Question 1

A neonate exhibited some preliminary signs of infection, but the infants condition resolved spontaneously prior to discharge home from the hospital. This infants recovery was most likely due to what type of immunity?

Accepted Answer

Natural immunity, or nonspecific immunity, is present at birth. Active acquired or specific immunity develops after birth. Cytokines are proteins that mediate the immune response; they are not a type of immunity.

Question 2

A gerontologic nurse is caring for an older adult patient who has a diagnosis of pneumonia. What agerelated change increases older adults susceptibility to respiratory infections?

Accepted Answer

As a consequence of impaired ciliary action due to exposure to smoke and environmental toxins, older adults are vulnerable to lung infections. This vulnerability is not the result of thymus atrophy, stenosis of the bronchi, or loss of diaphragmatic muscle tone.

Question 3

A nurse is explaining the process by which the body removes cells from circulation after they have performed their physiologic function. The nurse is describing what process?

Accepted Answer

Apoptosis, or programmed cell death, is the bodys way of destroying worn out cells such as blood or skin cells or cells that need to be renewed. Opsonization is the coating of antigenantibody molecules with a sticky substance to facilitate phagocytosis. The body does not use phagocytosis or the cellular immune response to remove cells from circulation.

Question 4

A patient is responding to a microbial invasion and the patients differentiated lymphocytes have begun to function in either a humoral or a cellular capacity. During what stage of the immune response does this occur?

Accepted Answer

In the response stage, the differentiated lymphocytes function in either a humoral or a cellular capacity. In the effector stage, either the antibody of the humoral response or the cytotoxic (killer) $\mathrm{T}$ cell of the cellular response reaches and connects with the antigen on the surface of the foreign invader. In the recognition stage, the recognition of antigens as foreign, or non-self, by the immune system is the initiating event in any immune response. During the proliferation stage the circulating lymphocytes containing the antigenic message return to the nearest lymph node.

Question 5

A nurse is reviewing the immune system before planning an immunocompromised patients care. How should the nurse characterize the humoral immune response?

Accepted Answer

The humoral response is characterized by the production of antibodies by B lymphocytes in response to a specific antigen. Phagocytosis and direct attack on microbes occur in the context of the cellular immune response.

Question 6

A patient is undergoing testing to determine the overall function of her immune system. What test can be performed to evaluate the functioning of the patients cellular immune system?

Accepted Answer

Cellular (cell-mediated) immunity tests include the delayed hypersensitivity skin test, since this immune response is specifically dependent on the cellular immune response. Each of the other listed tests assesses functioning of the humoral immune system.

Question 7

Diagnostic testing has revealed a deficiency in the function of a patients complement system. This patient is likely to have an impaired ability to do which of the following?

Accepted Answer

Complement has three major physiologic functions: defending the body against bacterial infection, bridging natural and acquired immunity, and disposing of immune complexes and the byproducts associated with inflammation. Complement does not mark the parameters of the immune response; complement does not collect immune complexes during inflammation.

Question 8

A patients current immune response involves the direct destruction of foreign microorganisms. This aspect of the immune response may be performed by what cells?

Accepted Answer

Cytotoxic T cells (also called CD8 + cells) participate in the destruction of foreign organisms. Memory $\mathrm{T}$ cells and suppressor $\mathrm{T}$ cells do not perform this role in the immune response. The complement system does not exist as a type of $\mathrm{T}$ cell.

Question 9

A nurse is explaining how the humoral and cellular immune responses should be seen as interacting parts of the broader immune system rather than as independent and unrelated processes. What aspect of immune function best demonstrates this?

Accepted Answer

$\mathrm{T}$ cells interact closely with $\mathrm{B}$ cells, indicating that humoral and cellular immune responses are not separate, unrelated processes, but rather branches of the immune response that interact. Movement of B cells does not clearly show the presence of a unified immune system. The differentiation between types of $\mathrm{T}$ cells and the role of the complement system do not directly suggest a single immune system.

Question 10

A nurse is caring for a patient who has had a severe antigen/antibody reaction. The nurse knows that the portion of the antigen that is involved in binding with the antibody is called what?

Accepted Answer

The portion of the antigen involved in binding with the antibody is referred to as the antigenic determinant. This portion is not known as an antibody lock, antigenic sequence, or antibody channel.

Question 11

A patient is being treated for cancer and the nurse has identified the nursing diagnosis of Risk for Infection Due to Protein Losses. Protein losses inhibit immune response in which of the following ways?

Accepted Answer

Depletion of protein reserves results in atrophy of lymphoid tissues, depression of antibody response, reduction in the number of circulating $T$ cells, and impaired phagocytic function. This specific nutritional deficit does not cause T-cell mutation, an increase in the production of interferons, or apoptosis of cytokines.

Question 12

A patient is vigilant in her efforts to take good care of herself but is frustrated by her recent history of upper respiratory infections and influenza. What aspect of the patients lifestyle may have a negative effect on immune response?

Accepted Answer

Rigorous exercise or competitive exerciseusually considered a positive lifestyle factorcan be a physiologic stressor and cause negative effects on immune response. The patients habits around diet and sleep do not present obvious threats to immune function.

Question 13

The nurse is assessing a clients risk for impaired immune function. What assessment finding should the nurse identify as a risk factor for decreased immunity?

Accepted Answer

Stress is a psychoneuroimmunologic factor that is known to depress the immune response. Use of beta blockers, a family history of cancer, and a prior PE are significant assessment findings, but none represents an immediate threat to immune function.

Question 14

The nurse is completing a focused assessment addressing a patients immune function. What should the nurse prioritize in the physical assessment?

Accepted Answer

During the assessment of immune function, the anterior and posterior cervical, supraclavicular, axillary, and inguinal lymph nodes are palpated for enlargement. If palpable nodes are detected, their location, size, consistency, and reports of tenderness on palpation are noted. Because of the central role of lymph nodes in the immune system, they are prioritized over the heart, liver, and abdomen, even though these would be assessed.

Question 15

A patients exposure to which of the following microorganisms is most likely to trigger a cellular response?

Accepted Answer

Viral, rather than bacterial antigens, induce a cellular response.

Question 16

A patient was recently exposed to infectious microorganisms and many $\mathrm{T}$ lymphocytes are now differentiating into killer $\mathrm{T}$ cells. This process characterizes what stage of the immune response?

Accepted Answer

In the proliferation stage, $\mathrm{T}$ lymphocytes differentiate into cytotoxic (or killer) $\mathrm{T}$ cells, whereas $\mathrm{B}$ lymphocytes produce and release antibodies. This does not occur in the response, recognition, or effector stages.

Question 17

The nurse knows that the response of natural immunity is enhanced by processes that are inherent in the
Physical and chemical barriers of the body. What is a chemical barrier that enhances the response of natural immunity?

Accepted Answer

Chemical barriers, such as mucus, acidic gastric secretions, enzymes in tears and saliva, and substances in sebaceous and sweat secretions, act in a nonspecific way to destroy invading bacteria and fungi. Not all body fluids are chemical barriers, however. Cell cytoplasm, interstitial fluid, and CSF are not normally categorized as chemical barriers to infection.

Question 18

A nursing student is giving a report on the immune system. What function of cytokines should the student describe?

Accepted Answer

Separate subpopulations of helper $\mathrm{T}$ cells produce different types of cytokines and determine whether the immune response will be the production of antibodies or a cell-mediated immune response. Cytokines do not determine whether cells are foreign, determine if lymphokines will be activated, or determine the role of memory $\mathrm{T}$ cells.

Question 19

A patient has undergone treatment for septic shock and received high doses of numerous antibiotics during the course of treatment. When planning the patients subsequent care, the nurse should be aware of what potential effect on the patients immune function?

Accepted Answer

Large doses of antibiotics can precipitate bone marrow suppression, affecting immune function.
Antibiotics are not noted to cause apoptosis, thymus atrophy, or lymphoma.

Question 20

A patients recent diagnostic testing included a total lymphocyte count. The results of this test will allow the care team to gauge what aspect of the patients immunity?

Accepted Answer

A total lymphocyte count is a test used to determine cellular immune function. It is not normally used for testing humoral immune function and the associated antigenantibody.

Quiz 35: Assessment of Immune Function