Nokea
You obtain these assessment data while completing an admission for a patient with a history of a liver transplant who is receiving cyclosporine (Sandimmune),prednisone (Deltasone) and mycophenolate (CellCept) to suppress immune function. Which one will be of most concern?
- A. The patient’s gums appear very pink and swollen.
- B. The patient’s blood glucose is increased to 162 mg/dL.
- C. The patient has a non-tender swelling above the clavicle.
- D. The patient has 1+ pitting edema in the feet and ankles.
Correct Answer: C
Rationale: A non-tender swelling above the clavicle could indicate lymphadenopathy which may be a sign of infection or malignancy. This is particularly concerning in an immunocompromised patient. The other findings while important are less urgent and can be managed with standard nursing interventions.
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What are the characteristics of the carbonic acid–bicarbonate buffer system (select all that apply)?
- A. CO2 is eliminated by the lung
- B. Neutralizes HCl acid to yield carbonic acid and salt
- C. H2CO3 formed by neutralization dissociates into H2O and CO2
- D. Shifts H+ in and out of cell in exchange for other cations such as potassium and sodium
Correct Answer: A
Rationale: This buffer system eliminates CO2 via lungs, neutralizes acids/bases, shifts hydrogen ions across membranes, and maintains pH balance.
Which of the following best describes the relationship between innate and adaptive immunity?
- A. Innate immunity suppresses adaptive immunity
- B. Adaptive immunity enhances innate immune functions
- C. Innate immunity activates and stimulates adaptive immunity
- D. They function entirely independently of each other
Correct Answer: C
Rationale: The correct answer is C because innate immunity plays a crucial role in initiating and influencing adaptive immunity. Innate immunity activates and stimulates adaptive immune responses by recognizing pathogens and initiating the adaptive immune system to produce specific responses. This relationship is essential for the body's overall immune defense.
Choice A is incorrect because innate immunity does not suppress adaptive immunity; instead, they work together synergistically. Choice B is incorrect because adaptive immunity does not enhance innate immune functions, but rather complements them. Choice D is incorrect because innate and adaptive immunity are interconnected and work together to provide comprehensive immune protection.
Which of the following is a physical barrier provided by innate immunity?
- A. Antibodies
- B. T lymphocytes
- C. Tight junctions in epithelial cells
- D. Phagocytosis
Correct Answer: C
Rationale: The correct answer is C: Tight junctions in epithelial cells. These junctions physically prevent pathogens from entering the body. Antibodies (A) and T lymphocytes (B) are components of adaptive immunity, not physical barriers. Phagocytosis (D) is a cellular process, not a physical barrier.
What is the function of CD14 with respect to LPS recognition?
- A. It is an accessory protein that allows the transport of newly synthesized TLR-4 onto the cell membrane
- B. It is a cytosolic protein that binds LPS that has been internalized via TLR-4/MD-2
- C. It acts as an adaptor in the TLR-4 signaling pathway
- D. It is expressed on the cell membrane and shuttles LPS to the vicinity of TLR-4/MD-2
Correct Answer: D
Rationale: The correct answer is D because CD14 is a glycosylphosphatidylinositol (GPI)-anchored protein expressed on the cell membrane that binds to LPS and facilitates its delivery to the TLR-4/MD-2 complex for recognition. CD14 does not transport TLR-4 (Choice A), bind LPS internally (Choice B), or act as an adaptor in the signaling pathway (Choice C). The key role of CD14 is to shuttle LPS to TLR-4/MD-2, initiating the immune response.
Which of the following is NOT a feature of T cells?
- A. They recognize three-dimensional structures of a pathogen
- B. Their receptors possess specificity
- C. Their receptors have one antigen-binding site
- D. Their antigen receptors are never secreted
Correct Answer: A
Rationale: The correct answer is A because T cells do not recognize three-dimensional structures of a pathogen. T cell receptors interact with processed antigen fragments presented by MHC molecules on antigen-presenting cells. Choice B is correct because T cell receptors possess specificity for antigens. Choice C is incorrect because T cell receptors have multiple antigen-binding sites. Choice D is incorrect as T cell receptors can be secreted as soluble forms.