Nokea
A 20-year-old patient has a family history of colon cancer. Genetic testing shows he has the gene for familial adenomatous polyposis. What should the nurse teach the patient to do?
- A. Change his diet
- B. Have annual colonoscopies
- C. Consider a referral for gene therapy
- D. Not to have children so they will not be affected
Correct Answer: B
Rationale: Regular colonoscopies are crucial for early detection and prevention of colorectal cancer in individuals with familial adenomatous polyposis.
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A patient prescribed corticosteroids for arthritis is surprised to learn of an immune disorder. What should the nurse explain as the reason for the patient not demonstrating typical signs of immune dysfunction?
- A. The arthritis is masking the normal immune response.
- B. The corticosteroids are causing the thymus gland to malfunction.
- C. The arthritis is interfering with the function of immunoglobulins.
- D. Corticosteroids are impacting normal immune response functioning.
Correct Answer: D
Rationale: The correct answer is D because corticosteroids are known to suppress the immune system by inhibiting the production of pro-inflammatory cytokines and preventing the activation of immune cells. This suppression can lead to a decreased immune response, making it less likely for the patient to exhibit typical signs of immune dysfunction.
A: The arthritis masking the immune response is not a plausible explanation as arthritis does not directly affect immune function.
B: Corticosteroids do not cause the thymus gland to malfunction; they mainly impact immune response at the cellular level.
C: Arthritis affecting immunoglobulin function is not a common mechanism of immune dysfunction in this context.
What is the significance of isotype switching in B cells?
- A. It enables the production of IgM only
- B. It enhances antibody affinity for antigens
- C. It changes the constant region to produce different antibody isotypes
- D. It eliminates antigen-specific B cells
Correct Answer: C
Rationale: Isotype switching in B cells involves changing the constant region to produce different antibody isotypes, such as IgG, IgA, or IgE. This is important for diversifying the functions of antibodies without altering antigen specificity. It allows for different effector functions, such as opsonization, neutralization, or complement activation. This process does not eliminate antigen-specific B cells, as it maintains the immunological memory. Isotype switching does not directly affect antibody affinity for antigens, which is primarily determined by somatic hypermutation and affinity maturation. It is not limited to producing IgM only, as B cells can switch to other isotypes based on the cytokine microenvironment.
If HLA-DR4 is considered a 'risk' allele for disease 'X', this means:
- A. All individuals with the HLA-DR4 allele will get disease X
- B. All individuals with disease X have the HLA-DR4 allele
- C. An individual with the HLA-DR4 allele has an increased chance of developing disease X compared to other individuals
- D. All of the above are true
Correct Answer: C
Rationale: The correct answer is C because having the HLA-DR4 allele increases the likelihood of developing disease X but does not guarantee it. Choice A is incorrect because not all individuals with HLA-DR4 will get disease X. Choice B is incorrect because not all individuals with disease X have the HLA-DR4 allele. Choice D is incorrect because it falsely states that all statements are true, which is not the case.
In a patient with leukocytosis with a shift to the left, what does the nurse recognize as causing this finding?
- A. The complement system has been activated to enhance phagocytosis.
- B. Monocytes are released into the blood in larger-than-normal amounts.
- C. The response to cellular injury is not adequate to remove damaged tissue and promote healing.
- D. The demand for neutrophils causes the release of immature neutrophils from the bone marrow.
Correct Answer: D
Rationale: A 'shift to the left' refers to an increase in immature neutrophils in circulation, which occurs when there is a high demand for neutrophils due to infection or inflammation. This phenomenon indicates that the bone marrow is releasing immature neutrophils to meet the body's needs.
Which of the following is considered a defining characteristic of a TH2 response?
- A. Production of IgM antibodies
- B. Activation of CTL
- C. Recruitment and activation of neutrophils
- D. Production of IgE antibodies
Correct Answer: D
Rationale: The correct answer is D: Production of IgE antibodies. A TH2 response is characterized by the production of IgE antibodies, which are essential in allergic reactions. IgM antibodies (A) are produced during the primary immune response. Activation of CTL (B) is associated with a TH1 response. Neutrophils (C) are primarily involved in the innate immune response and are not specific to TH2 responses. In summary, the production of IgE antibodies is a defining characteristic of a TH2 response, distinguishing it from other immune responses.