Deck 16: Altered Immune Response and Transplantation

Question 1

The nurse should explain to a patient undergoing plasmapheresis for treatment of an autoimmune disorder that this procedure involves which of the following?

A) Selective destruction of autoantibodies
B) Separation and removal of specific blood cells
C) Exchanging saline or albumin for blood plasma
D) Removal of white cells responsible for immune reactions

Answer 1

Exchanging saline or albumin for blood plasma

Question 2

What initial evidence would indicate to the nurse that a patient is experiencing a systemic anaphylaxis to an injected allergen?

A) Dyspnea
B) Dilation of the pupils
C) Itching and edema at the injection site
D) A wheal-and-flare reaction at the injection site

Answer 2

Itching and edema at the injection site

Question 3

The nurse encourages a new mother to breastfeed her infant,even for a short time,because colostrum will provide the infant with which type of immunity?

A) Indefinite active immunity to childhood illnesses
B) Passive immunity to all childhood illnesses for several months
C) Passive immunity to diseases to which the mother has immunity
D) Active immunity for several years to diseases to which the mother has immunity

Answer 3

Passive immunity to diseases to which the mother has immunity

Question 4

Which of the following processes represents the replacement of a patient's diseased organ with an organ harvested from another species?

A) Cadaveric transplantation
B) Ex vivo transplantation
C) Xenotransplantation
D) Hybridoma transplantation

Question 5

After being bitten by an unknown insect,a patient who is allergic to wasp stings is brought to a clinic by a co-worker.On arrival,the patient is anxious and is having difficulty breathing.What should the nurse's first action be?

A) Administer oxygen.
B) Maintain the patient's airway.
C) Remove the stinger from the site.
D) Place the patient in a recumbent position with his legs elevated.

Question 6

A patient has been undergoing immunotherapy for 1 year.How does the nurse recognize that the goals of immunotherapy are achieved?

A) When blood analysis reveals increased IgG levels
B) When blood analysis reveals decreased IgE levels
C) When blood analysis reveals increased natural killer cells
D) When blood analysis reveals decreased T helper (CD4)cells

Question 7

When monitoring older adult patients for signs of cancer,the nurse explains that the incidence of cancer is increased in this age group primarily as a result of the decreased action of which of the following cells?

A) D lymphocytes
B) T lymphocytes
C) Immunoglobulins
D) Granulocyte colony-stimulating factor

Question 8

While the nurse is obtaining a health history from a patient with a secondary immunodeficiency disorder,awareness of the most common cause of this disorder prompts the nurse to ask specifically about which of the following treatments?

A) Dietary intake
B) Medication use
C) Stress management
D) History of radiation therapy

Question 9

The nurse is administering skin testing with intracutaneous injections of allergens on a patient's forearm.Immediately after the nurse administers one of the injections,the patient complains of itching at the site and of weakness and dizziness.What should the nurse do first?

A) Elevate the arm above the shoulder.
B) Administer subcutaneous epinephrine.
C) Apply a tourniquet above the injection site.
D) Apply a local anti-inflammatory cream to the site.

Question 10

Which of the following is a side effect of corticosteroids?

A) Peptic ulcers
B) Nausea and vomiting
C) Pulmonary edema
D) Decreased appetite

Question 11

A patient with a severe allergic reaction is treated with epinephrine.The nurse recognizes that the rationale for the use of epinephrine is that epinephrine opposes the effects of which one of the following?

A) Adrenergic receptors
B) Lymphokines
C) Interleukin-2
D) Lysosomal enzymes

Question 12

The nurse discusses the prevention and management of allergic reactions with a beekeeper who has developed a hypersensitivity to bee bites.The nurse identifies a need for additional teaching when the patient makes which of the following statements?

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

Question 13

A patient is treated at a clinic with an injection of long-acting penicillin for a streptococcal throat infection.Her history reveals that she has received penicillin before with no allergic responses.When the penicillin injection is administered,what should the nurse inform the patient about?

A) She must wait in the clinic area for 20 minutes before she is discharged.
B) Given that she has taken penicillin before without problems,she can safely take it now.
C) She would have immediate symptoms if she had developed an allergy to penicillin.
D) She should monitor for fever and skin rash typical of type III immune-complex reactions.

Question 14

A patient develops a severe angioedema involving her face,hands,and feet,with burning and stinging of the lesions.What significant risk factor for allergies should the nurse ask the patient about?

A) A family history of allergies
B) The use of over-the-counter medications
C) Recurrent respiratory infections
D) A history of a recent fungal infection

Question 15

Which one of the following actions would the nurse take to treat a patient who is experiencing anaphylactic shock?

A) Place the patient in Trendelenburg position.
B) Using cooling blankets to maintain cool body temperature.
C) Administer epinephrine 1:1000 as ordered.
D) Administer low-flow oxygen via nasal prongs.

Question 16

A patient is diagnosed with systemic lupus erythematosus (SLE).What does the nurse understand is included in the pathophysiology that occurs in this autoimmune disorder?

A) Systemic tissue destruction initiated by sensitized T cells attacking DNA antigens and releasing lymphokines
B) A deficiency of T suppressor (CD8)cells,allowing unchecked destruction of all organ tissue by T cytotoxic cells
C) Activation of the complement cascade as a result of IgM binding with viral antigens,causing cytolysis of vascular tissue
D) DNA released into the circulation and reacting with an antibody

Question 17

What is the role of serotonin that is released from platelets during an allergic response?

A) It increases vascular permeability.
B) It stimulates irritant receptors.
C) It dilates smooth muscle.
D) It stimulates vasodilation.

Question 18

A patient who is employed as a laboratory technician is scheduled for knee surgery.While obtaining a health history from the patient,the nurse learns that the patient has a history of allergic rhinitis,asthma,and multiple food allergies.What is most important that the nurse do with this information?

A) Document the allergic history,and be alert for the possibility of a type I latex allergy.
B) Encourage the patient to carry an epinephrine kit in case a type IV allergic reaction to latex develops.
C) Advise the patient to use oil-based hand creams to decrease contact with natural proteins in latex gloves.
D) Recommend that the patient use vinyl gloves instead of latex gloves in preventing bloodborne pathogen contact.

Question 19

Which of the following is an example of a type IV delayed hypersensitivity reaction?

A) Transfusion reaction
B) Serum sickness
C) Contact dermatitis
D) Systemic lupus erythematosis