Unit5: Ch 11 (Porth's 5th Ed) - Innate and Adaptive Immunity Flashcards
- The nurse knows which of the following statements listed below relative to a client with
malignant melanoma treated with alpha interferon (IFN-a) is accurate? Alpha interferon
(IFN-a)
A) will kill certain microorganisms that may help spread the cancer.
B) plays an important role in the modulation of the inflammatory response.
C) helps keep all the blood levels at a higher level.
D) controls the migration of leukocytes to their primary site.
Ans: B
Feedback:
IFNs are cytokines that primarily protect the host against viral infections and play a role
in the modulation of the inflammatory response
- The nurse knows which of the following statements listed below is accurate regarding
the functions and nature of cytokines relative to a variety of pathologies?
A) “A particular cytokine can have varied effects on different systems, a fact that
limits their therapeutic use.”
B) “Cytokine production is constant over time, but effects are noted when serum
levels cross a particular threshold.”
C) “Most cytokines are produced by granular leukocytes, and different cells are
capable of producing the same cytokine.”
D) “Cytokine actions are self-limiting, in that activation of one precludes activation
of other cytokines with similar actions.”
Ans: A
Feedback:
Because cytokines can mediate diverse effects due to their pleiotropic properties, they
can have significant side effects. Cytokine production is brief, not constant, and
production does not normally take place in granulocytes. Activation of a cytokine does
not necessarily limit other similar cytokines, and additive effects are not uncommon.
- The nurse knows that a drug in a category identified as a colony-stimulating factor
(CSF) helps
A) cells engulf and digest microbes that want to attach to cell membranes and destroy
normal cell function.
B) produce cells that will be the first responder cells to protect against cancer
formation.
C) stimulate the person’s immune system so that he or she can kill his or her own
cancer cells.
D) stimulate bone marrow to produce large numbers of mature cells such as platelets
and erythrocyte
Ans: D
Feedback:
CSFs participate in hematopoiesis by stimulating bone marrow pluripotent stem and
progenitor or precursor cells to produce large numbers of mature platelets, erythrocytes,
lymphocytes, neutrophils, and monocytes
- Which of the following individual situations listed below best exemplifies the processes
of innate immunity?
A) A child who has experienced heat and swelling of his skinned knuckle
B) An adult who complains of itching and is sneezing because he is allergic to pollen
C) A client whose blood work indicates increased antibody titers during an acute
illness
D) A client who has experienced rejection of a donor liver after transplantation
Ans: A
Feedback:
In a skinned knuckle, one of the body’s main innate defenses, the skin, is breached. The
heat and swelling that accompany a breach in the skin are inflammatory responses, part
of the body’s innate immune defenses. Allergies are an inappropriate adaptive response
mediated by immunoglobulin E; antibody titers increase during illness in response to the
infection; and transplanted organs are rejected because the organ is recognized as
foreign. These are all aspects of specific, acquired immunity
- The nurse knows which of the following components listed below is needed for
long-lasting immunity in a client with a diagnosis of sepsis without the causative agent
identified?
A) Neutrophils
B) Lymphocytes
C) Colony-stimulating factors
D) Natural killer cells
Ans: B
Feedback:
Lymphocytes provide lifelong immunity and an antigen-specific response to harmful
microorganisms. Neutrophils, macrophages, and natural killer cells do not provide this
- A client has been identified as having an excess of macrophage inhibitory factor,
causing the client to have inhibited movement and activity of macrophages. Which of
the following processes listed below would the health care team member expect to
remain unaffected?
A) Amplification of the immune response
B) Destruction of virus-infected or tumor cells
C) Initiation of adaptive immunity
D) Specificity and memory of the immune response
Feedback:
Specificity and memory are the defining characteristics of the adaptive immune system,
and macrophages do not perform this particular role. Amplification of the immune
response, destruction of virus-infected or tumor cells, and initiation of adaptive
immunity are all components of macrophage activity
- A client who has a diagnosis of an autoimmune disease asks his nurse why it is that his
immune system does not attack all of the cells that make up his body. Which of the
following aspects of pathogen recognition in the innate immune system listed below
would underlie the nurse’s response?
A) Normal host cells excrete inhibitory proteins that are detected by natural killer
cells.
B) Intraepithelial lymphocytes and natural killer cells possess specific, highly diverse
receptors.
C) Pattern recognition receptors (PRRs) ensure that cells are correctly identified.
D) Leukocytes possess pathogen-associated molecular patterns (PAMPs)
Ans: C
Feedback:
PRRs recognize the structure of invaders and thus prevent activation by healthy somatic
cells, though neither intraepithelial lymphocytes nor natural killer cells possess the high
level of specification and diversity of receptors associated with the adaptive immune
system. Host cells do not excrete inhibitory proteins, and PAMPs exist on pathogens,
not on leukocytes
- A 60-year-old male client with an acute viral infection is receiving interferon therapy.
The physician is teaching the family of the client about the diverse actions of the
treatment and the ways that it differs from other anti-infective therapies. Which of the
following teaching points listed below should the physician least likely include?
A) “Interferon can help your father’s unaffected cells adjacent to his infected cells
produce antiviral proteins that can stop the spread of the infection.”
B) “Interferon can help limit the replication of the virus that’s affecting your father.”
C) “Interferon helps your father’s body recognize infected cells more quickly.”
D) “Interferon can bolster your father’s immune system through the stimulation of
natural killer cells that attack viruses.”
Ans: D
Feedback:
Interferons can activate macrophages in the fight against viral invaders, but they are not
noted to stimulate the action of natural killer cells. Answers A, B, and C all capture
elements of the action of interferons.
- Which of the following phenomena would be least likely to result in activation of the
complement system?
A) Recognition of an antibody bound to the surface of a microbe
B) Increase in tissue blood flow and capillary permeability, so fluids/proteins can
leak into the area
C) Activation of toll-like receptors (TLRs) on complement proteins
D) Direct recognition of microbial proteins
Ans: C
Feedback:
Toll-like receptors are not associated with the complement system. The complement
system may be activated by antibody recognition, mannose binding, or microbial protein
recognition.
- A nurse is providing care for a client who is immunocompromised following
chemotherapy. The nurse knows which of the following characterizations of the
adaptive immune system listed below is responsible for the client’s disruption in his
normal immune function?
A) Epitopes on antigens are recognized by immunoglobulin receptors following
presentation by accessory cells.
B) Haptens combine to form epitopes that stimulate the response of regulatory and
effector cells.
C) Effector cells orchestrate the immune response of regulatory cells toward an
antigen.
D) Accessory cells such as macrophages are engulfed by regulatory cells, stimulating
effector cells.
Ans: A
Feedback:
In the adaptive immune response, accessory cells present antigen epitopes to receptors,
initiating the immune response of lymphocytes. Epitopes may combine to form haptens,
and regulatory cells orchestrate effector cells. Regulatory cells do not engulf accessory
cells.
- The nurse knows the cells primarily programmed to remove the invading organisms and
remember the antigen to respond rapidly during the next exposure are
A) CD4 and CD8 cells.
B) natural killer (NK) cells and macrophages
C) T and B lymphocytes.
D) white blood cells and platelets
Ans: C
Feedback:
T and B lymphocytes are unique in that they are the only cells in the body capable of
recognizing specific antigens present on the surfaces of microbial agents and other
pathogens.
- A 53-year-old female hospital patient has received a kidney transplant following renal
failure secondary to hypertension. As part of the teaching while she was on the organ
wait list, she was made aware that she would need to take antirejection drugs for the rest
of her life. Which aspect of the immune system underlies this necessity?
A) The lack of identifiable major histocompatibility complex (MHC) molecules will
stimulate the innate immune response.
B) Donor organ antibodies will be identified as foreign and stimulate an immune
response.
C) Antirejection drugs will stimulate the production of familiar MHC molecules.
D) MHC molecules will never develop in the cells of the donor organ, and effector
cells will be continually stimulated.
Ans: D
Feedback:
The lack of familiar MHC molecules will stimulate an immune response by effector
cells in the absence of antirejection drugs. An innate immune response is not central to
the response, but rather the adaptive immune system. Lack of known MHC molecules,
not foreign antibodies, accounts for the immune response, and familiar MHC molecules
will not be produced by the donor kidney cells.
- A client has been inhaling viruses periodically while on a cross-country flight. Which of
the following situations listed below would most likely result in the stimulation of the
client’s T lymphocytes and adaptive immune system?
A) Presentation of a foreign antigen by a familiar immunoglobulin
B) Recognition of a foreign major histocompatibility complex (MHC) molecule
C) Recognition of a foreign peptide bound to a self-major histocompatibility complex
(MHC) molecule
D) Cytokine stimulation of a T lymphocyte with macrophage or dendritic cell
mediation
Ans: C
Feedback:
The stimulation of T cells requires the recognition of a foreign peptide bound to a
self-major histocompatibility complex (MHC) molecule. Immunoglobulins do not play
an antigen-presenting role, and foreign MHC molecules and cytokines do not stimulate
the adaptive immune system.
- Three days ago, a mother delivered her full-term infant who had been identified as
having an in utero infection. The infant is receiving antibiotic and phototherapy, and the
mother is breast-feeding. Which of the following types of immunoglobulins could most
reasonably be expected to predominate in the infant’s immune system?
A) IgA, IgM, IgD
B) IgG, IgA, IgM
C) IgE, IgG, IgD
D) IgM, IgD, Igm
Ans: B
Feedback:
Infants are born with IgG from transfer across the placenta, while IgA is found in
colostrum. IgM is indicative of an in utero infection.
- A middle school student is scheduled to receive booster immunizations, and the father
asks the nurse why the booster is necessary. What characteristic of the adaptive immune
system listed below would provide the rationale for the nurse’s response?
A) Some antibodies require a repeat of the primary immune response.
B) Some antibodies have a duration measured in months rather than years.
C) A secondary response causes a sharp rise in antibody levels.
D) Antigen receptors on CD4+ cells require multiple exposures separated by time.
Ans: C
Feedback:
Booster immunizations take advantage of the increase in antibodies that accompanies a
repeat exposure. The primary immune response cannot be repeated, and antibodies
survive beyond several months. Antigen receptors on CD4+ cells do not require multiple
exposures.