Chapter 07: Infection and Defects in Mechanisms of Defense My Nursing Test Banks

Huether and McCance: Understanding Pathophysiology, 5th Edition

Chapter 07: Infection and Defects in Mechanisms of Defense

Test Bank

MULTIPLE CHOICE

1. When a patient asks the nurse what hypersensitivity is, how should the nurse respond? Hypersensitivity is best defined as:

a.

A reduced immune response found in most pathologic states

b.

A normal immune response to an infectious agent

c.

An excessive or inappropriate response of the immune system to a sensitizing antigen

d.

Antigenic desensitization

ANS: C

Hypersensitivity is an altered immunologic response to an antigen that results in disease or damage to the individual.

Hypersensitivity is not a reduced immune response.

Hypersensitivity is not a normal response to an infectious agent.

Antigenic desensitization is performed to decrease hypersensitivity.

REF: p. 165

2. A 5-year-old female takes a hike through the woods during a school field trip. Upon returning home, she hugs her father, and he later develops poison ivy. Which of the following immune reactions is he experiencing?

a.

IgE-mediated

b.

Tissue specific

c.

Immune complex

d.

Cell-mediated

ANS: D

Secondary contact activates a type IV cell-mediated reaction that causes dermatitis.

The fathers response is a secondary, cell mediated, not a primary type IgE mediated.

The fathers response is secondary, not tissue specific.

The fathers response is a type IV, not an immune complex response.

REF: p. 189

3. 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 immunologic reactions against transfusions, transplanted tissue, or the fetus during pregnancy.

Autoimmunity is a disturbance in the immunologic 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: p. 190

4. While planning care, a nurse recalls seasonal allergic rhinitis is expressed through:

a.

IgE-mediated reactions

b.

Tissue-specific reactions

c.

Antigen-antibody complexes

d.

Type II hypersensitivity reactions

ANS: A

Seasonal allergic rhinitis is expressed through IgE-mediated reactions.

Tissue-specific reaction is an autoimmune reaction.

Antigen-antibody reactions are type III and are organ specific.

Type II hypersensitivity reactions are tissue specific.

REF: p. 190

5. A patient presents with poison ivy on the extremities, face, and buttocks. This condition is 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 up 72 hours 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.

REF: p. 190

6. A 10-year-old male is stung by a bee while playing in the yard. He begins itching and develops pain, swelling, redness, and respiratory difficulties. He is suffering from:

a.

Immunodeficiency

b.

Autoimmunity

c.

Anaphylaxis

d.

Tissue-specific hypersensitivity

ANS: C

Anaphylaxis occurs within minutes of reexposure 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 immunologic tolerance of self-antigens.

Tissue-specific reaction is an autoimmune reaction.

REF: p. 190

7. When a patient presents at the emergency department for an allergic reaction, the nurse recognizes 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.

REF: p. 190

8. When histamine is released in the body, which of the following responses would the nurse expect?

a.

Bronchial dilation

b.

Edema

c.

Vasoconstriction

d.

Constipation

ANS: B

Increased vascular permeability leads to edema and is a direct response to histamine.

Histamine produces bronchoconstriction.

Histamine produces vasodilation.

Histamine does not produce constipation; it increases gastric acidity.

REF: p. 190

9. Which information would indicate more teaching is needed regarding hypersensitivity reactions? Type _______ hypersensitivity reactions involve an antibody response.

a.

I

b.

II

c.

III

d.

IV

ANS: D

Type IV reactions are mediated by T lymphocytes and do not involve antibodies.

Type I reactions involve antibody responses.

Type II reactions involve antibody responses.

Type III reactions involve antibody responses.

REF: p. 195

10. A 10-year-old male presents to his primary care provider reporting wheezing and difficulty breathing. History reveals that both of the childs parents suffer from allergies. Which of the following terms would be used to classify the child?

a.

Desensitized

b.

Atopic

c.

Hyperactive

d.

Autoimmune

ANS: B

Atopic individuals are genetically predisposed to the development of allergies.

Desensitization is a term used to describe the process of reducing the severity to allergies.

Hypersensitivity is an altered immunologic response to an antigen that results in disease or damage to the individual.

Autoimmunity is a disturbance in the immunologic tolerance of self-antigens.

REF: p. 201

11. A 30-year-old female presents to her primary care provider reporting fatigue, excessive sweating, and increased appetite. Physical examination reveals protruding eyes, and laboratory testing reveals hyperthyroidism secondary to autoantibody production. This disorder falls into the category of type _____ hypersensitivity.

a.

I

b.

II

c.

III

d.

IV

ANS: B

The patient is experiencing type II hypersensitivity. In hyperthyroidism, autoantibody binds to and activates receptors for thyroid-stimulating hormone (TSH) (a pituitary hormone that controls the production of the hormone thyroxine by the thyroid).

The patient is experiencing a type II reaction, not type I, which is the most common type of allergic reaction.

The patient is experiencing a type II reaction, not type III, which is not organ specific.

The patient is experiencing a type II reaction; type IV is a delayed reaction.

REF: p. 193

12. A 30-year-old male is having difficulty breathing and has been spitting blood. He reports that he began experiencing this reaction after cleaning his pigeons cages. Testing reveals he is suffering from allergic alveolitis. Which of the following is he 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 sicknesstype 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.

REF: p. 193

13. A nurse recalls 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 related to type I reactions.

Contact dermatitis is related to type IV reactions.

Rheumatoid arthritis is related to type IV reactions.

REF: p. 193

14. Several prisoners are experiencing symptoms of tuberculosis. A tuberculin reaction test was ordered. This test is an example of type _____ hypersensitivity.

a.

I

b.

II

c.

III

d.

IV

ANS: D

Tuberculosis testing is an example of type IV hypersensitivity.

Tuberculosis testing is an example of type IV hypersensitivity, not type I.

Tuberculosis testing is an example of type IV hypersensitivity, not type II.

Tuberculosis testing is an example of type IV hypersensitivity, not type III.

REF: p. 196

15. When a nurse cares for a patient with systemic lupus erythematosus (SLE), the nurse remembers 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 an autoimmune disorder, not alloimmune.

SLE is an autoimmune disorder not homoimmune.

SLE is an autoimmune disorder not alleimmune.

REF: p. 197

16. A 30-year-old female complains of fatigue, arthritis, rash, and changes in urine color. 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.

Antinuclear antibodies

c.

Antiherpes antibodies

d.

Anti-CMV antibodies

ANS: B

The presence of antinuclear antibodies is a diagnostic criterion for SLE.

The presence of antinuclear antibodies is a diagnostic criterion for SLE. It would be positive LE.

The presence of antinuclear antibodies is a diagnostic criterion for SLE, not antiherpes.

The presence of antinuclear antibodies is a diagnostic criterion for SLE, not anti-CMV.

REF: p. 198

17. A 40-year-old female 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.

REF: p. 198

18. 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.

100% is too high; the chance is 25%.

75% is too high; the chance is 25%.

50% is too high; the chance is 25%.

REF: p. 199

19. When a nurse notices that a patient has type O blood, the nurse realizes that anti-_____ antibodies are present in the patients 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.

Type O individuals have both A and B antibodies.

Type O individuals have both A and B antibodies.

Type O individuals will have A and B antibodies, but not O.

REF: p. 198

20. In addition to matching ABO antigens, a blood transfusion must also 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.

Blood transfusions do not need to be matched to immunoglobulins.

Blood transfusions do not need to be matched to platelet compatibility.

REF: p. 198

21. A 15-year-old male suffers from severe hemorrhage following a motor vehicle accident. He 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 can receive type O.

Type AB can accept type O.

REF: p. 198

22. When an immunologist teaches about the relationship that benefits the organism but causes no harm to the host, the immunologist is describing which of the following?

a.

Symbiosis

b.

Mutualism

c.

Commensalism

d.

Pathogenicity

ANS: C

Commensalism benefits only the microorganism; there is no harm to the human.

Parasitic microorganisms establish symbiosis with another species in which the parasite benefits at the expense of the other species.

Mutualism benefits the human and the microorganism.

Pathogenicity benefits the microorganism, but harms the human. (Opportunism is the situation that occurs when benign microorganisms become pathogenic because of decreased human-host resistance.)

REF: p. 166

23. The microorganisms that make up the normal human flora are important for:

a.

Regulating inflammation

b.

Secreting bacteriostatic substances

c.

Activating white blood cells

d.

Preventing the colonization and multiplication of pathogens

ANS: D

Normal flora are provided with nutrients from ingested food, and in exchange they produce enzymes that produce antibacterial factors that prevent colonization by pathogenic microorganisms.

Normal flora prevent colonization of pathogens; they do not regulate inflammation.

Normal flora prevent colonization of pathogens; they do not secrete bacteriostatic substances.

Normal flora prevent colonization of pathogens; they do not activate white blood cells.

REF: p. 166

24. When bacterial pathogens enter a patients body, they can defend themselves from an immune response by:

a.

Producing capsules

b.

Phagocytosis

c.

Retreating

d.

Developing antibodies

ANS: A

Bacterial survival and growth depend on the effectiveness of the bodys defense mechanisms and on the bacteriums ability to resist these defenses. Many pathogens devise ways of preventing destruction by the inflammatory and immune systems by producing thick capsules of carbohydrate or protein.

Bacteria do not produce phagocytosis.

Bacteria do not retreat.

Bacteria do not develop antibodies.

REF: p. 168

25. 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? The antigen is:

a.

Alive, but less infectious

b.

Mutated, but highly infectious

c.

Normal, but not infectious

d.

Inactive, but infectious

ANS: A

Attenuated vaccines are alive, but less infectious.

Attenuated vaccines are alive, not mutated or highly infectious.

Attenuated vaccines are normal, but mutated doesnt relate to the answer.

Attenuated vaccines are alive, but less infectious; they are not inactive.

REF: p. 177

26. An immunologist is discussing endotoxin production. Which information should the immunologist include? Endotoxins are produced by:

a.

Gram-negative bacteria

b.

Gram-positive bacteria

c.

Gram-negative fungi

d.

Gram-positive fungi

ANS: A

Endotoxins are produces by gram-negative bacteria.

Endotoxins are produced primarily by gram-negative bacteria, not gram-positive.

Endotoxins are produced primarily by gram-negative bacteria, not gram-negative fungi.

Endotoxins are produced primarily by gram-negative bacteria, not gram-positive fungi.

REF: p. 171

27. A 5-year-old male becomes ill with a severe cough. Histologic 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.

REF: p. 171

28. A 50-year-old female 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 typically do not produce endotoxins and thus do not manifest in shock.

Fungi do not produce the endotoxic shock symptoms described.

Viruses do not produce symptoms of shock.

REF: p. 171

29. After studying about viruses, which information indicates the student has a good understanding of viruses? Viruses:

a.

Contain no DNA or RNA

b.

Are capable of independent reproduction

c.

Replicate their genetic material inside host cells

d.

Are easily killed by antimicrobials

ANS: C

Virus replication depends totally on their ability to infect a permissive host cell, a cell that cannot resist viral invasion and replication.

Viruses contain both DNA and RNA.

Viruses are incapable of independent reproduction.

Viruses cannot be killed by antimicrobials.

REF: p. 171

30. A patient has chicken pox. How does the varicella replicate?

a.

With the host cell DNA

b.

Using host cell DNA polymerase

c.

Using reverse transcriptase

d.

In the cytoplasm

ANS: D

Generally, all RNA viruses replicate their genetic material in the cytoplasm of the infected cell.

Generally, all RNA viruses replicate their genetic material in the cytoplasm of the infected cell, not the host cell DNA.

Generally, all RNA viruses replicate their genetic material in the cytoplasm of the infected cell, not the polymerase.

Generally, all RNA viruses replicate their genetic material in the cytoplasm of the infected cell, not using reverse transcriptase.

REF: p. 171

31. A 25-year-old female reports having unprotected sexual intercourse with several men. Blood tests reveal that she is positive for human papillomavirus. What else should the nurse assess for?

a.

Vaginal discharge

b.

Liver failure

c.

Breast cancer

d.

Warts

ANS: D

Direct contact with papillomavirus can lead to warts.

Direct contact with papillomavirus can lead to warts, not vaginal discharge.

Direct contact with papillomavirus can lead to warts, not liver failure.

Direct contact with papillomavirus can lead to warts, not breast cancer.

REF: p. 172

32. 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 can be opportunistic.

Diseases caused by fungi are called mycoses. Mycoses can be opportunistic and are not treatable with penicillin.

Diseases caused by fungi are called mycoses. Mycoses can be opportunistic and are common.

Diseases caused by fungi are called mycoses. Mycoses can be opportunistic and occur with other infections.

REF: p. 174

33. When trying to distinguish between an infectious disease and noninfectious disease, what is the hallmark symptom for most infectious diseases?

a.

Fever

b.

Jaundice

c.

Vomiting

d.

Pain

ANS: A

The hallmark of most infectious diseases is fever.

The hallmark of most infectious diseases is fever, not jaundice.

The hallmark of most infectious diseases is fever, not vomiting.

The hallmark of most infectious diseases is fever, not pain.

REF: p. 175

34. Which information indicates a correct understanding of viral vaccines? Most viral vaccines contain:

a.

Active viruses

b.

Attenuated viruses

c.

Killed viruses

d.

Viral toxins

ANS: B

Viral vaccines contain live viruses that are weakened (attenuated).

Viral vaccines contain live viruses that are weakened (attenuated), not active.

Viral vaccines contain live viruses that are weakened (attenuated), not killed.

Viral vaccines contain live viruses that are weakened (attenuated), not toxins.

REF: p. 187

35. Which information indicates a good understanding of bacterial vaccines? Most bacterial vaccines contain:

a.

Active bacteria

b.

Synthetic bacteria

c.

Dead bacteria

d.

Bacterial toxins

ANS: C

Vaccines are biological preparations of weakened or dead pathogens that when administered stimulate production of antibodies or cellular immunity against the pathogen without causing disease.

Vaccines are biological preparations of weakened or dead pathogens, not active bacteria.

Vaccines are biological preparations of weakened or dead pathogens, not synthetic bacteria.

D

Vaccines are biological preparations of weakened or dead pathogens, not bacterial toxins.

REF: p. 178

36. A nurse recalls 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 neighboring microorganisms by plasmid exchange.

Antibiotic resistance is a result of mutations, not proliferation, which is increased growth.

Antibiotic resistance is a result of genetic mutations, not attenuation.

Antibiotic resistance is a result of genetic mutations, not specialization.

REF: p. 176

37. 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.

Anemia is not a manifestation of immunodeficiency.

Hypersensitivity is not a symptom of immunodeficiency.

Autoantibody production is not a symptom of immunodeficiency.

REF: p. 201

38. A 5-year-old male 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 immunologic 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.

Combined immunologic deficiency is not manifested by these symptoms.

Complement deficiency is not manifested by these symptoms.

REF: p. 201

39. A 22-year-old was recently diagnosed with acquired immunodeficiency syndrome (AIDS). Which decreased lab finding would be expected to accompany this virus?

a.

CD4 T-helper

b.

CD8 T-helper

c.

CDC cells

d.

CDC10 cells

ANS: A

The major immunologic finding in AIDS is the striking decrease in the number of CD4-positive (CD4+) T cells.

The change occurs in CD4 cells, not CD8.

CDC is not a type of cell.

CDC10 cells are not a type of cell.

REF: p. 186

40. 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.

REF: p. 184

41. A 30-year-old male 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 treatment of HIV infection is a combination of drugs, termed highly active antiretroviral therapy (HAART).

Approved AIDS medications are classified by mechanism of action; nucleoside and nonnucleoside inhibitors of reverse transcriptase (reverse transcriptase inhibitors).

Inhibitors of the viral protease (protease inhibitors) are also part of therapy for AIDS.

Inhibitors of viral entrance into the target cell (entrance inhibitors) are also part of the treatment of AIDS.

REF: p. 186

42. When the immunologist says that pathogens possess infectivity, what is the immunologist explaining? Infectivity allows pathogens to:

a.

Spread from one individual to others and cause disease

b.

Induce an immune response

c.

Invade and multiply in the host

d.

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 pathogens mechanism of action.

REF: p. 167

43. When the immunologist says that pathogens possess virulence, what does virulence mean?

a.

Spreads from one individual to others and causes disease

b.

Induces an immune response

c.

Causes disease

d.

Damages tissue

ANS: C

Virulence is the capacity of a pathogen to cause severe diseasefor 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 pathogens mechanism of action.

REF: p. 167

44. The nurse would correctly respond that the etiology of a congenital immune deficiency is due to a(n):

a.

Negative response to an immunization

b.

Adverse response to a medication

c.

Renal failure

d.

Genetic defect

ANS: D

A primary (congenital) immune deficiency is caused by a genetic defect.

A primary (congenital) immune deficiency is caused by a genetic defect, not a response to an immunization; if such could occur, the etiology would be secondary.

A primary (congenital) immune deficiency is caused by a genetic defect, not an adverse response to a medication; if such could occur, the etiology would be secondary.

A primary (congenital) immune deficiency is caused by a genetic defect, not renal failure; if such could occur, the etiology would be secondary.

REF: p. 178

45. An infant is experiencing hemolytic disease of the newborn. Which of the following would the nurse expect to find in the infants history and physical?

a.

The mother was exposed to measles.

b.

The father 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 mothers against erythrocytes of their Rh-positive fetuses.

This disorder is due to Rh incompatibility, not the mothers exposure to measles.

This disorder is due to Rh incompatibility, not the fathers exposure to Agent Orange.

This disorder is due to Rh incompatibility, not the babys prematurity.

REF: p. 189

Mosby items and derived items 2012 Mosby, Inc., an imprint of Elsevier Inc.

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