Nokea
Chickenpox is an example of which of the following types of immunities?
- A. Innate
- B. Natural active
- C. Artificial
- D. Cell-mediated
Correct Answer: B
Rationale: Chickenpox is an example of natural active immunity, as it is acquired through natural exposure to the varicella-zoster virus, leading to the production of antibodies and memory cells.
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To determine whether a patient's angioedema has responded to prescribed therapies, which of the following actions should the nurse take first?
- A. Ask about any clear nasal discharge.
- B. Obtain blood pressure and heart rate.
- C. Check for swelling of the lips and tongue.
- D. Assess extremities for wheal and flare lesions.
Correct Answer: C
Rationale: Angioedema is characterized by swelling of the eyelids, lips, and tongue. Wheal and flare lesions, clear nasal drainage, and hypotension and tachycardia are characteristics of other allergic reactions.
For early detection of an anaphylactic reaction in a patient who has received allergen testing using the cutaneous scratch method, which of the following actions should the nurse take first?
- A. Check blood pressure and pulse rate.
- B. Auscultate the lung sounds bilaterally.
- C. Monitor pupil size and reaction to light.
- D. Assess the arm at the site of the skin testing.
Correct Answer: D
Rationale: The initial symptoms of anaphylaxis are itching and edema at the site of the exposure. Hypotension, tachycardia, dilated pupils, and wheezes occur later. Rapid administration of epinephrine when excessive itching or swelling at the skin site is observed can prevent the progression to anaphylaxis.
Which of the following instructions should the nurse include when teaching a patient with possible allergies about intradermal skin testing?
- A. Do not eat anything for about 6 hours before the testing.'
- B. Take an oral antihistamine about an hour before the testing.'
- C. Plan to wait in the clinic for 20-30 minutes after the testing.'
- D. Reaction to the testing will take about 48-72 hours to occur.'
Correct Answer: C
Rationale: Allergic reactions usually occur within minutes after injection of an allergen, and the patient will be monitored for at least 20 minutes for anaphylactic reactions after the testing. Medications that might modify the response, such as antihistamines, should be avoided before allergy testing. There is no reason to be NPO for skin testing. Results with intradermal testing occur within minutes.
The nurse is conducting an annual health examination on an older adult patient who states, 'I don't understand why I need to have so many cancer screening tests now. I feel just fine!' Based upon this statement, which of the following topics will the nurse include in the patients' teaching plan?
- A. Consequences of aging on cell-mediated immunity
- B. Decrease in antibody production associated with aging
- C. Impact of poor nutrition on immune function in older people
- D. Incidence of cancer-stimulating infections in older individuals
Correct Answer: A
Rationale: The primary impact of aging on immune function is on the activity of T cells, which are responsible for tumour immunity. Antibody function is not impacted as much by aging and does not protect against malignancy. Poor nutrition does contribute to decreased immunity, but there is no evidence that it is a contributing factor for this patient. Although some types of cancers are associated with specific infections, this patient does not have an active infection.
The nurse is caring for a patient who has experienced Goodpasture's syndrome. Which of the following adverse effects should the nurse be aware of?
- A. Thrombocytopenia
- B. Leukopenia
- C. Angioedema
- D. Pulmonary hemorrhage
Correct Answer: D
Rationale: Goodpasture's syndrome is a rare disorder involving the lungs and the kidneys. An antibody-mediated autoimmune reaction occurs involving the glomerular and alveolar basement membranes. The circulating antibodies combine with tissue antigen to activate the complement system which causes deposits of IgG to form along the basement membranes of the lungs or the kidneys. This reaction may result in pulmonary hemorrhage and glomerulonephritis.