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A client with chronic renal failure has begun treatment with a colony-stimulating factor. What medication does the nurse anticipate administering to the client that will promote the production of blood cells?
- A. Etanercept (Enbrel)
- B. Infliximab (Remicade)
- C. Epoetin alfa (Epogen)
- D. Adalimumab (Humira)
Correct Answer: C
Rationale: Colony-stimulating factors are cytokines that prompt the bone marrow to produce, mature, and promote the functions of blood cells. CSFs enable stem cells in bone marrow to differentiate into specific types of cells such as leukocytes, erythrocytes, and platelets. Pharmacologic preparation of CSFs, such as epoetin alfa (Epogen), is used to promote the natural production of blood cells in people whose own hematopoietic functions have become compromised. The other medications are tumor necrosis factor inhibitors.
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A parent of a child who has been having frequent bouts of tonsillitis brings the child back to the clinic for another sore throat. The parent asks the nurse, 'What are tonsils good for anyway?' What is the best response by the nurse?
- A. They really do not have a function and should be removed.
- B. These tissues filter bacteria from tissue fluid.
- C. The tissue acts as an emergency reservoir of blood.
- D. The tissue removes blood and bacteria.
Correct Answer: B
Rationale: Tonsils and adenoids filter bacteria from tissue fluid. Because they are exposed to pathogens in the oral cavity, they can become infected and locally inflamed. The spleen acts as an emergency reservoir of blood and removes blood and bacteria, not the tonsils.
What type of immunoglobulin does the nurse recognize that promotes the release of vasoactive chemicals such as histamine when a client is having an allergic reaction?
- A. IgG
- B. IgA
- C. IgM
- D. IgE
Correct Answer: D
Rationale: IgE promotes the release of vasoactive chemicals such as histamine and bradykinin in allergic, hypersensitivity, and inflammatory reactions. IgG neutralizes bacterial toxins and accelerates phagocytosis. IgA interferes with the entry of pathogens through exposed structures or pathways. IgM agglutinates antigens and lyses cell walls.
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.
The anatomy and physiology instructor is explaining a cell-mediated response to the pre-nursing students. What actions would the instructor explain occur in a cell-mediated response?
- A. Toxins of invading antigens are neutralized.
- B. The invading antigens link together (agglutination).
- C. The invading antigens precipitate.
- D. T-cell lymphocytes survey proteins in the body and attack the invading antigens.
Correct Answer: D
Rationale: During a cell-mediated response, T-cell lymphocytes 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. For example, a cell-mediated response occurs when an organ is transplanted. Immunoglobulins hinder the antigens physically by neutralizing their toxins through agglutination or by causing them to precipitate.