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A gerontologic nurse is caring for an older adult patient who has a diagnosis of pneumonia. What age-related change increases older adults susceptibility to respiratory infections?
- A. Atrophy of the thymus
- B. Bronchial stenosis
- C. Impaired ciliary action
- D. Decreased diaphragmatic muscle tone
Correct Answer: C
Rationale: As a consequence of impaired ciliary action due to exposure to smoke and environmental toxins, older adults are vulnerable to lung infections. This vulnerability is not the result of thymus atrophy, stenosis of the bronchi, or loss of diaphragmatic muscle tone.
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A nurse is explaining the process by which the body removes cells from circulation after they have performed their physiologic function. The nurse is describing what process?
- A. The cellular immune response
- B. Apoptosis
- C. Phagocytosis
- D. Opsonization
Correct Answer: B
Rationale: Apoptosis, or programmed cell death, is the bodys way of destroying worn out cells such as blood or skin cells or cells that need to be renewed. Opsonization is the coating of antigenantibody molecules with a sticky substance to facilitate phagocytosis. The body does not use phagocytosis or the cellular immune response to remove cells from circulation.
The nurse should recognize a patients risk for impaired immune function if the patient has undergone surgical removal of which of the following?
- A. Thyroid gland
- B. Spleen
- C. Kidney
- D. Pancreas
Correct Answer: B
Rationale: A history of surgical removal of the spleen, lymph nodes, or thymus may place the patient at risk for impaired immune function. Removal of the thyroid, kidney, or pancreas would not directly lead to impairment of the immune system.
The nurse is assessing a clients risk for impaired immune function. What assessment finding should the nurse identify as a risk factor for decreased immunity?
- A. The patient takes a beta blocker for the treatment of hypertension.
- B. The patient is under significant psychosocial stress.
- C. The patient had a pulmonary embolism 18 months ago.
- D. The patient has a family history of breast cancer.
Correct Answer: B
Rationale: Stress is a psychoneuroimmunologic factor that is known to depress the immune response. Use of beta blockers, a family history of cancer, and a prior PE are significant assessment findings, but none represents an immediate threat to immune function.
A nurse is reviewing the immune system before planning an immunocompromised patients care. How should the nurse characterize the humoral immune response?
- A. Specialized cells recognize and ingest cells that are recognized as foreign.
- B. T lymphocytes are assisted by cytokines to fight infection.
- C. Lymphocytes are stimulated to become cells that attack microbes directly.
- D. Antibodies are made by B lymphocytes in response to a specific antigen.
Correct Answer: D
Rationale: The humoral response is characterized by the production of antibodies by B lymphocytes in response to a specific antigen. Phagocytosis and direct attack on microbes occur in the context of the cellular immune response.
A nurse is reviewing a patients medication administration record in an effort to identify drugs that may contribute to the patients recent immunosuppression. What drug is most likely to have this effect?
- A. An antibiotic
- B. A nonsteroidal anti-inflammatory drug (NSAID)
- C. An antineoplastic
- D. An antiretroviral
Correct Answer: C
Rationale: Chemotherapy affects bone marrow function, destroying cells that contribute to an effective immune response and resulting in immunosuppression. Antibiotics in large doses cause bone marrow suppression, but antineoplastic drugs have the most pronounced immunosuppressive effect. NSAIDs and antiretrovirals do not normally have this effect.