Deck 11: Disorders of the Immune System

Question 1

A client who is planning to get pregnant is ordered to obtain a rubella titer screening test. The test shows negative immunoglobulin M (IgM). Which information does the nurse acquire because of the test result?
1)Has been exposed to rubella
2)Has had a rubella infection
3)Needs to have the rubella vaccine
4)Is immune to rubella

Answer 1

3

Question 2

Which is the predominant immunoglobulin produced after a host's re-exposure to an antigen?
1)Immunoglobulin G (IgG)
2)Immunoglobulin A (IgA)
3)Immunoglobulin E (IgE)
4)Immunoglobulin D (IgD)

Answer 2

1

Question 3

The registered nurse is reviewing the role of CD4 cells in the diagnosis of HIV. Which conclusions made by the nurse are correct? Select all that apply.
1)"The CD4 cells directly attack antigens."
2)"The CD4 cells produce immunoglobulins."
3)"The CD4 cells mature into plasma cells."
4)"HIV attacks CD4 cells."
5)"The CD4 cells take part in cell-mediated immunity."

Answer 3

4, 5

Question 4

A registered nurse is teaching nursing students about passive acquired adaptive immunity. Which statement made by a student nurse indicates the need for additional learning?
1)"It provides immediate immunity."
2)"It is a short-term immunity."
3)"It is not associated with immunologic memory."
4)"It is activated after the administration of a vaccine."

Question 5

In which location does maturation of T lymphocytes occur?
1)Spleen
2)Bone marrow
3)Thymus gland
4)Lymph nodes

Question 6

A nurse is reviewing the prescriptions of four clients. Assess the effects of the medications prescribed. Which client does the nurse identify as being most likely treated for chronic mucocutaneous candidiasis? Client 1
Client 2
Client 3
Client 4
Ketoconazole
Codeine
Amoxicillin
Acyclovir
1)Client 1
2)Client 2
3)Client 3
4)Client 4

Question 7

The nurse is providing care to a client with a positive enzyme-linked immunosorbent assay (ELISA) test. On examination, the client is found to have fever, weight loss, and Candida infection. The client also reports having night sweats. Which CD4 level does the nurse expect? 1.700 cells per microliter
2)500 cells per microliter
3)200 cells per microliter
4)350 cells per microliter

Question 8

A 27-year-old client is pregnant. The blood group of the client and the fetus are incompatible. Which antibodies produced by the mother against the fetus's blood cells do not affect the fetus?
1)Immunoglobulin M (IgM)
2)Immunoglobulin G (IgG)
3)Immunoglobulin D (IgD)
4)Immunoglobulin E (IgE)

Question 9

Which cells are known as granular lymphocytes?
1)Kupffer cells
2)Microglial cells
3)T cells
4)Natural killer cells

Question 10

Which is an example of passive acquired adaptive immunity?
1)Newborns receiving immunity through breast milk
2)Individuals being immune to chickenpox after infection
3)Individuals becoming immune to measles after infection
4)Newborns responding to prenatal immunity factors

Question 11

The nurse is employed in a community health clinic. An adult client tells the nurse, "I had sex with a person who afterwards told me they are HIV positive." Which nursing intervention does the nurse immediately implement?
1)Assist in the initiation of pre-exposure prophylaxis (PrEP)
2)Seek identification of the client's sexual partner
3)Obtain information about the timeline of exposure
4)Inform the laboratory of the need for an HIV RNA blood test.

Question 12

The nurse is aware immunoglobulin A (IgA) is mostly found in which body fluid?
1)Tears
2)Plasma
3)Blood
4)Sweat

Question 13

A registered nurse is teaching a student nurse about assessing the results of a Mantoux test administered to an adolescent client. The results exhibit a 5-mm tissue induration. Which statement made by the student nurse indicates effective learning?
1)"The client has an active case of tuberculosis (TB)."
2)"The client has had an exposure to TB."
3)"The client has not had an exposure to TB."
4)"The client should be given TB vaccine immediately."

Question 14

A registered nurse is teaching a nursing student about the diagnostic test done for chronic mucocutaneous candidiasis. What statement made by the student nurse indicates effective teaching?
1)"Potassium hydroxide wet mount is used to diagnose Candida infection."
2)"An antinuclear antibodies test is used to diagnose Candida infection."
3)"A C-reactive protein test is used to diagnose Candida infection."
4)"Urinalysis is used to diagnose Candida infection."

Question 15

The nurse is counseling a client who is at risk for contracting HIV but is currently asymptomatic. The client states, "I am not taking drugs when I am not, or may never be, sick." Which comment by the nurse is best at this time?
1)"Any antibodies you are producing are not effective in the fight against the disease."
2)"When you realize you are sick, your immune system is already compromised."
3)"Very early initiation of antiretroviral drugs can preserve immune function."
4)"It is not too late for you to consider starting a postexposure prophylaxis program."

Question 16

A registered nurse is teaching a student nurse about the common side effects of methotrexate therapy, which is used to treat clients with rheumatoid arthritis. Which statement made by the student nurse indicates effective learning?
1)"The client's white blood cell count will be below 4,500 cells per microliter."
2)"The client's weight will increase by a minimum of 2 kilograms."
3)"The client's urine specific gravity will be 1.030."
4)"The client's joint destruction and pain will be reversed."

Question 17

A client with scleroderma reports painful ulcers on the knees. Which condition does the nurse recognize?
1)Telangiectasia
2)Calcinosis
3)Sclerodactyly
4)Raynaud's phenomenon

Question 18

The nurse is providing care for a client who is recovering from hepatitis A. The nurse is aware that which immunity is developed by the client after experiencing this illness?
1)Innate immunity
2)Active acquired adaptive immunity
3)Passive acquired adaptive immunity
4)Adaptive immunity

Question 19

A client develops an erythematous rash on the hands 2 days after working in the garden. Which type of hypersensitivity reaction has the client developed?
1)Type I immediate
2)Type II cytotoxic
3)Type III immune complex-mediated
4)Type IV delayed

Question 20

The nurse is preparing a community presentation for clients about autoimmune disease. Which disease does the nurse use as an example in the presentation?
1)Osteoarthritis
2)Rheumatoid arthritis
3)Type 2 diabetes
4)Chronic obstructive pulmonary disease

Question 21

The registered nurse is presenting a nursing workshop about immunity and introduces the topic of diagnosis and treatment of hypogammaglobinemia. Which statements by attendees indicate the need for additional information? Select all that apply.
1)"The diagnosis is usually made when a child is 1 year old."
2)"Bronchiectasis is common in clients with this condition."
3)"Decreased immunoglobulin G (IgG) levels are observed in clients with the disorder."
4)"Decreased levels of immunoglobulin M (IgM) are the strongest indicator of the disease."
5)"Live vaccine administration to the client is the cardinal treatment."

Question 22

The registered nurse is teaching a client about the criteria used in the diagnosis of AIDS. Which criteria and parameters does the nurse present to the client? Select all that apply.
1)"HIV RNA assay measures the viral load in clients with AIDS."
2)"A viral load of 5,000 copies indicates the client is at a high risk of developing AIDS."
3)"A CD4 to CD8 ratio of 2:1 is observed in clients with AIDS."
4)"A negative enzyme-linked immunosorbent assay (ELISA) test indicates the client is positive for HIV."
5)"A Western blot test is a conformity test for HIV antibodies."

Question 23

A registered nurse is teaching nursing staff about interpreting blood test reports and urinalysis reports of clients with systemic lupus erythematosus (SLE). Which statements made by attending nurses indicate effective teaching? Select all that apply.
1)"A high antinuclear antibodies (ANA) level is more specific to clients with SLE."
2)"Erythrocyte sedimentation rate is high in clients with SLE."
3)"Leukopenia and thrombocytopenia are often observed in clients with SLE."
4)"C-reactive proteins are low in clients with acute SLE."
5)"Urinalysis reports of clients with SLE show bacteriuria and pyuria."