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Chapter 6: Introduction to the Immune System and the Inflammatory Response

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Chapter 6: Introduction to the Immune System and the Inflammatory Response

10 problems · 0 figures

6-1 §6.RQ source ↗

A client is diagnosed with a viral infection. The health care provider prescribes antivirals to treat the infection. The nurse explains to the client that antivirals work by targeting the viral cells directly. Which type of immunity is primarily responsible for recognizing and attacking viral cells in this scenario?
  1. a.
    Innate immunity
  2. b.
    Passive immunity
  3. c.
    Antibody-mediated immunity
  4. d.
    Cell-mediated immunity

Answer

D. Cell-mediated immunity
Cell-mediated immunity is primarily responsible for recognizing and attacking infected cells, including viral cells.

6-2 §6.RQ source ↗

A client with rheumatoid arthritis (RA) is prescribed hydroxychloroquine as part of the treatment plan. The nurse is educating the client about the medication and its specific benefits for RA management. Which statement by the nurse best explains the application of hydroxychloroquine in treating RA?
  1. a.
    “Hydroxychloroquine works by directly suppressing the immune system, preventing it from attacking your joints and reducing RA symptoms.”
  2. b.
    “Hydroxychloroquine acts as a pain reliever and anti-inflammatory medication, helping to alleviate joint pain and swelling associated with RA.”
  3. c.
    “Hydroxychloroquine modifies the disease progression of RA by slowing down joint damage and preserving joint function over time.”
  4. d.
    “Hydroxychloroquine enhances the production of specific antibodies that target the inflammation in your joints, leading to improved RA outcomes.”

Answer

C. “Hydroxychloroquine modifies the disease progression of RA by slowing down joint damage and preserving joint function over time.”
When treating RA, hydroxychloroquine is used to modify the disease progression by reducing joint inflammation and preventing joint damage.

6-3 §6.RQ source ↗

A client with rheumatoid arthritis is prescribed a biologic drug to manage the inflammatory condition. Before administering the biologic drug, which of the following is a priority for the nurse to assess to ensure the client’s health and safety?
  1. a.
    Evaluate the client’s tuberculosis (TB) status
  2. b.
    Measure the client’s blood glucose level
  3. c.
    Check the client’s vision and eye health
  4. d.
    Assess the client’s vital signs

Answer

A. Evaluate the client’s tuberculosis (TB) status
Biologic drugs, particularly tumor necrosis factor-alpha (TNF-alpha) inhibitors, can increase the risk of reactivating latent tuberculosis.

6-4 §6.RQ source ↗

A client presents to the emergency department with a swollen, painful, and warm right ankle after a recent fall. The nurse observes redness and limited movement in the affected joint. The client’s vital signs are stable. Based on the assessment findings, which conclusion should the nurse draw regarding the client's condition?
  1. a.
    The client is experiencing a localized allergic reaction, leading to inflammation and limited joint movement.
  2. b.
    The wound site shows signs of infection, indicated by the presence of redness, swelling, and warmth.
  3. c.
    The client is demonstrating the five cardinal signs of inflammation, suggesting the body's response to tissue injury.
  4. d.
    The wound may be due to poor blood circulation, causing localized redness and swelling.

Answer

C. The client is demonstrating the five cardinal signs of inflammation, suggesting the body's response to tissue injury.
The five cardinal signs of inflammation are redness (rubor), swelling (tumor), warmth (calor), pain (dolor), and loss of function (functio laesa).

6-5 §6.RQ source ↗

A client is prescribed ibuprofen 800 mg every 6 hours for pain relief. On hand, there are ibuprofen tablets labeled 200 mg each. How many tablets should the nurse administer to the client for each dose?
  1. a.
    2 tabs
  2. b.
    3 tabs
  3. c.
    4 tabs
  4. d.
    5 tabs

Answer

C. 4 tabs
800 m g ÷ 200 m g = 4 t a b l e t s

6-6 §6.RQ source ↗

A nursing student is studying about vaccines and immunizations. The student asks the instructor to clarify the difference between a vaccine and an immunization. How should the instructor respond?
  1. a.
    “A vaccine and an immunization are the same thing and can be used interchangeably to describe the process of protecting individuals from infectious diseases.”
  2. b.
    “A vaccine is a preventive measure taken to minimize the risk of developing an infection, while an immunization is the body's natural ability to fight off diseases.”
  3. c.
    “A vaccine is a weakened or killed form of a disease-causing microorganism, while an immunization is the actual infection caused by the vaccine.”
  4. d.
    “A vaccine is a medication containing weakened or killed pathogens or antigens, given to prevent future infections, while an immunization is the process of administering the vaccine.”

Answer

D. “A vaccine is a medication containing weakened or killed pathogens or antigens, given to prevent future infections, while an immunization is the process of administering the vaccine.”
A vaccine is a medication containing weakened or killed pathogens or antigens, given to prevent future infections, while an immunization is the process of administering a vaccine.

6-7 §6.RQ source ↗

A client with osteoarthritis is prescribed indomethacin, a nonsteroidal anti-inflammatory drug (NSAID). The client has also been taking aspirin over the counter to assist with the pain. The nurse should monitor the client for which potential adverse effect?
  1. a.
    Hyperglycemia
  2. b.
    Respiratory depression
  3. c.
    Gastrointestinal bleeding
  4. d.
    Hypotension

Answer

C. Gastrointestinal bleeding
NSAIDs can cause irritation and damage to the gastrointestinal lining, resulting in gastrointestinal bleeding.

6-8 §6.RQ source ↗

A client with gout is prescribed an antigout drug to manage gout attacks. The nurse should advise the client to limit the daily intake of which food while on this medication?
  1. a.
    Red meat
  2. b.
    Dairy products
  3. c.
    Fresh strawberries
  4. d.
    Green, leafy vegetables

Answer

A. Red meat
Red meat is high in purines, which can increase uric acid levels and exacerbate gout symptoms.

6-9 §6.RQ source ↗

A client is planning to travel to a country with a high risk of hepatitis A infection. The health care provider recommends hepatitis A vaccination before the trip. The client asks the nurse about the difference between active and passive immunity. How should the nurse respond?
  1. a.
    “Active immunity is a temporary form of protection acquired from the transfer of maternal antibodies during pregnancy. Passive immunity is achieved through vaccination, where your immune system responds to the vaccine and produces antibodies.”
  2. b.
    “Active immunity involves receiving pre-formed antibodies from an external source, like the hepatitis A vaccine. Passive immunity occurs when your immune system actively produces antibodies upon exposure to the live virus during an infection.”
  3. c.
    “Active immunity is achieved through receiving pre-formed antibodies from an external source, such as the hepatitis A vaccine. Passive immunity occurs when antibodies are passed from the birthing parent to the fetus/infant during pregnancy or when breastfeeding.”
  4. d.
    “Active immunity is conferred through the transfer of pre-formed antibodies from one person to another, such as receiving immune globulin for hepatitis A. Passive immunity is achieved through vaccination, which stimulates your immune system to produce antibodies.”

Answer

C. “Active immunity is achieved through receiving pre-formed antibodies from an external source, such as the hepatitis A vaccine. Passive immunity occurs when antibodies are passed from the birthing parent to the fetus/infant during pregnancy or when breastfeeding.”
In active immunity, the body's immune system actively responds to the presence of an antigen, such as a vaccine, and produces its own antibodies. The client receives long-lasting protection from future infections due to the development of memory cells. On the other hand, passive immunity involves the transfer of pre-formed antibodies from an external source, such as immune globulin or maternal antibodies, providing immediate but temporary protection.

6-10 §6.RQ source ↗

A client with rheumatoid arthritis is prescribed adalimumab at a dose of 40 mg every other week. The vials of adalimumab available are labeled as 40 mg per 0.8 mL. How many milliliters should the nurse administer to the client for each dose?
  1. a.
    0.2 mL
  2. b.
    0.4 mL
  3. c.
    0.6 mL
  4. d.
    0.8 mL

Answer

D. 0.8 mL
Divide the prescribed dose (40 mg) by the concentration of the adalimumab solution (40 mg/0.8 mL); 40 m g ÷ 40 m g / 0.8 m L = 0.8 m L .

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Problems and answers are adapted from Pharmacology for Nurses by Tina Barbour-Taylor, Leah Mueller (Sabato), Donna Paris and Dorie Weaver, OpenStax, and are used under the CC BY-NC-SA 4.0 licence. Access for free at https://openstax.org/books/pharmacology/pages/1-introduction. Illustrations: Copyright Rice University, OpenStax, under CC BY-NC-SA 4.0 license. This adaptation is released under the same licence, is non-commercial, and is neither affiliated with nor endorsed by OpenStax or Rice University.