B-cell proliferation dependent on?

A) Presence of NK (natural killer)cells
B) Complement system
C) Antigen stimulation
D) Lymphokines

Question 41

List the sequence of a plasmapheresis procedure.(Separate letters by a comma and space as follows: A,B,C,D)

A) Removal of whole blood in one arm
B) Circulation of blood through cell separator
C) Remainder of plasma returned through vein in opposite arm
D) Separation of plasma and its cellular components
E) Replacement of plasma with lactated Ringer
F) Removal of undesirable components