The nurse is caring for a client who is hospitalized on a medical unit for a systemic infection. The client asks the nurse which defenses the body has
... [Show More] against infection. Which physiologic barriers that protect the body against microorganisms should the nurse include in the response to the client? Select all that apply.
A) The spleen
B) Adequate urinary output
C) Intact skin
D) Generalized inflammation
E) The thymus gland - Adequate urinary output
Intact skin
A client receives the yellow fever vaccine before traveling to the Amazon Basin and asks the nurse how the vaccine provides protection. Which responses by the nurse are most appropriate? Select all that apply.
A) "Human macrophages engulf the weakened vaccine virus as if it is dangerous, and antigens stimulate the immune system to attack it."
B) "In the lymph nodes, which are part of the lymphoid system, the macrophages present yellow fever antigens to T cells and B cells."
C) "A response from yellow fever-specific T cells is activated. B cells secrete yellow fever antibodies."
D) "The vaccine contains large amounts of protective antibodies that were produced in another host organism, so it provides immediate protection against yellow fever."
E) "The initial weak infection is eliminated and the client is left with a supply of memory T and B cells for future protection against yellow fever." - "Human macrophages engulf the weakened vaccine virus as if it is dangerous, and antigens stimulate the immune system to attack it."
"In the lymph nodes, which are part of the lymphoid system, the macrophages present yellow fever antigens to T cells and B cells."
"A response from yellow fever-specific T cells is activated. B cells secrete yellow fever antibodies."
"The initial weak infection is eliminated and the client is left with a supply of memory T and B cells for future protection against yellow fever."
A nurse who works in the emergency department is providing care for a group of clients. Which client demonstrates a declining immune response that typically occurs with the aging process?
A) An 88-year-old client with pneumonia who has a temperature of 99.5°F
B) A 70-year-old client who has swelling and redness around an abdominal incision from an open appendectomy
C) A 58-year-old client who complains of redness and itching after developing a rash from contact with poison ivy
D) A 56-year-old client who has 8 mm induration at the site of a PPD skin test administered 72 hours earlier - An 88-year-old client with pneumonia who has a temperature of 99.5°F
The nurse is conducting a physical assessment for a client with a compromised immune system. Which actions by the nurse are appropriate? Select all that apply.
A) Assessing general appearance
B) Recommending increased fluid intake
C) Inspecting the mucous membranes of the nose and mouth
D) Palpating the cervical lymph nodes
E) Checking joint range of motion (ROM), including that of the spine - Assessing general appearance
Inspecting the mucous membranes of the nose and mouth
Palpating the cervical lymph nodes
Checking joint range of motion (ROM), including that of the spine
The nurse is caring for a client who has come to an urgent care clinic due to an arm infection. The client reports being bitten by a raccoon on a recent camping trip. Based on this data, which treatment option does the nurse anticipate for this client?
A) Injection of rabies immunoglobulin only
B) Administration of rabies vaccine only
C) Both injection of rabies immunoglobulin and administration of rabies vaccine
D) Neither injection of rabies immunoglobulin nor administration of rabies vaccine - Both injection of rabies immunoglobulin and administration of rabies vaccine
The nurse is providing care to a client with a compromised immune system. Which independent nursing intervention is appropriate for the nurse to include in the client's plan of care?
A) Educating the client on the importance of a nutritious diet
B) Administering corticosteroids per order
C) Prescribing prophylactic antibiotic therapy
D) Recommending gene transfer therapy - Educating the client on the importance of a nutritious diet
A nurse is caring for a client with who is experiencing leukocytosis. When providing care to this client, which action by the nurse is most appropriate?
A) Instructing the client on the use of an electric razor and soft toothbrush
B) Evaluating the client for bleeding and bruising
C) Assessing the client for the source of infection
D) Placing the client in reverse isolation - Assessing the client for the source of infection [Show Less]