Deck 23: The Immune System

Question 1

An older patient is diagnosed with bacteremia and asks what caused the condition. What should be included in the nurse's response? Select all that apply.
1) "The virus that causes chickenpox and shingles also causes bacteremia."
2) "An infected wound can introduce bacteria into the bloodstream causing bacteremia."
3) "Older patients are at risk of bacteremia caused by antibiotic use and superinfections."
4) "Bacteremia can be caused by bacteria from a urinary tract infection entering the bloodstream."
5) "Bacteremia, caused by bacteria entering the bloodstream, can be a complication of pneumonia."

Answer 1

2, 4, 5

Question 2

The nurse is reviewing the white blood cell count for an older patient. Which type of cell has memory and self recognition?
1) Monocytes
2) Neutrophils
3) Lymphocytes
4) Thrombocytes

Answer 2

3

Question 3

An acute care facility is working to decrease the risk of nosocomial infections in older patients. Which preventative action should be included?
1) Limit the sanitization of equipment.
2) Adopt aspiration precautions for dysphagia.
3) Provide antibiotics as prescribed for viral infections.
4) Insert an indwelling urinary catheter for urinary incontinence.

Answer 3

2

Question 4

The nurse is caring for a patient with shingles. How does the nurse best explain its etiology?
1) Erysipelas
2) HIV/AIDS
3) Bacteremia
4) Herpes zoster

Question 5

The healthcare provider suggests that an older patient take daily vitamin supplements to enhance immunity. On which supplements should the nurse instruct the patient? Select all that apply.
1) Zinc
2) Iodine
3) Vitamin D
4) Vitamin C
5) Magnesium

Question 6

An older patient with pneumonia requests information on maintaining a healthy lifestyle for illness prevention. What should the nurse include? Select all that apply.
1) Maintain a healthy weight.
2) Restrict the intake of dairy products.
3) See the physician for any signs of an infection.
4) Take a daily multivitamin/mineral supplement.
5) Engage in regular moderate exercise 30 minutes a day, 5 days a week.

Question 7

An older patient is diagnosed with tuberculosis. What should be included in the nurse's disease process instruction? Select all that apply.
1) It can affect other body tissues.
2) It is uncommon in nursing homes.
3) It spreads by airborne transmission.
4) It is a chronic infection of the lungs.
5) Older people are at higher risk for the disease.

Question 8

The nurse is preparing a presentation to senior citizens about the influenza vaccination. Which information should the nurse include? Select all that apply.
1) A new vaccination is needed annually.
2) It is contraindicated to those with an allergy to eggs.
3) It should not be taken if a chronic disease is present.
4) The vaccination is given once after the age of 65 years.
5) Most people who receive the pneumonia vaccination do not need the influenza vaccine.

Question 9

The nurse is planning care for an older patient recently diagnosed with HIV who wants to remain sexually active. Which would be a priority nursing diagnosis for this patient?
1) Self-care deficit related to depression
2) Social isolation related to fear of AIDS
3) Risk for infection related to immunodeficiency
4) Knowledge deficit related to preventing transmission of HIV

Question 10

An older patient with rheumatoid arthritis rates current pain as being a 3 on a scale from 1 to 10. Which nonpharmacological interventions can the nurse provide to help this patient? Select all that apply.
1) Massage
2) Warm soaks
3) Diversion activities
4) Relaxation techniques
5) Immobilization of painful areas

Question 11

An older patient is hesitant to receive a vaccination against shingles due to lack of knowledge. What will be included in the nurse's teaching?
1) Shingles are treated successfully with antibiotics.
2) Shingles cause vesicular lesions along spinal nerves.
3) Shingles are sometimes difficult to diagnose.
4) Shingles result from reactivation of a herpes simplex virus.

Question 12

An older patient is surprised to learn of the diagnosis of rheumatoid arthritis. What can the nurse explain to the patient about this disorder? Select all that apply.
1) Antibodies form against the person's own IgG.
2) The onset of the disorder is slower in older adults.
3) It is a delayed hypersensitivity response to an antigen.
4) There can be abnormalities in both B and T immunity cells.
5) Inflammatory process is stimulated by T cells and destroys articular cartilage.

Question 13

The nurse is caring for an older patient recently diagnosed with HIV. What best describes the delay in diagnosis?
1) Older patients have an increased immunity to fight the infection.
2) Older patients' symptoms are less severe than younger patients with HIV/AIDS.
3) Older patients often have symptoms that may be attributed to other conditions associated with age.
4) Older patients are more likely to have contracted the disease from contaminated blood or blood products.

Question 14

An older patient experienced an anaphylactic reaction after eating shrimp. How would the nurse best describe this response?
1) Type I hypersensitivity response
2) Type II hypersensitivity response
3) Type III hypersensitivity response
4) Type IV hypersensitivity response

Question 15

The physician orders a pneumococcal vaccination for a 70-year-old patient. How does the nurse best describe this immunization?
1) Antibody response is lower in the older person
2) Cellular response in the immune system increases
3) Aging causes a decreased antibody production to self
4) Increased production of IgE leads to greater risk of pneumonia

Question 16

The nurse is caring for an older patient with a disease caused by a secondary immunodeficiency disorder. Which are secondary disorders? Select all that apply.
1) HIV
2) Cirrhosis
3) Medications
4) Malnutrition
5) Diabetes mellitus

Question 17

A patient asks the nurse how the immune system protects the body. What is the nurse's best response?
1) "Self-recognition allows the immune system to recognize foreign parts."
2) "Memory means that the immune system develops lasting protection against specific invaders."
3) "Specificity is the ability of the immune system to react with a particular response to one antigen."
4) "Tolerance is the term for the ability of the immune system to differentiate between the person's body and foreign substances."

Question 18

The nurse administers an annual flu vaccination to an older patient who asks if they need the pneumonia vaccination too. What is the nurse's best response?
1) "Pneumonia can develop as a complication of the flu."
2) "Everyone needs a flu vaccination and pneumococcal vaccination annually."
3) "Older people should receive either the influenza or the pneumococcal vaccine annually."
4) "Two pneumococcal vaccinations, one year apart, are recommended for persons over the age of 65.

Question 19

An older patient is diagnosed with asthma. What should the nurse teach the patient about this health problem? Select all that apply.
1) It is a type I hypersensitivity response.
2) Items that precipitate attacks must be identified.
3) It is not particularly prevalent in the older person.
4) Symptoms of the disorder likely were present earlier in life.
5) Medications to treat may aggravate other medical problems.

Question 20

For which older patient should the nurse suspect a decline in the responsiveness of the immune system?
1) 78-year-old patient with pneumonia and temperature of 99.5°F
2) 68-year-old patient with a red itchy rash from contact with poison ivy
3) 80-year-old patient with swelling and redness around an abdominal incision
4) 66-year-old patient with 8 mm induration from a mumps skin test 72 hours earlier

Question 21

The nurse is planning interventions to help improve the immune function of an older patient. What should be included in this patient's plan of care? Select all that apply.
1) Teach to avoid alcohol.
2) Educate on the effects of stress.
3) Encourage to take daily vitamin supplements.
4) Remind to obtain a yearly influenza vaccination.
5) Encourage to utilize positive coping strategies to stress.

Question 22

An older patient experiences an allergic reaction to latex. Which should the nurse explain to the patient about this allergy?
1) "You probably never realized that you had a latex allergy."
2) "Allergic reactions happen more often when you are sick."
3) "Allergic reactions can take up to 2 weeks with a latex allergy."
4) "You were receiving medication that caused the reaction to latex."

Question 23

An older patient has been hospitalized twice in one year for a lung infection. How should the nurse describe the relationship between aging and risk of infection?
1) "With aging, the immune system diminishes and then stops working."
2) "With aging, there is an overall increase in the speed of the immune response."
3) "With aging, there is an increase in the number of B cells, which hinders the immune response."
4) "With aging, there is a decrease in the strength of the immune system, increasing the risk for infection."

Question 24

The nurse planning to implement a Tai Chi program at a senior center is meeting resistance by program attendees. How should the nurse respond to the resistance?
1) "Tai Chi is a popular Chinese exercise."
2) "Getting out and moving around helps."
3) "Studies have been shown that Tai Chi is beneficial to the immune system."
4) "Studies have shown that Tai Chi will help reduce the levels of IgG and IgM."

Question 25

The charge nurse is planning an inservice for nursing staff on the theories of aging. What information should the instructor include about immune dysregulation?
1) Immune cells attack the normal body tissues.
2) The immune system is not able to defend the body from foreign invaders as we age.
3) The ability to differentiate between invaders and normal tissues diminishes with age.
4) Changes in the immune system disrupt the regulation of immune process components.