Exam 3

Question 1

Antigen

Answer 1

A foreign agent that triggers the production of antibodies by the immune system

Question 2

Antibodies

Answer 2

Proteins used by the immune system to identify and neutralize foreign agents such as viruses and bacteria

Question 3

Auto-antibody

Answer 3

An antibody made by the immune system that attacks an individuals own proteins.

Question 4

Thymus

Answer 4

Located in the anterior superior mediastinum: functions are the development of T-Lymphocytes and the production and secretion of thymosins.

Question 5

Lymphatic tissue

Answer 5

Connective tissue containing many lymphosytes; transports immune cells, antigen-presenting cells, fatty acids, and fats, filters body fluids.

Question 6

Bone marrow

Answer 6

Soft, fatty tissue found inside bones. Contains stem cells and leukocytes.

Question 7

Neutrophils

Answer 7

An infection-fighting agent. Usually the fist to arrive on the scene of an infection, neutrophils escape from the capillary wall and migrate to the site of infection. Once they get to the site, neutrophils phagocyte microorganisms, preventing the infection from spreading.

Question 8

Basophils

Answer 8

When blood cells that bind IgE and release histamine in anaphylaxis

Question 9

Eosinophils

Answer 9

White blood cells involved in allergic reactions

Question 10

Monocytes

Answer 10

White-blood cells that replenish macrophages and dendritic cells in normal states and respond to inflammation by migrating to infected tissue to become macrophages and dendritic cells, which elicits an immune response

Question 11

Macrophages

Answer 11

White Blood cells within tissues, produced by differentiation on monocytes. Functions are phagocytosis and stimulating lymphocytes and other immune cells to respond to pathogens.

Question 12

Mast Cells

Answer 12

Connective tissue cells that contain histamine heparin hyaluronic acid slow reacting substance of anaphylaxis and serotonin

Question 13

B cells (B lymphocytes)

Answer 13

B cells mature in the bone marrow where they differentiate into memory cells or immunoglobulin secreting (antibody) cells. B cells eliminate bacteria, neutralize bacterial toxins, prevent viral reinfection, and produce immediate inflammation response.

Question 14

Plasma Cells

Answer 14

White blood cells that develop from B cells and produce large volumes of specific antibodies.

Question 15

T cells

Answer 15

T cells are produced in the bone marrow and mature in the thymus hence “T” cell. Two major types of T cells work to destroy antigens-regulator cells and effector cells.

Question 16

Killer cell

Answer 16

A type of T cell that destroys cells infected with viruses by releasing lymphokines that destroy cell walls. Also called cytotoxic cells and effector cells.

Question 17

Memory B cells

Answer 17

Type of B cells that activate of calls up B cells to produce antibodies.

Question 18

NK lymphocytes

Answer 18

Natural killer cells that destroy cancer cells, foreign cells, and virus-infected cells.

Question 19

Complement

Answer 19

A group of inactive proteins in the circulation that when activated stimulate the release of other chemical mediators promoting inflammation chemotaxis and phagocytosis.

Question 20

Histamine

Answer 20

Release by mast cells and basophils, especially during allergic reaction triggereing the inflammation response. Increase the permeability of the capillaries to white blood cells and other proteins in order to allow them to engage foreign invaders in the infected tissues.

Question 21

Kinins (e.g. bradyminin)

Answer 21

Induce vasodilation and contraction of smooth muscle.

Question 22

Prostaglandins

Answer 22

A group of lipid compounds that have a variety of effects, including constriction or dilation in vascular smooth muscles cells control of cell growth and sensitizing spinal neurons to pain.

Question 23

Leukotrines

Answer 23

Fatty molecules of the immune system that contribute to contracation of bronchiolar smooth muscles.

Question 24

Cytokins (Messengers)

Answer 24

Small cell-signaling protien molecules that are extensively involved in intracellular communication. Include intrleukins interferons and lymphokines.

Question 25

Tumor necrosis factor (TNF)

Answer 25

A group of cytokines that can cause cell death (apoptosis)

Question 26

Chemotactic factors

Answer 26

Attract phagocytes to the area of inflammation

Question 27

Acquired Immunity: Natural Active

Answer 27

Pathogens enter the body and cause illness; antibodies form

Question 28

Acquired Immunity: Artificial Active

Answer 28

Vaccine (live or attenuated organisms) is injected into the body. No illness results but antibodies form.

Question 29

Acquired Immunity: Natural passive

Answer 29

Antibodies are passed directly from mother to child to provide temporary protection

Question 30

Acquired Immunity: Artificial passive

Answer 30

Antibodies are injected into the body (antiserum) to provide temporary protection or to minimize severity of an infection

Question 31

First Line of Defense

Answer 31

Physical and chemical barriers

Question 32

Second Line of Defense

Answer 32

Inflammation

Question 33

Third Line of Defense

Answer 33

Immunity

Question 34

Immune Processes: Innate Immunity

Answer 34

Nonspecific Involves inflammatory processes

Question 35

Immune processes: Adaptive (acquired) immunity

Answer 35

Targeted to a specific antigen Involves T and B lymphocytes

Question 36

A client with allergies is prescribed diphenhydramine (Benadryl), a first-generation antihistamine. Which statement indicates the client understands the teaching concerning this medication? "If I get any ringing in my ears, I should notify my HCP" "I will have to taper off this medication when I am ready to stop taking it" "It is not uncommon to get a moon face and elevated glucose when taking this medication" "I will probably get drowsy when I take this medication"

Answer 36

"I will probably get drowsy when I take this medication"

Question 37

Bob is learning that inflammation is important to understand in relationship to many diseases. He knows there are both signs of acute and chronic inflammation. Which of the following is an effect from an acute inflammatory response? Select all that apply Induration (hardened tissue) Decreased temperature Blisters Erythema pain

Answer 37

Erythema Pain

Question 38

Cardinal signs of inflammation

Answer 38

Rubor (redness) Tumor (Swelling) Calor (heat) Dolor (Pain) Functio laesa (loss of fundtion)

Question 39

What are the benefits of inflammation?

Answer 39

Limit tissue destruction Isolate infection Initiate healing

Question 40

Which white blood cells release histamine during an acute inflammatory response

Answer 40

Mast Cells

Question 41

What occurs during the vascular stage of inflammation?

Answer 41

Local circulation is slowed and exudate forms at the site of injury.

Question 42

Phases of Acute Inflammation

Answer 42

1. Stimulus (injury, infection, chemical agent). 2. Vascular stage - slowing the local circulation and forming exudate at the site of inflammation. 3. Cellular stage - the migration of neutrophils to the site. 4. Either resolution where the tissue returns to normal, or persistence which can lead to chronic inflammation.

Question 43

A patient who takes aspirin for rheumatoid arthritis is admitted to the hospital complaining of headache and ringing in the ears. The plasma salicylate level is elevated. What should the nurse do?

Answer 43

withhold the aspirin and notify the provider

Question 44

A patient who is taking acetaminophen for pain wants to know why it does not cause gastrointestinal upset, as do other over-the counter pain medications. The nurse will explain that this is most likely because of which property of acetaminophen?

Answer 44

It has minimal effects on cyclooxygenase inhibition at peripheral sites.

Question 45

What is the goal of phagocytosis?

Answer 45

To engulf and destroy foreign substances.

Question 46

Which characteristic best describes the inflammatory response?

Answer 46

Regulated by chemical mediators

Question 47

Which exudate contains watery fluid and results from plasma at the inflammatory site?

Answer 47

Serous

Question 48

________ should not be given during pregnancy and lactation due to effects on developing bones and teeth of the fetus/infant.

Answer 48

Tetracycline

Question 49

Which of the following methods has been identified as helping prevent the development of antimicrobial resistance?

Answer 49

Using narrow spectrum antibiotics when possible

Question 50

The microorganisms that make up the normal human flora are essential for:

Answer 50

Preventing the colonization and multiplication of pathogens.

Question 51

A patient is diagnosed with a viral infection and asks why they cannot get an antibiotic to help them feel better. The best response from the nurse is:

Answer 51

"Antibiotics are not effective in treating viral infections"

Question 52

The nurse effectively uses isolation equipment (gown, gloves, mask); how does this interrupt the chain of infection?

Answer 52

Blocks the mode of transmission

Question 53

Which of the following describes the incidence of a disease?

Answer 53

The number of new cases of a disease within a defined population.

Question 54

Which of the following impacts the ability of a pathogen to cause an infection? Select all that apply. The number of microorganisms present Susceptibility of the host (patient) Ability of the pathogen to enter and live in the host Virulence of the pathogen

Answer 54

The number of microorganisms present Susceptibility of the host (patient) Ability of the pathogen to enter and live in the host Virulence of the pathogen AKA All of them

Question 55

Which of the following describes the incidence of a disease? The number of new cases of a disease within a defined population. The spread of disease beyond continental borders. The number of active cases at any given time. An abrupt increase in the number of cases.

Answer 55

The number of new cases of a disease within a defined population.

Question 56

How can nurses break the chain of infection? Select all that apply. Following guidelines for dressing changes. Avoiding patients with contagious diseases. Wearing proper PPE. Hand washing.

Answer 56

Following guidelines for dressing changes. Wearing proper PPE. Hand washing.

Question 57

A patient acquired an infection while in the hospital. This is considered a:

Answer 57

Nosocomial infection

Question 58

Why is it essential for patients with tuberculosis to be monitored during treatment?

Answer 58

To ensure they complete treatment.

Question 59

A client has systemic lupus erythematosus (SLE). What statement best describes this client's immune response?

Answer 59

An immune response that no longer recognizes normal body tissue.

Question 60

Which patient will develop active immunity? A patient who:

Answer 60

Has natural exposure to an antigen or receives an immunization.

Question 61

A 10-year old male is stung by a bee while playing in the yard. He experiences a severe allergic reaction and has to go to the ER. The nurse providing care realizes this reaction is the result of:

Answer 61

IgE

Question 62

The most abundant class of antibody in the serum is:

Answer 62

IgG

Question 63

The first antibody to develop in a typical primary immune response is:

Answer 63

IgM

Question 64

Functions of antibodies include all of the following EXCEPT:

Answer 64

Phagocytosis

Question 65

Which of the following is NOT a potential side effect of vaccines?

Answer 65

Elevated liver enzymes

Question 66

A client has a severe anaphylactic reaction to a bee sting. Which priority discharge intervention should the nurse discuss with the client?

Answer 66

Have an Epi-Pen available at all times.

Question 67

A 6-year-old female is diagnosed with a bacterial infection of the respiratory system. Which of the following will be made by her body to fight the antigen?

Answer 67

Antibodies

Question 68

When the immunoglobulin crosses the placenta, what type of immunity does the fetus receive?

Answer 68

Passive

Question 69

Severe immune dysfunction, significant increase in risk of opportunistic infections, and a diagnosis of AIDS results when a person's CD4+ cells/mm3 count falls below

Answer 69

200

Question 70

Antibodies are secreted from which cell type?

Answer 70

Plasma cells

Question 71

What causes the loss of cell-mediated and humoral immunity in acquired immunodeficiency syndrome (AIDS)?

Answer 71

Loss of CD4 lymphocytes

Question 72

An Rh- mother gives birth to an Rh+ newborn, and the baby develops hemolytic disease of the newborn. What type of sensitivity reaction is this?

Answer 72

Type II

Question 73

You are administering a flu shot to a patient, and they ask, "How does this vaccine work?" What is the best response?

Answer 73

"Immunizations sensitize your body to prepare antibodies against the flu in case you are exposed to it in the future"

Question 74

With Autoimmune conditions, the body...

Answer 74

incorrectly recognizes some of its own tissues as foreign and attacks them

Question 75

Immunodeficiency results when the immune system...

Answer 75

loses the ability to react to anitgens

Question 76

Allergies occur when the body...

Answer 76

overreacts to antigens (hypersensitivity)

Question 77

Which of the following changes is expected in a patient experiencing anaphylaxis? High blood pressure due to tachycardia. Low blood pressure do to bradycardia. High blood pressure due to vasoconstriction. Low blood pressure due to vasodilation.

Answer 77

Low blood pressure due to vasodilation.

Question 78

In anaphylaxis, degranulation of mast cells and basophils causes local and systemic responses leading to:

Answer 78

Dilation of vascular smooth muscle Constriction of bronchial smooth muscle Increase in vascular permeability

Question 79

You are administering an infusion of Belimumab (monoclonal antibodies) to a patient with systemic lupus erythematosus. What education should be provided?

Answer 79

The patient should be instructed not to get vaccines for 30 days after the infusion. Avoid being around sick patients and recognize symptoms of infection For infusion related reaction, slow the rate; watch for hypersensitivity

Question 80

Why would a patient be given emtricitabine and tenofovir (Truvada)?

Answer 80

To reduce the risk of infection with HIV.

Question 81

Which statements are true regarding HIV drug resistance? Select all that apply. Correct! Some patients are infected with drug-resistant HIV. Correct! Treatment non-adherence is the most common cause of drug resistance. The drugs that were created to treat HIV are losing efficacy in most patients. Correct! Tests can be performed to guide drug selection when drug resistance occurs.

Answer 81

Some patients are infected with drug-resistant HIV. Treatment non-adherence is the most common cause of drug resistance. Tests can be performed to guide drug selection when drug resistance occurs.

Question 82

What are the three layers of human defense mechanisms?

Answer 82

Barriers innate immunity adaptive immunity

Question 83

When is innate immunity present?

Answer 83

From birth

Question 84

Is previous exposure to foreign antigens required for innate immune defenses?

Answer 84

no

Question 85

What are examples of physical and mechanical barriers in the human defense?

Answer 85

skin mucous membrane

Question 86

What role do antibacterial peptides play in human defenses?

Answer 86

They provide a biochemical barrier against pathogenic microorganisms

Question 87

What is the function of normal bacterial flora in human defense?

Answer 87

It pervents colonization by pathogens

Question 88

What is inflammation?

Answer 88

A rapid and nonspecific protective response to cellular injury

Question 89

Where can inflammatio occur

Answer 89

Only in vascularized tissue

Question 90

What are the macroscopic hallmarks of inflammation?

Answer 90

Redness swelling heat pain loss of function

Question 91

What are the three key plasma protein systems involved in inflammation?

Answer 91

The complement system The clotting system and the kinin system

Question 92

How is the complement system activated?

Answer 92

By antigen-antibody reactions of bacterial polusaccharides