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CHA 2 Exam 1 | Comprehensive Questions and Answers Latest Updated 2025/2026 With 100% Verified Solutions The source of all blood cells and many immune system cells. - Bone marrow Leukocytes provide protection through defensive actions. What are these specific actions? - o Recognition of self versus non-self for the initiation of defensive inflammation and immunity actions for protection. o Destruction of foreign invaders, cellular debris, and unhealthy or abnormal self cells. o Production of antibodies directed against invaders. What are the three processes needed for human protection through immunity? - (1) Inflammation (innate-native actions) (2) Antibody-mediated immunity (specific adaptive responses) (3) Cell-mediated immunity (specific adaptive responses) The function of this leukocyte is nonspecific digestion and phagocytosis of microorganisms and foreign proteins. - Neutrophils *(Note: key word being nonspecific) Neutrophil function provide protection after invaders, especially bacteria, enter the body. This powerful army of small cells destroys invaders by phagocytosis and enzymatic digestion, although each cell is small and can take part in only one episode of phagocytosis. Nonspecific recognition of foreign proteins and microorganisms; ingestion and phagocytosis. Assists with antibody-mediated immunity and cell-mediated immunity. - Macrophage
Releases vasoactive amines during allergic reactions and in response to parasitic infestations. - Eosinophils For many people with allergic asthma, what is the cell type in the respiratory tract that triggers mediators of inflammation and asthma attacks? - Eosinophils The number of circulating eosinophils increases during an allergic response; when the numbers are very high (eosinophilia), they can cause allergic responses or make them worse. Which change would the nurse expect to see in the WBC differential of a patient who has a prolonged, severe intestinal helminth infestation? - High eosinophil count Releases histamines, kinins, and heparin in areas of tissue damage. - Basophils Basophils stimulate both general inflammation and in inflammation of allergic reactions. When allergens bind to the IgE on the basophil, the basophil membrane opens and releases the vasoactive amines into the blood, where most of them act on smooth muscle and blood vessel walls. Mature in tissues, especially those near blood vessels, lung tissue, skin, and mucous membranes. Have binding sites for the stems of IgE molecules and, when activated, are involved in allergic reactions. They also maintain and prolong inflammation and allergic reactions. - Tissue mast cells Inhibits blood and protein clotting. - Heparin *Basophil function acts on blood vessels with basophil chemicals (vasoactive amines), which include heparin, histamine, serotonin, kinins, and leukotrienes. Dilates arterioles and constricts small vein, slowing blood flow and decreasing venous return. This effect causes blood to collect in capillaries and arterioles. - Histamine
Leukocytes and tissue mast cells in this area secrete histamine, serotonin, and kinins that constrict small veins and dilate arterioles. These changes cause redness and warmth of the tissue. This increased blood flow increases delivery of nutrients to injured tissues. Edema, swelling, and pain occur as blood flow to the area increases (hyperemia). Edema protects the area from further injury by creating a cushion of fluid. What happens in the second stage of inflammation? - Is the cellular exudate response. Neutrophils, basophils, eosinophils, and tissue mast cells are active in this stage, with continuing activation triggered by the release of cytokines from macrophages in the area. When an infection stimulating inflammation lasts longer than just a few days, the bone marrow begins to release immature neutrophils, reducing the number of circulating mature neutrophils. This problemlimits helpful effects of inflammation and increases the risk for sepsis. What happens in the third stage of inflammation? - Features tissue repair and replacement. This stage begins at the time of injury and is critical to the final function of the inflamed area. WBCs involved in inflammation start the replacement of lost tissues or repair of damaged tissues by inducing the remaining healthy cells to divide. In tissues that cannot divide, WBCs trigger new blood vessel growth and scar tissue formation. What is neutrophilia? And why does it occur? - An increased number of circulating neutrophils This occurs in the second stage of inflammation, known as the cellular exudate part of the response. In the final steps of stage I in the inflammatory process, as a result of a small amount of macrophages at the site of injury, macrophages secrete proinflammatory cytokines. Some cytokines cause neutrophils from the bone marrow to move to the site of injury, increasing the number of neutrophils (neutrophilia) or invasion, this process leads to stage II.
How do macrophages contribute to the neurophilia that occurs in response to an acute bacterial infection? - At the onset of invasion, macrophages secrete a colony-stimulating factor to induce the bone marrow to increase production and release of neutrophils. What is plamapheresis? - Plasmapheresis (sometimes called plasma exchange) is an in-hospital procedure prescribed by a primary health care provider in which the patients plasma is treated to remove the antibodies causing the disease. B-cells start as stem cells in the bone marrow, the primary lymphoid tissue. However, the lymphocyte stem cells released into the blood migrate and mature in secondary lymphoid tissues. What are the secondary lymphoid tissues for B-cells? - o Spleen o Parts of lymph nodes o Tonsils o Mucosa of the intestinal tract This type of adaptive immunity occurs when antigens enter a human and he or she responds by making specific antibodies against the antigen. - Active immunity Is ACTIVE because the body takes an ACTIVE part in making antibodies. Explain how natural active immunity occurs. - Occurs when an antigen enters your body naturally without human assistance and your body responds by actively making antibodies against that antigen (e.g., influenza A virus). Illness does not occur again after a second exposure to the same antigen. This immunity is the most effective type of adaptive immunity and is the longest lasting. Explain how artificial active immunity occurs. - The protection developed by vaccination or immunization. This type of protective immunity is used to prevent serious and potentially deadly illnesses (e.g., tetanus, diphtheria, polio).
These cells prevent hypersensitivity and immunity overreactions on exposure to non-self cells or proteins. Preventing the formation of antibodies directed against normal, healthy self cells. - Regulator T-cells, also known as Tregs **When Tregs are less active or nonfunctional, immunity is unchecked resulting is systemic inflammatory disease and continuous WBC activation. Both innate-native immunity and adaptive immunity actions are greatly increased as is the risk for development of autoimmune disorders. These cells have direct cytotoxic effects on some non-self cells without first being sensitized. They are most effective in destroying unhealthy or abnormal self cells such as cancer cells and virally infected body cells. - Natural killer (NK) cells These cells are most effective against self cells infected by parasites, such as viruses or protozoa. - Cytotoxic T-cells Parasite-infected self cells have both self proteins and the parasites antigen on the cell surface. This allows immune system cells to recognize the infected self cell as abnormal, and the cytotoxic T-cells can bind to it, punch a hole, and deliver a "lethal hit" of enzymes to the infected cell, causing it to lyse and die. Important in preventing the development of cancer and metastasis after exposure to carcinogens. - Cell- mediated immunity CMI helps protect the body through the ability to differentiate self from non-self. The non-self cells infected by organisms that live within host cells, especially viruses. CMI watches for and rids the body of self cells that might potentially harm the body. Reaction of IgE antibody on mast cells with antigen, which results in release of mediators, especially histamine. - Type 1: Rapid or Immediate hypersensitivity reaction The most common type of hypersensitivity from excessive inflammation caused by overactive immunity. What are examples of Type 1 reactions? - o Angioedema o Anaphylaxis
o Allergic asthma o Hay fever (rhinosinusitis) An allergen is an antigen that triggers excessive inflammation or immunity overreactions ONLY in susceptible individuals. In what ways can allergens be contacted? - o Inhaled (pollen, fungal spores, dander, dust, grass) o Ingested (food, drugs, food additives) o Injected (venom, drugs, contrast dyes) o Skin or mucous membrane contacted (latex, pollens, foods, environmental proteins) This hypersensitivity reaction occurs when the body makes autoantibodies directed against self cells that have some for of foreign protein attached to them. - Type 2 cytotoxic hypersensitivity reaction Reaction of IgG with host cell membrane or antigen absorbed by host cell membrane. *Remember that CYTOTOXIC T-cells are able to recognize infected self cells and destroy them. *As well as NK cells who have CYTOTOXIC effects and are most effective in destroying unhealthy or abnormal self cells such as cancer cells and virally infected body cells. What are examples of a type 2 hypersensitivity reaction? - o Hemolytic transfusion reaction o Autoimmune hemolytic anemia o Goodpasture syndrome o Myasthenia gravis What is Goodpasture's syndrome? This autoimmune disease is an example of which hypersensitivity reaction? - Autoimmune disease that attacks the basement membranes of the lungs, alevoli, and glomerulus.
This hypersensitivity reaction has T-lymphocytes (T-cells) as the activated immune system component triggering the excessive responses. - Type 4: Delayed hypersensitivity reaction Activates macrophages and induces inflammation. Antibodies and complement are NOT involved (*remember T-cells are part of cell-mediated immunity NOT antibody-mediated immunity). Sensitized T-cells (from a previous exposure) respond to an antigen by releasing chemical mediators and triggering macrophages to destroy the antigen. A type 4 response typically occurs hours to days after exposure. What are common examples of type 4 reactions? - o Contact dermatitis such as poison ivy o Local response to insect stings o Positive PPD test for TB o Graft rejection What is used for the treatment of type 4 hypersensitivity reactions? - Corticosteroids
- can reduce the discomfort and help resolve the reaction more quickly. Histamine (H1) antagonists such as diphenhydramine are not useful for type 4 reactions because histamine is not the main mediator. Because IgE does not cause this type of reaction, desensitization does not reduce the response. What assessment findings would alert the nurse the need to immediately intervene and prepare for possible intubation in a patient with angioedema? - o Inability to swallow o Feeling of a lump in the throat o Stridor *Indications for intubation are the presence of stir and the inability of the patient to swallow. These symptoms indicate that the edema has spread to the larynx.
What is angioedema? - A severe type 1 hypersensitivity reaction that involves the blood vessels and all layers of the skin, mucous membranes, and subcutaneous tissues in the affected area. Angioedema response is a deep-tissue problem of IgE-mediated release of inflammatory proteins, especially bradykinin. Most often seen in the lips, face, tongue, larynx, and neck. With angioedema the reaction is mediated through antibodies and release of vasoactive amines (especially bradykinin). Because of this, what are the two most useful drugs used with this hypersensitivity reaction? - o Corticosteroids (this is going to suppress the antibody-mediated immune response). o Epinephrine (constrict blood vessels to counteract the vasoactive amines) What are priority nursing interventions for a patient with angioedema? - o Stopping the reaction o Ensuring an adequate airway o O2 via NC o Corticosteroid and epinephrine drug therapy o Supplies for possible tracheostomy o Determine the cause o Teach patient to avoid the offending agent Ensure that he or she knows to seek emergency care as soon as any signs or symptoms of the problem occur. (Such as lip swelling or a slight itching in the back of the throat from time to time). Anaphylaxis episodes can vary in severity and can be fetal. What is the major factor in fetal outcomes for anaphylaxis? - Delay in the administration of epinephrine
What interventions does the nurse implement to help manage a patients SLE symptoms? - o Manage persistent pain (acetaminophen and NSAIDs can help moderate daily joint and muscle pain) *during periods of increased SLE activity and more intense pain, corticosteroids are used. o Manage fatigue (make a work, family, leisure list to determine which are "must" activities) (low impact exercises improve endurance) o Drug therapy (corticosteroids such as prednisone remain a common cornerstone of therapy for SLE) o Instruct patients to avoid prolonged exposure to sunlight and other forms of UV light. What is Sjogren syndrome? - Seen in patients with advanced RA Symptoms include: o Dry eyes o Dry mouth o Dry vagina What education would the nurse provide regarding Epi-pens? - o Always keep the device with you (at least two) o When needed, inject the drug into the top of your thigh, slightly to the outside, holding the device so the needle enters straights down. o You can inject the drug right through your pants; just avoid seams and pockets where the fabric is thicker. o Use the device when any symptoms of anaphylaxis is present and before you call 911. **IT IS BETTER TO USE THE DRUG WHEN IT IS NOT NEEDED THAN TO NOT USE IT WHEN IT IS NEEDED! o Get to the hospital when you need to use the device
o Frequently check expiration date of device; if the date is close to expiring or has expired, obtain a replacement device. A rare acute inflammatory disorder that affects the axons and/or myelin of the PNS resulting in ascending muscle weakness or paralysis. - Gillain-Barre syndrome How is AIDS (HIV III) diagnosed? - A diagnosis of AIDS requires that the adult be HIV positive and have either a CD4+ T-cell count less than 200 cells/ mm3 or less than 14%. *Once AIDS is diagnose, even if the patients T-cell count improves or if the percentage rises above 14%, or the infection is successfully treated, the AIDS diagnosis remains. What are priority assessments for a patient with Guillain Barre syndrome? - o Respiratory support patients may have difficulty maintaining a patent airway especially with rapid GB syndrome (ascending paralysis is moving fast). o Skin assessment may have skin breakdown from immobility or osteoporosis (no weight bearing). o GI/ GU o Depression d/t loss of function o Pain assessment worse at night **(treatments such as gabapentin) o Nonpharmacological Q2h position changes, ice or heat o Involve family in plan o Education on disease process 0 Neurological assessment Characterized by weakness or rapid failure of the muscles that are under voluntary control caused by a breakdown in the communication between the nerves and muscle. - Myasthenia Gravis This is a progressive acquired autoimmune disorder. Two types: o Ocular (vision)
A. Superficial lesions over the cheeks and nose B. Shortness of breath C. Weight loss D. Fatigue and fever - A. Superficial lesions over the cheeks and nose Although all of these symptoms can be signs of SLE, the classic sign is the butterfly rash over the cheeks and nose. A 57-year-old patient is admitted with acute bronchitis. During the admission interview, he tells the nurse he's allergic to bananas. The nurse is aware that the patient may also be allergic to: A. Iodine-containing drugs B. Latex C. Cephalosporins D. Penicillins - B. Latex patients that are allergic to certain cross-reactive foods (including apricots, avocados, bananas, cherries, chestnuts, grapes, kiwis, passion fruit, peaches, and tomatoes) may also be allergic to latex. When exposed to latex, they may have an allergic reaction similar to the ones these foods produce. Patients with allergies to shellfish may be allergic to iodine-containing drugs. *Iodine and shellfish go together An autoimmune disorder, is caused by the destruction of acetylcholine receptors causing muscle weakness. - Myasthenia Gravis Caused by a postviral illness characterized by ascending paralysis. - Guillan Barre syndrome Caused by the loss of the myelin sheath surrounding peripheral nerves - Multiple Sclerosis
What are some important educational topics to discuss with a patient newly diagnosed with systemic lupus erythematosus? - They're immunosuppressed so we need to watch for fever. If they have a fever they need to pay attention because this could cause or be in the midst of an exacerbation. Skin needs to be protected with sunscreen. Gloves may need to be worn depending on climate. Pregnancy may be compromised or lead to an exacerbation. You suspect an HIV-III (AIDS) patient has tuberculosis (TB) based off of their symptoms. A PPD test was performed and the results come back negative. What is the most appropriate action for the nurse at this time? - Maintain airborne precautions along with standard precautions for the patient until parameters other than a skin test come back negative for TB. The adult with TB and a CD4+ T-cell count below 200/ mm3 may not have a positive TB skin test because of an inability to mount an immune response to the antigen, a condition known as anergy. What priority education would you provide to the patient newly diagnosed with aspiration pneumonia and their family? - CPR and heimlich maneuver **Airway patency is the priority!
