Deck 35: Assessment of Immune Function

Question 1

A woman has been diagnosed with breast cancer and is being treated aggressively with a chemotherapeutic regimen. As a result of this regimen, she has an inability to fight infection due to the fact that her bone marrow is unable to produce a sufficient amount of what?

A) Lymphocytes
B) Cytoblasts
C) Antibodies
D) Capillaries

Answer 1

Lymphocytes

Question 2

During a mumps outbreak at a local school, a patient, who is a school teacher, is exposed. She has previously been immunized for mumps. What type of immunity does she possess?

A) Acquired immunity
B) Natural immunity
C) Phagocytic immunity
D) Humoral immunity

Answer 2

Acquired immunity

Question 3

A gardener sustained a deep laceration while working and requires sutures. The patient is asked about
The date of her last tetanus shot, which is over 10 years ago. Based on this information, the patient will receive a tetanus immunization. The tetanus injection will allow for the release of what?

A) Antibodies
B) Antigens
C) Cytokines
D) Phagocytes

Answer 3

Antibodies

Question 4

An infection control nurse is presenting an inservice reviewing the immune response. The nurse describes the clumping effect that occurs when an antibody acts like a cross-link between two antigens. What process is the nurse explaining?

A) Agglutination
B) Cellular immune response
C) Humoral response
D) Phagocytic immune response

Question 5

A nurse has administered a childs scheduled vaccination for rubella. This vaccination will cause the child to develop which of the following?

A) Natural immunity
B) Active acquired immunity
C) Cellular immunity
D) Mild hypersensitivity

Question 6

A patient with a history of dermatitis takes corticosteroids on a regular basis. The nurse should assess the patient for which of the following complications of therapy?

A) Immunosuppression
B) Agranulocytosis
C) Anemia
D) Thrombocytopenia

Question 7

A nurse is planning the assessment of a patient who is exhibiting signs and symptoms of an autoimmune disorder. The nurse should be aware that the incidence and prevalence of autoimmune diseases is known to be higher among what group?

A) Young adults
B) Native Americans
C) Women
D) Hispanics

Question 8

A 16-year-old has been brought to the emergency department by his parents after falling through the glass of a patio door, suffering a laceration. The nurse caring for this patient knows that the site of the injury will have an invasion of what?

A) Interferons
B) Phagocytic cells
C) Apoptosis
D) Cytokines

Question 9

A man was scratched by an old tool and developed a virulent staphylococcus infection. In the course of the mans immune response, circulating lymphocytes containing the antigenic message returned to the nearest lymph node. During what stage of the immune response did this occur?

A) Recognition stage
B) Proliferation stage
C) Response stage
D) Effector stage

Question 10

A patient with cystic fibrosis has received a double lung transplant and is now experiencing signs of rejection. What is the immune response that predominates in this situation?

A) Humoral
B) Nonspecific
C) Cellular
D) Mitigated

Question 11

A patient is being treated for bacterial pneumonia. In the first stages of illness, the patients dyspnea was accompanied by a high fever. Currently, the patient claims to be feeling better and is afebrile. The patient is most likely in which stage of the immune response?

A) Recognition stage
B) Proliferation stage
C) Response stage
D) Effector stage

Question 12

The nurse is providing care for a patient who has multiple sclerosis. The nurse recognizes the autoimmune etiology of this disease and the potential benefits of what treatment?

A) Stem cell transplantation
B) Serial immunizations
C) Immunosuppression
D) Genetic engineering

Question 13

A patients injury has initiated an immune response that involves inflammation. What are the first cells to arrive at a site of inflammation?

A) Eosinophils
B) Red blood cells
C) Lymphocytes
D) Neutrophils

Question 14

A nurse is planning a patients care and is relating it to normal immune response. During what stage of the immune response should the nurse know that antibodies or cytotoxic $\mathrm{T}$ cells combine and destroy the invading microbes?

A) Recognition stage
B) Proliferation stage
C) Response stage
D) Effector stage

Question 15

The nurse should recognize a patients risk for impaired immune function if the patient has undergone surgical removal of which of the following?

A) Thyroid gland
B) Spleen
C) Kidney
D) Pancreas

Question 16

A nurse is admitting a patient who exhibits signs and symptoms of a nutritional deficit. Inadequate intake of what nutrient increases a patients susceptibility to infection?

A) Vitamin $\mathrm{B}_{12}$
B) Unsaturated fats
C) Proteins
D) Complex carbohydrates

Question 17

A nurse has admitted a patient who has been diagnosed with urosepsis. What immune response predominates in sepsis?

A) Mitigated
B) Nonspecific
C) Cellular
D) Humoral

Question 18

A patient is admitted with cellulitis and experiences a consequent increase in white blood cell count. The nurse is aware that during the immune response, pathogens are engulfed by white blood cells that ingest foreign particles. What is this process known as?

A) Apoptosis
B) Phagocytosis
C) Antibody response
D) Cellular immune response

Question 19

A nurse is reviewing a patients medication administration record in an effort to identify drugs that may contribute to the patients recent immunosuppression. What drug is most likely to have this effect?

A) An antibiotic
B) A nonsteroidal anti-inflammatory drug (NSAID)
C) An antineoplastic
D) An antiretroviral

Question 20

A patient requires ongoing treatment and infection-control precautions because of an inherited deficit in immune function. The nurse should recognize that this patient most likely has what type of immune disorder?

A) A primary immune deficiency
B) A gammopathy
C) An autoimmune disorder
D) A rheumatic disorder

Question 21

A neonate exhibited some preliminary signs of infection, but the infants condition resolved spontaneously prior to discharge home from the hospital. This infants recovery was most likely due to what type of immunity?

A) Cytokine immunity
B) Specific immunity
C) Active acquired immunity
D) Nonspecific immunity

Question 22

A gerontologic nurse is caring for an older adult patient who has a diagnosis of pneumonia. What agerelated change increases older adults susceptibility to respiratory infections?

A) Atrophy of the thymus
B) Bronchial stenosis
C) Impaired ciliary action
D) Decreased diaphragmatic muscle tone

Question 23

A nurse is explaining the process by which the body removes cells from circulation after they have performed their physiologic function. The nurse is describing what process?

A) The cellular immune response
B) Apoptosis
C) Phagocytosis
D) Opsonization

Question 24

A patient is responding to a microbial invasion and the patients differentiated lymphocytes have begun to function in either a humoral or a cellular capacity. During what stage of the immune response does this occur?

A) The recognition stage
B) The effector stage
C) The response stage
D) The proliferation stage

Question 25

A nurse is reviewing the immune system before planning an immunocompromised patients care. How should the nurse characterize the humoral immune response?

A) Specialized cells recognize and ingest cells that are recognized as foreign.
B) T lymphocytes are assisted by cytokines to fight infection.
C) Lymphocytesare stimulated to become cells that attack microbes directly.
D) Antibodies are made by B lymphocytes in response to a specific antigen.

Question 26

A patient is undergoing testing to determine the overall function of her immune system. What test can be performed to evaluate the functioning of the patients cellular immune system?

A) Immunoglobulin testing
B) Delayed hypersensitivity skin test
C) Specific antibody response
D) Total serum globulin assessment

Question 27

Diagnostic testing has revealed a deficiency in the function of a patients complement system. This patient is likely to have an impaired ability to do which of the following?

A) Protecting the body against viral infection
B) Marking the parameters of the immune response
C) Bridging natural and acquired immunity
D) Collecting immune complexes during inflammation

Question 28

A patients current immune response involves the direct destruction of foreign microorganisms. This aspect of the immune response may be performed by what cells?

A) Suppressor $\mathrm{T}$ cells
B) Memory $\mathrm{T}$ cells
C) Cytotoxic T cells
D) Complement $\mathrm{T}$ cells

Question 29

A nurse is explaining how the humoral and cellular immune responses should be seen as interacting parts of the broader immune system rather than as independent and unrelated processes. What aspect of immune function best demonstrates this?

A) The movement of B cells in and out of lymph nodes
B) The interactions that occur between $\mathrm{T}$ cells and $\mathrm{B}$ cells
C) The differentiation between different types of $\mathrm{T}$ cells
D) The universal role of the complement system

Question 30

A nurse is caring for a patient who has had a severe antigen/antibody reaction. The nurse knows that the portion of the antigen that is involved in binding with the antibody is called what?

A) Antibody lock
B) Antigenic sequence
C) Antigenic determinant
D) Antibody channel

Question 31

A patient is being treated for cancer and the nurse has identified the nursing diagnosis of Risk for Infection Due to Protein Losses. Protein losses inhibit immune response in which of the following ways?

A) Causing apoptosis of cytokines
B) Increasing interferon production
C) Causing CD4+ cells to mutate
D) Depressing antibody response

Question 32

A patient is vigilant in her efforts to take good care of herself but is frustrated by her recent history of upper respiratory infections and influenza. What aspect of the patients lifestyle may have a negative effect on immune response?

A) The patient works out at the gym twice daily.
B) The patient does not eat red meats.
C) The patient takes over-the-counter dietary supplements.
D) The patient sleeps approximately 6 hours each night.

Question 33

The nurse is assessing a clients risk for impaired immune function. What assessment finding should the nurse identify as a risk factor for decreased immunity?

A) The patient takes a beta blocker for the treatment of hypertension.
B) The patient is under significant psychosocial stress.
C) The patient had a pulmonary embolism 18 months ago.
D) The patient has a family history of breast cancer.

Question 34

The nurse is completing a focused assessment addressing a patients immune function. What should the nurse prioritize in the physical assessment?

A) Percussion of the patients abdomen
B) Palpation of the patients liver
C) Auscultation of the patients apical heart rate
D) Palpation of the patients lymph nodes

Question 35

A patients exposure to which of the following microorganisms is most likely to trigger a cellular response?

A) Herpes simplex
B) Staphylococcus aureus
C) Pseudomonas aeruginosa
D) Beta hemolytic Streptococcus

Question 36

A patient was recently exposed to infectious microorganisms and many $\mathrm{T}$ lymphocytes are now differentiating into killer $\mathrm{T}$ cells. This process characterizes what stage of the immune response?

A) Effector
B) Proliferation
C) Response
D) Recognition

Question 37

The nurse knows that the response of natural immunity is enhanced by processes that are inherent in the
Physical and chemical barriers of the body. What is a chemical barrier that enhances the response of natural immunity?

A) Cell cytoplasm
B) Interstitial fluid
C) Gastric secretions
D) Cerebrospinal fluid

Question 38

A nursing student is giving a report on the immune system. What function of cytokines should the student describe?

A) Determining whether a cell is foreign
B) Determining if lymphokines will be activated
C) Determining whether the $\mathrm{T}$ cells will remain in the nodes and retain a memory of the antigen
D) Determining whether the immune response will be the production of antibodies or a cell-mediated response

Question 39

A patient has undergone treatment for septic shock and received high doses of numerous antibiotics during the course of treatment. When planning the patients subsequent care, the nurse should be aware of what potential effect on the patients immune function?

A) Bone marrow suppression
B) Uncontrolled apoptosis
C) Thymus atrophy
D) Lymphoma

Question 40

A patients recent diagnostic testing included a total lymphocyte count. The results of this test will allow the care team to gauge what aspect of the patients immunity?

A) Humoral immune function
B) Antigen recognition
C) Cell-mediated immune function
D) Antibody production