Nokea
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.
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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.
The nurse has several clients scheduled for annual wellness examinations throughout the day. For which client should the nurse prepare the shingles vaccine?
- A. A 24-year-old client who is pregnant
- B. A 32-year-old client who has never had chickenpox
- C. A 65-year-old client who had chicken pox at the age of 12
- D. A 17-year-old client who will be attending college and living in a dormitory
Correct Answer: C
Rationale: The Centers for Disease Control and Prevention recommends annual seasonal influenza vaccine and pneumococcal polysaccharide vaccine (PPSV23; Pneumovax) for all adults 65 years or older or those who are at high risk, and the shingles vaccine (Zostavax) for all individuals who are over the age of 50. Based on this information, the nurse prepares to administer the shingles vaccine to the client who is 65 years of age. The other clients are not eligible to receive this vaccine until the age of 50 years.
The nurse is beginning the physical examination of a client who has reported fatigue. What documentation will the nurse provide to describe this general appraisal of the client's health?
- A. The client appears mildly ill, listless, and disheveled.
- B. The client has a blood pressure of 120/72 mm Hg.
- C. The client is alert and oriented to all spheres.
- D. The client has palpable peripheral pulses in the upper extremities.
Correct Answer: A
Rationale: The beginning of the physical examination is a general appraisal of the client's health. The nurse notes whether the client appears healthy, acutely or mildly ill, malnourished, extremely tired, or listless. The next thing the nurse will do is obtain vital signs and then perform a more comprehensive examination.
A client has had a kidney transplant performed for end-stage kidney disease. What type of immune response that T-cell lymphocytes perform is related to this type of surgery?
- A. Activation of the complement system
- B. Stimulation of colony-stimulating factors
- C. A cell-mediated response
- D. Naturally acquired active immunity
Correct Answer: C
Rationale: 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. An example of a cell-mediated response is one that occurs when an organ is transplanted. The complement system cooperates with antibodies to attract phagocytes and coat antigens to make them more recognizable for phagocytosis and stimulate inflammation and is not related to the surgery. Colony-stimulating factors prompt the bone marrow to produce, mature, and promote the functions of blood cells. Naturally acquired active immunity is a direct result of infection by a specific microorganism.
What is the function of the thymus gland?
- A. Produces stem cells
- B. Programs B lymphocytes to become regulator or effector B cells
- C. Develops the lymphatic system
- D. Programs T lymphocytes to become regulator or effector T cells
Correct Answer: D
Rationale: The thymus gland is located in the neck below the thyroid gland. It extends into the thorax behind the top of the sternum. The thymus gland produces lymphocytes during fetal development. It may be the embryonic origin of other lymphoid structures such as the spleen and lymph nodes. After birth, the thymus gland programs T lymphocytes to become regulator or effector T cells. The thymus gland becomes smaller during adolescence but retains some activity throughout the life cycle. The other options are incorrect.