Deck 13: Inflammation, infection, and Immunity
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Deck 13: Inflammation, infection, and Immunity
1
On a visit to administer the fifth in a series of 10 antibiotic doses,the home health nurse is told that the patient is now complaining about a bothersome vaginal discharge.The nurse will communicate the problem to arrange for medication and teaches the patient that this condition is probably the result of:
A) Poor genital hygiene-not changing underwear often enough
B) Allergy to the soap or soap products used in the genital area
C) Superinfection response to the antibiotic medication
D) Sexual contact with another infected person
A) Poor genital hygiene-not changing underwear often enough
B) Allergy to the soap or soap products used in the genital area
C) Superinfection response to the antibiotic medication
D) Sexual contact with another infected person
Superinfection response to the antibiotic medication
2
The patient in early labor says to the nurse,"I will pass on protection from diseases,and the baby will not ever need any shots." The best response by the nurse should be:
A) "Babies are born with innate (natural) immunity at birth."
B) "Babies are born with immunoglobulin E (IgE), an antibody that crosses the placenta, but it only briefly protects the baby."
C) "Yes, immediate antibody immunity from the mother is the first line of defense against disease for babies."
D) "Yes, the mother passes on cell-mediated immunity."
A) "Babies are born with innate (natural) immunity at birth."
B) "Babies are born with immunoglobulin E (IgE), an antibody that crosses the placenta, but it only briefly protects the baby."
C) "Yes, immediate antibody immunity from the mother is the first line of defense against disease for babies."
D) "Yes, the mother passes on cell-mediated immunity."
"Babies are born with immunoglobulin E (IgE), an antibody that crosses the placenta, but it only briefly protects the baby."
3
A patient who is receiving daily steroids for the control of a condition calls the nurse to ask advice about whether a small child who has been exposed to influenza should come and visit because she has not had any symptoms.An appropriate response by the office nurse would be:
A) "Yes, let the child visit. There is no reason not to visit, because this child is not sick."
B) "No, the child should not visit. Infectious diseases are often most communicable in the short period before the child actually becomes ill."
C) "It would be up to the patient. Plan not to get overtired with a small child running and bouncing around."
D) "Take the child who is not sick to her own physician, and ask this question first."
A) "Yes, let the child visit. There is no reason not to visit, because this child is not sick."
B) "No, the child should not visit. Infectious diseases are often most communicable in the short period before the child actually becomes ill."
C) "It would be up to the patient. Plan not to get overtired with a small child running and bouncing around."
D) "Take the child who is not sick to her own physician, and ask this question first."
"No, the child should not visit. Infectious diseases are often most communicable in the short period before the child actually becomes ill."
4
The nurse is bathing a patient who is immunodeficient and suffering from a Cryptococcus infestation.The organism is classified as a:
A) Bacterium
B) Virus
C) Fungus
D) Protozoa
A) Bacterium
B) Virus
C) Fungus
D) Protozoa
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5
The patient with the diagnosis of Clostridium difficile infection asks what has caused the diarrhea.The nurse responds that it is caused by:
A) Protozoal infection
B) Fecal-oral contamination
C) Inflammatory response
D) Long-term antibiotic therapy
A) Protozoal infection
B) Fecal-oral contamination
C) Inflammatory response
D) Long-term antibiotic therapy
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6
The school nurse cautions a group of parents about children playing barefoot on dirt that may lead them to be exposed to infections caused by:
A) Helminthes
B) Protozoa
C) Rickettsiae
D) Mycoplasmas
A) Helminthes
B) Protozoa
C) Rickettsiae
D) Mycoplasmas
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7
A patient has had several increasingly severe allergic reactions during last year's pollen season.This year,the patient comes regularly to the office to receive some antigen injections.The nurse teaches that these will:
A) Combat infection brought on by the allergic response.
B) Act as a steroid to lessen the allergic response.
C) Increase tolerance to the antigen.
D) Decrease the production of the antibodies.
A) Combat infection brought on by the allergic response.
B) Act as a steroid to lessen the allergic response.
C) Increase tolerance to the antigen.
D) Decrease the production of the antibodies.
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8
With the exposure to an antigen,the nurse explains that the initiator of the inflammatory response is the presence of histamine,which is released by the:
A) Neutrophils
B) Eosinophils
C) Basophils
D) Monocytes
A) Neutrophils
B) Eosinophils
C) Basophils
D) Monocytes
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9
The home health nurse recommends air conditioner duct cleaning as a precaution against diseases caused by:
A) Bacteria
B) Viruses
C) Fungi
D) Protozoa
A) Bacteria
B) Viruses
C) Fungi
D) Protozoa
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10
The school nurse starts a clean-up campaign at a local elementary school in an effort to combat some of the allergens that cause one of the most common allergic response disorders,which is:
A) Anaphylaxis
B) Asthma
C) Contact dermatitis
D) Urticaria
A) Anaphylaxis
B) Asthma
C) Contact dermatitis
D) Urticaria
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11
The nurse explains that although some drugs reduce inflammation,they also hinder the body's immune response.Examples of such drugs are:
A) Antihistamines and salicylates
B) Bronchodilators and corticosteroids
C) Cardiotonic and anticholinergics
D) Diuretics and sedatives
A) Antihistamines and salicylates
B) Bronchodilators and corticosteroids
C) Cardiotonic and anticholinergics
D) Diuretics and sedatives
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12
A community picnic is held.A number of the attendees become ill after the picnic.The pathogen in this case was acquired via:
A) Indirect contact
B) Common vehicle
C) Airborne transmission
D) Vector transmission
A) Indirect contact
B) Common vehicle
C) Airborne transmission
D) Vector transmission
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13
The home health nurse is teaching the family that the most effective method to control the spread of communicable disease is to:
A) Isolate the infected person from all contact with noninfected persons.
B) Vigorously petition the community health department to increase spraying.
C) Administer prophylactic antibiotics to the rest of the family.
D) Demonstrate and monitor a return demonstration of a good hand-washing technique by the family.
A) Isolate the infected person from all contact with noninfected persons.
B) Vigorously petition the community health department to increase spraying.
C) Administer prophylactic antibiotics to the rest of the family.
D) Demonstrate and monitor a return demonstration of a good hand-washing technique by the family.
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14
The patient receiving a large intramuscular (IM)dose of antibiotic was asked to please wait 20 to 30 minutes before checking out.The reason for this request is that:
A) The office staff needs to make sure that the right medicine was administered before the patient leaves.
B) The nurse always forgets to ask the patient about allergies before administering the antibiotic.
C) Antibiotics are a common source of severe allergic reactions within the first few minutes after an injection.
D) The staff wants to make sure that the patient has time to pay for the services delivered that day.
A) The office staff needs to make sure that the right medicine was administered before the patient leaves.
B) The nurse always forgets to ask the patient about allergies before administering the antibiotic.
C) Antibiotics are a common source of severe allergic reactions within the first few minutes after an injection.
D) The staff wants to make sure that the patient has time to pay for the services delivered that day.
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15
When a mosquito or a fly carries an organism that infects another living organism,this mode of transmission is infection via:
A) Common vehicle
B) Direct excretion
C) Ingestion
D) Vector
A) Common vehicle
B) Direct excretion
C) Ingestion
D) Vector
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16
The nurse caring for an patient who is immunosuppressed is diligent about protecting the patient from infection.When visitors come in,in addition to having them put on isolation attire,the nurse prohibits them from bringing a:
A) Battery-operated DVD player
B) Book
C) Potted plant
D) Box of candy
A) Battery-operated DVD player
B) Book
C) Potted plant
D) Box of candy
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17
The large,heavy,and older adult patient after a stroke develops an infected decubitus on the sacrum during the hospital stay.Approximately 2 weeks after the patient has gone home,the patient returns to the hospital with pneumonia.The distinction between these two infections is:
A) The decubitus infection was transmitted from other patients on the unit, but the pneumonia was transmitted from a neighbor visiting when the patient was at home.
B) The decubitus and pneumonia are caused by the same host.
C) The decubitus is termed a health care-associated infection, and the pneumonia is termed a community-acquired infection.
D) The decubitus is considered to be caused by protozoa, whereas the pneumonia is considered unpreventable because of the size of the patient.
A) The decubitus infection was transmitted from other patients on the unit, but the pneumonia was transmitted from a neighbor visiting when the patient was at home.
B) The decubitus and pneumonia are caused by the same host.
C) The decubitus is termed a health care-associated infection, and the pneumonia is termed a community-acquired infection.
D) The decubitus is considered to be caused by protozoa, whereas the pneumonia is considered unpreventable because of the size of the patient.
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18
The nurse explains that a medication given to a patient with a severe inflammatory response mimics a hormone secreted by the adrenal cortex.This hormone is:
A) Aldosterone
B) Testosterone
C) Histamine
D) Cortisol
A) Aldosterone
B) Testosterone
C) Histamine
D) Cortisol
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19
The nurse assesses that the patient who has acquired a health care-associated infection is most likely the patient with:
A) Abdominal abscess after a ruptured appendix
B) Lice and nits that have come from the emergency department
C) Urinary infection after the insertion of a Foley catheter
D) Two-day, postoperative foot fungus after a hip replacement
A) Abdominal abscess after a ruptured appendix
B) Lice and nits that have come from the emergency department
C) Urinary infection after the insertion of a Foley catheter
D) Two-day, postoperative foot fungus after a hip replacement
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20
The nurse is discussing the body's first and second lines of defense against infection with a community group.The first line of defense includes:
A) Teeth
B) Sweat
C) White blood cells
D) T lymphocytes
A) Teeth
B) Sweat
C) White blood cells
D) T lymphocytes
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21
The nurse assesses a high eosinophil count in a pediatric patient.The nurse recognizes that this elevation is an indicator of ____________________.
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22
The organs involved in immunity include the tonsils,spleen,lymph nodes,and:
A) Liver
B) Lungs
C) Periosteum
D) Pancreas
A) Liver
B) Lungs
C) Periosteum
D) Pancreas
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23
The patient is hospitalized with cryptococcal pneumonia and AIDS.The nurse knows that the Standard Precautions for this patient will include the most important precaution of:
A) Hands are washed before and after gloving.
B) Once gloves are put on, they do not need to be changed until care is finished.
C) Needles and sharps should be placed in puncture-resistant containers on the medicine cart out of the room.
D) Mouth-to-mouth resuscitation must be performed immediately unless the patient is a designated as "do not resuscitate."
A) Hands are washed before and after gloving.
B) Once gloves are put on, they do not need to be changed until care is finished.
C) Needles and sharps should be placed in puncture-resistant containers on the medicine cart out of the room.
D) Mouth-to-mouth resuscitation must be performed immediately unless the patient is a designated as "do not resuscitate."
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24
The daughter of an 89-year-old resident in a long-term care facility asks if she may give her father an over-the-counter (OTC)antihistamine that she uses for seasonal allergy.The nurse's most appropriate response would be:
A) "Yes. OTCs are mild and very helpful."
B) "No. Many antihistamines cause confusion in the older adult."
C) "Yes. The drug might energize him so he won't be so drowsy."
D) "No. Allergic symptoms should be allowed to run their course."
A) "Yes. OTCs are mild and very helpful."
B) "No. Many antihistamines cause confusion in the older adult."
C) "Yes. The drug might energize him so he won't be so drowsy."
D) "No. Allergic symptoms should be allowed to run their course."
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25
The nurse reminds the patient who is to undergo hyperbaric oxygen therapy that the clothing worn into the chamber must be made of ____________________.
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26
The Centers for Disease Control and Prevention (CDC)has issued new guidelines for infection control.Nursing care plans for patients with infection mainly address which protocol?
A) Disease-specific precautions
B) Manner in which clean gloves are worn
C) Standard Precautions guidelines
D) Placement of needles and sharps
A) Disease-specific precautions
B) Manner in which clean gloves are worn
C) Standard Precautions guidelines
D) Placement of needles and sharps
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27
The school nurse is required to report to the health department all cases of:
A) Rubella
B) Lyme disease
C) Pediculosis
D) Salmonella
E) Clostridium difficile
A) Rubella
B) Lyme disease
C) Pediculosis
D) Salmonella
E) Clostridium difficile
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28
The nurse is aware that wound healing can be enhanced with the administration of vitamin:
A) A
B) B
C) C
D) D
A) A
B) B
C) C
D) D
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29
Prioritize the events of an antibody-mediated immunity response.
A)Antibodies seek out and bind with specific antigen.
B)Antigen binds to a B lymphocyte.
C)Circulating antibody-antigen complexes are destroyed.
D)Antibodies are produced.
E)Antibodies are replenished.
A)Antibodies seek out and bind with specific antigen.
B)Antigen binds to a B lymphocyte.
C)Circulating antibody-antigen complexes are destroyed.
D)Antibodies are produced.
E)Antibodies are replenished.
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30
Persons with human immunodeficiency virus (HIV)have acquired Pneumocystis jiroveci (PCP),a serious pulmonary infection caused by ____________________.
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31
The nurse explains that the difference between medical asepsis and surgical asepsis is that medical asepsis requires:
A) Good hand-washing technique.
B) That no nonsterile product come into contact with the patient.
C) Elimination of all microorganisms.
D) Hand-washing with antimicrobial soap for 3 minutes.
A) Good hand-washing technique.
B) That no nonsterile product come into contact with the patient.
C) Elimination of all microorganisms.
D) Hand-washing with antimicrobial soap for 3 minutes.
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32
After receiving an injection of penicillin,the patient undergoes an anaphylactic reaction.The nurse should immediately:
A) Administer oxygen.
B) Prepare fluids to combat shock.
C) Notify the charge nurse.
D) Cover with several blankets.
A) Administer oxygen.
B) Prepare fluids to combat shock.
C) Notify the charge nurse.
D) Cover with several blankets.
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