chapter 33 - Chapter 33 Immunologic Disorders MULTIPLE...

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Chapter 33: Immunologic Disorders MULTIPLE CHOICE 1. The nurse explains that the inflammatory response is initiated by immunoglobulin (IgE) and the: 1. macrophages and eosinophils. 2. macrophage and histamine. 3. monocytes and basophils. 4. neutrophils and IgE. ANS: 2 Basophils initiate a massive inflammatory response with histamine that quickly brings other WBCs to the site of an infection. PTS: 1 DIF: Cognitive Level: Knowledge REF: 593 OBJ: 1 TOP: Components of the Immune System KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance 2. The nurse uses a picture to show the histamine releasing mast cells that are: 1. circulating in the blood. 2. circulating in the lymph. 3. attached to organ tissue. 4. embedded in the bone marrow. ANS: 1 Mast cells are located in organ tissue when they release their histamine. The organ to which they are attached is the host of the inflammatory response. If the organ is the lung, the re- sponse may be asthma; if the organ is the colon, the response may be diarrhea. PTS: 1 DIF: Cognitive Level: Knowledge REF: 593 OBJ: 1 TOP: Mast Cells KEY: Nursing Process Step: Assessment MSC: NCLEX: Health Promotion and Maintenance 3. The nurse differentiates that passive acquired immunity means that the antibodies were: 1. acquired from outside the host and instilled in the host. 2. manufactured in response to a disease in the host. 3. innately acquired because of being born a human being. 4. cell-mediated inside the host. ANS: 1 Gamma globulin injections provide passive acquired immunity. The antibodies that are in- jected have been produced by another host, collected, fused in the mixture, and injected into a separate host. This gives the host a passive acquired immunity that only lasts for 2 to 3 months. PTS: 1 DIF: Cognitive Level: Analysis REF: 594 OBJ: 1 TOP: Functions of the Immune System
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KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance 4. The nurse is alarmed by a complete blood count that shows a large “shift to the left.” The nurse assesses this to mean that the cell level count of: 1. neutrophils has dropped by 10%. 2. basophils has increased by 25%. 3. neutrophils has increased by 60%. 4. neutrophils has increased by 60%. ANS: 4 A “shift to the left” indicates a sharp rise in the neutrophils (white blood cells) to around 60%. The outpouring of these cells from the marrow indicates a very serious and perhaps overpowering infection. Many of the cells are young and will not be able to keep up their work of immunity for as long as more mature cells would maintain immunity. PTS: 1 DIF: Cognitive Level: Comprehension REF: 597 OBJ: 4 TOP: Nursing Diagnosis KEY: Nursing Process Step: Nursing Diagnosis MSC: NCLEX: Physiological Integrity 5. The symptom that the nurse would recognize as being pertinent to a possible diagnosis of systemic lupus erythematosus (SLE) is: 1. “butterfly” rash of the face.
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