Sherpath: Immune System Function and Dysfunction: Chapter 11, Care of Patients with Immune and Lymphatic Disorders

Question 1 of 9

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Which concept would the nurse discuss about organ rejection with a patient who plans to schedule a kidney transplant?

• Correct
  • The organ is seen as a foreign “nonself” cell.A transplanted organ is seen as a foreign “nonself” cell by the body.
• • The organ needs to be sensitized to the patient’s blood cells.Transplanted organs cannot be sensitized to the body.
• • If the blood type matches, the organ will not cause a problem.Matching blood types and organs donated from family members are not always compatible for transplantation.
• • If the organ is from a family member, no antigens will be produced.Matching blood types and organs donated from family members are not always compatible for transplantation.

Question 2 of 9

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Which characteristic would the nurse recall about the body’s immune cells when discussing the autoimmune properties of systemic lupus erythematosus (SLE) with a patient?

• • The cells multiply too rapidly.Autoimmune diseases do not cause cells to multiple too rapidly.
• • The cells produce too many antibodies.Autoimmune diseases do not cause cells to produce too many antibodies
• • The cells are not produced in sufficient numbers.Autoimmune diseases do not cause cells to not be produced in sufficient numbers.
• Correct
  • The cells produce abnormal antibodies that attack the target cells instead of foreign agents.An autoimmune disease, such as SLE, is characterized by an overactive immune response in which the immune cells produce abnormal antibodies that attack the body’s own cells, rather than foreign agents, such as bacteria, fungi, and viruses.

Question 3 of 9

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Which statement, if made by the patient who recently had a kidney transplant, indicates understanding of the prescribed immunosuppressive therapy?

• • “I will be able to stop taking these medications after a few years.”Post-transplant immunosuppressive therapy is lifelong, so the patient will have to take these medications for the rest of his or her life.
• Correct
  • “A bonus is that these medications will help with my rheumatoid arthritis.”Immunosuppressive medications are helpful in the management of some autoimmune disorders including rheumatoid arthritis.
• • “Once I am prescribed a dosage for these medications, it will not change.”The dosage of these medications will be adjusted according to the systemic and immune response of each patient to prevent toxicity.
• • “I don’t have to worry about my body rejecting the organ because I’m on these medications.”Lifelong immunosuppressive therapy does not eliminate the danger of organ rejection or other health complications.

Question 4 of 9

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Which information is important to include in the discharge teaching for the patient who is taking corticosteroids after a liver transplant?

• • Choose high-protein, high-calorie snacks.Patients taking corticosteroids should choose low-calorie snacks to ensure that they are not overeating because weight gain is a common side effect.
• • It is fine to eat sushi if it is consumed in moderation.Raw foods should be avoided in immunocompromised patients taking corticosteroids.
• Correct
  • Wear a mask if you need to be around large groups of people.Patients taking corticosteroids are immunocompromised and should protect themselves from infection while in large crowds.
• • It is normal to experience a low-grade fever and chills while taking corticosteroids.A low-grade fever and chills are signs of infection and should be reported to the provider immediately as patients taking corticosteroids are at increased risk of infection.

Question 5 of 9

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Which assessment is most important for the nurse to perform on the patient with Guillain-Barré syndrome? Select all that apply. One, some, or all responses may be correct.

• • Body weightBody weight is not usually affected by Guillain-Barré syndrome.
• Correct
  • Muscle strengthIt is important for the nurse to assess muscle strength because ascending muscle weakness is a key characteristic of Guillain-Barré syndrome.
• • Neurologic statusNeurologic status is not typically affected by Guillain-Barre syndrome.
• Correct
  • Respiratory functionAs ascending muscle weakness occurs with Guillain-Barre syndrome, respiratory function may be affected, and the patient may require mechanical ventilation.
• Correct
  • Deep tendon reflexesDeep tendon reflexes disappear with Guillain-Barre syndrome, so it is important for the nurse to consistently assess them.

Question 6 of 9

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For which clinical manifestation would the nurse expect to assess in the patient with scleroderma?

• • Loose skinThe nurse would expect that a patient with scleroderma would have tightened, hard skin.
• • HypotensionHypertension can be triggered by release of protein into the urine from scleroderma.
• Correct
  • Atrial fibrillationCardiac dysrhythmias are a common clinical manifestation of scleroderma.
• • Excessive thirstExcessive thirst is a common clinical manifestation of diabetes mellitus, not scleroderma.

Question 7 of 9

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Which statement, if made by the patient recently diagnosed with systemic lupus erythematosus (SLE), indicates an understanding of this diagnosis?

• • “I got this disorder from being infected with a virus.”Genetics, hormones, immunologic response, and environmental influences may play a role in the development of this disease, but the true cause is largely unknown.
• • “Thankfully, my skin will remain unaffected by this disorder.”The skin is the main organ that is affected with SLE.
• Correct
  • “It is important for me to discuss my birth control options with my provider.”Oral contraceptives can cause SLE exacerbations, so it is important for the patient to discuss birth control options with their provider.
• • “The severity of the symptoms I am having now should remain similar throughout the course of my life.”The symptoms of SLE often wax and wane throughout the course of the disease, so severity of symptoms may improve or get worse over time.

Question 8 of 9

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Which statement, if made by the patient with systemic lupus erythematosus (SLE), warrants intervention by the nurse?

• • “I need to check my skin every day for open areas.”Patients with SLE should check their skin daily for any open areas or rashes.
• Correct
  • “I will limit the amount of time I spend in the tanning bed.”Tanning beds should be avoided for patients with SLE as they can cause exacerbations and skin rashes.
• • “I will see my dermatologist about switching to a mild cleanser.”Patients with SLE should use mild cleansing products on the skin, so it is a good idea for them to talk with their dermatologist for their options.
• • “It is important for me to apply sunscreen liberally any time I am outside.”It is important for patients with SLE to use a sun protection factor (SPF) 30 or higher sunblock any time they are outside to protect their skin.

Question 9 of 9

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Which laboratory value would the nurse expect when caring for the patient with systemic lupus erythematosus (SLE)?

• • Hemoglobin 14.5 g/dLThis is a normal hemoglobin value. In SLE, the nurse would expect to see anemia, or low hemoglobin.
• • Platelet count 156,000/uLThough on the low end, this platelet count is still normal. The nurse would expect to see thrombocytopenia, or a low platelet count, in a patient with SLE.
• Correct
  • C-reactive protein 25 mg/LElevated C-reactive protein indicates the presence of inflammation, which is common with SLE.
• • White blood cell count 12,000/uLThe nurse would expect to see leukocytopenia, not leukocytosis, in a patient with SLE.