Quiz: Immunologic System and Infectious Diseases
A nurse is caring for a client who had Clostridium welchii (Clostridium perfringens) cultured from a wound of the lower extremity. Which disease results when this organism enters a wound, causing crepitus?
1 Anthrax
2 Tetanus
3 Botulism
Correct 4 Gangrene
C. welchii (C. perfringens) is a spore-forming bacterium that produces a toxin that decays muscle, releasing a gas; it is one of the major causative agents for gas gangrene. Clostridium tetani enters the body via puncture of the skin and affects the nervous system; gas gangrene does not occur with this organism. Anthrax disease is caused by Bacillus anthracis, not Clostridium. Clostridium botulinum contaminates food that is then ingested, causing botulism.
Which is the first medication approved to reduce the risk of human immunodeficiency virus (HIV) infection in unaffected individuals?
1. Truvada
2. Abacavir
3. Cromolyn
4. Methdilazine
Rationale: Truvada is the first medication approved to reduce the risk of HIV infection in unaffected individuals who are at a high risk of HIV infection. Abacavir is administered to treat HIV infection and is a reverse transcriptase inhibitor. Cromolyn is administered in the management of allergic rhinitis and asthma. Methdilazine, an antihistamine, is administered to treat the skin and provide relief from itching.
Which parameter should the nurse consider while assessing the psychologic status of a client with acquired immune deficiency syndrome (AIDS)?
1 Sleep pattern
2 Severity of pain
3 Cognitive changes
4 Presence of anxiety
Presence of anxiety should be considered while assessing the psychologic status of a client with AIDS. Sleep patterns and severity of pain are related to the assessment of activity and rest, a physical status. Cognitive changes are related to the assessment of neurologic status.
A nurse is caring for a client with a negative-pressure wound treatment device. When should the nurse tell the client to call the wound center about this system?
1 When the negative pressure seal is broken
2 When the tubing coming from the wound has no kinks
3 When the drainage chamber is one-third full of exudate
4 When the dressing has a small amount of exudate under the seal
Which is the first antibody formed after exposure to an antigen?
1 IgA
2 IgE
3 IgG
Correct 4 IgM
IgM (immunoglobulin M) is the first antibody formed by a newly sensitized B-lymphocyte plasma cell. IgA has very low circulating levels and is responsible for preventing infection in the upper and lower respiratory tracts, and the gastrointestinal and genitourinary tracts. IgE has variable concentrations in the blood and is associated with antibody-mediated hypersensitivity reactions. IgG is heavily expressed on second and subsequent exposures to antigens to provide sustained, long-term immunity against invading microorganisms.
After several years of unprotected sex, a client is diagnosed as having acquired immunodeficiency syndrome (AIDS). The client states, "I'm not worried because they have a cure for AIDS." What is the best response by the nurse?
1 "Repeated phlebotomies may be able to rid you of the virus."
2 "You may be cured of AIDS after prolonged pharmacologic therapy."
3 "Perhaps you should have worn condoms to prevent contracting the virus."
Correct 4 "There is no cure for AIDS, but there are drugs that can slow down the virus."
Stating "There is no cure for AIDS, but there are drugs that can slow down the virus" is an honest response that corrects the client's misconception about the effectiveness of the current antiviral medications. Phlebotomy is not the treatment used to remove the virus from the client's body. Current pharmacologic treatment does not eliminate the virus from the body; it can slow its progress and may even effect a remission (although the medications are never discontinued), but there is no known cure. Stating "Perhaps you should have worn condoms to prevent contracting the virus" is a nontherapeutic, judgmental response that can alienate the client and precipitate feelings of guilt.
A client with localized redness and swelling due to a bee sting reports intense local pain, a burning sensation, and itching. What would be the most appropriate nursing action?
Correct 1 Applying cold compresses to the affected area
2 Ensuring the client keeps the skin clean and dry
3 Monitoring for neurological and cardiac symptoms
4 Advising the client to launder all clothes with bleach
A client with a bee sting may have localized redness, swelling, pain, and itching due to an allergic reaction. The nurse should apply cold compresses to the affected area to reduce the pain in the client. A client with Candida albicans infection should keep his or her skin clean and dry to prevent further fungal infections. A client with a Borrelia burgdorferi infection may suffer from cardiac, arthritic, and neurologic manifestations. Therefore the nurse has to monitor for these symptoms. Direct contact may transmit a Sarcoptes scabiei infection; the nurse should make sure that the client’s clothes are bleached to prevent the transmission of the infection.
The bacteria Clostridium botulinum causes which condition in a client?
1 Upper respiratory tract infection
2 Toxic shock syndrome
3 Urinary tract infection
Correct 4 Food poisoning with progressive muscle paralysis
Clostridium botulinum bacteria causes food poisoning with progressive muscle paralysis. Toxic shock syndrome is caused by the bacteria Staphylococcus aureus. Many viruses and bacteria can cause upper respiratory tract infection but Clostridium is not one of them. Klebsiella-Enterobacter organisms most likely cause urinary tract infections.
What is a common characteristic of Sjögren’s syndrome (SS)?
Correct 1 Dry eyes
2 Muscle cramping
3 Urinary tract infection
4 Elevated blood pressure
Sjögren’s syndrome (SS) is a group of problems that often appear with other autoimmune disorders. Problems include dry eyes, which are caused by autoimmune destruction of the lacrimal glands. Muscle cramping, urinary tract infection, and elevated blood pressure are not common characteristics of Sjögren’s syndrome (SS).
Which bacteria colonies are commonly found in a client’s large intestine?
Correct 1 Escherichia coli
2 Neisseria gonorrhoeae
3 Staphylococcus aureus
4 Haemophilus influenzae
Escherichia coli are bacteria that are part of the normal flora in the large intestine. Neisseria gonorrhoeae causes gonorrhea and pelvic inflammatory disease. Staphylococcus aureus secretes toxins that damage cells and causes skin infections, pneumonia, urinary tract infections, acute osteomyelitis, and toxic shock syndrome. Haemophilus influenzae causes nasopharyngitis, meningitis, and pneumonia.
Which symptoms are common during the fulminant stage of inhalation of anthrax? Select all that apply.
Correct 1 Dyspnea
2 Dry cough
Correct 3 Diaphoresis
4 Mild chest pain
Correct 5 High temperature
The fulminant stage of inhalation of anthrax is manifested by dyspnea, diaphoresis, and a high body temperature. The prodromal stage of inhalation of anthrax is manifested by a dry cough and mild chest pain.
What should be used to clean needles and syringes between intravenous drug users (IDUs)?
Correct 1 Bleach
2 Hot water
3 Ammonia
4 Rubbing alcohol
Intravenous drug users (IDUs) should be instructed to fill syringes with household bleach and shake the syringe for 30 to 60 seconds. Hot water, ammonia, or rubbing alcohol are not used to disinfect used syringes.
Which type of hepatitis virus spreads through contaminated food and water?
Correct 1 Hepatitis A virus
2 Hepatitis B virus
3 Hepatitis C virus
4 Hepatitis D virus
Hepatitis A virus spreads through contaminated food and water. Hepatitis B, C, and D viruses spread through contaminated needles, syringes, and blood products.
A client who abused intravenous drugs was diagnosed with the human immunodeficiency virus (HIV) several years ago. What does the nurse explain to the client regarding the diagnostic criterion for acquired immunodeficiency syndrome (AIDS)?
1 Contracts HIV-specific antibodies
2 Develops an acute retroviral syndrome
3 Is capable of transmitting the virus to others
Correct 4 Has a CD4+T-cell lymphocyte level of less than 200 cells/µL (60%)
AIDS is diagnosed when an individual with human immunodeficiency virus (HIV) develops one of the following: a CD4+T-cell lymphocyte level of less than 200 cells/µL (60%), wasting syndrome, dementia, one of the listed opportunistic cancers (e.g., Kaposi sarcoma [KS], Burkitt lymphoma), or one of the listed opportunistic infections (e.g., Pneumocystis jiroveci pneumonia, Mycobacterium tuberculosis). The development of HIV-specific antibodies (seroconversion), accompanied by acute retroviral syndrome (flulike syndrome with fever, swollen lymph glands, headache, malaise, nausea, diarrhea, diffuse rash, joint and muscle pain) 1 to 3 weeks after exposure to HIV reflects acquisition of the virus, not the development of AIDS. A client who is HIV positive is capable of transmitting the virus with or without the diagnosis of AIDS.
Which virus is responsible for causing infectious mononucleosis in clients?
1 Parvovirus
2 Coronavirus
3 Rotavirus
Correct 4 Epstein-Barr virus
Epstein-Barr virus is responsible for mononucleosis and possibly Burkitt’s lymphoma. Parvovirus and rotavirus cause gastroenteritis. Corona virus causes upper respiratory tract infections.
Which immunoglobulin crosses the placenta?
1 IgE
2 IgA
Correct 3 IgG
4 IgM
IgG is the only immunoglobulin that crosses the placenta. IgE is found in the plasma and interstitial fluids. IgA lines the mucous membranes and protects body surfaces. IgM is found in plasma; this immunoglobulin activates due to the invasion of ABO blood antigens.
A client is concerned about contracting malaria while visiting relatives in Southeast Asia. What should the nurse teach the client to avoid to prevent malaria?
Correct 1 Mosquito bites
2 Untreated water
3 Undercooked food
4 Overpopulated areas
Malaria is caused by the protozoan Plasmodium falciparum, which is carried by mosquitoes. Avoiding untreated water, undercooked food, and overpopulated areas will not prevent protozoa from entering the bloodstream.
Which are examples of a type IV hypersensitivity reaction? Select all that apply.
Correct 1 Poison ivy allergic reaction
Correct 2 Sarcoidosis
3 Myasthenia gravis
4 Rheumatoid arthritis
5 Systemic lupus erythematosus
Sarcoidosis and poison ivy reactions are examples of type IV hypersensitivity reactions. In type IV hypersensitivity, the inflammation is caused by a reaction of sensitized T cells with the antigen and the resultant activation of macrophages due to lymphokine release. Myasthenia gravis is an example of a type II or cytotoxic hypersensitivity reaction. Rheumatoid arthritis and systemic lupus erythematosus are examples of type III immune complex–mediated reactions.
0
1619