Nokea
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.
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A 16-year-old has been brought to the emergency department by his parents after falling through the glass of a patio door, suffering a laceration. The nurse caring for this patient knows that the site of the injury will have an invasion of what?
- A. Interferons
- B. Phagocytic cells
- C. Apoptosis
- D. Cytokines
Correct Answer: B
Rationale: Monocytes migrate to injury sites and function as phagocytic cells, engulfing, ingesting, and destroying greater numbers and quantities of foreign bodies or toxins than granulocytes. This occurs in response to the foreign bodies that have invaded the laceration from the dirt on the broken glass. Interferon, one type of biologic response modifier, is a nonspecific viricidal protein that is naturally produced by the body and is capable of activating other components of the immune system. 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. Cytokines are the various proteins that mediate the immune response. These do not migrate to injury sites.
A patient requires ongoing treatment and infection-control precautions because of an inherited deficit in immune function. The nurse should recognize that this patient most likely has what type of immune disorder?
- A. A primary immune deficiency
- B. A gammopathy
- C. An autoimmune disorder
- D. A rheumatic disorder
Correct Answer: A
Rationale: Primary immune deficiency results from improper development of immune cells or tissues. These disorders are usually congenital or inherited. Autoimmune disorders are less likely to have a genetic component, though some have a genetic component. Overproduction of immunoglobulins is the hallmark of gammopathies. Rheumatic disorders do not normally involve impaired immune function.
A nurse is planning the assessment of a patient who is exhibiting signs and symptoms of an autoimmune disorder. The nurse should be aware that the incidence and prevalence of autoimmune diseases is known to be higher among what group?
- A. Young adults
- B. Native Americans
- C. Women
- D. Hispanics
Correct Answer: C
Rationale: Many autoimmune diseases have a higher incidence in females than in males, a phenomenon believed to be correlated with sex hormones.
A patient is responding to a microbial invasion and the patients differentiated lymphocytes have begun to function in either a humoral or a cellular capacity. During what stage of the immune response does this occur?
- A. The recognition stage
- B. The effector stage
- C. The response stage
- D. The proliferation stage
Correct Answer: C
Rationale: In the response stage, the differentiated lymphocytes function in either a humoral or a cellular capacity. In the effector stage, either the antibody of the humoral response or the cytotoxic (killer) T cell of the cellular response reaches and connects with the antigen on the surface of the foreign invader. In the recognition stage, the recognition of antigens as foreign, or non-self, by the immune system is the initiating event in any immune response. During the proliferation stage the circulating lymphocytes containing the antigenic message return to the nearest lymph node.
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.