The most abundant class of immunoglobulin in serum is
- A. IgE
- B. IgA
- C. IgD
- D. IgG
Correct Answer: D
Rationale: The correct answer is D: IgG. IgG is the most abundant class of immunoglobulin in serum, constituting about 75% of total immunoglobulins. IgG plays a crucial role in humoral immunity, providing long-term protection against pathogens. IgE (A) is involved in allergic responses, IgA (B) is mainly found in mucosal secretions, and IgD (C) functions as a cell surface receptor on B cells. IgG is the primary immunoglobulin responsible for secondary immune responses and provides the bulk of the adaptive immune response.
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Which of the following is a clinical feature of Grave's disease?
- A. Pulmonary fibrosis
- B. Exophthalmos and goiter
- C. Skin vasculitis
- D. Eczematous reaction
Correct Answer: B
Rationale: The correct answer is B: Exophthalmos and goiter. In Grave's disease, there is an overproduction of thyroid hormones leading to hyperthyroidism. Exophthalmos (bulging eyes) and goiter (enlarged thyroid gland) are classic clinical features due to autoimmune stimulation of thyroid-stimulating hormone receptors. Pulmonary fibrosis (A) is not typically associated with Grave's disease. Skin vasculitis (C) and eczematous reaction (D) are also not commonly seen in Grave's disease.
Why do opportunistic diseases develop in an individual with AIDS?
- A. They are side effects of drug treatment of AIDS.
- B. They are sexually transmitted to individuals during exposure to HIV.
- C. They are characteristic in individuals with stimulated B and T lymphocytes.
- D. These infections or tumors occur in a person with an incompetent immune system.
Correct Answer: D
Rationale: Opportunistic diseases arise because the immune system is severely compromised in individuals with AIDS, making them susceptible to infections and cancers they would otherwise resist.
The nurse is reinforcing teaching to a person who has tested positive for HIV. Which test should the nurse explain is done to confirm the diagnosis of HIV?
- A. Western blot
- B. Rheumatoid factor
- C. Antinuclear antibodies
- D. Immunoglobulin assay
Correct Answer: A
Rationale: The correct answer is A: Western blot. This test is used to confirm the diagnosis of HIV by detecting specific antibodies produced in response to the virus. It is considered the gold standard for confirming HIV infection due to its high specificity and sensitivity. The other choices (B, C, D) are not used to diagnose HIV. Rheumatoid factor and antinuclear antibodies are tests for autoimmune conditions, while immunoglobulin assay measures levels of antibodies in the blood, not specific to HIV.
Which of the following factors makes it important for the nurse to provide special care to older clients with immune system disorders?
- A. Age-related changes
- B. Poor diet
- C. Use of multiple drugs (polypharmacy)
- D. Reduced activity levels
Correct Answer: A
Rationale: Age-related changes in the immune system known as immunosenescence make older adults more susceptible to infections and less responsive to vaccines.
Protease inhibitors interfere with
- A. Release of new viral particles from infected cells
- B. Processing of gp160
- C. Proviral stage
- D. Reverse transcription of viral RNA into DNA
Correct Answer: D
Rationale: Protease inhibitors interfere with the final step in HIV replication, which is the cleavage of the polyprotein into individual functional proteins. Inhibiting protease prevents the formation of mature infectious viral particles. This step occurs after reverse transcription of viral RNA into DNA, making choice D the correct answer. Choices A, B, and C are incorrect because protease inhibitors do not affect the release of new viral particles, processing of gp160, or the proviral stage of HIV replication.