Pathophysiology Module 6 Infection and Mechanisms of Disease – Flashcards

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A patient has cancer and develops an immune deficiency. Which type of immune deficiency will the nurse observe on the chart? Congenital Primary Secondary Genetic
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Secondary Primary (congenital) immune deficiency is caused by a genetic defect, whereas secondary (acquired) immune deficiency is caused by another condition, such as cancer, infection, or normal physiologic changes, such as aging.
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A patient is experiencing an allergic reaction. Which principle should the nurse remember? When mast cells degranulate, they release: toxins. histamine. bradykinin. antibodies.
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histamine. When stimulated by cell injury or the presence of microorganisms, the mast cell releases preformed mediators such as histamine.
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A patient has a primary immune deficiency. Which of the following is deficient? Complement and phagocytes Mast cells and antibodies Antigens and allergens Histamine and B cells
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Complement and phagocytes Primary immune deficiencies are classified into five groups: defects of B lymphocytes, T lymphocytes, both B and T lymphocytes (combined), phagocytes, or complement.
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A patient has Bruton agammaglobulinemia. While checking lab results, which of the following does the nurse expect to find? High levels of IgA Low levels of B cells Low levels of fibrin High levels of antibodies
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Low levels of B cells Bruton agammaglobulinemia has few or no circulating B cells, although T cell number and function are normal.
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A patient has Wiskott-Aldrich syndrome. While the nurse is checking lab results, which of the following will be low? IgG IgM IgE IgA
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IgM Wiskott-Aldrich syndrome is an X-linked recessive disorder, where IgM antibody production is greatly depressed.
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A patient has hypogammaglobulinemia from a B cell immune deficiency disorder. What should the nurse teach the patient about gamma globulin injections for this condition? This treatment is only temporary. This treatment will provide a cure. This treatment may cause an exacerbation. This treatment should be avoided.
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This treatment is only temporary. The administration of gamma globulins can temporarily restore immune function (although these antibodies are only effective for 3 to 4 weeks).
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nurse observes the term immunodeficiency. Which disorder does the nurse suspect the patient is experiencing? Allergy Autoimmunity Alloimmunity AIDS
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AIDS
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A patient undergoes a kidney transplant. The patient starts to reject the new kidney. Which type of reaction is the patient experiencing? Autoimmune Allergy Antibody Alloimmune
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Alloimmune
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A nurse is discussing the human immunodeficiency virus (HIV) and how it attacks the body. Which information should the nurse include? HIV attaches to CD4 receptors found on: helper T cells. cytotoxic T cells. plasma cells. viruses.
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helper T cells.
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A nurse is teaching about histamine receptors. Which concepts should the nurse discuss together? H2 and edema H1 and lung H1 and decreased gastric secretions H2 and blood vessels
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H1 and lung H1 receptors are found on lungs and blood vessels. H2 receptors are found in the stomach to increase gastric secretions.
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A patient has poison ivy. Which type of reaction did this patient experience? Type IV Type III Type II Type I
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Type IV
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A patient is experiencing an allergic reaction. When the nurse assesses the skin, fluid-filled blisters surrounded by redness (hives) are noted. Which medical term should the nurse use to describe this finding? Erythema Anaphylaxis Pruritus Urticaria
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Urticaria Urticaria is characterized by white fluid-filled blisters (wheals) surrounded by areas of redness (flares).
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A patient has systemic lupus erythematosus. A nurse will classify this type of disease as: antitoxin. allergen. alloimmune. autoimmune.
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autoimmune. Systemic lupus erythematosus (SLE) is the most common, complex, and serious of the autoimmune disorders.
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A nurse is describing the allergic response. Which information should the nurse include? After degranulation, the mast cells release histamine that performs the functions of: vasodilation and increased vascular permeability. decreased gastric secretions and attraction of viruses. bronchodilation and activation of the complement cascade. dehydration and opsonization of bacteria.
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vasodilation and increased vascular permeability. Histamine causes vasodilation, increased vascular permeability, increased gastric secretions and bronchoconstriction.
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Which of the following patients would have a transfusion reaction? A patient with type AB receiving blood from a person with type B A patient with type B receiving blood from a person with type B A patient with type O receiving blood from a person with type AB A patient with type A receiving blood from a person with type O
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A patient with type O receiving blood from a person with type AB
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A nurse is describing the mechanisms by which Type II reactions can affect cells. Which information should the nurse include? Antibody-dependent cell-mediated cytotoxicity--involve natural killer cells Defective peripheral tolerance--T regulatory cells fail to adequately suppress autoreactive lymphocytes Retroviruses--infect and destroy helper T cells (CD4+ lymphocytes) Cryoglobulins--deposit in fingers, toes, and nose at low temperatures
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Antibody-dependent cell-mediated cytotoxicity--involve natural killer cells The fourth mechanism by which Type II reactions can affect cells is antibody-dependent cell-mediated cytotoxicity. This mechanism involves natural killer (NK) cells.
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A patient has Graves disease. Which type of hypersensitivity reaction is this patient experiencing? Type I Type II Type III Type IV
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Type II
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A patient had a hypersensitivity reaction involving the formation of antibodies against tissue-specific antigen. Which type of hypersensitivity reaction did the patient experience? Type I Type II Type III Type IV
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Type II Type II hypersensitivity reactions involve the formation of antibodies that attack the bodys own tissues.
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A patient has a hypersensitivity reaction mediated by Tc cells. A nurse recalls this type of hypersensitivity reaction is called: Type I Type II Type III Type IV
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Type Iv
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When a person has an allergic reaction to a bee sting, which type of hypersensitivity response is occurring? Type I Type II Type III Type IV
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Type I
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A nurse is discussing the formation of antigen-antibody (immune) complexes that get deposited on vessel walls or in extravascular tissue. Which hypersensitivity reaction is the nurse describing? Type I Type II Type III Type IV
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Type III Type III hypersensitivity reactions are caused by the formation of antigen-antibody (immune) complexes that later get deposited in vessel walls or extravascular tissue.
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A patient has a positive tuberculin skin test for detecting the presence of tuberculosis. A nurse realizes the patient experienced which type of hypersensitivity reaction? Type I Type II Type III Type IV
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Type IV Because this reaction takes 24 to 72 hours to appear, it is a classic example of a type IV hypersensitivity reaction.
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A nurse is teaching about hypersensitivity reactions. Which information should the nurse include? _____________ are stimulated to release histamine by the presence of antibodies in a type I hypersensitivity reaction. Mast cells Macrophages B lymphocytes T lymphocytes
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Mast cells During a type I hypersensitivity reaction, the presence of IgE stimulates mast cell degranulation releasing histamine.
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A patient has a Type I hypersensitivity reaction. Which elevated lab result should the nurse check? IgG IgD IgM IgE
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IgE
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A nurse is providing care to an atopic patient. Which principle should the nurse use to guide nursing care? Repeated exposure to an allergen in an atopic individual will cause the: allergic response to become worse. antibody production to become suppressed. autoimmune formation to increase. Tc cell activity to increase significantly.
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allergic response to become worse.
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A nurse is conducting a physical assessment on a patient. Which cluster of symptoms would indicate to the nurse that the patient experienced a Type I hypersensitivity reaction? Chest pain, shortness of breath, and abdominal cramping Weight loss, anxiety, and tremors Rhinorrhea, watery eyes, and pruritis Jaundice, fatigue, and decreased urine output
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Rhinorrhea, watery eyes, and pruritis Rhinorrhea, watery eyes, and pruritis (itching) are all common manifestations of allergic rhinitis.
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A nurse is describing histamine receptors. Which information should the nurse include? __________ receptors, when bound to histamine, stimulate gastric acid secretion in the stomach. H1 H2 H3 H4
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H2 H2 receptors are found on the cells lining the stomach. The presence of histamine will increase gastric acid secretion.
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A nurse is asked what happens when H1 receptors are stimulated by histamine. How should the nurse respond? a.Bronchodilation b. increased permeability c. Prolonged vasoconstriction d Increased gastric secretions
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Increased permeability Binding histamine to H1 receptors on endothelial cells results in increased capillary permeability from endothelial cell retraction.
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Which finding will cause the nurse the most concern for a patient with a Type I hypersensitivity response? Eczema. Allergic rhinitis. Serous otitis. Anaphylaxis.
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Anaphylaxsis
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A nurse is asked about desensitization therapy for allergies. What is the nurse's best response? Minute amounts of allergens are given in increasing amounts. Decreasing amounts of IgE are injected into the body. Individuals with Type III hypersensitivities will benefit from this treatment. Antihistamines are a part of this process and will be given monthly.
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Minute amounts of allergens are given in increasing amounts
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Which statement indicates the nurse needs more teaching regarding Type II hypersensitivity? Tissue injury is caused by: a. autoantibody activation of complement and subsequent destruction of target cells. b. autoantibody stimulation of NK cells that destroy target cells. c. autoantibody opsonization of target cells and subsequent phagocytosis. d. autoantibody mediation of neutrophils with detoxification of their toxic substances.
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autoantibody mediation of neutrophils with detoxification of their toxic substances. Neutrophils are attracted, bind to the tissues, and release toxic substances into the tissue causing injury. Type II hypersensitivities involve the production of autoantibodies that target the bodys own tissues in all three ways: stimulation NK cells, opsonization of target cells, and activation of complement.
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Which characteristic does the nurse know is related to a type IV hypersensitivity reaction? Antibody-dependent cell-mediated toxicity Delayed response Life-threatening symptoms Complement system mediation
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Delayed response
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A nurse is describing the pathophysiology of Type IV hypersensitivities. Which information should the nurse include? Type IV hypersensitivities tissue effects are initiated by: B cells that release IgD 24 to 48 hours after exposure. the release of neutrophil chemotactic factor. the stimulation of cytotoxic T cells. the release of large quantities of IgE.
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Stim of cytotoxic T cells
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A nurse recalls Raynaud phenomenon is an example of a: type I hypersensitivity. type II hypersensitivity. type III hypersensitivity. type IV hypersensitivity.
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Type III Raynaud phenomenon involves immune complex deposition in blood vessels and is therefore characterized as a type III hypersensitivity.
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When the maternal immune system becomes sensitized against antigens expressed by the fetus, what type of immune reaction does the nurse expect to occur? Autoimmune Anaphylaxis Alloimmune Allergic
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Alloimmune
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A nurse recalls Graves disease is an autoimmune disease caused by autoantibodies that: stimulate the production of thyroid hormone. block the effects of thyroid hormone. destroy the thyroid gland. destroy cells that normally respond to thyroid hormone.
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Stim production of thyroid hormone
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Which statement indicates a nurse needs more teaching regarding autoimmunity? Autoimmunity can result from: type I hypersensitivity. type II hypersensitivity. type III hypersensitivity. type IV hypersensitivity.
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type I hypersensitivity. Type I hypersensitivities result in mast cell degranulation, and problems are caused by the effects of histamine and other inflammatory mediators. In type II, III, and IV reactions, the body begins to recognize self-antigen as foreign
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Which statement indicates the staff member understood the teaching from the nurse? The following is a known mechanism for the development of an autoimmune disease: the development of anti IgG antibodies. alterations in ABO blood groups. the breakdown of tolerance. the production of memory cells.
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the breakdown of tolerance.
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Which of the following groups should the nurse screen first for systemic lupus erythematosus (SLE)? Women, 50-70 years old Women, 20-40 years old Men, 50-70 years old Men, 20-40 years old
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Women, 20-40 years old
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Which statement indicates a nurse has a good understanding of the pathophysiology of systemic lupus erythematosus (SLE)? Disease characteristics of SLE include: a. Tc cell destruction of lung tissue and the gastrointestinal lining. b. deposition of immune complexes in the kidneys, brain, and heart. c. selective autoantibody destruction of the thyroid gland. d. absence of the antinuclear antibodies and antiDNA antibodies.
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b. deposition of immune complexes in the kidneys, brain, and heart
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Which of the following assessment findings are typical of a patient with SLE? Wheezing, eczema, and itching Pulmonary edema, leg swelling, and vein distention Arthralgia, anemia, and rash Nasal polyps, headache, and rhinorrhea
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Arthralgia, anemia, and rash
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A nurse recalls hyperacute allograft rejection is caused by: cytokines and growth factors produced by trauma to vascular endothelial cells. preformed antibodies that react immediately with the graft. Tc and NK cell destruction of the graft. production of antibodies to the new graft by B lymphocytes
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preformed antibodies that react immediately with the graft. Hyperacute rejection is an immediate reaction to the graft caused by the presence of preformed antibodies to the transplanted tissue. In most cases these antibodies are present from previous transplantation or transfusion.
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A person with type O blood has which of the following antigens present on their red blood cells? A and B Rh O No antigens
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No antigens
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A nurse is caring for a patient with type AB blood. Which principle does the nurse understand about this patient? This patient is likely to have: a.high titers (levels) of anti-A antibodies. b. high titers (levels) of anti-B antibodies. c. no antibodies against A or B antigen. d. high titers (levels) of anti-A antibodies and anti-B antibodies.
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No antibodies against A or B
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If a transfusion of A-negative blood to an O-positive individual occurred, which result would the nurse expect? Improved red blood cell count Clumping and lysis of red blood cells Production of anti-B antibodies A type I hypersensitivity reaction
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Clumping and lysis of red blood cells
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Which term can the nurse use to describe a person with type AB blood? Universal bone marrow transplant donor Universal bone marrow transplant recipient Universal blood donor Universal blood recipient
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Universal blood recipient
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to prevent hemolytic disease of the newborn, which situation will cause the nurse to intervene? Rh negative fetus and Rh positive mom Rh positive fetus and Rh positive mom Rh negative fetus and Rh negative mom Rh positive fetus and Rh negative mom
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Rh positive fetus and Rh negative mom
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When caring for a patient with immunodeficiencies, which principle should the nurse use to guide nursing care? Patients with immunodeficiencies are most at risk for: hypersensitivity reactions. fungal infections only. opportunistic infections. transient ischemic attacks.
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opportunistic infections.
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A patient has an immunodeficiency disorder from an X-linked recessive disease characterized by decreased IgM production. Which diagnosis will the nurse observe documented on the chart? Severe combined immunodeficiency disease (SCID) Wiskott-Aldrich syndrome DiGeorge syndrome Bare lymphocyte syndrome
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Wiskott-Aldrich syndrome this is an X-linked recessive disease characterized by decreased IgM production. Individuals with this disorder are especially susceptible to viruses and encapsulated bacteria.
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A patient presents with recurrent respiratory tract infections and chronic yeast infections of the gastrointestinal tract. Which immune disease does the nurse suspect the patient is experiencing? Severe combined immunodeficiency IgA deficiency Bruton agammaglobulinemia Autoimmunity
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IgA deficiency
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A nurse is describing the pathophysiology of the HIV infection. Which information should the nurse include? HIV inserts its genetic material by binding to the _____ on the helper T cell. gp 120 receptor CD8 receptor CD4 receptor phospholipids
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CD4 receptor Correct HIV inserts its genetic material by binding to the CD4 receptor on the helper T cell. The CD8 receptor is on cytotoxic T cells.
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If blood cell counts from an individual with AIDS were analyzed, the nurse would expect to see very low quantities of: T helper cells mast cells. red blood cells. neutrophils.
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T helper cells
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A patient is undergoing a skin test and food challenge. The nurse realizes the patient is being tested for: compatibility of donor tissue. type I hypersensitivities. potential surgery for obesity. autoimmune diseases.
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type I hypersensitivities.
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A patient has Graves disease. Which type of hypersensitivity reaction occurred? Type I Type II Type III Type IV
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Type II
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When a nurse checks the patient's PPD tuberculosis skin test, the area is hard and red. Which term should the nurse use to describe the hard area? Helminth Erythema Induration Swelling
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Induration The reaction site is infiltrated with T lymphocytes and macrophages, resulting in a clear hard center (induration) and a reddish surrounding area (erythema)
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A nurse is describing primary immune deficiency. Which primary deficiencies should the nurse include? BThe nurse should monitor the patient for infections caused by: capsulated viruses. fermented yeast. wet fungi. encapsulated bacteria.
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A-- B lymphocytes and complement B --encapsulated bacteria. B-lymphocyte deficiencies result in an increased susceptibility to infection, especially those caused by encapsulated bacteria.
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While checking lab results, the nurse notices a patient has low levels of antibodies. What term should the nurse use to describe this condition? Agammaglobulinemia Hypogammaglobulinemia Anemia Septicemia
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Hypogammaglobulinemia The results are lower levels of circulating immunoglobulins (hypogammaglobulinemia) or occasionally totally or nearly absent immunoglobulins (agammaglobulinemia).
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A patient has DiGeorge syndrome. Which assessment findings should the nurse monitor for in this patient? Elevated T cells and hypocalcemia Enlarged parathyroid gland and erythema Low calcium levels and tetany Decreased B cells and allergies
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Low calcium levels and tetany Low blood calcium levels cause the development of tetany or involuntary rigid muscular contraction.
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A child has bare lymphocyte syndrome. What is the prognosis for this patient? Most patients have a complete recovery with treatment. Most patients do not live past the age of 5. Some patients will have remissions and exacerbations. Some patients will require surgery to cure this syndrome.
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Most patients do not live past the age of 5. Children with this deficiency develop serious, life-threatening infections and usually die before the age of 5 years.
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A patient has Wiskott-Aldrich syndrome. Which typical assessment findings should the nurse monitor for in this patient? Decreased IgM and bleeding Increased IgE and clotting Decreased IgG and wheezing Increased IgA and coughing
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Decreased IgM and bleeding Wiskott-Aldrich syndrome is an X-linked recessive disorder, where IgM antibody production and platelets are depressed.
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A patient has a complement deficiency. Which patient will the nurse assess for the most severe type of deficiency? A patient with a deficiency in: C1 C2 C3 C4
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C3 deficiency is the most severe defect.
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A patient has phagocytic deficiency. What component of the phagocytic process does the nurse suspect the patient is missing? Dendrite cells Halide Myeloperosidase Hydrogen peroxide
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Hydrogen peroxide Affected individuals with phagocytic deficiency have adequate myeloperoxidase and halide but lack the necessary hydrogen peroxide.
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A patient has a B-lymphocyte deficiency. Which treatment will the nurse prepare to give? Physical therapy Heat therapy Live attenuated vaccine Gamma globulin injection
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Gamma globulin injection When immunocompromise is due to B-lymphocyte deficiencies and associated hypo- or agammaglobulinemia, the administration of gamma globulins can temporarily restore immune function.
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A patient has a congenital disorder that affects IgA cells. A nurse recalls this type of immune deficiency is called: passive. active. secondary. primary
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primary. Primary (congenital) immune deficiency is caused by a genetic defect, whereas secondary (acquired) immune deficiency is caused by another condition, such as cancer, infection, or normal physiologic changes, such as aging.
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A patient has Bruton agammaglobulinemia. Which condition would cause the nurse most concern? Otitis media Sore throat Septicemia Afebrile
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Septicemia Bruton agammaglobulinemia results in repeated infections, such as otitis media, streptococcal sore throat, and conjunctivitis, and more serious conditions, such as septicemia
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A nurse wants to teach about the most common primary immune deficiency condition. Which of the following should the nurse describe? Phagocyte deficiency IgG subclass deficiency Selective immunoglobulin A deficiency Common variable immune deficiency
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Common variable immune deficiency The three most commonly diagnosed deficiencies are common variable immune deficiency (34%), selective immunoglobulin A (IgA) deficiency (24%), and IgG subclass deficiency (17%).
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A patient has DiGeorge syndrome. Which organ should the nurse discuss when describing the pathophysiology of this disease? Thymus Thyroid Liver Lung
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Thymus
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A patient has a combined immune deficiency. Which important principle should the nurse remember? A patient with a combined immune deficiency lacks: IgA and IgG. T and B lymphocytes. Tc and Th cells. phagocytes and macrophages.
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T and B lymphocytes. Combined deficiencies result from defects that directly affect the development of both T and B lymphocytes
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A nurse is discussing the pathophysiology of bare lymphocyte deficiency. Which of the following information should the nurse include? Inability to produce major histocompatibility complex molecule Deficiencies of terminal components of the complement cascade Infection and destruction of the Th cell, which is necessary for development of T and B cells Disturbance in the immunologic tolerance of self-antigens leading to autoimmunity
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Inability to produce major histocompatibility complex molecule The bare lymphocyte syndrome is an immune deficiency characterized by an inability of lymphocytes and macrophages to produce major histocompatibility complex (MHC) class I or class II molecules.
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A patient has a complement deficiency of C5 and C7. Which type of infection should the nurse monitor for in this patient? Staphylococcus caused infections Neisseria caused infections Streptococcus caused infections Escherichia coli caused infections
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Neisseria caused infections Deficiencies of terminal components of the complement cascade (C5, C6, C7, C8, or C9 deficiencies) are associated with increased infections with only one group of bacteria those of the genus Neisseria (Neisseria meningitides or N. gonorrhoeae).
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A patient needs a transplant. Which relative should the nurse assess first to have the highest chance of sharing both HLA haplotypes, making him or her a good match for an organ transplant? Mother Father Sibling Aunt/uncle
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Sibling Since each sibling receives one haplotype from each parent, they have the highest chance of sharing both.
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