Nokea
The immunoglobulin class which is the least abundant in the normal adult is
- A. IgG
- B. IgA
- C. IgE
- D. IgD
Correct Answer: C
Rationale: The correct answer is C, IgE. IgE is the least abundant immunoglobulin in the normal adult because it is primarily involved in allergic responses and parasitic infections, leading to its lower baseline levels compared to other classes. IgG is the most abundant and provides long-term immunity. IgA is found in mucosal areas and secretions, crucial for local immunity. IgD functions primarily as a B cell receptor and its levels are relatively low in circulation. Therefore, IgE stands out as the least abundant in the normal adult due to its specialized role in immune responses.
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The 'rapid' HIV antibody testing is performed on a patient at high risk for HIV infection. What should the nurse explain about this test?
- A. The test measures the activity of the HIV and reports viral loads as real numbers.
- B. This test is highly reliable, and in 5 minutes the patient will know if HIV infection is present.
- C. If the results are positive, another blood test and a return appointment for results will be necessary.
- D. This test detects drug-resistant viral mutations that are present in viral genes to evaluate resistance to antiretroviral drugs.
Correct Answer: C
Rationale: While rapid tests provide preliminary results quickly, confirmatory testing is required for accurate diagnosis.
Which of the following statements is incorrect about celiac disease?
- A. There is a strong genetic association: more than 90% of celiac patients express the HLA allele DO2 or DO8
- B. It is technically an allergy but has some features of autoimmunity
- C. The disease is mainly caused by an abnormal innate response to gluten while adaptive cells are not involved
- D. The disease is entirely driven by gluten exposure. The gut lesions observed in these patients disappeared upon removal of gluten from the diet
Correct Answer: C
Rationale: The correct answer is C because celiac disease primarily involves an abnormal adaptive immune response to gluten, not an innate response. Here's the rationale: 1) Celiac disease is characterized by a T-cell mediated response to gluten peptides in genetically susceptible individuals. 2) The adaptive immune system, particularly T cells, plays a crucial role in the pathogenesis by recognizing gluten peptides presented by HLA-DQ2 or HLA-DQ8 molecules. 3) This adaptive immune response leads to inflammation and damage to the intestinal mucosa. 4) In contrast, the innate immune system may also be activated, but it is not the primary driver of the disease.
Summary:
A: Correct - There is a strong genetic association with HLA alleles.
B: Incorrect - Celiac disease is primarily driven by an adaptive immune response, not just features of autoimmunity.
D: Incorrect - While gluten exposure triggers the immune response, the disease is not solely driven by gluten intake.
What is a typical time frame for Type IV hypersensitivity reactions to develop?
- A. Within minutes
- B. 1-3 hours
- C. 24-72 hours
- D. 5-7 days
Correct Answer: C
Rationale: The correct answer is C (24-72 hours) for Type IV hypersensitivity reactions to develop. This type of reaction involves T cell-mediated immune responses, which take time to develop. Initially, sensitization occurs, followed by activation of memory T cells upon re-exposure to the antigen. This process typically takes 24-72 hours to manifest clinically. Choices A (Within minutes), B (1-3 hours), and D (5-7 days) are incorrect because Type IV reactions do not exhibit immediate responses like Type I hypersensitivity reactions (Choice A), nor do they typically take as long as 5-7 days to develop (Choice D). The time frame of 1-3 hours (Choice B) is too short for the characteristic delayed hypersensitivity reaction seen in Type IV responses.
A patient with acquired immunodeficiency syndrome (AIDS) has a negative tuberculosis (TB) skin test. Which nursing action is indicated next?
- A. Obtain a chest x-ray and sputum smear.
- B. No further action is needed after the negative skin test.
- C. Teach about the anti-tuberculosis drug isoniazid (INH).
- D. Schedule TB testing again in 6 months.
Correct Answer: A
Rationale: A negative TB skin test in an immunocompromised patient such as one with AIDS does not rule out TB infection. Further diagnostic testing such as a chest x-ray and sputum smear is necessary to confirm the absence of TB. Teaching about INH or scheduling another test is premature without further diagnostic confirmation.
A patient is experiencing an immune response that involves the T lymphocytes. For which types of immunity should the nurse plan care for this patient?
- A. Passive immunity
- B. Humoral immunity
- C. Acquired immunity
- D. Cell-mediated immunity
Correct Answer: D
Rationale: The correct answer is D: Cell-mediated immunity. T lymphocytes are primarily involved in cell-mediated immunity, where they directly attack infected cells or pathogens. This type of immunity is crucial in fighting intracellular pathogens like viruses. Other choices are incorrect because:
A: Passive immunity involves receiving pre-formed antibodies, not T lymphocytes.
B: Humoral immunity involves B cells producing antibodies, not T lymphocytes.
C: Acquired immunity is a general term encompassing both humoral and cell-mediated immunity, but T lymphocytes specifically play a key role in cell-mediated immunity.