1. For which illness should airborne precautions be implemented?
Influenza
2 Chickenpox
Pneumonia
Respiratory syncytial virus
2. A client diagnosed with osteomyelitis is being discharged. Which statement indicates a need for further teaching?
1. "I will take the antibiotic at the same time every day."
2. "I will take the antibiotic regularly until my symptoms subside."
3. "I will take the antibiotic with food if I develop gastric distress when on the antibiotic."
4. "I will notify my healthcare provider and stop taking the medication if I develop a rash or shortness of breath."
The antibiotic should be taken as prescribed for the full length of treatment. The client should not discontinue the medication when symptoms subside. The statements "I will take the antibiotic at the same time every day," "I will take the antibiotic with food if I develop gastric distress when on the antibiotic," and "I will notify my healthcare provider and stop taking the medication if I develop a rash or shortness of breath" demonstrate understanding of the discharge instructions.
SI Immune and Oncology Review Questions
3. The nurse suspects that a client with inhalation anthrax is in the fulminant stage of the disease. Which symptom supports the nurse’s conclusion?
Fever
Dry cough
Hematemesis
Mild chest pain
4. What is the function of the immune system?
To protect the body from a variety of harmful substances
5. Monocytes move from the systemic circulatory system into general connective tissues, where they differentiate into what phagocytic cell type?
Macrophage
6. Which of the following cell types of the innate immune system does not perform phagocytosis?
Basophils
7. Give four reasons why secondary immune responses are faster and more effective than primary immune responses.
(i) Memory cells outnumber naive pathogen-specific lymphocytes because they have already gone through clonal selection and proliferation when antigen was encountered previously.
(ii) Memory cells can be activated more quickly than naive lymphocytes.
(iii) Memory cells are not restricted to circulation between the bloodstream and secondary lymphoid organs, but can also enter non-lymphoid tissues and can therefore respond to infections sooner.
(iv) Owing to the molecular processes of somatic hypermutation and isotype switching, immunoglobulins made by memory B cells are of a higher quality and possess constant regions that will direct secreted antibody to the appropriate anatomical locations to combat infection.They will therefore compete more efficiently for antigen than naive lymphocytes and in so doing will inhibit the activation of naive lymphocytes.
8. Myelogenous leukemias are caused by the cancerous production of innate (non-specific) immune system cells: in which tissue is such production most likely to occur?
Bone Marrow
9. Humoral immunity is a type of adaptive immunity that results in the circulation of which of the following throughout the blood?
Antibodies
10. What do the granules in basophils contain?
Histamines and heparin
11. Which sexually transmitted disease is treated with antiviral drugs?
Syphilis
Gonorrhea
Genital herpes
Chlamydial infection
Genital herpes
Rationale
Genital herpes is a sexually transmitted disease caused by herpes simplex virus. Therefore antiviral drugs are used to treat this condition. Bacteria cause syphilis, gonorrhea, and chlamydial infections.
12. Recognition of self vs. non-self by the adaptive immune system in humans is accomplished in which of the following ways?
Exposure of T cells to the body's own antigens in the thymus
13. Which portion of an antibody provides antigen-binding sites?
Variable portion
14. The bacteria Clostridium botulinum causes which condition in a client?
Upper respiratory tract infection
Toxic shock syndrome
Urinary tract infection
Food poisoning with progressive muscle paralysis
Food poisoning with progressive muscle paralysis
Rationale
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.
15. Which of the following is not one of the three main antigen-presenting cell types?
Natural killer cells
16. Which drug can be administered via the intramuscular route to treat anaphylaxis?
1. Epinephrine
2. Methdilazine
3. Phenylephrine
4. Mycophenolate mofetil
Epinephrine is administered through the intramuscular route to treat anaphylaxis. Methdilazine is administered to treat allergic reactions and pruritus. Phenylephrine is administered orally, not intramuscularly, to treat anaphylaxis. Mycophenolate mofetil is administered intravenously as an immunosuppressant agent.
17. Major histocompatibility complex (MHC) refers to a large group of genes that code for proteins that play an essential role in which of the following?
Antigen presentation to T lymphocytes
18. Central tolerance refers to which of the following processes?
Destruction of lymphocytes that are specific for self-antigens
19. 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?
Applying cold compresses to the affected area
Ensuring the client keeps the skin clean and dry
Monitoring for neurological and cardiac symptoms
Advising the client to launder all clothes with bleach
Applying cold compresses to the affected area
Rationale
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.
20. In the developing fetus, prenatal hematopoiesis (the differentiation and development of immune cells) is not generally known to occur in which of the following organs?
Appendix
21. Explain (A) why only memory B cells, and not naive B cells, participate in secondary immune responses to particular pathogens, and (B) why this is advantageous to the host.
A. Naive B cells carry the inhibitory Fc receptor FcγRIIB1. Complexes composed of antigen and IgG produced in the primary response, or by reactivated memory cells, cross-link FcγRIIB1 and the B-cell receptor, which suppresses naive B-cell activation. In contrast, memory B cells do not carry this receptor, and so are not inhibited in this way.
B. The suppression of naive B cells means that only reactivated memory B cells (which have already undergone isotype switching and somatic hypermutation) make antibodies. Thus all the antibodies made are of high affinity and are primarily of the IgG, IgA, or IgE isotype. Suppression of naive B cells eliminates repetition of the events that took place in the primary immune response, which would, if not inhibited, lead to the production of low-affinity IgM antibodies rather than high-affinity, isotype-switched antibodies that are more effective at removing the pathogen.
22. General term for a lymphocyte that is responsible for the phenomenon of immunological memory is?
Memory cells
0
1673