ExamView - Chapter - 08

Chapter 08: Infection and Defects in Mechanisms of Defence
Power-Kean et al: Huether and McCance’s Understanding Pathophysiology, Second Canadian Edition
MULTIPLE CHOICE
1. When a patient asks the nurse what hypersensitivity is, how should the nurse respond?
a. Hypersensitivity is a reduced immune response found in most pathological states.
b. Hypersensitivity is a normal immune response to an infectious agent.
c. Hypersensitivity is an altered response of the immune system to a sensitizing
antigen.
d. Hypersensitivity is antigenic desensitization.
ANS: C
Hypersensitivity is an altered immunological response to an antigen that results in disease or damage to the individual. It is not a
reduced immune response or a response to an infectious agent. Antigenic desensitization is performed to decrease hypersensitivity.
DIF: Cognitive Level: Understand

REF: Hypersensitivity: Allergy, Autoimmunity, and Alloimmunity
TOP: Physiological Integrity
2. When the maternal immune system becomes sensitized against antigens expressed by the fetus, what type of immune reaction
occurs?
a. Autoimmune
b. Anaphylaxis
c. Alloimmune
d. Allergic
ANS: C
Alloimmunity can be observed during immunological reactions against transfusions, transplanted tissue, or the fetus during
pregnancy. Autoimmunity is a disturbance in the immunological tolerance of self-antigens. The most rapid and severe immediate
hypersensitivity reaction is anaphylaxis. An allergic response occurs related to exposure to an allergen.

REF: Hypersensitivity: Allergy, Autoimmunity, and Alloimmunity
3. A patient presents with poison ivy on the extremities, face, and buttocks after an initial exposure 2 days ago. What is this condition
an example of?
a. Anaphylaxis
b. Serum sickness
c. Delayed hypersensitivity
d. Viral disease
ANS: C
The response to poison ivy is a delayed hypersensitivity because it takes 1 to 2 days to develop. Anaphylaxis is immediate. Serum
sickness-type reactions are caused by the formation of immune complexes in the blood and their subsequent generalized deposition
in target tissues. Poison ivy is not a viral disease.
DIF: Cognitive Level: Understand REF: Mechanisms of Hypersensitivity | Figure 8.16

4. A 10-year-old child is stung by a bee while playing in the yard. Within minutes the child begins itching and develops wheezing and
breathing difficulties. What is the child suffering from?
a. Immunodeficiency
b. Autoimmunity
c. Anaphylaxis
d. Tissue-specific hypersensitivity
ANS: C
Anaphylaxis occurs within minutes of re-exposure to the antigen and can be either systemic (generalized) or cutaneous (localized).
Immunodeficiency is a decrease in the immune response. Autoimmunity is a disturbance in the immunological tolerance of
self-antigens. Tissue-specific reaction is an autoimmune reaction.
DIF: Cognitive Level: Understand REF: Mechanisms of Hypersensitivity

5. When a patient presents at the emergency department for an allergic reaction, the nurse recognizes that the most severe
consequence of a type I hypersensitivity reaction is:
a. urticaria.
b. hives.
c. anaphylaxis.
d. antibody-dependent cell-mediated cytotoxicity (ADCC).
ANS: C
The most rapid and severe immediate hypersensitivity type I reaction is anaphylaxis. Urticaria, or hives, is a dermal (skin)
manifestation of allergic reactions. Hives and urticaria are similar responses. ADCC is a mechanism that involves natural killer
(NK) cells. Antibodies on the target cell are recognized by Fc receptors on the NK cells, which release toxic substances that destroy
the target cell.
DIF: Cognitive Level: Understand REF: Mechanisms of Hypersensitivity | Figure 8.16

Copyright © 2023, Elsevier Inc. All rights reserved. 1

6. Which hypersensitivity reaction does not involve an antibody?
a. I
b. II
c. III
d. IV
ANS: D
Type IV reactions are mediated by T lymphocytes and do not involve antibodies. All the remaining options are associated with
antibody responses.

REF: Type 1V: Cell-Mediated Hypersensitivity Reactions TOP: Physiological Integrity
7. A 30-year-old patient is having difficulty breathing and has been spitting blood. The patient reports that they began experiencing
this reaction after cleaning their pigeons’ cages. Testing reveals the patient is suffering from allergic alveolitis. Which of the
following is the patient experiencing?
a. Serum sickness
b. Raynaud phenomenon
c. Antibody-dependent cytotoxicity
d. Arthus reaction
ANS: D
The Arthus reaction is a model of localized or cutaneous reactions. Serum sickness-type reactions are caused by the formation of
immune complexes in the blood and their subsequent generalized deposition in target tissues. Typically affected tissues are the
blood vessels, joints, and kidneys. Raynaud phenomenon is a condition caused by the temperature-dependent deposition of immune
complexes in the capillary beds of the peripheral circulation. Antibody-dependent cytotoxicity is a type II form.
DIF: Cognitive Level: Analyze

REF: Type III: Immune Complex-Mediated Hypersensitivity Reactions
8. A nurse recalls that an example of an immune-complex-mediated disease is:

a. bronchial asthma.
b. contact dermatitis.
c. serum sickness.
d. rheumatoid arthritis.
ANS: C
Immune-complex disease can be a systemic reaction, such as serum sickness, and related to type III reactions. Bronchial asthma is
not an immune-complex-mediated disease and is related to type I reactions. Neither contact dermatitis nor rheumatoid arthritis is
related to type III reactions.

9. When a nurse cares for a patient with systemic lupus erythematosus (SLE), the nurse remembers that this disease is an example of:
a. autoimmunity.
b. alloimmunity.
c. homoimmunity.
d. alleimmunity.
ANS: A
SLE is the most common, complex, and serious of the autoimmune disorders. SLE is not identified as alloimmune, homoimmune,
or alleimmune.
DIF: Cognitive Level: Analyze REF: Autoimmunity

10. A 30-year-old patient with female genitalia complains of fatigue, arthritis, rash, and changes in urine colour. Laboratory testing
reveals anemia, lymphopenia, and kidney inflammation. Assuming a diagnosis of SLE, which of the following is also likely to be
present?
a. Anti-LE antibodies
b. Autoantibodies
c. Antiherpes antibodies
d. Anti-CMV antibodies
ANS: B
The presence of autoantibodies is a diagnostic criterion for SLE. Diagnostic criterion for SLE would include positive LE. Neither
antiherpes nor anti-CMV antibodies are associated with a diagnosis SLE.


11. A 40-year-old patient with female genitalia is diagnosed with SLE. Which of the following findings would be considered a
symptom of this disease?
a. Gastrointestinal ulcers
b. Decreased glomerular filtration rate
c. Rash on trunk and extremities
d. Photosensitivity
ANS: D
Photosensitivity is one of the 11 common clinical findings in SLE. Gastrointestinal ulcers are not a finding in SLE. Proteinuria is a
symptom of SLE. A rash on the face is a symptom, but not a rash on the body.

12. What is the chance that two siblings share both HLA haplotypes, making them a good match for an organ transplant from one to the
other?
a. 100%
b. 75%
c. 50%
d. 25%
ANS: D
Odds dictate that children will share one haplotype with half their siblings and either no haplotypes or both haplotypes with a
quarter of their siblings. Thus, the chance of finding a match among siblings is much higher (25%) than the general population.
DIF: Cognitive Level: Understand REF: Alloimmunity

13. When a nurse notices that a patient has type O blood, the nurse realizes that anti-_____ antibodies are present in the patient’s body.
a. A only
b. B only
c. A and B
d. O
ANS: C
Type O individuals have both anti-A and anti-B antibodies but not O.
DIF: Cognitive Level: Understand REF: Alloimmunity | Figure 8.18

14. In addition to matching ABO antigens, what else does a blood transfusion need to be matched for?
a. HLA type
b. Rh antigen
c. Immunoglobulins
d. Platelet compatibility
ANS: B
Blood transfusions must also be matched for the Rh antigen. Blood transfusions do not need to be matched to HLA,
immunoglobulins, or platelet compatibility.

15. A 15-year-old patient suffers from severe hemorrhage following a motor vehicle accident. The patient is given a blood transfusion,
but shortly afterward the red blood cells are destroyed by agglutination and lysis. Which of the following blood type transfusion
type matches would cause this?
a. A-A
b. B-O
c. AB-O
d. A-AB
ANS: D
A person with type A blood also has circulating antibodies to the B carbohydrate antigen. If this person receives blood from a type
AB or B individual, a severe transfusion reaction occurs, and the transfused erythrocytes are destroyed by agglutination or
complement-mediated lysis. Type A can receive type A blood. Type B and type AB can receive type O.

16. A person is given an attenuated antigen as a vaccine. When the person asks what was given in the vaccine, how should the nurse
respond?
a. The antigen in the vaccine is alive, but less infectious.
b. The vaccine contains antigen that is mutated.
c. The antigen in the vaccine is normal, but not infectious.
d. The vaccine contains antigen that is dead and inactive.
ANS: A
Attenuated vaccines are alive, but less infectious. Attenuated vaccines are not mutated or highly infectious. The antigen is not dead
and inactive.
DIF: Cognitive Level: Understand REF: Active Immunization


17. An immunologist is discussing endotoxin production. Which information should the immunologist include?
a. Endotoxins are produced by Gram-negative bacteria.
b. Endotoxins are produced by Gram-positive bacteria.
c. Endotoxins are produced by Gram-negative fungi.
d. Endotoxins are produced by Gram-positive fungi.
ANS: A
Endotoxins are produced by Gram-negative bacteria. They are not produced by Gram-positive bacteria or any type of fungi.
DIF: Cognitive Level: Understand REF: Table 8.2 | Bacterial Disease

18. A 5-year-old child becomes ill with a severe cough. Histological examination reveals a bacterial infection, and further laboratory
testing reveals cell membrane damage and decreased protein synthesis. Which of the following is the most likely cause of this
illness?
a. Endotoxin
b. Exotoxin
c. Hemolysis
d. Septicemia
ANS: B
Exotoxins are enzymes that can damage the plasma membranes of host cells or can inactivate enzymes critical to protein synthesis,
and endotoxins activate the inflammatory response and produce fever. Endotoxins released by blood-borne bacteria cause the
release of vasoactive enzymes that increase the permeability of blood vessels. Hemolysis is the breakdown of red cells. Septicemia
is the growth of bacteria in the blood.
DIF: Cognitive Level: Understand REF: Bacterial Disease

19. A 50-year-old patient experiences decreased blood pressure, decreased oxygen delivery, cardiovascular shock, and subsequent
death. A complication of endotoxic shock is suspected. Which of the following is the most likely cause?
a. Gram-positive bacteria
b. Fungi
c. Gram-negative bacteria
d. Virus
ANS: C
Symptoms of Gram-negative septic shock are produced by endotoxins. Once in the blood, endotoxins cause the release of
vasoactive peptides and cytokines that affect blood vessels, producing vasodilation, which reduces blood pressure; causes
decreased oxygen delivery; and produces subsequent cardiovascular shock. Gram-positive bacteria nor fungi do not produce
endotoxins and thus do not manifest in shock. Viruses do not produce symptoms of shock.
DIF: Cognitive Level: Understand REF: Bacterial Disease

20. After studying about viruses, which information indicates the student has a good understanding of viruses?
a. Viruses contain no DNA or RNA.
b. Viruses are capable of independent reproduction.
c. Viruses replicate their genetic material inside host cells.
d. Viruses are easily killed by antimicrobials.
ANS: C
Virus replication depends totally on the ability of the virus to infect a permissive host cell, a cell that cannot resist viral invasion
and replication. Viruses contain both DNA and RNA, are incapable of independent reproduction, and cannot be killed by
antimicrobials.
DIF: Cognitive Level: Understand REF: Viral Disease

21. After studying about fungi, which information indicates a correct understanding of fungi? Fungi causing deep or systemic
infections:
a. are easily treated with penicillin.
b. are extremely rare.
c. never occur with other infections.
d. are commonly opportunistic.
ANS: D
Diseases caused by fungi are called mycoses. Mycoses are common and can be opportunistic and occur with other infections but
are not treatable with penicillin.
DIF: Cognitive Level: Understand REF: Fungal Disease


22. What is true about viral vaccines?
a. They contain active viruses.
b. They are attenuated viruses.
c. They contain killed viruses.
d. They are a blend of viral toxins.
ANS: B
Viral vaccines contain live viruses that are weakened (attenuated). Viral vaccines do not contain active viruses, killed viruses, or
toxins.

REF: Passive Immunotherapy | Initial Clinical Presentation TOP: Physiological Integrity
23. What is true about bacterial vaccines?

a. They contain fully active bacteria.
b. They are made from synthetic bacteria.
c. They contain dead bacteria.
d. They are a blend of bacterial toxins.
ANS: C
Bacterial vaccines are biological preparations of dead pathogens or extracts of bacterial antigens. When administered, they
stimulate production of antibodies or cellular immunity against the pathogen without causing disease. Vaccines are not fully active
bacteria, nor are they synthetic or toxins.
DIF: Cognitive Level: Understand REF: Active Immunization

24. A nurse recalls that bacteria become resistant to antimicrobials by:

a. proliferation.
b. attenuation.
c. specialization.
d. mutation.
ANS: D
Antibiotic resistance is usually a result of genetic mutations that can be transmitted directly to neighbouring microorganisms by
plasmid exchange. Antibiotic resistance is not a result of proliferation, attenuation, or specialization.
DIF: Cognitive Level: Understand REF: Antimicrobials

25. What common symptom should be assessed in individuals with immunodeficiency?

a. Anemia
b. Recurrent infections
c. Hypersensitivity
d. Autoantibody production
ANS: B
The clinical hallmark of immunodeficiency is a propensity to unusual or recurrent severe infections. The type of infection usually
reflects the immune system defect. Neither anemia, autoantibody production, nor hypersensitivity is a manifestation of
immunodeficiency.
DIF: Cognitive Level: Understand REF: Deficiencies in Immunity

26. A 5-year-old child with male genitalia presents with low-set ears, a fish-shaped mouth, and involuntary rapid muscular contraction.
Laboratory testing reveals decreased calcium levels. Which of the following diagnosis is most likely?
a. B-lymphocyte deficiency
b. T-lymphocyte deficiency
c. Combined immunological deficiency
d. Complement deficiency
ANS: B
DiGeorge syndrome results in greatly decreased T-cell numbers and function and is evidenced by abnormal development of facial
features that are controlled by the same embryonic pouches; these include low-set ears, fish-shaped mouth, and other altered
features. B-lymphocyte deficiency is not manifested by these symptoms. Neither combined immunological deficiency nor
complement deficiency is manifested by these symptoms.
DIF: Cognitive Level: Analyze REF: DiGeorge Syndrome

27. A 22-year-old was recently diagnosed with acquired immune deficiency syndrome (AIDS). Which cell type would you expect to be
decreased in a laboratory finding?
a. CD4+ T-helper cells
b. CD8 T-helper cells
c. CDC cells
d. CDC10 cells
ANS: A
The major immunological finding in AIDS is the striking decrease in the number of CD4+ T cells. The change occurs in CD4 cells,
not CD8. Neither CDC nor CDC 10 is a type of cell.
DIF: Cognitive Level: Understand REF: AIDS TOP: Physiological Integrity

28. Which of the following is a characteristic of the human immunodeficiency virus (HIV), which causes AIDS?
a. HIV only infects B cells.
b. HIV is a retrovirus.
c. Infection does not require a host cell receptor.
d. After infection, cell death is immediate.
ANS: B
AIDS is an acquired dysfunction of the immune system caused by a retrovirus (HIV) that infects and destroys CD4+ lymphocytes
(T-helper cells). HIV infection begins when a virion binds to CD4, not a B cell. Infection requires a host cell receptor. The cell
remains dormant but does not die.
DIF: Cognitive Level: Understand REF: Pathogenesis of AIDS

29. A 30-year-old patient was diagnosed with HIV. Which of the following treatments would be most effective?
a. Reverse transcriptase inhibitors
b. Protease inhibitors
c. Entrance inhibitors
d. Highly active antiretroviral therapy (HAART)
ANS: D
The current regimen for the treatment of HIV infection is a combination of medications, termed highly active antiretroviral therapy
(HAART). The remaining options are individual components of the HAART treatment format.
DIF: Cognitive Level: Understand REF: Treatment and Prevention of HIV and AIDS
30. When the immunologist says that pathogens possess infectivity, what is the immunologist explaining?
a. Infectivity involves the ability of pathogens to spread from one individual to
others and cause disease.
b. Infectivity involves pathogens inducing an immune response.
c. Infectivity involves pathogens invading and multiplying in the host.
d. Infectivity occurs because pathogens damage tissue.
ANS: C
Infectivity is the ability of the pathogen to invade and multiply in the host. Communication is the ability to spread from one
individual to others and cause disease. Immunogenicity is the ability of pathogens to induce an immune response. Damaging tissues
is the pathogen’s mechanism of action.

REF: Microorganisms and Humans: A Dynamic Relationship TOP: Physiological Integrity
31. When the immunologist says that pathogens possess virulence, what does virulence mean?
a. Pathogens spread from one individual to others and cause disease.
b. Pathogens induce an immune response.
c. Pathogens causes disease.
d. Pathogens have the capacity to damage tissue.
ANS: C
Virulence is the capacity of a pathogen to cause severe disease—for example, measles virus is of low virulence; rabies virus is
highly virulent. Communication is the ability to spread from one individual to others and cause disease. Immunogenicity is the
ability of pathogens to induce an immune response. Damaging tissues is the pathogen’s mechanism of action.

REF: Microorganisms and Humans: A Dynamic Relationship TOP: Physiological Integrity
32. What is the etiology of a congenital immune deficiency?

a. A negative response to an immunization
b. An adverse response to a medication
c. Kidney failure
d. A genetic defect
ANS: D
A primary (congenital) immune deficiency is caused by a genetic defect. A primary (congenital) immune deficiency is not a
response to an immunization, an adverse response to a medication, or due to kidney failure.
DIF: Cognitive Level: Understand REF: Deficiencies in Immunity

33. An infant is experiencing hemolytic disease of the newborn. Which of the following would the nurse expect to find in the infant’s
history and physical?
a. The childbearing parent was exposed to measles.
b. The parent with male genitalia was exposed to Agent Orange.
c. The baby is Rh positive.
d. The baby was born 6 weeks prematurely.
ANS: C
Hemolytic disease of the newborn was most commonly caused by IgG anti-D alloantibody produced by Rh-negative childbearing
parents against erythrocytes of their Rh-positive fetuses. This disorder is not due to the childbearing parent’s exposure to measles,
the exposure of the parent with male genitalia to Agent Orange, or the baby’s prematurity.


MULTIPLE RESPONSE
1. A 30-year-old patient with female genitalia is diagnosed with systemic lupus erythematosus (SLE). Which symptoms are a result of
a type II hypersensitivity? (Select all that apply.)
a. Anemia
b. Seizures
c. Lymphopenia
d. Facial rash
e. Photosensitivity
ANS: A, C
The patient is experiencing type II hypersensitivity when experiencing anemia and lymphopenia. Seizures, facial rash, and
photosensitivity are not associated with type II hypersensitivity reactions.

REF: Autoimmune Disease: System Lupus Erythematosus TOP: Physiological Integrity

ExamView - Chapter - 08

Uploaded by

Document Information

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

ExamView - Chapter - 08

Uploaded by

Copyright:

Available Formats

Chapter 08: Infection and Defects in Mechanisms of Defence

DIF: Cognitive Level: Understand

DIF: Cognitive Level: Understand

DIF: Cognitive Level: Understand REF: Mechanisms of Hypersensitivity | Figure 8.16

DIF: Cognitive Level: Understand REF: Mechanisms of Hypersensitivity

DIF: Cognitive Level: Understand REF: Mechanisms of Hypersensitivity | Figure 8.16

Copyright © 2023, Elsevier Inc. All rights reserved. 1

DIF: Cognitive Level: Understand

DIF: Cognitive Level: Analyze

8. A nurse recalls that an example of an immune-complex-mediated disease is:

DIF: Cognitive Level: Analyze

DIF: Cognitive Level: Analyze REF: Autoimmunity

DIF: Cognitive Level: Analyze

Copyright © 2023, Elsevier Inc. All rights reserved. 2

DIF: Cognitive Level: Analyze

DIF: Cognitive Level: Understand REF: Alloimmunity

DIF: Cognitive Level: Understand REF: Alloimmunity | Figure 8.18

DIF: Cognitive Level: Understand REF: Alloimmunity

DIF: Cognitive Level: Understand REF: Alloimmunity

DIF: Cognitive Level: Understand REF: Active Immunization

Copyright © 2023, Elsevier Inc. All rights reserved. 3

DIF: Cognitive Level: Understand REF: Table 8.2 | Bacterial Disease

DIF: Cognitive Level: Understand REF: Bacterial Disease

DIF: Cognitive Level: Understand REF: Bacterial Disease

DIF: Cognitive Level: Understand REF: Viral Disease

DIF: Cognitive Level: Understand REF: Fungal Disease

Copyright © 2023, Elsevier Inc. All rights reserved. 4

DIF: Cognitive Level: Understand

23. What is true about bacterial vaccines?

DIF: Cognitive Level: Understand REF: Active Immunization

24. A nurse recalls that bacteria become resistant to antimicrobials by:

DIF: Cognitive Level: Understand REF: Antimicrobials

25. What common symptom should be assessed in individuals with immunodeficiency?

DIF: Cognitive Level: Understand REF: Deficiencies in Immunity

DIF: Cognitive Level: Analyze REF: DiGeorge Syndrome

DIF: Cognitive Level: Understand REF: AIDS TOP: Physiological Integrity

Copyright © 2023, Elsevier Inc. All rights reserved. 5

DIF: Cognitive Level: Understand REF: Pathogenesis of AIDS

DIF: Cognitive Level: Understand

DIF: Cognitive Level: Understand

32. What is the etiology of a congenital immune deficiency?

DIF: Cognitive Level: Understand REF: Deficiencies in Immunity

DIF: Cognitive Level: Understand REF: Alloimmunity

Copyright © 2023, Elsevier Inc. All rights reserved. 6

DIF: Cognitive Level: Analyze

Copyright © 2023, Elsevier Inc. All rights reserved. 7

You might also like