FSCJ NUR1023C
Volume III
Section 1: Cellular Regulation, Immunity, & Infection
1. A client with neutropenia is admitted to the oncology unit. Which nursing intervention is
the absolute highest priority to prevent infection?
A) Administering prophylactic intravenous antibiotics.
B) Strict adherence to meticulous hand hygiene by all staff and visitors.
C) Placing the client in a negative-pressure isolation room.
D) Encouraging the client to eat fresh, raw fruits and vegetables.
Elaboration: Hand hygiene is the single most effective way to prevent the transmission of
pathogens to an immunocompromised host. Neutropenic patients require a positive-pressure
room, and raw fruits/vegetables are strictly prohibited due to bacterial surface
contamination.
2. A client receives a vaccination for the influenza virus. This type of immunity is classified
as:
A) Natural active immunity.
B) Artificial active immunity.
C) Natural passive immunity.
D) Artificial passive immunity.
Elaboration: The body is artificially introduced to an antigen (the vaccine), prompting the
host's own immune system to actively produce antibodies.
3. The nurse assesses a client with a systemic inflammatory response. Which laboratory
finding is the most sensitive indicator of acute, active systemic inflammation?
A) A decreased platelet count.
B) An elevated C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR).
C) A decreased blood urea nitrogen (BUN).
D) An elevated serum albumin level.
Elaboration: CRP and ESR are non-specific acute-phase reactants produced by the liver in
response to inflammatory cytokines. They spike rapidly during acute systemic inflammation.
, 4. A client experiences an anaphylactic reaction to an intravenous antibiotic. The nurse
understands this is a Type I hypersensitivity reaction mediated primarily by which
immunoglobulin?
A) IgG.
B) IgM.
C) IgE.
D) IgA.
Elaboration: IgE antibodies bind to mast cells and basophils. Upon subsequent exposure to
the allergen, they trigger massive degranulation and the systemic release of histamine.
5. When assessing a client with a suspected localized surgical site infection, the nurse
expects to find:
A) A core body temperature of 103.5°F.
B) A sudden drop in blood pressure.
C) Erythema, edema, localized heat, and purulent drainage at the incision.
D) Generalized lethargy and severe muscle aches.
Elaboration: Localized signs of infection are confined to the specific tissue site. High fever,
hypotension, and generalized lethargy indicate a systemic infection or sepsis.
6. A client with HIV has a CD4+ T-cell count of 150 cells/mm³. The nurse recognizes that
the client has transitioned to AIDS and is at extreme risk for:
A) Autoimmune disorders like lupus.
B) Opportunistic infections and rare malignancies.
C) Severe allergic anaphylaxis.
D) Hyperactive graft rejection.
Elaboration: A CD4 count below 200 cells/mm³ indicates profound immunosuppression. The
body can no longer fight off harmless environmental pathogens, leading to opportunistic
infections like Pneumocystis pneumonia.
7. A nurse is exposed to a bloodborne pathogen via a needlestick injury. The
administration of Hepatitis B immune globulin (HBIG) provides which type of immunity?
A) Natural active immunity.
B) Artificial active immunity.
, C) Natural passive immunity.
D) Artificial passive immunity.
Elaboration: HBIG contains pre-formed antibodies. It provides immediate, artificial, and
temporary (passive) protection because the nurse's body did not create the antibodies itself.
8. A client is prescribed a broad-spectrum antibiotic. The nurse instructs the client to
complete the entire course of therapy primarily to prevent:
A) Gastrointestinal upset.
B) The development of multi-drug resistant organisms (MDROs).
C) Anaphylactic shock.
D) The development of a viral superinfection.
Elaboration: Stopping antibiotics early leaves the strongest, most resistant bacteria alive to
mutate and replicate, contributing directly to antibiotic resistance.
9. Which white blood cell is the "first responder" to an acute bacterial infection?
A) Lymphocyte.
B) Macrophage.
C) Neutrophil.
D) Eosinophil.
Elaboration: Neutrophils are the most abundant leukocytes and are the first to arrive at the
site of tissue injury or bacterial invasion to begin phagocytosis.
10. A client with rheumatoid arthritis is taking high-dose corticosteroids. The nurse must
monitor the client closely for which primary complication?
A) Masked signs of severe infection and delayed wound healing.
B) Profound hypoglycemia.
C) Severe dehydration and hyperkalemia.
D) An overactive immune response.
Elaboration: Corticosteroids are potent immunosuppressants and anti-inflammatories. They
blunt the classic signs of infection (fever, redness), allowing a severe infection to go
unnoticed while also elevating blood sugar and delaying tissue repair.
Section 2: Intracranial Regulation & Sensory Function