Nokea
A client is cutting vegetable for dinner and accidently cuts a finger. What response is desirable to destroy foreign agents such as microorganisms to prevent infection from developing in the finger?
- A. A cell-mediated response
- B. The release of antibodies
- C. The release of memory cells
- D. Passive immunity
Correct Answer: B
Rationale: Antibodies are chemical substances that destroy foreign agents such as microorganisms, which decrease the risk of infection at the site. A cell-mediated response occurs when T cells survey proteins in the body, actively analyze the surface features, and respond to those that differ from the host by directly attacking the invading antigen such as an organ transplant. Memory cells convert to plasma cells on reexposure to a specific antigen. When activated, B cells accumulate in lymphoid tissues and result in swollen lymph nodes. Passive immunity develops when ready-made antibodies are given to a susceptible person. They provide immediate but short-lived protection from an invading antigen.
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A client who is a teenager has been brought to the clinic by the parent and is suspected of having an immune system disorder. What tests would the nurse expect to be ordered for this young client?
- A. Cerebral spinal fluids aspiration
- B. Sedimentary rate
- C. Complete blood count with differential
- D. Complete chemistry panel
Correct Answer: C
Rationale: Laboratory tests are used to identify immune system disorders. They usually include a complete blood count with differential. Protein electrophoresis screens for diseases associated with a deficiency or excess of immunoglobulins. T-cell and B-cell assays (or counts) and the enzyme-linked immunosorbent assay may be performed. The other options are not diagnostic of immune disorders.
The nurse is obtaining medication history information from a client with Crohn's disease. What medication would the nurse include when asking what medications the client has taken for suppression of the inflammatory and immune response?
- A. Nonsteroidal anti-inflammatory
- B. Angiotensin-converting enzyme inhibitors (ACE-I)
- C. Diuretics
- D. Corticosteroids
Correct Answer: D
Rationale: 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 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.
An older adult client, who leads a sedentary lifestyle, and a younger client, who has a very stressful and active lifestyle, require a vaccine against a particular viral disorder. The nurse knows that in one of these clients, the vaccine will be less effective. In which client is the vaccine more likely to be less effective and why?
- A. The older client because of age
- B. The older client because of lifestyle
- C. The younger client because of age
- D. The younger client because of lifestyle
Correct Answer: A
Rationale: Vaccines are less effective in an older adult than in a younger adult because the activity of the immune system declines with the aging process. The lifestyle of the client does not have great implications on the effectiveness of a vaccine.
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.