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Dorman 0031 4/5/2013

68-year-old male presents to the emergency department with complaints of a 2-day history of difficulty breathing, cough, and chest pain. Upon triage assessment, the patient is found to have a fever and decreased oxygen saturation. A chest X ray reveals that the patient has pneumonia. Oxygen therapy is initiated, and he is admitted for observation and treatment. As the RN, you document your assessment of the patient in the chart prior to transfer to an inpatient unit. What is the most appropriate term for the subjective manifestations of disease as reported by the patient?
a. signs
b. symptoms
c. syndromes
d. signs and symptoms

b. symptoms

What is the most appropriate term for the objective manifestations of disease?
a. signs
b. symptoms
c. syndromes
d. signs & symptoms

a. signs

You are informed that the patient's sputum culture was positive for Streptococcus pneumoniae. Which of the following is the most appropriate type of isolation for this patient, considering the portal of exit for the pathogen in this case?
a. standard isolation (gloves)
b. contact isolation (gown and gloves)
c. droplet isolation (gown, gloves and mask)
d. airborne isolation (gown, gloves, mask and negative airflow room)

c. droplet isolation (gown, gloves, and mask)

The effect of "good" microbes against invading microbes is called
a. microbial antagonism
b. microbial synergism
c. endogenous infection
d. communicable disease

a. microbial antagonism

Each of the following are inoculation of normal biota to a newborn except
a. the birth process through the birth canal
b. breast feeding
c. contact with hospital staff
d. all of the above

d. all of the above

Pathogenic microbes that cause disease in healthy people are called
a. opportunistic pathogens
b. normal biota
c. indigenous biota
d. true pathogens

d. true pathogens

The primary, natural habitat of a pathogen where it continues to exist is called the
a. carrier
b. vector
c. reservoir
d. source

c. resevoir

Animals that participate in the life cycles of pathogens and transmit pathogens from host to host are
a. aerosols
b. mechanical vectors
c. droplet nuclei
d. biological vectors

d. biological vectors

Which of the following is not an anti-phagocytic factor?
a. production of leukocidins
b. adhering to the host
c. secretion of a capsule
d. ability to survive intracellularly

b. adhering to the host

Enterotoxins are
a. virulence factors
b. toxins that target the gut
c. proteins
d. endotoxins

b. toxins that target the gut

The suffix -emia means
a. blood
b. disease
c. inflammation
d. tumor

a. blood

All infectious diseases
a. are contagious
b. occur only in humans
c. are caused by microorganisms or their products
d. involve viruses as pathogens

c. are caused by microorganisms or their products

The principal government agency responsible for tracking infectious diseases in the United States is
a. Centers for Disease Control and Prevention
b. World Health Organization
c. National Institutes of Health
d. Pan American Health Organization

a. Centers for Disease Control and Prevention

The number of new cases of a disease in a population over a specific period of time compared with the healthy population is a/an
a. mortality rate
b. morbidity rate
c. incidence rate
d. prevalence rate

c. incidence rate

Koch's postulates are easily satisfied for viral diseases.
a. true
b. false

b. false

Joe is a 16-year-old male with cystic fibrosis. He has been admitted several times to your pulmonary inpatient unit with multiple microbial infections. Because of the thickness of his mucous secretions, his cilia become immobile and unable to clear his lungs of bacteria harboring mucous. He is supposed to perform daily vigorous airway mucous clearance at home with a vibrating vest and IPV (Intrapulmonary Percussive Ventilation) device. However, he says that it takes hours and he does not always feel sick. So, he often skips these therapy sessions. If JV's cilia are unable to clear his lungs of mucous, what line of defense is being breached?
a. first
b. second
c. third
d. first and second

a. first

JV asks you, as his bedside nurse, to explain to him why he keeps getting sick from the same bacteria. What is an appropriate response?
a. "Your lungs produce these organisms because your cilia are permanently damaged"
b. "The mucous in your lungs traps and harbors microorganisms, and when it can't be cleared, the microbes begin to breach your natural lines of defense"
c. "Your disease stunts your immunity, so you can't actually fight those bacteria"
d. "Your entire immune system is compromised"

b. "The mucous in your lungs traps and harbors

JV is very intelligent and realizes that he needs to be more diligent with his mucous clearing exercises. He asks you if it is okay if he only does his exercises only when he is not feeling well. What would be the correct response?
a. "It's okay to not do them if you're not feeling sick. Your body will protect itself"
b. "Your body doesn't have the ability to protect itself as well as it could if you didn't have cystic fibrosis. You must do your exercises regularly"
c. "As long as you do them twice as often when you start to feel sick, you'll make up the difference."
d. "Do them every other day and you should be fine."

b. "Your body doesn't have the ability to protect itself as well as it could if you didn't have cystic fibrosis. You must do your exercises regularly"

Keratin is an important aspect of non-specific defense because it
a. is toxic to pathogens
b. creates a physical barrier against pathogens
c. destroys pathogens
d. physically restricts pathogens to a specific region of the body

b. creates a physical barrier against pathogens

The most numerous WBCs that have multi-lobed nuclei and are very phagocytic are
a. eosinophils
b. neutrophils
c. monocytes
d. lymphocytes

b. neutrophils

Which body fluid is not involved primarily with immune function
a. blood
b. lymph
c. cerebral spinal fluid
d. extracellular fluid

c. cerebral spinal fluid

A type of monocyte that has long, thin processes to trap pathogens are
a. dendritic cells
b. eosinophils
c. macrophages
d. platelets

a. dendritic cells

Which gland shrinks in size during adulthood and has hormones that function in maturation of T lymphocytes?
a. lymph nodes
b. thymus
c. spleen
d. bone marrow

c. thymus

Which of the following is mismatched dealing with inflammation?
a. rubor - redness
b. calor - warmth
c. tumor - cancer
d. dolar - pain

c. tumor- cancer

The circulating substances that affect the hypothalamus and initiate fever are
a. complement
b. interferon
c. leukotrines
d. pyrogens

d. pyrogens

Each of the following are benefits of fever except it
a. reduces the ability of temperature-sensitive organisms to multiply
b. decreases the availability of iron
c. increases metabolism
d. stimulates hematopoiesis

d. stimulates hematopoiesis

What type of molecules act to draw phagocytes to foreign substances?
a. GALT
b. PRR
c. PAMPs
d. lysosomes

c. PAMPs

Which of the following is incorrect about complement?
a. composed of at least 20 blood proteins
b. is part of the innate but not adaptive immune respose
c. act in a cascade reaction
d. involves a classical pathway

b. is part of the innate but not adaptive immune response

What is the first step in the major events of the inflammation process?
a. formation of pus and edema
b. vascular reactions
c. injury and mast cells releasing chemical mediators
d. activation of the complement system

c. injury and mast cells releasing chemical mediators

Plasma is also called lymph.
a. true
b. false

b. false

Helper T cells
a. function in allergic reactions
b. directly destroy target cells
c. suppress immune reactions
d. activate B cells and other T cells

d. activate B cells and other T cells

The major histocompatability complex is
a. glycoproteins, called MHC antigens, found on all body cells
b. a set of genes that code for MHC glycoproteins
c. located in the bone marrow
d. located in the thymus gland

b. a set of genes that code for MHC glyoproteins

Class I MHC genes code for
a. certain secreted complement components
b. self-receptors recognized by T lymphocytes
c. all HLA antigens
d. receptors located primarily on macrophages and B cells

b. self-receptors recognized by T lymphocytes

The region of each antibody molecule where the amino acid composition is very different from one clone of B lymphocytes to another is the
a. variable region
b. joining region
c. constant region
d. light region

a. variable region

The Smith family brought their 2-week-old son into your family practice office for a checkup. They have already expressed multiple concerns to you concerning sleep, feeding, and crying, but their concerns have been about things that are typical for a newborn. You try your best to calm their fears, and they are receptive for the most part. However, when it comes time to discuss vaccination with them, they refuse to vaccinate their son because they have heard vaccines that can cause autism in children. Which of the following statements is not true concerning vaccines?
a. they consist of killed or inactivated cells
b. they consist of live but weakened microbes
c. it is possible to be allergic to vaccine preparations
d. autism only happens in rare instances because of vaccination

d. autism only happens in rare instances because of vaccination

What kind of immunity will be conferred to the Smith's son through vaccination?
a. active natural
b. passive natural
c. active artificial
d. passive artificial

c. active artificial

The morning after the Smith's son is vaccinated, Mrs. Smith calls you at the office to report that their son has now developed a low-grade fever. She is afraid that he is developing meningitis from one of the vaccines, because he is also fussy. What is a proper response?
a. "I understand you are frightened. However, site pain and low fever are common side effects. You can help minimize both with Tylenol."
b. "I'm very sorry I didn't listen to your concerns earlier. Bring your son to the closest ER for evaluation immediately."
c. "You sound upset. How can you be sure he has a fever?"
d. "This fever and fussiness are probably from an unrelated illness, and it's just a coincidence he just received vaccinations."

a. "I understand you are frightened. However, site pain and low fever are common side effects. You can help minimize both with Tylenol."

The molecular fragment on an antigen molecule that a lymphocyte recognizes and responds to is called a/an
a. epitope
b. hapten
c. superantigen
d. variable region

a. epitope

Properties of effective antigens include all the following except
a. are foreign to the immune system
b. have molecular complexity
c. are large molecules with multiple epitopes
d. have large polymers made up of repeating subunits

d. have large polymers made up of repeating subunits

Small foreign molecules that are too small by themselves to elicit an immune response are termed
a. epitope
b. hapten
c. antigen binding site
d. variable region

b. hapten

Which of the following is not a property of B cells?
a. produce plasma cells and memory cells
b. low numbers circulate in the blood
c. require antigen presented with MHC proteins
d. receptors are called immunoglobins

c. require antigen presented with MHC proteins

Each _____ fragment of an antibody molecule contains the variable regions of a heavy and light chain that folds into a groove for one epitope.
a. variable
b. Fab
c. Fc
d. terminal

b. Fab

The beauty of specific immunity is the production of ____ that provide long-lasting protection.
a. antibodies
b. plasma cells
c. T helper cells
d. memory cells

d. memory cells

An example of natural passive immunity would be
a. chickenpox infection followed by lifelong immunity
b. chickenpox vaccine triggers extended immunity to chickenpox
c. giving a person immune serum globulins to chickenpox virus after exposure to the disease
d. a fetus acquiring maternal IgG to the chickenpox virus across the placenta

d. a fetus acquiring maternal IgG to the chickenpox virus across the placenta

During which response to the antigen do we display a latent period of no secretory antibody synthesis?
a. primary
b. secondary
c. tertiary
d. memory response

a. primary

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