ATI LPN
Questions on Immune System Questions
Question 1 of 5
Most important diagnostic criterion for CLL?
Correct Answer: B
Rationale: The correct answer is B: Absolute lymphocytosis. This is the most important diagnostic criterion for Chronic Lymphocytic Leukemia (CLL). CLL is characterized by a high number of mature-looking lymphocytes in the blood. The presence of absolute lymphocytosis (>5,000/microliter) is a key feature in diagnosing CLL. Hypogammaglobulinemia (choice A) can occur in CLL but is not the primary diagnostic criterion. Male predominance (choice C) and enlarged lymph nodes (choice D) are common features of CLL but do not serve as the primary diagnostic criterion.
Question 2 of 5
Least present immunoglobulin?
Correct Answer: C
Rationale: The correct answer is IgE (Choice C) as it is the least present immunoglobulin in the body. IgE is primarily involved in allergic responses and defense against parasites. IgA (Choice A) is present in mucosal linings, IgD (Choice B) is involved in the activation of B cells, and IgM (Choice D) is the first antibody produced in response to an infection. Therefore, IgE is the least abundant immunoglobulin compared to the other choices.
Question 3 of 5
Client having bone marrow biopsy today. Priority action?
Correct Answer: B
Rationale: The correct answer is B because ensuring a valid consent is on the chart is the priority before any procedure, including a bone marrow biopsy. This step ensures that the client has been properly informed about the procedure, risks, benefits, and has given their consent. Administering pain medication (choice A) should be done after ensuring proper consent. Having the client shower in the morning (choice C) is not a priority before the procedure. Premedicating with sedatives (choice D) may not be necessary or appropriate for all clients and should be decided based on individual assessment.
Question 4 of 5
A client with a diagnosis of primary immunodeficiency disease informs the nurse that the client has been experiencing a new onset of a dry cough and occasional shortness of breath. After determining that the client's vital signs are within reference ranges, what action should the nurse take?
Correct Answer: C
Rationale: The correct answer is C: Assess the client for signs and symptoms of infection. 1. Given the client's primary immunodeficiency disease, they are at increased risk for infections. 2. The new onset of a dry cough and shortness of breath could indicate a respiratory infection. 3. Vital signs being within reference ranges do not rule out an underlying infection. 4. Assessing for signs of infection allows for timely intervention and treatment. Summary: A: Administering a nebulized bronchodilator is not appropriate without assessing for infection first. B: Performing oral suctioning is not indicated based on the client's symptoms. D: Teaching deep breathing and coughing exercises may be helpful, but assessing for infection is the priority.
Question 5 of 5
A client's current antiretroviral regimen includes enfuvirtide (T-20). What dietary counseling will the nurse provide based on the client's medication regimen?
Correct Answer: D
Rationale: The correct answer is D: Take this medication without regard to meals. Enfuvirtide is administered by injection and should be taken with or without food. It is not affected by food intake, so there is no specific dietary counseling needed. A: Avoiding high-fat meals is not necessary for enfuvirtide. B: There is no need to limit fluid intake for this medication. C: Limiting sodium intake is not specifically related to enfuvirtide therapy. In summary, the other choices are incorrect because enfuvirtide does not require any specific dietary restrictions or recommendations.