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.
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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.
The nurse is beginning the physical examination of a client who has reported fatigue. What documentation will the nurse provide to describe this general appraisal of the client's health?
- A. The client appears mildly ill, listless, and disheveled.
- B. The client has a blood pressure of 120/72 mm Hg.
- C. The client is alert and oriented to all spheres.
- D. The client has palpable peripheral pulses in the upper extremities.
Correct Answer: A
Rationale: The beginning of the physical examination is a general appraisal of the client's health. The nurse notes whether the client appears healthy, acutely or mildly ill, malnourished, extremely tired, or listless. The next thing the nurse will do is obtain vital signs and then perform a more comprehensive examination.
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.
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.
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