The nursing students are learning about the immune system in their anatomy and physiology class. What would these students learn is a component of the immune system?
- A. Stem cells
- B. Cytokines
- C. Lymphoid tissues
- D. Red blood cells
Correct Answer: C
Rationale: The immune system actually is a collection of specialized white blood cells and lymphoid tissues that cooperate to protect a person from external invaders and the body's own altered cells. The function of these structures is assisted and supported by the activities of natural killer cells, antibodies, and nonantibody proteins such as cytokines and the complement system. Red blood cells and stem cells are not part of the immune system.
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A client is cutting vegetable for dinner and accidently cuts a finger. What response is desirable to destroy foreign agents such as microorganisms to prevent infection from developing in the finger?
- A. A cell-mediated response
- B. The release of antibodies
- C. The release of memory cells
- D. Passive immunity
Correct Answer: B
Rationale: Antibodies are chemical substances that destroy foreign agents such as microorganisms, which decrease the risk of infection at the site. A cell-mediated response occurs when T cells survey proteins in the body, actively analyze the surface features, and respond to those that differ from the host by directly attacking the invading antigen such as an organ transplant. Memory cells convert to plasma cells on reexposure to a specific antigen. When activated, B cells accumulate in lymphoid tissues and result in swollen lymph nodes. Passive immunity develops when ready-made antibodies are given to a susceptible person. They provide immediate but short-lived protection from an invading antigen.
The nurse is caring for a client on tube feedings. The physician has ordered Osmolite HN as the feeding formula for the client. The family asks why the physician has ordered Osmolite HN instead of another formula to feed their family member. What is an important reason that tube-feeding formulas, such as Impact, Immun-Aid, or Perative, be recommended to clients?
- A. To suppress immune system function
- B. To block tumor necrosis factor
- C. To enhance the production of T-cell lymphocytes and NK cells
- D. To stimulate the immune system to attack tumor cells
Correct Answer: C
Rationale: Immune-enhancing tube-feeding formulas enhance the production of lymphocytes and NK cells, resulting in increased cell-mediated immunity. Drugs such as azathioprine, cyclosporine, and muromonab-CD3 suppress immune system function, whereas infliximab and etanercept minimize inflammation by blocking tumor necrosis factor. Aldesleukin is used as biologic therapy for clients who do not respond to conventional cancer treatment. Aldesleukin stimulates the immune system's ability to attack tumor cells.
A client with chronic renal failure has begun treatment with a colony-stimulating factor. What medication does the nurse anticipate administering to the client that will promote the production of blood cells?
- A. Etanercept (Enbrel)
- B. Infliximab (Remicade)
- C. Epoetin alfa (Epogen)
- D. Adalimumab (Humira)
Correct Answer: C
Rationale: Colony-stimulating factors are cytokines that prompt the bone marrow to produce, mature, and promote the functions of blood cells. CSFs enable stem cells in bone marrow to differentiate into specific types of cells such as leukocytes, erythrocytes, and platelets. Pharmacologic preparation of CSFs, such as epoetin alfa (Epogen), is used to promote the natural production of blood cells in people whose own hematopoietic functions have become compromised. The other medications are tumor necrosis factor inhibitors.
A parent of a child who has been having frequent bouts of tonsillitis brings the child back to the clinic for another sore throat. The parent asks the nurse, 'What are tonsils good for anyway?' What is the best response by the nurse?
- A. They really do not have a function and should be removed.
- B. These tissues filter bacteria from tissue fluid.
- C. The tissue acts as an emergency reservoir of blood.
- D. The tissue removes blood and bacteria.
Correct Answer: B
Rationale: Tonsils and adenoids filter bacteria from tissue fluid. Because they are exposed to pathogens in the oral cavity, they can become infected and locally inflamed. The spleen acts as an emergency reservoir of blood and removes blood and bacteria, not the tonsils.
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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