NURS 123 Test 1

jasmine's version from 2016-02-02 14:19

Section 1

Question Answer
The characteristic vascular changes at the site of an injury produce Increased permeability and leakage. Vascular changes increase permeability and leakage into the interstitial spaces.
Which statement indicates the nurse has an accurate understanding of mast cells? Degranulate in response to chemical agents. Mast cells also degranulate or release their granules in response to physical injury, immunologic stimulation, and activation of toll-like receptors by bacteria and viruses.
Which information is correct regarding phagocytosis? Digestion of the capillary basement membrane during diapedesis. Leukocytes digest the capillary basement membrane and migrate into the surrounding tissues through the retracted endothelial junctions.
A person has a large open wound that has formed scar tissue. The nurse knows which type of healing has occurred? Secondary. Secondary healing occurs when scar tissue is formed and a large area of tissue is destroyed. With an open wound, epithelialization, scar formation, and contraction take longer and healing occurs through secondary intention.
Which statement indicates the nurse has an accurate understanding concerning passive immunity? Passive immunity “Can be transferred from a donor to a recipient.” Passive immunity is produced when antibodies formed by one individual are transferred to another individual.
Which information is most correct regarding IgAs? IgAs are Found in saliva and other body secretions. There are two classes of IgA immunoglobulins, IgA1 and IgA2. IgA2 are found in body secretions including saliva.
Which information is correct regarding the secondary immune response? IgG is significantly increased. IgM is produced in similar quantities to the primary response, but IgG is produced in considerably greater numbers
Alloimmunity occurs when The immune system produces a response to tissues of another individual. This type of immune response may occur with transfusion, transplantation, or in response to the fetus during pregnancy.
A person has a type I allergic reaction. Which pathophysiologic response is occurring? IgE and products of tissue mast cells are released. Type I reactions are mediated by antigen-specific IgE and the products of tissue mast cells.
A person arrives at the clinic and reports mild tiredness and discomfort after exposure to a family member with the flu. The nurse suspects the person is in the Prodromal period. This period is characterized by mild symptoms.
Which information is correct regarding parasitic and protozoan infections? Malaria is a common parasitic infection. Malaria is the most common parasitic infection worldwide.
An person who is HIV positive is hospitalized with pneumonia caused by Pneumocystis jiroveci. The nurse understands that this development indicates the person Has progressed from HIV to AIDS. The presence of atypical or opportunistic infections is diagnostic for progression of HIV disease to AIDS.
A nurse is asked how antibiotics work. How should the nurse reply? Inhibition of protein synthesis. Protein synthesis is necessary for microorganism replication and antibiotic inhibit this process.
The stage of resistance in Selye's general adaptation syndrome includes Mobilization that contributes to fight or flight response. In this stage of the GAS, mobilization leads to fight or flight and adaptation.
Which information indicates the nurse has a good understanding of epinephrine? Epinephrine actions include a(n) Increase of serum glucose concentration. This occurs because of gluconeogenesis, glycogenolysis, and reduced uptake of glucose by muscle.
A patient has stress and releases cortisol. The nurse realizes that cortisol Increases the rate of protein synthesis in the liver. Cortisol stimulates the synthesis of proteins by the liver. This is the anabolic action of cortisol.
A patient has stress. The nurse realizes that some changes in the immune system might include Decreased natural killer cells. Stress-induced immune changes affect many immune cell functions, including decreased natural killer cell.
A woman who was admitted to the hospital after a motor vehicle accident has a splenic laceration and requires a blood transfusion. During the transfusion, she develops a fever, back pain, flushing. This type of immunologic reaction is known as Alloimmunity; It occurs when the immune system of one individual produces an immunologic reaction against tissues of another individual such as during a transfusion, transplanted tissue, or a fetus during pregnancy.
One week after recovering from the transfusion reaction, the woman develops pneumonia that may be caused by poor inspiration and cough as a result of the pain from her splenic laceration. The woman is administered several antibiotics to assist her body in fighting the infection. The goal of antibiotic therapy is the elimination of the pathogen. The mechanisms of action of most antibiotic agents are Blocking deoxyribonucleic acid (DNA) replication; Most anitbiotics inhibit the function or production of the cell wall, interfere with folic acid metabolism, prevent protein synthesis and block DNA replication. Modification of the target molecule is a mechanism of genetic mutation for antibiotic resistance.

Section 2

Question Answer
Endorphins Any of a group of hormones secreted within the brain and nervous system, and having a number of physiological functions; Peptides that activate the body’s opiate receptors, causing an analgesic effect; May experience insensitivity to pain, increased feelings of excitement, positive well-being, and euphoria
Enkephalins Body’s natural painkillers; Leu- and met-enkephalins occur naturally in the brain; internally derived and bind to the body’s opioid receptors; May experience insensitivity to pain, increased feelings of excitement, positive well-being, and euphoria
Dynorphins An opiate-like chemical found in the brain, which blocks transmission of pain signals along nerve fibers, creating potent analgesic effects. It is also found throughout the central and peripheral nervous systems; Most are agonists at opioid receptor sites, however some are involved in pain regulation and others in the hypothalamic regulation of eating and drinking
Stress and negative emotions increase levels of Pro-inflammatory cytokines, providing a possible link amoung stress, immune function, and disease
Stress-induced immune changes affect immune cell functions by Causing decreased natural kill (NK) cell and T-cell cytotoxicity and impaired B-cell function
A client has stress. The nurse realizes that some changes in the immune system might include Decreased natural killer (NK) cells
Psychological Distress General state of unpleasant arousal after life events that result in physiologic, emotional, cognitive, and behavior changes
Coping Is managing stressful demands and challenges that are appraised as taxing or exceeding the resources of the person; May be adaptive or maladaptive
Stress-age syndrome Excitability changes in the limbic system and hypothalamus; Increased catecholamines, antidiuretic hormone (ADH), Adrenocorticotropic hormone (ACTH), and cortisol; Decreased testosterone, thyroxine, and other hormones; Alterations of opioid peptides; Immunodepression and alterations in lipoproteins; Hypercoagulation of the blood; Free radical damage of cells; Development of stress reactions; Lower adaptive reserve and coping mechanisms

Section 3

Question Answer
Regeneration Complete cell repair not typical
Resolution Returning injured tissue to the original structure and function
Repair Replacement of destroyed tissue with scar tissue
Debridment Cleaning up dissolved clots, microorganisms, erythrocytes, and dead tissue cells
Healing Fillin in the wound; Sealing the wound (epithelialization); Contraction
Maturation phase Scar tissue formation; Scar remodeling
Primary wound No tissue loss; open cut, clean out, sew up
Secondary wound Cannot be sewn together; Results in secondary healing
Purposes of inflammation Limit spread of infection; Control bleeding; Interact with adaptive immunity; Prepare for healing
The inflammatory process Vasodilation: Vessels is opening and it is RED and HOT; Permeability of vessel - lets stuff in and out "EDEMA;” Cellular Infiltration- pus; Thrombosis- clots; Stimulation of nerve endings- pain
What is the vascular response to inflammation? 1) initial transient vasoconstriction (seconds), 2) vasodilation, 3) increased capillary permeability, 4) exudation of fluid and cells, 5) diapedesis- cell migration
Complement system Destroys pathogens directly; Proteins are defenders against bacteria; And 3 pathways: Classic, Lectin, and Alternative pathway
Classic pathway The antibodies target the antigens
Lectin pathway Activated by bacteria-carb
Alternative pathway Activated by gram negative bacteria
Clotting system Creates a clot to prevent bleeding; Uses fibrin
Kinin system Functions to activate and assist inflammatory cells bradykinin protein
Local manifestation Heat, swelling, redness, pain, happens at a specific site, and vascular changes
Systematic manifestation whole body; fever (cause by pyrogens); leukocytosis and increased plasma protein synthesis
What is an antigen? Molecule recognized by the immune system; think "non self;” Pathogens, food, pollen, etc. Molecule that reacts with antibody or lymphocyte receptor


Question Answer
Immunogen triggers an immune response
What causes a strong reaction? The more foriegn the antigen, the stronger the response; *think degrees of tissue matches in transplants
Clonal Diversity Bone marrow/ thymus; Immature immune cells are immature but immune competent; Move to secondary lymph organs
How are B and T cells different? Different origins; B cells attack outside the cell; and T cells attack inside the cell
T cells In the thymus; Waits for antigens in secondary lymph organs; Central tolerance
B cells Mature B cell becomes plasma cell producing antibody, they need antigen exposure to become mature
Helper T cell Help the antigen driven maturation of B and T cells; Magnify the interaction between antigen presenting cells (APCs) and immunocompetent lymphocytes
B Cell Activation Plasma cell is a factory for antibody production; Numerous cells cover all the different antibodies
T Cell Activation T suppressor/regulatory cells; Prevents self killing; Prevents over-activation of immune system
Active immunity Immunization; Usually long term
Passive immunity Think of getting from pregnancy or from blood transfusion; Usually short lived
Major Histocompatibility Complex (MHC) Group of genes that code for proteins found on the surfaces of cells that help the immune system recognize foreign substances; Uses polypeptide proteins; Interact with helper T cells
CD1 Have lipids; Similar to MHC, yet lipids
Where are antibodies located? Tears, sweat, saliva, mucous, breast milk
What are proteins made of? Antigen-binding fragment; Crystalline fragment; Polypeptide chain
IgM First antigen response
IgG Most abundant; Second responder; Crosses placenta
IgA Mostly in secretions
IgE Least concentrated; Allergic response; Fights parsites
Functions of antibodies Neutralize bacteria, neutralize viruses, form antigen-antibody complexes to kill bacteria, opsonization, cell-killing mechanisms
Allergy Enviornmental allergy
Autoimmunity Disturbance in identification of self
Allommunity Reaction to foreign tissue
What happens during a blood transfusion reaction? Cells attack foreign cells; clots; respiratory and kidneys damaged; death
Type I IgE mediated; environmental; allergic reaction
Type II Tissue specific reaction (antibodies binds to tissue specific antigens
Type III Immune complex mediated; deposited in vessel walls
Type IV Cell mediate/ delayed; t lymphocyte mediated process
Primary immune deficiencyGenetic, from single gene defect; b lymp deficiencies, t lymph deficiencies, both, complement deficiencies, phagocyte deficiencies
Secondary Immune Deficiencies Acquired; more common; caused by stress
Normal causes of secondary immune deficiencies STRESS; dietary inefficiencies; environment; physical trauma; medical treatments; infections like AIDS
Make sure you know blood typing O neg, universal giver; AB+, universal receiver
What is the leading cause of death globally? Ischemic Heart Disease or infectious disease as stated on pg. 298 and 333 of the patho book
How does HIV affect cells? Binds to the surface of t helper cells, preventing an immune response
Cells affected by AIDS? T helper cells; t cells; decreased thymic production of new t cells; damage to lymph nodes/secondary lymph organs
4 stages of infection 1. incubation- microbes multiplying, no symptoms; 2. prodromal- mild symptoms; 3. invasion- maxed response/symptoms; and 4. convalescent- removed infection/healthy
How is HIV transmitted? Blood; mucous membranes etc.
Physiology of stress 1. initiated by CNS; 2. CRH is released; and 3. Norepinephrine is released; Can be real or perceived threat
Norepinepherine Raise blood pressure; Dilates the eyes; Increases sweat
Epinephrine Greater cardiac influence; vasodilation; and increased glucose levels
What does cortisol do in the body? Anti-inflammatory and causes poor wound healing and an increased susceptibility to infection
GAS 1. Alarm stage: fight or flight; 2. stages of resistance or adaptation; and 3. exhaustion: only occurs if stress continues and adaptation is unsuccessful
Stress and cancer? Stress causes the release of cortisol; decreases immune function; allow cancer to grow more rapidly
Endemic Relatively high; Native or restricted to a certain country or area; Constant rates of infection in a specific population
Epidemic A widespread occurrence of an infectious disease in a community at a particular time (i.e., flu epidemic and epidemic of typhoid); Number of new infection population greatly exceeds number usually observed
Pandemic Spreads over a large area, like a continent, whole country, or the whole world