Quiz 2 Flashcards
Which of the following cell types are involved in humoral immunity?
A: B lymphocytes are involved in the humoral immune response. T lymphocytes are involved in cellular immunity.
A public health nurse is preparing an educational campaign to address a recent local increase in the incidence of HIV infection. The nurse should prioritize what intervention?
A: Educational programs that focus on control and prevention
Until an effective vaccine is developed, preventing HIV by eliminating and reducing risk behaviors is essential. Educational interventions are the primary means by which behaviors can be influenced. Screening is appropriate, but education is paramount. Enhancing immune function does not prevent HIV infection. Ineffective use of standard precautions applies to very few cases of HIV infection.
The nurse is revising a client’s plan of care. What is an example of an expected client outcome?
A: The client will have the ability to climb a flight of stairs without experiencing difficulty in breathing.
The expected outcome needs to be precise and measurable, not general; otherwise, measurement could be generalized. The ability to climb a flight of stairs without experiencing difficulty in breathing is measurable. An expectation of stable blood pressure is not measurable. Purchasing a pair of glasses or attending weekday church is not specific.
Based on the nurse’s base knowledge of primary immunodeficiencies, how would the nurse complete this statement? Primary immunodeficiencies:
A: develop early in life after protection from maternal antibodies decreases.
A nurse is preparing to administer an antiretroviral medication to a client who is positive for HIV. The nurse identifies the drug as a nucleoside reverse transcriptase inhibitor (NRTI). What drug will the nurse administer?
A: Lamivudine
Lamivudine (Epivir) is an antiretroviral agent that belongs to the class of NRTIs. Delavirdine (Rescriptor), etravirine (Intelence), and nevirapine (Viramune) are examples of non-nucleoside reverse transcriptase inhibitors (NNRTIs).
The nurse is developing a health-promotion program at a company in which many employees are women in their 20s and 30s. For this population, the nurse plans to include information about:
A: Parenting issues
Young adults in their reproductive years want information about parenting issues. Values training is geared more for adolescents. Information about bone-density screening and mammography are for older women.
A nurse is caring for a client who wants to quit smoking. The client tells the nurse he has thrown out all of his cigarettes. Which stage is the client in, according to the transtheoretical model of change?
A: Action
The client is in the action stage of the transtheoretical model of change because this is the stage where the client takes decision action—in this case, the client throws away cigarettes in order to stop smoking. The precontemplative stage is when the client does not express a desire to change. The contemplative stage is when the client only begins to think about change.
The nurse is obtaining the medical history of a client with Crohn’s disease. What medication would the nurse include when asking about what medications the client has taken for suppression of the inflammatory and immune response?
A: Corticosteroids
The nurse obtains a history of immunizations, recent and past infectious diseases, and recent exposure to infectious diseases. The nurse reviews the client’s drug history because certain drugs, such as corticosteroids, suppress the inflammatory and immune responses. Nonsteroidal anti-inflammatory medication does not suppress the inflammatory and immune responses of Crohn’s disease. An ACE-I prevents the conversion of angiotensin I to angiotensin II and does not suppress the inflammatory or immune response. Diuretics also do not suppress the immune response but help reduce excess fluid from the kidneys.
The nurse notes that an older adult was treated for a wound infection and pneumonia within the last 6 months. Which factor will the nurse attribute to this client’s illnesses?
A: Immunosenescence
Immunosenescence is the term for age-related changes in the immune system. These changes have been linked to the increased rates of illness and mortality in older adults, and an increased incidence of infections. There is no evidence that polypharmacy has caused an increase in infections in the older adult. The development of infections is not directly linked to vitamin intake or self-care activities.
T-cell and B-cell lymphocytes are the primary participants in the immune response. What do they do?
T-cell and B-cell lymphocytes distinguish harmful substances and ignore those natural and unique to a person.
Which phase of the process of patient teaching ends when the strategies have been completed and when the client’s responses to the actions have been recorded?
A: Implementation
The implementation phase ends when the teaching strategies have been completed and when the patient’s responses to the actions have been recorded. Assessment in the teaching-learning process is directed toward the systematic collection of data about the client’s learning needs and readiness to learn, as well as the family’s learning needs. Planning has to do with specifying the expected outcomes and assigning priorities to the diagnoses. Evaluation determines how effectively the client has responded to teaching and to what extent the goals have been achieved.
A client with AIDS has become forgetful with a limited attention span, decreased ability to concentrate, and delusional thinking. What condition is represented by these symptoms?
A: AIDS dementia complex (ADC)
ADC, a neurologic condition, causes the degeneration of the brain, especially in areas that affect mood, cognition, and motor functions. Such clients exhibit forgetfulness, limited attention span, decreased ability to concentrate, and delusional thinking. DSP is characterized by abnormal sensations, such as burning and numbness in the feet and later in the hands. Candidiasis is a yeast infection that may develop in the oral, pharyngeal, esophageal, or vaginal cavities or in the folds of the skin. CMV infects the choroid and retinal layers of the eye, leading to blindness, and can also cause ulcers in the esophagus, colitis, diarrhea, pneumonia, and encephalitis.
Which assessment should be completed if immune dysfunction is suspected in the neurosensory system?
A: Ataxia
Ataxia should be assessed when immune dysfunction in the neurosensory system is suspected. Hematuria, discharge, and frequency of and burning upon urination are associated with the genitourinary system.
A community health nurse is preparing learning materials for an upcoming public seminar for adults. What factors will the nurse consider, based on applying concepts of adult learning readiness? Select all that apply.
A:
1) Culture
2) Personal values
3) Physical status
4) Emotional status
A nursing instructor is giving a lecture on the immune system. The instructor’s discussion on phagocytosis will include:
A: neutrophils and monocytes.
Neutrophils and monocytes are phagocytes, cells that perform phagocytosis.
The nurse is aware that the phagocytic immune response, one of the body’s responses to invasion, involves the ability of cells to ingest foreign particles. Which of the following engulfs and destroys invading agents?
A: Macrophages
A client with ataxia-telangiectasia is admitted to the unit. The nurse caring for the client would expect to see what included in the treatment regimen?
A: IV gamma globulin administration
Treatment for ataxia-telangiectasia includes IV gamma globulin, antimicrobial therapy, and bone marrow transplantation. It does not include platelet administration, factor VIII administration, or thymus grafting.
A client with acquired immune deficiency syndrome (AIDS) comes to the clinic reporting difficulty swallowing. The client says, “It hurts so much when I swallow.” Inspection reveals creamy white patches in the client’s mouth. What will the nurse suspect?
A: Candidiasis
The client’s complaints and physical examination suggest oral candidiasis. Wasting syndrome involves involuntary weight loss greater than 10% of the client’s baseline body weight and either chronic diarrhea for more than 10 days or chronic weakness and documented intermittent or constant fever in the absence of any concurrent illness that could explain these findings. Cryptococcus neoformans is a fungal infection that affects the neurologic system. Clostridium difficile is a common cause of chronic diarrhea in clients with AIDS.
