Nokea
The nurse has several clients scheduled for annual wellness examinations throughout the day. For which client should the nurse prepare the shingles vaccine?
- A. A 24-year-old client who is pregnant
- B. A 32-year-old client who has never had chickenpox
- C. A 65-year-old client who had chicken pox at the age of 12
- D. A 17-year-old client who will be attending college and living in a dormitory
Correct Answer: C
Rationale: The Centers for Disease Control and Prevention recommends annual seasonal influenza vaccine and pneumococcal polysaccharide vaccine (PPSV23; Pneumovax) for all adults 65 years or older or those who are at high risk, and the shingles vaccine (Zostavax) for all individuals who are over the age of 50. Based on this information, the nurse prepares to administer the shingles vaccine to the client who is 65 years of age. The other clients are not eligible to receive this vaccine until the age of 50 years.
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The nurse is obtaining medication history information from a client with Crohn's disease. What medication would the nurse include when asking what medications the client has taken for suppression of the inflammatory and immune response?
- A. Nonsteroidal anti-inflammatory
- B. Angiotensin-converting enzyme inhibitors (ACE-I)
- C. Diuretics
- D. Corticosteroids
Correct Answer: D
Rationale: The nurse obtains a history of immunizations, recent and past infectious diseases, and recent exposure to infectious diseases. The nurse reviews the client's drug history because certain drugs, such as corticosteroids, suppress the inflammatory and immune responses. Nonsteroidal anti-inflammatory medication does not suppress the inflammatory and immune responses of Crohn's disease. An ACE-I prevents the conversion of angiotensin I to angiotensin II and does not suppress the inflammatory or immune response. Diuretics also do not suppress the immune response but help reduce excess fluid from the kidneys.
A child is brought to the clinic with a rash and is subsequently diagnosed with measles. The parent reports also having had measles as a young child. What type of immunity to measles develops after the initial infection?
- A. Naturally acquired active immunity
- B. Artificially acquired active immunity
- C. Naturally acquired passive immunity
- D. Artificially acquired passive immunity
Correct Answer: A
Rationale: Immunity to measles that develops after the initial infection is an example of naturally acquired active immunity. Artificially acquired active immunity results from the administration of a killed or weakened microorganism or toxoid (attenuated toxin), whereas passive immunity develops when ready-made antibodies are given to a susceptible client.
What is the function of the thymus gland?
- A. Produces stem cells
- B. Programs B lymphocytes to become regulator or effector B cells
- C. Develops the lymphatic system
- D. Programs T lymphocytes to become regulator or effector T cells
Correct Answer: D
Rationale: The thymus gland is located in the neck below the thyroid gland. It extends into the thorax behind the top of the sternum. The thymus gland produces lymphocytes during fetal development. It may be the embryonic origin of other lymphoid structures such as the spleen and lymph nodes. After birth, the thymus gland programs T lymphocytes to become regulator or effector T cells. The thymus gland becomes smaller during adolescence but retains some activity throughout the life cycle. The other options are incorrect.
What type of cytokine will attract neutrophils and monocytes to remove debris?
- A. Lymphokines
- B. Cytotoxic T cells
- C. Suppressor T cells
- D. Regulator T cells
Correct Answer: A
Rationale: Lymphokines, a type of cytokine, attract cells when they detect antigens and direct B-cell lymphocytes to multiply and mature. Cytotoxic T cells bind to invading cells, destroy the targeted invader by altering their cellular membrane and intracellular environment, and stimulate the release of chemicals called lymphokines. Suppressor T cells limit or turn off the immune response in the absence of continued antigenic stimulation. Regulator T cells are made up of helper and suppressor cells.
A client is informed of having a low white blood cell count and being at risk for the development of infections. The client asks, 'Where do I make new white blood cells?' What is the best response by the nurse?
- A. White blood cells are produced in the plasma.
- B. White blood cells are produced in the thymus gland.
- C. White blood cells are produced in the lymphatic tissue.
- D. White blood cells are produced in the bone marrow.
Correct Answer: D
Rationale: White blood cells (leukocytes) are produced in the bone marrow. They are not produced in the plasma, thymus gland, or the lymphatic tissue.