Question 1

A client who has a diagnosis of an autoimmune disease asks his nurse why it is that his immune system does not attack all of the cells that make up his body. Which of the following aspects of pathogen recognition in the innate immune system listed below would underlie the nurse's response?

Accepted Answer

A)   Normal host cells excrete inhibitory proteins that are detected by natural killer cells.
B)   Intraepithelial lymphocytes and matural killer cells possess specific, highly diverse receptors.
C)   Pattern recognition receptors (PRRs)  ensure that cells are correctly identified.
D)   Leukocytes possess pathogen-associated molecular patterns (PAMPs)  C

Question 2

The nurse knows high incidences of infectious illnesses among the older adults who reside in a long-term care facility are most likely to have diminished immune capacity because of

Accepted Answer

A)   decreased numbers and responsiveness of T lymphocytes.
B)   decreased antigen recognition by B lymphocytes.
C)   overexpression of cytokines and receptors.
D)   altered function in peripheral lymphocytes. A

Question 3

Which of the following situations can best be characterized as an example of passive immunity?

Accepted Answer

A)   A 6-month-old infant receives his scheduled immunization against measles, mumps, and rubella.
B)   A 9-year-old boy is immune to chicken pox after enduring the infection before 1 year.
C)   An 8-year-old girl recovers from a respiratory infection after intravenous antibiotic treatment.
D)   A 6-week-old infant receives antibodies from his mother's breast milk. D

Question 4

A middle school student is scheduled to receive booster immunizations, and the father asks the nurse why the booster is necessary. What characteristic of the adaptive immune system listed below would provide the rationale for the nurse's response?

Accepted Answer

A)   Some antibodies require a repeat of the primary immune response.
B)   Some antibodies have a duration measured in months rather than years.
C)   A secondary response causes a sharp rise in antibody levels.
D)   Antigen receptors on CD4+ cells require multiple exposures separated by time.

Question 5

A 60-year-old male client with an acute viral infection is receiving interferon therapy. The physician is teaching the family of the client about the diverse actions of the treatment and the ways that it differs from other anti-infective therapies. Which of the following teaching points listed below should the physician least likely include?

Accepted Answer

A)   "Interferon can help your father's unaffected cells adjacent to his infected cells produce antiviral proteins that can stop the spread of the infection."
B)   "Interferon can help limit the replication of the virus that's affecting your father."
C)   "Interferon helps your father's body recognize infected cells more quickly."
D)   "Interferon can bolster your father's immune system through the stimulation of natural killer cells that attack viruses."

Question 6

The nurse knows which of the following statements listed below is accurate regarding the functions and nature of cytokines relative to a variety of pathologies?

Accepted Answer

A)   "A particular cytokine can have varied effects on different systems, a fact that limits their therapeutic use."
B)   "Cytokine production is constant over time, but effects are noted when serum levels cross a particular threshold."
C)   "Most cytokines are produced by granular leukocytes, and different cells are capable of producing the same cytokine."
D)   "Cytokine actions are self-limiting, in that activation of one precludes activation of other cytokines with similar actions."

Question 7

A 53-year-old female hospital patient has received a kidney transplant following renal failure secondary to hypertension. As part of the teaching while she was on the organ wait list, she was made aware that she would need to take antirejection drugs for the rest of her life. Which aspect of the immune system underlies this necessity?

Accepted Answer

A)   The lack of identifiable major histocompatibility complex (MH
C)   molecules will stimulate the innate immune response.
B)   Donor organ antibodies will be identified as foreign and stimulate an immune response.
C)   Antirejection drugs will stimulate the production of familiar MHC molecules.
D)   MHC molecules will never develop in the cells of the donor organ, and effector cells will be continually stimulated.

Question 8

The nurse knows that a drug in a category identified as a colony-stimulating factor (CSF) helps

Accepted Answer

A)   cells engulf and digest microbes that want to attach to cell membranes and destroy normal cell function.
B)   produce cells that will be the first responder cells to protect against cancer formation.
C)   stimulate the person's immune system so that he or she can kill his or her own cancer cells.
D)   stimulate bone marrow to produce large numbers of mature cells such as platelets and erythrocytes.

Question 9

Three days ago, a mother delivered her full-term infant who had been identified as having an in utero infection. The infant is receiving antibiotic and phototherapy, and the mother is breast-feeding. Which of the following types of immunoglobulins could most reasonably be expected to predominate in the infant's immune system?

Accepted Answer

A)   IgA, IgM, IgD
B)   IgG, IgA, IgM
C)   IgE, IgG, IgD
D)   IgM, IgD, Igm

Question 10

The nurse knows which of the following statements listed below relative to a client with malignant melanoma treated with alpha interferon (IFN-a) is accurate? Alpha interferon (IFN-a)

Accepted Answer

A)   will kill certain microorganisms that may help spread the cancer.
B)   plays an important role in the modulation of the inflammatory response.
C)   helps keep all the blood levels at a higher level.
D)   controls the migration of leukocytes to their primary site.

Question 11

Which of the following phenomena would be least likely to result in activation of the complement system?

Accepted Answer

A)   Recognition of an antibody bound to the surface of a microbe
B)   Increase in tissue blood flow and capillary permeability, so fluids/proteins can leak into the area
C)   Activation of toll-like receptors (TLRs)  on complement proteins
D)   Direct recognition of microbial proteins

Question 12

A client has been inhaling viruses periodically while on a cross-country flight. Which of the following situations listed below would most likely result in the stimulation of the client's T lymphocytes and adaptive immune system?

Accepted Answer

A)   Presentation of a foreign antigen by a familiar immunoglobulin
B)   Recognition of a foreign major histocompatibility complex (MH
C)   molecule
C)   Recognition of a foreign peptide bound to a self-major histocompatibility complex (MH
C)   molecule
D)   Cytokine stimulation of a T lymphocyte with macrophage or dendritic cell mediation

Question 13

A nurse is providing care for a client who is immunocompromised following chemotherapy. The nurse knows which of the following characterizations of the adaptive immune system listed below is responsible for the client's disruption in his normal immune function?

Accepted Answer

A)   Epitopes on antigens are recognized by immunoglobulin receptors following presentation by accessory cells.
B)   Haptens combine to form epitopes that stimulate the response of regulatory and effector cells.
C)   Effector cells orchestrate the immune response of regulatory cells toward an antigen.
D)   Accessory cells such as macrophages are engulfed by regulatory cells, stimulating effector cells.

Question 14

A newly diagnosed HIV-positive adolescent has blood work drawn, which includes a CD8 T-cell count. The nurse knows which of the following functions of CD8 T cells listed below will assist the adolescent's immune system in fighting off the viral attack? Select all that apply.

Accepted Answer

A)   Release destructive enzymes
B)   Trigger intracellular programmed death
C)   Cause allergens to surround the virus
D)   Boost antigen-antibody response
E)   Remove foreign material from lymph before it enters the blood

Question 15

A 10-year-old child with strep throat asks the nurse, "why there are large bumps [lymph nodes] on my neck when my throat gets sore?" The nurse replies lymph nodes

Accepted Answer

A)   help your body fight off infections by allowing special cells (lymphocytes and macrophages)  move through the lymph chain and engulf and destroy germs.
B)   bring in cells into the lymph node (your bump)  to stop the germs from going anywhere else in the body
C)   bring all kind of good cells to your throat so that they can wall the strep off and keep the germs from getting any food or water."
D)   help your tonsils get bigger with cells that will bring immune cells into your throat to prevent any other infections.

Question 16

Which of the following individual situations listed below best exemplifies the processes of innate immunity?

Accepted Answer

A)   A child who has experienced heat and swelling of his skinned knuckle
B)   An adult who complains of itching and is sneezing because he is allergic to pollen
C)   A client whose blood work indicates increased antibody titers during an acute illness
D)   A client who has experienced rejection of donor liver after transplantation

Question 17

The nurse knows the cells primarily programmed to remove the invading organisms and remember the antigen to respond rapidly during the next exposure are

Accepted Answer

A)   CD4 and CD8 cells.
B)   natural killer (NK)  cells and macrophages
C)   T and B lymphocytes.
D)   white blood cells and platelets.

Question 18

A student states, "It seems like helper T cells do a lot more than just 'help' the cellular immunity process." Which of the following responses listed below best conveys an aspect of the role of CD4+ helper T cells in immunity?

Accepted Answer

A)   "Without helper T cells, no antigens would be presented."
B)   "Helper T cells play a major role in stimulating and regulating the whole process."
C)   "Without helper T cells, the wrong antibodies would end up being produced."
D)   "Helper T cells are key to the hematopoiesis that produces all the components of the immune system."

Question 19

A client has been identified as having an excess of macrophage inhibitory factor, causing the client to have inhibited movement and activity of macrophages. Which of the following processes listed below would the health care team member expect to remain unaffected?

Accepted Answer

A)   Amplification of the immune response
B)   Destruction of virus-infected or tumor cells
C)   Initiation of adaptive immunity
D)   Specificity and memory of the immune response

Question 20

The nurse knows which of the following components listed below is needed for long-lasting immunity in a client with a diagnosis of sepsis without the causative agent identified?

Accepted Answer

A)   Neutrophils
B)   Lymphocytes
C)   Colony-stimulating factors
D)   Natural killer cells

Exam 13: Organization and Control of Neural Function