Deck 18: Immune System Function, Assessment, and Therapeutic Measures

Question 1

The nurse is reinforcing teaching to a person being tested for HIV in a clinic.Which test should the nurse explain is done first in HIV testing?

A) ELISA test
B) Western blot test
C) Viral load studies
D) Rheumatoid factor test

Answer 1

ELISA test

Question 2

The nurse is assisting in the preparation of a teaching plan for an older patient.What information about maintaining a healthy immune system should the nurse recommend be included in this plan? (Select all that apply.)

A) Get a pneumovax vaccine yearly.
B) Obtain a varicella booster every 3 years.
C) Get a diphtheria and tetanus booster every 10 years.
D) Avoid people with colds or other infectious illnesses.
E) Get an influenza vaccine yearly before influenza season.
F) Obtain vaccination against hepatitis B if infection risk is moderate to high.

Answer 2

Get a diphtheria and tetanus booster every 10 years.
Avoid people with colds or other infectious illnesses.
Get an influenza vaccine yearly before influenza season.
Obtain vaccination against hepatitis B if infection risk is moderate to high.

Question 3

The nurse is caring for a patient with anemia.Which laboratory results should the nurse identify as being consistent with this diagnosis? (Select all that apply.)

A) RDW = 12% in a 28-year-old female
B) MCV = 72/mm³ in a 19-year-old female
C) WBC = 7 ´ 109/L in a 39-year-old male
D) RBC = 4.4 ´ 1012/L in a 31-year-old male
E) WBC = 5.2 ´ 109/L in a 22-year-old female
F) RBC = 5.7 ? 1012/L in a 43-year-old female

Answer 3

RBC = 4.4 ´ 1012/L in a 31-year-old male
WBC = 5.2 ´ 109/L in a 22-year-old female

Question 4

The nurse is reviewing the immune system with a patient newly diagnosed with an autoimmune disorder.What should the nurse explain as the purpose of antibodies?

A) They destroy foreign antigens.
B) Work on many different antigens
C) Are specific according to blood type
D) Attach to antigens to label them for destruction

Question 5

The nurse determines that a patient has long-term immunity against a disease.Which part of the immune system should the nurse recognize is responsible for this patient's long-term immunity?

A) IgE
B) IgG
C) Mast cells
D) Plasma cells

Question 6

A patient is experiencing an immune response that involves the T lymphocytes.For which types of immunity should the nurse plan care for this patient?

A) Passive immunity
B) Humoral immunity
C) Acquired immunity
D) Cell-mediated immunity

Question 7

The nurse is caring for a patient with an infection.Which immunoglobulin should the nurse understand is produced first when an infection occurs?

A) IgD
B) IgE
C) IgG
D) IgM

Question 8

The nurse is caring for a patient who is experiencing an immune response involving B and T cells.Which type of immunity is the patient demonstrating?

A) Passive immunity
B) Humoral immunity
C) Acquired immunity
D) Cell-mediated immunity

Question 9

The nurse has contributed to an educational program for staff members.Which statement made by a staff member indicates a correct understanding of how passive immunity is provided?

A) "Having an acute disease."
B) "Administration of a toxoid."
C) "Administration of a vaccine."
D) "Administration of immunoglobulin."

Question 10

The nurse is caring for a patient being tested for rheumatoid arthritis.In reviewing laboratory values,which should the nurse recognize as being diagnostic of rheumatoid arthritis?

A) C-reactive protein = 12 mg/L
B) Rheumatoid factor is negative.
C) White blood cells = 6000/mm³
D) Antinuclear antibody test is negative.

Question 11

The nurse is administering medications to a patient.Which medications should the nurse understand is being given to suppress C-reactive protein levels?

A) Aspirin and steroids
B) Antibiotics and diuretics
C) Epinephrine and antihistamines
D) Antihypertensives and antineoplastic agents

Question 12

The nurse provides care to older adults.What should the nurse recognize as being more likely to occur in an older adult than in a younger adult?

A) High fevers
B) Fewer infections
C) More autoimmune disorders
D) Greater antibody production

Question 13

The nurse is reinforcing teaching to a person who has tested positive for HIV.Which test should the nurse explain is done to confirm the diagnosis of HIV?

A) Western blot
B) Rheumatoid factor
C) Antinuclear antibodies
D) Immunoglobulin assay

Question 14

A patient prescribed corticosteroids for arthritis is surprised to learn of an immune disorder.What should the nurse explain as the reason for the patient not demonstrating typical signs of immune dysfunction?

A) The arthritis is masking the normal immune response.
B) The corticosteroids are causing the thymus gland to malfunction.
C) The arthritis is interfering with the function of immunoglobulins.
D) Corticosteroids are impacting normal immune response functioning.

Question 15

The nurse has contributed to a staff education program on immunity.Which participant response indicates a correct understanding of the type of immunity that protects newborns for the first 3 months of life as a result of maternal transmission of IgG?

A) "Active natural immunity occurs."
B) "Passive natural immunity occurs."
C) "Active artificial immunity occurs."
D) "Passive artificial immunity occurs."

Question 16

The nurse has administered prescribed allergen injections twice a week for several weeks to an individual with a bee sting allergy.The patient misses three appointments.What action should the nurse take on the patient's next visit?

A) Consult physician to confirm the dosage to be given.
B) Administer the same dosage as was given at the last visit.
C) Administer the dosage as originally prescribed for that visit.
D) Tell the patient that the entire immunotherapy schedule needs to be restarted.

Question 17

During data collection,the nurse learns the patient is allergic to shellfish.Which precautions should be implemented during the patient's hospitalization?

A) The patient should be placed in a private room.
B) The kitchen should use dedicated equipment for all of the patient's food preparation.
C) Iodine-based skin preparations should be replaced with different bactericidal cleansers.
D) The patient's allergy should be noted on the medical record and communicated clearly to all caretakers.

Question 18

The nurse is reviewing the immune system prior to discussing the actions with a patient.What type of cell should the nurse identify that is involved in cell-mediated immunity and has a cytotoxic action on tumor cells?

A) Lysosomes
B) Memory cells
C) Natural killer cells
D) Histocompatibility cells

Question 19

The nurse is preparing an injection for an individual who requires passive immunity.In which situation would passive immunity be indicated?

A) For permanent immunity against a disease
B) To overcome an allergic reaction that is relatively mild
C) To have ready-made antibodies after an exposure to pathogens
D) As a booster dose to stimulate the production of specific antibodies

Question 20

The nurse notes that a patient's eosinophil level is elevated.For which health problem should the nurse plan care for this patient?

A) Cancer
B) Allergic reactions
C) Acute viral infections
D) Autoimmune diseases

Question 21

A patient develops anaphylactic shock in response to eating something that has caused an allergic response in the past.What physiologic changes should the nurse expect to observe in this patient? (Select all that apply.)

A) Weak pulse
B) Muscle pain
C) Stomach cramps
D) Nausea and vomiting
E) Drop in blood pressure

Question 22

While collecting data the nurse suspects that a patient is experiencing an immune disorder.What data did the nurse use to come to this conclusion? (Select all that apply.)

A) Rash
B) Fever
C) Joint pain
D) Muscle cramps
E) Swollen glands

Question 23

While hospitalized it is discovered that a patient has an allergy to latex.What should this patient's discharge instructions include? (Select all that apply.)

A) Wear a medical alert bracelet.
B) Carry an epinephrine auto-injector.
C) Restrict the intake of dairy products.
D) Restrict exercise to 30 minutes each day.
E) Avoid consuming green leafy vegetables.

Question 24

The nurse is providing care for a patient who is to start receiving immunotherapy for severe environmental allergies.Which information should the nurse reinforce for patient and family education? (Select all that apply.)

A) "You will have to have shots about once a month for the treatment to work."
B) "After the first shot, we'll be able to teach you how to give your own allergy shots at home."
C) "You will need to remain in the clinic for half an hour after your shot in case you have any reaction."
D) "The shots have medicine that helps slow down your immune system so you aren't sick all the time."
E) "Reactions can occur up to 24 hours after the injection, so it is important to watch for any problems."
F) "Small amounts of things you are allergic to are being given in the shot so your body can become less sensitive to them."

Question 25

The nurse is caring for a patient with an immune disorder.Which classifications of medication should the nurse expect to be prescribed for this patient? (Select all that apply.)

A) Antibiotics
B) Epinephrine
C) Anticoagulants
D) Antihistamines
E) Corticosteroids

Question 26

The nurse has contributed to an educational program for staff members on immunity and classes of antibodies.Which statements indicate that the staff member understandings information about classes of antibodies? (Select all that apply.)

A) IgG crosses the placenta.
B) IgA is found in breast milk.
C) IgD is found on natural killer cells.
D) IgG provides short-term immunity.
E) IgE is not involved in allergic reactions.
F) IgM is found in blood and lymph drainage.