Immune Function and Disorders Practice Questions
20 free Immune Function and Disorders practice questions for the NCLEX Exam. Tap an option to answer — you get instant feedback, the correct answer, and a detailed explanation for every question.
A nurse is caring for a client with systemic lupus erythematosus (SLE). Which laboratory result best indicates the presence of an active inflammatory process?
- A Elevated erythrocyte sedimentation rate
- B Decreased serum creatinine
- C Increased hemoglobin levels
- D Negative antinuclear antibody (ANA) titer
Correct answer: Elevated erythrocyte sedimentation rate
The ESR is a non-specific indicator of inflammation; in SLE, an elevated rate suggests an active flare-up of the disease. While ANA is sensitive for SLE, the ESR specifically tracks the inflammatory response over time.
A client is diagnosed with an IgE-mediated type I hypersensitivity reaction. Which clinical manifestation should the nurse prioritize for immediate assessment?
- A Swelling of the lips and tongue
- B Localized urticaria and itching
- C Maculopapular rash on the trunk
- D Mild nasal congestion
Correct answer: Swelling of the lips and tongue
Angioedema of the lips and tongue can quickly lead to airway obstruction and is a hallmark of a systemic type I reaction (anaphylaxis). This requires immediate intervention compared to localized or mild symptoms.
Which instruction should the nurse include when teaching a client with HIV about preventing opportunistic infections?
- A Avoid cleaning kitty litter boxes.
- B Eat raw fruits and vegetables to increase vitamin intake.
- C Receive live-virus vaccines annually.
- D Use public hot tubs.
Correct answer: Avoid cleaning kitty litter boxes.
Toxoplasmosis is an opportunistic infection that can be transmitted through cat feces, posing a risk to immunocompromised clients. Clients with HIV should also avoid raw or undercooked foods and live vaccines if their CD4 count is low.
A nurse is reviewing the white blood cell (WBC) differential of a client with a parasitic infection. Which cell count does the nurse expect to be elevated?
- A Neutrophils
- B Monocytes
- C Eosinophils
- D Basophils
Correct answer: Eosinophils
Eosinophils are primarily responsible for combating parasitic infections and are also involved in allergic responses. Neutrophils typically rise in response to bacterial infections.
A client who had an organ transplant 3 months ago presents with fever, fatigue, and tenderness over the graft site. Which type of rejection does the nurse suspect?
- A Acute graft rejection
- B Hyperacute rejection
- C Chronic rejection
- D Graft-versus-host disease
Correct answer: Acute graft rejection
Acute rejection typically occurs within the first few months after transplantation and is characterized by systemic symptoms and localized graft tenderness. It is mediated by the recipient's T-lymphocytes reacting against the foreign tissue.
The nurse is preparing to administer Rho(D) immune globulin to a postpartum client. What is the primary purpose of this medication?
- A To provide active immunity against future pregnancies
- B To stimulate the production of maternal antibodies
- C To prevent maternal antibodies against Rh-positive blood
- D To treat hemolytic disease in the newborn after delivery
Correct answer: To prevent maternal antibodies against Rh-positive blood
Rho(D) immune globulin provides passive immunity by destroying fetal Rh-positive red blood cells in the maternal circulation before the mother's immune system can develop its own antibodies. This prevents sensitization for future pregnancies.
A client with rheumatoid arthritis (RA) is prescribed methotrexate. Which laboratory value is most important for the nurse to monitor?
- A Blood urea nitrogen (BUN) level
- B Complete blood count (CBC)
- C Serum potassium
- D Serum glucose
Correct answer: Complete blood count (CBC)
Methotrexate is a DMARD that can cause bone marrow suppression, leading to anemia, leukopenia, and thrombocytopenia. Monitoring the CBC is essential to detect these potentially life-threatening side effects early.
Which assessment finding is most characteristic of a client experiencing a systemic inflammatory response syndrome (SIRS)?
- A Temperature of 97.0°F (36.1°C)
- B Heart rate of 110 beats per minute
- C Respiratory rate of 14 breaths per minute
- D White blood cell count of 8,000/mm³
Correct answer: Heart rate of 110 beats per minute
SIRS criteria include a heart rate greater than 90 beats/min, a respiratory rate greater than 20, and a temperature greater than 100.4°F or less than 96.8°F. Tachycardia is a compensatory mechanism for decreased tissue perfusion and metabolic stress.
A nurse is teaching a client about the difference between innate and adaptive immunity. Which example should the nurse provide for innate immunity?
- A Production of antibodies after a flu shot
- B T-cell recognition of a specific viral antigen
- C Skin acting as a physical barrier to pathogens
- D Memory B-cell response during a second exposure
Correct answer: Skin acting as a physical barrier to pathogens
Innate immunity is the body's first line of defense and is non-specific, including physical barriers like the skin and mucous membranes. Adaptive immunity involves specific recognition and memory of antigens by lymphocytes.
A client is receiving a blood transfusion and begins to complain of lower back pain and chills. What is the nurse's first action?
- A Notify the healthcare provider.
- B Stop the transfusion immediately.
- C Check the client's vital signs.
- D Administer diphenhydramine as ordered.
Correct answer: Stop the transfusion immediately.
Back pain and chills are signs of a hemolytic transfusion reaction, which is a medical emergency. The transfusion must be stopped immediately to prevent further infusion of incompatible blood.
A client with AIDS has a CD4+ T-cell count of 150 cells/mm³. Which opportunistic infection is the client at highest risk for developing?
- A Pneumocystis jirovecii pneumonia
- B Seasonal influenza infection
- C Streptococcal pharyngitis infection
- D Cellulitis of the lower leg
Correct answer: Pneumocystis jirovecii pneumonia
A CD4+ count below 200 cells/mm³ defines the progression to AIDS and significantly increases the risk for PJP. This fungal infection is one of the most common and serious opportunistic infections in this population.
The nurse identifies that a client is in the 'window period' of HIV infection. What does this term imply?
- A The client is not infectious to others at this time.
- B The client has symptoms of full-blown AIDS.
- C The client may test HIV-negative despite being infected.
- D The client's CD4 count is rapidly rising at the present time.
Correct answer: The client may test HIV-negative despite being infected.
The window period is the time between initial infection and the point when the body produces enough antibodies to be detected by standard HIV tests. During this time, the client is highly infectious even if the test is negative.
Which discharge instruction is most important for a client with a newly diagnosed latex allergy?
- A Wash hands frequently with antibacterial soap.
- B Wear a medical alert identification bracelet.
- C Avoid eating shellfish and strawberries.
- D Use oil-based lotions to protect the skin.
Correct answer: Wear a medical alert identification bracelet.
A medical alert bracelet is vital for communicating a latex allergy to emergency responders, as many medical supplies contain latex. Clients should also be taught to avoid specific cross-reactive foods like bananas and avocados.
A nurse is assessing a client with scleroderma. Which finding is associated with the 'C' in CREST syndrome?
- A Cyanosis of the fingertips
- B Calcinosis of the skin
- C Chest pain on exertion
- D Cerebral edema
Correct answer: Calcinosis of the skin
CREST syndrome stands for Calcinosis, Raynaud's phenomenon, Esophageal dysmotility, Sclerodactyly, and Telangiectasia. Calcinosis involves painful calcium deposits in the skin and soft tissues.
A client is diagnosed with Goodpasture syndrome. The nurse should monitor which two organ systems most closely?
- A Neurological and Cardiovascular
- B Gastrointestinal and Skin
- C Pulmonary and Renal systems
- D Musculoskeletal and Endocrine
Correct answer: Pulmonary and Renal systems
Goodpasture syndrome is an autoimmune disorder where antibodies attack the basement membranes in the lungs and kidneys. This leads to pulmonary hemorrhage and rapidly progressive glomerulonephritis.
A nurse is educating a client about passive immunity. Which statement by the client indicates understanding?
- A 'I will get a flu shot every year to stay immune.'
- B 'My body will remember this virus for the rest of my life.'
- C 'I received antibodies from my mother through breast milk.'
- D 'I will develop immunity after I recover from the infection.'
Correct answer: 'I received antibodies from my mother through breast milk.'
Passive immunity involves the transfer of pre-formed antibodies from one individual to another, such as through breast milk or immunoglobulin injections. It provides immediate but temporary protection without stimulating the recipient's immune memory.
A client with a history of splenectomy is being discharged. Which vaccination is most critical for this client to receive?
- A Varicella vaccine
- B Pneumococcal vaccine
- C Hepatitis B vaccine
- D Human papillomavirus (HPV) vaccine
Correct answer: Pneumococcal vaccine
The spleen plays a major role in filtering encapsulated bacteria; therefore, asplenic clients are at high risk for overwhelming post-splenectomy infection (OPSI). Vaccination against Streptococcus pneumoniae is a priority intervention.
Which mechanism describes the pathophysiology of Myasthenia Gravis?
- A Progressive demyelination of the central nervous system
- B Destruction of dopamine-producing neurons in the brain
- C Antibodies attacking acetylcholine receptors at the NMJ
- D Excessive production of thyroid hormones in the body
Correct answer: Antibodies attacking acetylcholine receptors at the NMJ
Myasthenia Gravis is an autoimmune disease where antibodies block or destroy acetylcholine receptors. This results in impaired signal transmission and progressive muscle weakness, especially after repetitive use.
A client is experiencing an anaphylactic reaction to an IV antibiotic. After stopping the infusion, which medication should the nurse prepare to administer first?
- A Methylprednisolone
- B Diphenhydramine
- C Albuterol
- D Epinephrine
Correct answer: Epinephrine
Epinephrine is the first-line treatment for anaphylaxis as it rapidly causes bronchodilation and vasoconstriction to reverse airway obstruction and hypotension. Other medications like steroids and antihistamines are secondary treatments.
A client has a positive Western Blot test. How should the nurse interpret this result?
- A The client is infected with HIV, confirmed by this test.
- B The client is at risk for HIV but not currently infected.
- C The client has already developed full-blown AIDS.
- D The result is a false positive and needs to be repeated.
Correct answer: The client is infected with HIV, confirmed by this test.
The Western Blot is a confirmatory test used after a reactive ELISA/EIA screen to verify the presence of specific HIV antibodies. A positive result confirms HIV infection, though it does not necessarily mean the client has AIDS.