Question 1

What should the nurse include to assess for in the plan of care for a patient undergoing plasmapheresis?

Accepted Answer

Hypotension occurs during plasmapheresis because of transient volume changes in the blood.

Question 2

The nurse explains that when the patient received tetanus antitoxin with the antibodies in it,the patient received a ___________ type of immunity.

Accepted Answer

When a person receives an inoculation of antibodies from another source,as with tetanus antitoxin,it is considered a passive artificial immunity.

Question 3

What is the substance released by the T cells that stimulates the lymphocytes to attack an inflammation?

Accepted Answer

Lymphokines help attract macrophages to the site of the inflammation.

Question 4

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 nurse's first intervention?

Accepted Answer

Provision of oxygen is the initial primary intervention.Anaphylaxis may advance very rapidly and the patient may have to be intubated.Covering the patient with a warm blanket is not wrong,but not an initial intervention.

Question 5

A patient is admitted with a secondary immunodeficiency from chemotherapy.The nursing plan of care should include provisions for:

Accepted Answer

Immune deficient persons are at risk for infection and need to be protected aggressively for contagion.

Question 6

The nurse takes into consideration that when the antigen and antibody react,the complement system is activated which:

Accepted Answer

The complement system is a group of plasma proteins that are dormant until there is an antigen-antibody interaction.The proteins destroy the cell membrane and attract phagocytes.

Question 7

A patient is undergoing immunotherapy on a perennial basis.With this form of treatment,what should the patient receive?

Accepted Answer

Perennial therapy is most widely accepted,because it allows for a higher cumulative dose,which produces a better effect.Perennial therapy usually begins with 0.05 mL of 1:10,000 dilution and increases to 0.5 mL in a 6-week period.

Question 8

What is the term for transplantation of tissue between members of the same species?

Accepted Answer

The allograft is the transplantation of tissues between members of the same species,such as a graft for full-thickness burns.

Question 9

What is the purpose of plasmapheresis in the treatment of rheumatoid arthritis?

Accepted Answer

Plasmapheresis is the removal of plasma-containing components causing or thought to cause disease.

Question 10

Which person is most at risk for a hypersensitivity reaction?

Accepted Answer

The 84-year-old with the deteriorated immune system is a prime candidate for a delayed hypersensitivity reaction.

Question 11

Which of the following is an example of immunocompetence?

Accepted Answer

Immunocompetence is demonstrated by the immune system responding appropriately to a foreign stimulus and the body's integrity is maintained as with cold symptoms that resolve with residual illness.

Question 12

Health care facilities have reduced the incidence of serious latex reactions by:

Accepted Answer

Powder inside gloves can become aerosolized and cause inhalant reactions.

Question 13

The nurse recommends to the busy mother of three that the antihistamine fexofenadine (Allegra)would be more beneficial than diphenhydramine (Benadryl)because Allegra:

Accepted Answer

Allegra does not induce drowsiness as does Benadryl.

Question 14

In which patient should the nurse be most concerned about immunodeficiency disorder?

Accepted Answer

Radiation destroys lymphocytes and depletes the stem cells.Prolonged radiation depresses the bone marrow.

Question 15

How does normal aging change the immune system?

Accepted Answer

Normal aging causes deficiencies in both B and T cell activation,but the bone marrow is essentially uncompromised.The thymus decreases in size.

Question 16

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?

Accepted Answer

The drug epinephrine is given in the case of anaphylaxis because it is a quick-acting drug that produces bronchodilation and vasoconstriction,which relieves respiratory distress.The drug can be ordered to be repeated every 20 minutes.The patient may experience an increase in heart rate.

Question 17

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?

Accepted Answer

Injection of subcutaneous epinephrine should be given at the first sign of allergy.

Question 18

What would the nurse recommend for a 94-year-old home health patient with deteriorated cell-mediated immunity?

Accepted Answer

As the older adult loses some of the cell-mediated immunity,especially against pneumonia and influenza,it is recommended that they acquire the immunization.

Question 19

What is the etiology of autoimmune diseases based on?

Accepted Answer

Autoimmune disorders are failures of the tolerance to "self." B and T cells produce autoantibodies that can cause pathophysiologic tissue damage.Autoimmune disorders may be described as an immune attack on the self and result from the failure to distinguish "self" protein from "foreign" protein.

Question 20

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?

Accepted Answer

The nurse's responsibilities in patient education are as follows: Teach the patient preparation and administration of epinephrine subcutaneously.There is no need for the patient to take maintenance doses of corticosteroids because this was a short,rapid reaction.

Quiz 15: Care of the Patient with an Immune Disorder