Nokea
What type of immunoglobulin does the nurse recognize that promotes the release of vasoactive chemicals such as histamine when a client is having an allergic reaction?
- A. IgG
- B. IgA
- C. IgM
- D. IgE
Correct Answer: D
Rationale: IgE promotes the release of vasoactive chemicals such as histamine and bradykinin in allergic, hypersensitivity, and inflammatory reactions. IgG neutralizes bacterial toxins and accelerates phagocytosis. IgA interferes with the entry of pathogens through exposed structures or pathways. IgM agglutinates antigens and lyses cell walls.
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An older adult client, who leads a sedentary lifestyle, and a younger client, who has a very stressful and active lifestyle, require a vaccine against a particular viral disorder. The nurse knows that in one of these clients, the vaccine will be less effective. In which client is the vaccine more likely to be less effective and why?
- A. The older client because of age
- B. The older client because of lifestyle
- C. The younger client because of age
- D. The younger client because of lifestyle
Correct Answer: A
Rationale: Vaccines are less effective in an older adult than in a younger adult because the activity of the immune system declines with the aging process. The lifestyle of the client does not have great implications on the effectiveness of a vaccine.
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 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.
The nurse understands that which cells circulate throughout the body looking for virus-infected cells and cancer cells?
- A. Natural killer cells
- B. Cytokines
- C. Interleukins
- D. Interferons
Correct Answer: A
Rationale: Natural killer cells are lymphocyte-like cells that circulate throughout the body looking for virus-infected cells and cancer cells. Cytokines are chemical messengers released by lymphocytes, monocytes, and macrophages. Interleukins carry messages between leukocytes and tissues that form blood cells. Interferons are chemicals that primarily protect cells from viral infections.
The nurse is administering a skin test for detection of exposure to tuberculosis. How would the nurse determine if the client was exposed to tuberculosis?
- A. The client will have a productive cough.
- B. The injection area swells if the client has developed antibodies against the antigen.
- C. The injection area will become painful with induration if the client has antibodies against the antigen.
- D. The injection area will break out in a fine macular rash.
Correct Answer: B
Rationale: The injection area swells if the client has developed antibodies against the antigen. The client is not necessarily actively infectious if the test results are positive. Although a productive cough is one of the symptoms of active tuberculosis, it may also indicate other diseases and disorders. The area should not be painful, and the client should not break out with a rash.