Chapter 13: Immunity, Inflammation, and Infection
Linton: Introduction to Medical–Surgical Nursing, 6th Edition
MULTIPLE CHOICE
1. A patient in early labor says to the nurse, “I will pass on protection from diseases, and the
baby will not ever need any shots.” What is the best response by the nurse?
a.
“Babies are born with innate (natural) immunity at birth.”
b.
“Babies are born with immunoglobulin E (IgE), an antibody that crosses the
placenta, but it only briefly protects the baby.”
c.
“Yes, immediate antibody immunity from the mother is the first line of defense
against disease for babies.”
d.
“Yes, the mother passes on cell–mediated immunity.”
2. A school nurse starts a clean-up campaign at a local elementary school in an effort to combat
allergens. What is the most common allergic response disorder?
a.
Anaphylaxis
b.
Asthma
c.
Contact dermatitis
d.
Urticaria
3. A nurse is discussing the body’s first and second lines of defense against infection with a
community group. What does the body’s first line of defense include?
a.
Teeth
b.
Sweat
c.
White blood cells
d.
T lymphocytes
4. A nurse explains that a medication given to a patient with a severe inflammatory response
mimics a hormone secreted by the adrenal cortex. To what hormone is the nurse referring?
a.
Aldosterone
b.
Testosterone
c.
Histamine
d.
Cortisol
5. With the exposure to an antigen, a nurse explains that the initiator of the inflammatory
response is the presence of histamine. What is responsible for releasing histamine?
a.
Neutrophils
b.
Eosinophils
c.
Basophils
d.
Monocytes
6. A nurse is bathing a patient who is immunodeficient and has a Cryptococcus infestation. What
is the classification of this organism?
a.
Bacterium
b.
Virus
c.
Fungus
d.
Protozoa
7. A mosquito or a fly carries an organism that infects another living organism. What is this
mode of transmission of infection?
a.
Common vehicle
b.
Direct excretion
c.
Ingestion
d.
Vector
8. What is the most effective method to control the spread of communicable disease?
a.
Isolate the infected person from all contact with noninfected persons.
b.
Vigorously petition the community health department to increase spraying.
c.
Administer prophylactic antibiotics to the rest of the family.
d.
Demonstrate and monitor a return demonstration of a good hand washing
technique by the family.
9. An air conditioner duct cleaning is recommended by a home health nurse. What should this
precaution prevent the spread of in the patient’s home?
a.
Bacteria
b.
Viruses
c.
Fungi
d.
Protozoa
10. A school nurse cautions a group of parents about children playing barefoot on dirt. To what
infectious agents can this action expose the children?
a.
Helminthes
b.
Protozoa
c.
Rickettsiae
d.
Mycoplasmas
11. A large, heavy, and older adult patient has a stroke and develops an infected decubitus ulcer
on the sacrum during the hospital stay. Approximately 2 weeks after the patient has gone
home, the patient returns to the hospital with pneumonia. What is the distinction between
these two infections?
a.
The decubitus ulcer infection was transmitted from other patients on the unit, but
the pneumonia was transmitted from a neighbor visiting when the patient was at
home.
b.
The decubitus ulcer and pneumonia are caused by the same host.
c.
The decubitus ulcer is termed a health care–associated infection, and pneumonia is
termed a community-acquired infection.
d.
The decubitus ulcer is considered to be caused by protozoa, but the pneumonia is
considered unpreventable because of the size of the patient.
12. On a visit to administer the fifth in a series of 10 antibiotic doses, a home health nurse is told
that the patient is now complaining about a bothersome vaginal discharge. The nurse
communicates the problem and arranges for medication. What is the most likely cause of the
vaginal discharge?
a.
Poor genital hygiene—not changing underwear often enough
b.
Allergy to the soap or soap products used in the genital area
c.
Superinfection response to the antibiotic medication
d.
Sexual contact with another infected person
13. Which patient diagnosis is most likely related to acquiring a health care–associated infection?
a.
Abdominal abscess after a ruptured appendix
b.
Lice and nits that have come from the emergency department
c.
Urinary infection after the insertion of a Foley catheter
d.
Two-day, postoperative foot fungus after a hip replacement
14. A community picnic is held. A number of the attendees become ill after the picnic. How was
the pathogen acquired?
a.
Indirect contact
b.
Common vehicle
c.
Airborne transmission
d.
Vector transmission
15. A nurse caring for a patient who is immunosuppressed is diligent about protecting the patient
from infection. When visitors come in, in addition to having them put on isolation attire, what
should the nurse also prohibit?
a.
Battery-operated DVD player
b.
Book
c.
Potted plant
d.
Box of candy
16. A nurse explains that although some drugs reduce inflammation, they also hinder the body’s
immune response. What are examples of such drugs?
a.
Antihistamines and salicylates
b.
Bronchodilators and corticosteroids
c.
Cardiotonic and anticholinergics
d.
Diuretics and sedatives
17. A patient has had several increasingly severe allergic reactions during last year’s pollen
season. This year, the patient comes regularly to the office to receive some antigen injections.
What education will the nurse provide regarding these injections?
a.
They will combat infection brought on by the allergic response.
b.
They will act as a steroid to lessen the allergic response.
c.
They will increase tolerance to the antigen.
d.
They will decrease the production of the antibodies.
18. A patient who is receiving daily steroids for the control of a condition calls the nurse to ask
advice about whether a small child who has been exposed to influenza should come and visit
because she has not had any symptoms. What is the most appropriate response by the office
nurse?
a.
“Yes, let the child visit. There is no reason not to visit because this child is not
sick.”
b.
“No, the child should not visit. Infectious diseases are often most communicable in
the short period before the child actually becomes ill.”
c.
“It would be up to the patient. Plan not to get overtired with a small child running
and bouncing around.”
d.
“Take the child who is not sick to her own physician and ask this question first.”
19. A patient with the diagnosis of Clostridium difficile infection asks what has caused the
diarrhea. What is the best response by the nurse?
a.
It is caused by a protozoal infection.
b.
It is caused by a fecal–oral contamination.
c.
It is caused by an inflammatory response.
d.
It is caused by a long-term antibiotic therapy.
20. A patient receiving a large intramuscular dose of antibiotic was asked to please wait 20 to 30
minutes before checking out. What is the reason for this request?
a.
The office staff needs to make sure that the right medicine was administered before
the patient leaves.
b.
The nurse always forgets to ask the patient about allergies before administering the
antibiotic.
c.
Antibiotics are a common source of severe allergic reactions within the first few
minutes after an injection.
d.
The staff wants to make sure that the patient has time to pay for the services
delivered that day.
21. After receiving an injection of penicillin, a patient undergoes an anaphylactic reaction. What
should the nurse do first?
a.
Administer oxygen.
b.
Prepare fluids to combat shock.
c.
Notify the charge nurse.
d.
Cover with several blankets.
22. The Centers for Disease Control and Prevention (CDC) has issued new guidelines for
infection control. Nursing care plans for patients with infection should mainly address which
protocol?
a.
Disease-specific precautions
b.
Manner in which clean gloves are worn
c.
Standard Precautions guidelines
d.
Placement of needles and sharps
23. Which vitamin can enhance wound healing?
a.
A
b.
B
c.
C
d.
D
24. A patient is hospitalized with cryptococcal pneumonia and AIDS. What is the most important
standard precaution for the health care team to implement?
a.
Hands are washed before and after gloving.
b.
After gloves are put on, they do not need to be changed until care is finished.
c.
Needles and sharps should be placed in puncture-resistant containers on the
medicine cart out of the room.
d.
Mouth-to-mouth resuscitation must be performed immediately unless the patient is
a designated as “do not resuscitate.”
25. The organs involved in immunity include the tonsils, spleen, and lymph nodes. What other
organ is involved in immunity?
a.
Liver
b.
Lungs
c.
Periosteum
d.
Pancreas
26. What is required by medical asepsis that is not required by surgical asepsis?
a.
Good hand washing technique
b.
That no nonsterile product comes into contact with the patient
c.
Elimination of all microorganisms
d.
Hand washing with antimicrobial soap for 3 minutes
27. The daughter of an 89-year-old resident in a long-term care facility asks if she may give her
father an over-the-counter (OTC) antihistamine that she uses for seasonal allergy. What is the
nurse’s most appropriate response?
a.
“Yes. OTCs are mild and very helpful.”
b.
“No. Many antihistamines cause confusion in the older adult.”
c.
“Yes. The drug might energize him so he won’t be so drowsy.”
d.
“No. Allergic symptoms should be allowed to run their course.”
MULTIPLE RESPONSE
28. What occurrences of disease is the school nurse required to report to the health department?
(Select all that apply.)
a.
Rubella
b.
Lyme disease
c.
Pediculosis
d.
Salmonella
e.
Clostridium difficile
COMPLETION
29. A nurse assesses a high eosinophil count in a pediatric patient. The nurse recognizes that this
elevation is an indicator of _____.
30. Persons with human immunodeficiency virus (HIV) have acquired Pneumocystis jiroveci
(PCP), a serious pulmonary infection caused by _____.
31. A nurse reminds the patient who is to undergo hyperbaric oxygen therapy that the clothing
worn into the chamber must be made of _____.
OTHER
32. Prioritize the events of an antibody-mediated immunity response. (Separate the letters with a
comma and space: A, B, C, D.)
A. Antibodies seek out and bind with specific antigen.
B. Antigen binds to a B lymphocyte.
C. Circulating antibody–antigen complexes are destroyed.
D. Antibodies are produced.
E. Antibodies are replenished.