Chapter 62.
Immunological Disorders
1. Which Of The Following Is An Example Of Immunocompetence?
a. A Child That Is Immune To Measles Because Of An Inoculation
b. A Person Who Has Seasonal Allergies Every Fall
c. When The Symptoms Of A Common Cold Disappear In 1 Day
d. A Neonate Having A Natural Immunity From Maternal Antibodies
2. An Anxious Patient Enters The Emergency Room With Angioedema Of The Lips And Tongue,
Dyspnea, Urticaria, And Wheezing After Having Eaten A Peanut Butter Sandwich. What Should
Be The Nurses First Intervention?
a. Apply Cool Compresses To Urticaria
b. Provide Oxygen Per Non-Rebreathing Mask
c. Cover Patient With A Warm Blanket
d. Prepare For Venipuncture For The Delivery Of IV Medication
3. What Is The Etiology Of Autoimmune Diseases Based On?
a. Reaction To A Superantigen
b. Immune System Producing No Antibodies At All
c. T Cells Destroying B Cells
d. B And T Cells Producing Autoantibodies
4. A Patient Is Admitted With A Secondary Immunodeficiency From Chemotherapy. The Nursing
Plan Of Care Should Include Provisions For:
a. Infection Control.
b. Supporting Self-Care.
c. Nutritional Education.
d. Maintaining High Fluid Intake.
5. The Nurse Takes Into Consideration That When The Antigen And Antibody React, The
Complement System Is Activated Which:
a. Toughens The Cell Wall.
b. Generates More T Cells.
c. Attracts Phagocytes.
d. Makes The Antigen Resistant.
6. How Does Normal Aging Change The Immune System?
a. Depresses Bone Marrow
b. T Cells Become Hyperactive
c. B Cells Show Deficiencies In Activity
d. Increase In The Size Of The Thymus
7. What Would The Nurse Recommend For A 94-Year-Old Home Health Patient With Deteriorated
Cell-Mediated Immunity?
a. Avoiding The Influenza Vaccine
b. Getting Pneumonia Vaccine
c. Having Skin Tests For All Antigens
d. Taking Large Doses Of Beta-Carotene
8. A Patient Who Works In A Plant Nursery And Has Suffered An Allergic Reaction To A Bee Sting Is
Stabilized And Prepared For Discharge From The Clinic. During Discussion Of Prevention And
Management Of Further Allergic Reactions, The Nurse Identifies A Need For Additional Teaching
Based On Which Comment?
a. I Need To Think About A Change In My Occupation.
b. I Will Learn To Administer Epinephrine So That I Will Be Prepared If I Am Stung Again.
c. I Should Wear A Medic-Alert Bracelet Indicating My Allergy To Insect Stings.
d. I Will Need To Take Maintenance Doses Of Corticosteroids To Prevent Reactions To Further
Stings.
9. What Is The Substance Released By The T Cells That Stimulates The Lymphocytes To Attack An
Inflammation?
a. Lymphokine
b. Epinephrine
c. B Cells
d. Histamine
10. Immediately After The Nurse Administers An Intradermal Injection Of A Suspected Antigen
During Allergy Testing, The Patient Complains Of Itching At The Site, Weakness, And Dizziness.
Which Action By The Nurse Is Most Appropriate Initially?
a. Elevate The Arm Above The Shoulder
b. Administer Subcutaneous Epinephrine
c. Apply A Warm Compress To Area
d. Apply A Local Anti-Inflammatory Cream To The Site
11. Which Person Is Most At Risk For A Hypersensitivity Reaction?
a. 26-Year-Old Receiving His Second Desensitization Injection
b. 35-Year-Old Starting Back On Birth Control Tablets
c. The 52-Year-Old Started On A New Series Of Pyridium For Cystitis
d. The 84-Year-Old Receiving Penicillin For An Annually Recurring Respiratory Infection
12. The Nurse Recommends To The Busy Mother Of Three That The Antihistamine Fexofenadine
(Allegra) Would Be More Beneficial Than Diphenhydramine (Benadryl) Because Allegra:
a. Is Inexpensive.
b. Contains A Stimulant For An Energy Boost.
c. Does Not Dry Out The Mucous Membranes.
d. Does Not Induce Drowsiness.
13. The Patient Who Had An Asthma-Like Reaction To A Desensitization Shot Was Medicated With A
Subcutaneous Injection Of Epinephrine. What Effect Should The Nurse Assure The Anxious
Patient This Will Have?
a. Cause Vasodilation
b. Produce Bronchodilation
c. Cause Productive Coughing
d. Reduction Of Pulse Rate
14. Health Care Facilities Have Reduced The Incidence Of Serious Latex Reactions By:
a. Having Local And Injectable Corticosteroids On Hand For Employees
b. Desensitizing Staff Who Are Allergic
c. Supplying Extra Handwashing Stations In The Halls
d. Using Only Powder-Free Gloves
15. What Should The Nurse Include To Assess For In The Plan Of Care For A Patient Undergoing
Plasmapheresis?
a. Hypotension
b. Hypersensitivity
c. Urticaria
d. Flank Pain
16. A Patient Is Undergoing Immunotherapy On A Perennial Basis. With This Form Of Treatment,
What Should The Patient Receive?
a. Larger Doses Each Week
b. Higher Concentrations Each Week
c. Increased Amounts And Concentrations In 6-Week Cycles
d. The Same Amount And Concentration Each Visit
17. What Is The Term For Transplantation Of Tissue Between Members Of The Same Species?
a. Allograft
b. Autograft
c. Isograft
d. Homograft
18. In Which Patient Should The Nurse Be Most Concerned About Immunodeficiency Disorder?
a. The Patient Taking Desensitization Injections (Immunotherapy)
b. The Patient On Long-Term Radiation Therapy For Cancer
c. The Overweight Patient
d. The Patient Recently Diagnosed With Lupus Erythematosus
19. What Is The Purpose Of Plasmapheresis In The Treatment Of Rheumatoid Arthritis?
a. To Add Corticosteroids To Relieve Pain
b. To Remove Pathologic Substances Present In The Plasma
c. To Remove Waste Products Such As Urea And Albumin
d. To Add Antinuclear Antibodies
20. The Nurse Explains That When The Patient Received Tetanus Antitoxin With The Antibodies In It,
The Patient Received A Type Of Immunity.
a. Active Natural
b. Passive Natural
c. Active Artificial
d. Passive Artificial
21. Because The Older Adult Has Decreased Production Of Saliva And Gastric Secretions, They Are
At Risk For:
a. Mouth Ulcers.
b. Fissures In Corners Of The Mouth.
c. Gastrointestinal Infections.
d. Bloating.
22. What Is The Major Negative Effect Of Cell-Mediated Immunity?
a. Depression Of Bone Marrow
b. Rejection Of Transplanted Tissue
c. Activation Of The T Cells
d. Stimulation Of The B Cells
23. What Is B-Cell Proliferation Dependent On?
a. Presence Of NK (Natural Killer) Cells
b. Complement System
c. Antigen Stimulation
d. Lymphokines
24. What Timeframe Must Blood Be Transfused Within Once It Has Been Removed From
Refrigeration?
a. 2 Hours
b. 4 Hours
c. 6 Hours
d. 3 Hours
25. The LPN/LVN Has Arrived At The Patients Bedside With A Unit Of Packed Cells To Be Connected
To An IV That Is Infusing. When The RN Arrives, What Is The First Thing The Nurses Must Do?
a. Check To Ensure That The Donor And Recipient Numbers Match According To Policy
b. Request The Patient To Sign The Card On The Packed Cells
c. Immediately Administer The Packed Cells
d. Check The Patients ID Bracelet And Then Administer The Packed Cells
26. The Nurse Arrives At The Bedside Of A Patient Who Has Had A Unit Of Packed Cells Infusing In
His Right Arm For 35 Minutes. He Is Complaining Of Chills, Itching, And Shortness Of Breath.
What Should Be The Nurses Initial Action?
a. Cover With A Warm Blanket
b. Take The Patients Temperature
c. Elevate The Head Of The Bed
d. Stop The Transfusion And Continue With Saline
27. Which Symptom Would Be Classified As A Mild Transfusion Reaction?
a. Orthopnea
b. Tachycardia
c. Hypotension
d. Wheezing
28. What Should The Nurse Do Because Of The Increasing Strength Of The Dose In The Injections
For Immunotherapy?
a. Observe The Patient For At Least 20 Minutes After Administration
b. Take The Vital Signs Every 10 Minutes For An Hour
c. Have The Patient Lie Down Quietly For An Hour
d. Place A Warm Compress On The Area To Speed Its Absorption
29. If A Nurse Is Sensitive To Latex Gloves, What Potential Food Sensitivities Might The Nurse
Develop? (Select All That Apply.)
a. Peanuts
b. Avocados [CORRECT]
c. Milk
d. Bananas [CORRECT]
e. Tomatoes [CORRECT]
f. Potatoes [CORRECT]
30. Which Of The Following Provide The Body With Innate Immunity? (Select All That Apply.)
a. Skin And Mucous Membranes [CORRECT]
b. Lungs
c. Heart
d. Tears And Saliva [CORRECT]
e. Natural Intestinal And Vaginal Flora [CORRECT]
f. Stomach Acid [CORRECT]
The Innate Immune System Is Composed Of The Skin And Mucous Membranes, Cilia, Stomach
Acid, Tears, Saliva, Sebaceous Glands, And Secretions And Flora Of The Intestine And Vagina.
These Organs, Tissues, And Secretions Provide Biochemical And Physical Barriers To Disease.