CHAPTER 13:ALTERED IMMUNE RESPONSES AND
PRANSPORTATION
Chapter 13: Altered Immune Responses and Transplantation
Lewis: Medical-Surgical Nursing, 10th Edition
LEWIS: MEDICAL-SURGICAL NURSING, 10TH EDITION
MULTIPLE CHOICE
1. The nurse provides discharge instructions to a patient who has an immune deficiency
involving the T lymphocytes. Which health screening should the nurse include in the teaching
plan for this patient?
a. Screening for allergies
b. Screening for malignancies
c. Screening for antibody deficiencies
d. Screening for autoimmune disorders
ANS: B
Cell-mediated immunity is responsible for the recognition and destruction of cancer cells.
Allergic reactions, autoimmune disorders, and antibody deficiencies are mediated primarily by
B lymphocytes and humoral immunity.
DIF: Cognitive Level: Apply (application) REF: 196
TOP: Nursing Process: Implementation MSC: NCLEX: Health Promotion and Maintenance
2. Which example should the nurse use to explain an infant’s “passive immunity” to a new
mother?
a. Vaccinations
b. Breastfeeding
c. Stem cells in peripheral blood
d. Exposure to communicable diseases
ANS: B
Colostrum in breast milk provides passive immunity through antibodies from the mother.
These antibodies protect the infant for a few months. However, memory cells are not retained,
so the protection is not permanent. Active immunity is acquired by being immunized with
vaccinations or having an infection. Stem cells are unspecialized cells used to repopulate a
person's bone marrow after high-dose chemotherapy.
DIF: Cognitive Level: Apply (application) REF: 192
TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity
3. A patient is being evaluated for possible atopic dermatitis. The nurse expects elevation of
which laboratory value?
a. IgE c. Basophils
b. IgA d. Neutrophils
ANS: A
Serum IgE is elevated in an allergic response (type 1 hypersensitivity disorders). The
eosinophil level will be elevated rather than neutrophil or basophil counts. IgA is located in
body secretions and would not be tested when evaluating a patient who has symptoms of
atopic dermatitis.
DIF: Cognitive Level: Apply (application) REF: 194
TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity
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, 4. An older adult patient who is having an annual check-up tells the nurse, “I feel fine, and I
don’t want to pay for all these unnecessary cancer screening tests!” Which information should
the nurse plan to teach this patient?
a. Consequences of aging on cell-mediated immunity
b. Decrease in antibody production associated with aging
c. Impact of poor nutrition on immune function in older people
d. Incidence of cancer-associated infections in older individuals
ANS: A
The primary impact of aging on immune function is on T cells, which are important for
immune surveillance and tumor immunity. Antibody function is not affected as much by
aging. Poor nutrition can also contribute to decreased immunity, but there is no evidence that
it is a contributing factor for this patient. Although some types of cancer are associated with
specific infections, this patient does not have an active infection.
DIF: Cognitive Level: Apply (application) REF: 196
TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity
5. A patient who collects honey to earn supplemental income has developed a hypersensitivity to
bee stings. Which statement, if made by the patient, would indicate a need for additional
teaching?
a. “I need to find a different way to earn extra money.”
b. “I will take oral antihistamines before going to work.”
c. “I will get a prescription for epinephrine and learn to self-inject it.”
d. “I should wear a Medic-Alert bracelet indicating my allergy to bee stings.”
ANS: B
Because the patient is at risk for bee stings and the severity of allergic reactions tends to
increase with added exposure to allergen, taking oral antihistamines will not adequately
control the patient’s hypersensitivity reaction. The other patient statements indicate a good
understanding of management of the problem.
DIF: Cognitive Level: Apply (application) REF: 197
TOP: Nursing Process: Evaluation MSC: NCLEX: Physiological Integrity
6. Which information about intradermal skin testing should the nurse teach to a patient with
possible allergies?
a. “Do not eat anything for about 6 hours before the testing.”
b. “Take an oral antihistamine about an hour before the testing.”
c. “Plan to wait in the clinic for 20 to 30 minutes after the testing.”
d. “Reaction to the testing will take about 48 to 72 hours to occur.”
ANS: C
Allergic reactions usually occur within minutes after injection of an allergen, and the patient
will be monitored for at least 20 minutes for anaphylactic reactions after the testing.
Medications that might modify the response, such as antihistamines, should be avoided before
allergy testing. There is no reason to be NPO for skin testing. Results with intradermal testing
occur within minutes.
DIF: Cognitive Level: Apply (application) REF: 200
TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity
This study source was downloaded by 100000849838140 from CourseHero.com on 09-01-2022 12:47:09 GMT -05:00
https://www.coursehero.com/file/27821307/chapter-13-altered-immune-responses-and-transplantationdocx/
PRANSPORTATION
Chapter 13: Altered Immune Responses and Transplantation
Lewis: Medical-Surgical Nursing, 10th Edition
LEWIS: MEDICAL-SURGICAL NURSING, 10TH EDITION
MULTIPLE CHOICE
1. The nurse provides discharge instructions to a patient who has an immune deficiency
involving the T lymphocytes. Which health screening should the nurse include in the teaching
plan for this patient?
a. Screening for allergies
b. Screening for malignancies
c. Screening for antibody deficiencies
d. Screening for autoimmune disorders
ANS: B
Cell-mediated immunity is responsible for the recognition and destruction of cancer cells.
Allergic reactions, autoimmune disorders, and antibody deficiencies are mediated primarily by
B lymphocytes and humoral immunity.
DIF: Cognitive Level: Apply (application) REF: 196
TOP: Nursing Process: Implementation MSC: NCLEX: Health Promotion and Maintenance
2. Which example should the nurse use to explain an infant’s “passive immunity” to a new
mother?
a. Vaccinations
b. Breastfeeding
c. Stem cells in peripheral blood
d. Exposure to communicable diseases
ANS: B
Colostrum in breast milk provides passive immunity through antibodies from the mother.
These antibodies protect the infant for a few months. However, memory cells are not retained,
so the protection is not permanent. Active immunity is acquired by being immunized with
vaccinations or having an infection. Stem cells are unspecialized cells used to repopulate a
person's bone marrow after high-dose chemotherapy.
DIF: Cognitive Level: Apply (application) REF: 192
TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity
3. A patient is being evaluated for possible atopic dermatitis. The nurse expects elevation of
which laboratory value?
a. IgE c. Basophils
b. IgA d. Neutrophils
ANS: A
Serum IgE is elevated in an allergic response (type 1 hypersensitivity disorders). The
eosinophil level will be elevated rather than neutrophil or basophil counts. IgA is located in
body secretions and would not be tested when evaluating a patient who has symptoms of
atopic dermatitis.
DIF: Cognitive Level: Apply (application) REF: 194
TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity
This study source was downloaded by 100000849838140 from CourseHero.com on 09-01-2022 12:47:09 GMT -05:00
https://www.coursehero.com/file/27821307/chapter-13-altered-immune-responses-and-transplantationdocx/
, 4. An older adult patient who is having an annual check-up tells the nurse, “I feel fine, and I
don’t want to pay for all these unnecessary cancer screening tests!” Which information should
the nurse plan to teach this patient?
a. Consequences of aging on cell-mediated immunity
b. Decrease in antibody production associated with aging
c. Impact of poor nutrition on immune function in older people
d. Incidence of cancer-associated infections in older individuals
ANS: A
The primary impact of aging on immune function is on T cells, which are important for
immune surveillance and tumor immunity. Antibody function is not affected as much by
aging. Poor nutrition can also contribute to decreased immunity, but there is no evidence that
it is a contributing factor for this patient. Although some types of cancer are associated with
specific infections, this patient does not have an active infection.
DIF: Cognitive Level: Apply (application) REF: 196
TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity
5. A patient who collects honey to earn supplemental income has developed a hypersensitivity to
bee stings. Which statement, if made by the patient, would indicate a need for additional
teaching?
a. “I need to find a different way to earn extra money.”
b. “I will take oral antihistamines before going to work.”
c. “I will get a prescription for epinephrine and learn to self-inject it.”
d. “I should wear a Medic-Alert bracelet indicating my allergy to bee stings.”
ANS: B
Because the patient is at risk for bee stings and the severity of allergic reactions tends to
increase with added exposure to allergen, taking oral antihistamines will not adequately
control the patient’s hypersensitivity reaction. The other patient statements indicate a good
understanding of management of the problem.
DIF: Cognitive Level: Apply (application) REF: 197
TOP: Nursing Process: Evaluation MSC: NCLEX: Physiological Integrity
6. Which information about intradermal skin testing should the nurse teach to a patient with
possible allergies?
a. “Do not eat anything for about 6 hours before the testing.”
b. “Take an oral antihistamine about an hour before the testing.”
c. “Plan to wait in the clinic for 20 to 30 minutes after the testing.”
d. “Reaction to the testing will take about 48 to 72 hours to occur.”
ANS: C
Allergic reactions usually occur within minutes after injection of an allergen, and the patient
will be monitored for at least 20 minutes for anaphylactic reactions after the testing.
Medications that might modify the response, such as antihistamines, should be avoided before
allergy testing. There is no reason to be NPO for skin testing. Results with intradermal testing
occur within minutes.
DIF: Cognitive Level: Apply (application) REF: 200
TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity
This study source was downloaded by 100000849838140 from CourseHero.com on 09-01-2022 12:47:09 GMT -05:00
https://www.coursehero.com/file/27821307/chapter-13-altered-immune-responses-and-transplantationdocx/
