Worksheets216 Immune/EOL
Total questions: 50
Worksheet time: 2hrs 30mins
Name
Class
Date
1.
The nurse is concerned that a hospice client is approaching death when which of the following is assessed?
a)
Respiratory rate 16 and regular
b)
Blood pressure 110/60 mmHg
c)
Restlessness, irritability, and anxiety
d)
Periods of wakefulness are greater than periods of sleep
2.
The nurse explains that exposure to a pathogen stimulates the macrophages to migrate to the area of infection to ingest and destroy the pathogen. This is the process of:
a)
pathogen neutralization.
b)
immune response.
c)
antibody action.
d)
phagocytosis.
3.
The nurse explains that a vaccination provides defense against infection via:
a)
innate immunity.
b)
the inflammatory response.
c)
antibody-mediated immunity.
d)
cell-mediated immunity.
4.
The nurse who suffers an accidental needle stick following administration of an intramuscular injection to a patient anticipates that facility protocol will suggest immediate treatment with which type of immunotherapy?
a)
IgM
b)
IgD
c)
IgA
d)
IgG
5.
The nurse differentiates the humoral response from the cell-mediated response in that in the cell-mediated response:
a)
the sensitized lymphocytes attack the cell for which they were sensitized.
b)
cells produce new antibodies.
c)
the response does not occur until the white blood cell (WBC) count rises.
d)
there is a systemic response of fever and malaise.
6.
The nurse reviewing lab results notes that the C-reactive protein is elevated in the patient who had surgery 2 days ago. The nurse is aware this is an indication of:
a)
impending infection.
b)
possible hemorrhage.
c)
a drug allergic reaction.
d)
fluid deficit.
7.
The nurse exemplifies the action of killer T cells as being like a:
a)
tiger slowly stalking an antigen to devour it.
b)
mad hornet flying through circulating fluids seeking and killing antigens.
c)
spider waiting in a web for an antigen to get caught in it.
d)
bird dog pointing to an antigen so it can be attacked by phagocytes.
8.
The nurse reminds the patient that he can be protected by passive artificial immunity by:
a)
being injected with immune globulin.
b)
receiving immunizations.
c)
contracting the disease.
d)
consuming sufficient antioxidants.
9.
The nurse clarifies that a vaccination or immunization gives the person a(n) _____ immunity.
a)
active acquired
b)
passive acquired
c)
passive
d)
natural
10.
The nurse is evaluating the patient’s understanding of his new diagnosis of rheumatoid arthritis. Which statement reflects an understanding of the disease process?
a)
“My body lacks an appropriate response to invading bacteria.”
b)
“My body produces an immune response to my own cells and tissues.”
c)
“My body immediately produces a protein that is specifically designed to fight off anantigen.”
d)
My body has a delayed response in which lymphocytes attack whole cells like bacteria.”
11.
In caring for the patient who is HIV positive, the nurse should:
a)
wear gown, gloves, and mask at all times.
b)
limit visitors.
c)
monitor intake of salt.
d)
use Standard Precautions.
12.
The nurse clarifies that the HIV virus enters and alters the DNA of the _____ cell lymphocyte.
a)
B
b)
T
c)
CD4
d)
Killer T
13.
The nurse describes the initial diagnostic test for HIV as the enzyme-linked immunosorbent assay (EIA), which is performed to detect:
a)
human immunodeficiency virus.
b)
depleted phagocytes.
c)
numbers of T helper cells.
d)
HIV antibodies.
14.
The nurse will add a special caution to patient teaching for a patient with HIV infection who has a _____ for a house pet.
a)
dog
b)
cat
c)
bird
d)
gerbil
15.
An HIV patient has lost more than 10% of her weight along with having diarrhea for the last 30 days. The nurse knows that these are indications of:
a)
AIDS
b)
wasting syndrome
c)
an opportunistic infection
d)
anorexia
16.
The nurse is working in a trauma unit and is accidentally stuck with an IV needle following venipuncture of the patient. What is the nurse’s first action?
a)
Immediately begin taking the two- or three-drug regimen.
b)
Report the stick to the charge nurse immediately so follow-up can be initiated.
c)
Wash the punctured area with soap and water.
d)
Complete an incident report so immediate testing of the patient and nurse can begin.
17.
Education for the patient with systemic lupus erythematosus (SLE) should include what teaching point?
a)
Training with weights to increase strength
b)
Using alcohol-based skin products
c)
Managing pain with opioids
d)
Using potent sunscreen
18.
The nurse is performing an assessment on a patient admitted for diagnostic testing to rule out fibromyalgia. Which assessment finding would indicate that the patient actually may have the disorder?
a)
A decreased response to painful stimuli
b)
A pain response to nonpainful stimuli
c)
No response to painful stimuli
d)
Numbness and tingling in response to painful stimuli
19.
A patient with an immune deficiency disorder has been admitted to the medical unit due to a current infection and weight loss of 12% of his body weight. The most appropriate nutritional intervention for this patient would be to encourage foods high in:
a)
fat
b)
vitamin C
c)
vitamin B12
d)
protein
20.
A patient has been exposed to an allergen resulting in a hypersensitivity reaction. The nurse correctly recognizes that which immunoglobulin has been triggered?
a)
IgA
b)
IgB
c)
IgD
d)
IgE
21.
A pregnant client diagnosed with human immunodeficiency virus (HIV) is asking about her baby’s risk of infection. Which of the following does put the newborn at risk?
a)
Bottle-feeding
b)
Changing diapers
c)
Kissing the baby
d)
Vaginal birth
22.
Which of the following CD4+ count would be used to confirm the diagnosis of acquired immunodeficiency syndrome (AIDS)?
a)
155 cells/mcL
b)
255 cells/mcL
c)
455 cells/mcL
d)
755 cells/mcL
23.
The nurse, planning care for a client diagnosed with human immunodeficiency virus, realizes that the most common infection that occurs in clients with this health problem is:
a)
cytomegalovirus infection.
b)
Mycobacterium tuberculosis.
c)
Pneumocystis carinii pneumonia.
d)
Streptococcus pneumoniae.
24.
A client diagnosed with acquired immunodeficiency syndrome (AIDS) 6 years ago has a purple lesion located on the inner thigh. This lesion is most likely to be:
a)
AIDS-related syndrome.
b)
Burkitt’s lymphoma.
c)
cachexia
d)
Kaposi’s sarcoma.
25.
The nurse is providing discharge instructions to a client diagnosed with systemic lupus erythematosus (SLE). Which of the following would not be including in these instructions?
a)
“Activity will need to be decreased during an exacerbation.”
b)
“Body temperature should be monitored.”
c)
“Corticosteroid treatment must be slowly tapered off.”
d)
“Sunbathing decreases symptoms.”
26.
A patient in early labor says to the nurse, “I will pass on protection from diseases, and the baby will not ever need any shots.” What is the best response by the nurse?
a)
“Babies are born with innate (natural) immunity at birth.”
b)
“Babies are born with immunoglobulin E (IgE), an antibody that crosses the placenta, but it only briefly protects the baby.”
c)
“Yes, immediate antibody immunity from the mother is the first line of defense against disease for babies.”
d)
“Yes, the mother passes on cell-mediated immunity.”
27.
A nurse is discussing the body’s first and second lines of defense against infection with a community group. What does the body’s first line of defense include?
a)
teeth
b)
sweat
c)
White blood cells
d)
T lymphocytes
28.
A nurse explains that a medication given to a patient with a severe inflammatory response mimics a hormone secreted by the adrenal cortex. To what hormone is the nurse referring?
a)
aldosterone
b)
testosterone
c)
histamine
d)
cortisol
29.
With the exposure to an antigen, a nurse explains that the initiator of the inflammatory response is the presence of histamine. What is responsible for releasing histamine?
a)
neutrophils
b)
eosinophils
c)
basophils
d)
monocytes
30.
A patient has had several increasingly severe allergic reactions during last year’s pollen season. This year, the patient comes regularly to the office to receive some antigen injections. What education will the nurse provide regarding these injections?
a)
They will combat infection brought on by the allergic response.
b)
They will act as a steroid to lessen the allergic response.
c)
They will increase tolerance to the antigen.
d)
They will decrease the production of the antibodies.
31.
What is believed to be the last sense to remain intact during the death process?
a)
touch
b)
sight
c)
smell
d)
hearing
32.
A patient recently diagnosed with inoperable lung cancer tells a nurse, “I am looking forward to seeing my daughter graduate from college in 2 years.” What stage of grief should the nurse recognize this as according to Elizabeth Kübler-Ross?
a)
denial
b)
bargaining
c)
anger
d)
depression
33.
A patient who is terminally ill asks a nurse what is meant by a medical power of attorney. What is the nurse’s best explanation of this written document?
a)
“It allows another person to manage your financial affairs.”
b)
“It allows the physician to make any medical decisions that need to be made for you.”
c)
“It says you have given up all rights to make medical decisions for yourself.”
d)
“It allows you to select someone to make health care decisions for you only if you are unable to do so for yourself.”
34.
A patient who has been diagnosed with a terminal illness is crying when a nurse enters the room. The patient states, “I promised God that I would be a better person if He will just let me get over this disease.” What stage of grieving according to Kübler-Ross should the nurse recognize this as?
a)
denial
b)
anger
c)
bargaining
d)
depression
35.
What is responsible for initiating the inflammatory response in addition to immunoglobulin E (IgE)?
a)
Eosinophils
b)
Lymphocytes
c)
Basophils
d)
Neutrophils
36.
What is true concerning passive-acquired immunity?
a)
Antibodies are acquired from outside the host and instilled in the host.
b)
Antibodies are manufactured in response to a disease in the host.
c)
Antibodies are innately acquired because of being born a human being.
d)
Antibodies are cell mediated inside the host.
37.
What should a nurse include when developing a plan of care for a patient with human immunodeficiency virus (HIV)?
a)
Careful aseptic technique to prevent infection
b)
Instruction to limit fluids to prevent congestive heart failure
c)
Oral alcohol rinses to control mouth infections
d)
Selections of high-fat foods in the daily diet
38.
A 24-year-old woman is admitted to the hospital for a complete medical examination. Her current complaints are indicative of SLE. Which symptom would indicate this diagnosis?
a)
Recent weight gain of 10 lb
b)
Difficulty breathing in the morning
c)
Frequent episodes of diarrhea
d)
Musculoskeletal pain in the hands
39.
What is the primary function in the immune process of the spleen?
a)
Filter microorganisms from the blood.
b)
Store lymphocytes used to fight infections.
c)
Produce additional RBCs (red blood cells).
d)
Stimulate WBC production.
40.
Which nursing action should be implemented when performing skin testing?
a)
Select an 18-gauge needle.
b)
Inject 1 mL intradermally.
c)
Check the site in 2 to 3 days for swelling.
d)
Wrap the site with a pressure dressing.
41.
When is a patient with HIV considered to have progressed to AIDS?
a)
Two or more opportunistic infections are diagnosed.
b)
Kaposi sarcoma appears.
c)
CD4 cell level drops to 200.
d)
Patient tested positive for enzyme-linked immunosorbent assay (ELISA).
42.
A young man at the HIV clinic tells the nurse how relieved he is that he does not have HIV because he now has no symptoms at all when just a few weeks ago he felt awful. What is the most appropriate nursing response?
a)
“Flulike symptoms frequently are misdiagnosed as HIV.”
b)
“In the latent stage, the physical symptoms are reduced, but the HIV is still present in the lymph nodes.”
c)
“A high antibody count can overwhelm HIV infection in the early stage.”
d)
“Antiretroviral drugs are very effective in the first stage in reducing symptoms.”
43.
A nurse is caring for a patient with HIV infection taking Retrovir, a nucleoside antiviral that is a reverse transcriptase inhibitor. For what should the nurse be especially observant?
a)
Decreased urine output
b)
Hypertensive episodes
c)
Jaundice
d)
Edema of the face
44.
What should a patient be encouraged to do before the initiation of any anti-HIV drug protocol?
a)
Give up sexual activity for several months.
b)
Follow the strict dietary guidelines.
c)
Comply with the drug protocol.
d)
Involve the partner in a support program.
45.
A patient with HIV complains to the home health nurse that he has been having watery diarrhea for the past 10 days. The nurse suspects toxoplasmosis. What is the most significant question for the nurse to ask?
a)
“Have you stopped taking your antiviral medication?”
b)
“Have you been drinking alcohol?”
c)
“Have you been eating aged cheese or organ meats?”
d)
“Do you have a cat?”
46.
What should a nurse anticipate will happen when a patient’s first EIA result is positive?
a)
The diagnosis of AIDS is confirmed.
b)
The test is repeated in 6 to 8 months.
c)
Another blood sample must be obtained for testing.
d)
A Western blot test is performed on the same sample.
47.
The nurse is caring for a client diagnosed with human immune deficiency virus. The client’s CD4+ cell count is 399/mm3. What action by the nurse is best?
a)
Counsel the client on safer sex practices/abstinence.
b)
Encourage the client to abstain from alcohol.
c)
Facilitate genetic testing for CD4+ CCR5/CXCR4 co-receptors.
d)
Help the client plan high-protein/iron meals.
48.
A client is in the preoperative holding area prior to surgery. The nurse notes that the client has allergies to avocados and strawberries. What action by the nurse is best?
a)
Assess that the client has been NPO as directed.
b)
Communicate this information with dietary staff.
c)
Document the information in the client’s chart.
d)
Ensure the information is relayed to the surgical team.
49.
A client with Sjögren’s syndrome reports dry skin, eyes, mouth, and vagina. What nonpharmacologic comfort measure does the nurse suggest?
a)
Frequent eyedrops
b)
Home humidifier
c)
Strong moisturizer
d)
Tear duct plugs
50.
The nurse explains that in step 1 (sensitization) of becoming allergic, the body,
a)
develops immunoglobulin E (IgE) antibodies.
b)
forms mast cells.
c)
produces basophils.
d)
reacts with rhinitis, urticaria, asthma, or gastrointestinal (GI) manifestations.
100 %
