Nokea
A child is brought to the clinic with a rash and is subsequently diagnosed with measles. The parent reports also having had measles as a young child. What type of immunity to measles develops after the initial infection?
- A. Naturally acquired active immunity
- B. Artificially acquired active immunity
- C. Naturally acquired passive immunity
- D. Artificially acquired passive immunity
Correct Answer: A
Rationale: Immunity to measles that develops after the initial infection is an example of naturally acquired active immunity. Artificially acquired active immunity results from the administration of a killed or weakened microorganism or toxoid (attenuated toxin), whereas passive immunity develops when ready-made antibodies are given to a susceptible client.
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A client is informed of having a low white blood cell count and being at risk for the development of infections. The client asks, 'Where do I make new white blood cells?' What is the best response by the nurse?
- A. White blood cells are produced in the plasma.
- B. White blood cells are produced in the thymus gland.
- C. White blood cells are produced in the lymphatic tissue.
- D. White blood cells are produced in the bone marrow.
Correct Answer: D
Rationale: White blood cells (leukocytes) are produced in the bone marrow. They are not produced in the plasma, thymus gland, or the lymphatic tissue.
The nurse is caring for a client on tube feedings. The physician has ordered Osmolite HN as the feeding formula for the client. The family asks why the physician has ordered Osmolite HN instead of another formula to feed their family member. What is an important reason that tube-feeding formulas, such as Impact, Immun-Aid, or Perative, be recommended to clients?
- A. To suppress immune system function
- B. To block tumor necrosis factor
- C. To enhance the production of T-cell lymphocytes and NK cells
- D. To stimulate the immune system to attack tumor cells
Correct Answer: C
Rationale: Immune-enhancing tube-feeding formulas enhance the production of lymphocytes and NK cells, resulting in increased cell-mediated immunity. Drugs such as azathioprine, cyclosporine, and muromonab-CD3 suppress immune system function, whereas infliximab and etanercept minimize inflammation by blocking tumor necrosis factor. Aldesleukin is used as biologic therapy for clients who do not respond to conventional cancer treatment. Aldesleukin stimulates the immune system's ability to attack tumor cells.
Why would it be important for the nurse to question the client about sexual practices, history of substance use disorder, and lifestyle during the interview process?
- A. To find out if the client will be compliant with therapeutic treatments
- B. To determine if the client has practices that are risk factors for acquired immunodeficiency syndrome (AIDS)
- C. To determine if the client needs a referral to counseling services
- D. To determine what type of personality the client has
Correct Answer: B
Rationale: The nurse investigates the client's allergy history and asks about practices that put the client at risk for AIDS. The interview will not determine the client's ability to be compliant. The physician would make the determination if a counseling referral should be made. It is irrelevant to determine the personality traits in the initial interview.
What type of cytokine will attract neutrophils and monocytes to remove debris?
- A. Lymphokines
- B. Cytotoxic T cells
- C. Suppressor T cells
- D. Regulator T cells
Correct Answer: A
Rationale: Lymphokines, a type of cytokine, attract cells when they detect antigens and direct B-cell lymphocytes to multiply and mature. Cytotoxic T cells bind to invading cells, destroy the targeted invader by altering their cellular membrane and intracellular environment, and stimulate the release of chemicals called lymphokines. Suppressor T cells limit or turn off the immune response in the absence of continued antigenic stimulation. Regulator T cells are made up of helper and suppressor cells.
A client will be receiving a hepatitis B vaccination series prior to employment in a dialysis center. What type of immunity will this provide?
- A. Forced immunity
- B. Naturally acquired active immunity
- C. Passive immunity
- D. Artificially acquired active immunity
Correct Answer: D
Rationale: Artificially acquired immunity is obtained by receiving a killed or weakened microorganism or toxoid. Passive immunity develops when ready-made antibodies are given to a susceptible person. The antibodies provide immediate but short-lived protection from the invading antigen. Newborns receive passive immunity to some diseases for which their mothers have manufactured antibodies. Naturally acquired active immunity occurs as a direct result of infection by a specific microorganism. An example is the immunity to measles that develops after the initial infection. Not all invading microorganisms produce a response that gives lifelong immunity. There is not a type of immunity called forced immunity.