NCLEX-Style Questions: Immune & Infectious Disorders
1. A nurse is reviewing a client’s lab results. Which of the following findings
should the nurse recognize as an indication of neutropenia?
A. WBC count of 6,000/mm³
B. Neutrophil count of 1,800/mm³
C. Lymphocyte count of 3,000/mm³
D. Neutrophil count of 3,000/mm³
Correct Answer: B
Rationale: Neutropenia is defined as a neutrophil count less than
2,000/mm³. This increases the client’s risk for infection.
2. A nurse is caring for a client with AIDS. Which of the following actions is a
priority?
A. Monitor for signs of infection
B. Educate about medication adherence
C. Monitor nutritional intake
D. Assess skin integrity
Correct Answer: A
Rationale: Clients with AIDS are severely immunocompromised,
placing them at highest risk for opportunistic infections. Infection
prevention and early detection is the priority.
3. Which of the following laboratory tests confirms an HIV infection after an
initial positive ELISA screening?
A. CD4 count
B. Western blot
C. PCR
D. HIV RNA viral load
Correct Answer: B
Rationale: The Western blot is the confirmatory test following a
positive ELISA for HIV.
4. A nurse is teaching a client with a new diagnosis of HIV about infection
control. Which of the following statements indicates a need for further teaching?
A. "I can get HIV from sharing needles."
B. "I should avoid getting flu and pneumonia vaccines."
C. "I should always use a condom during sex."
D. "I can still hug my grandchildren."
Correct Answer: B
Rationale: Clients with HIV should be encouraged to receive
vaccines (excluding live vaccines during immunosuppression), such as
the influenza and pneumococcal vaccines.
5. Which WBC is primarily responsible for allergic reactions and parasitic
infections?
A. Neutrophils
B. Monocytes
C. Eosinophils
D. Lymphocytes
, Correct Answer: C
Rationale: Eosinophils are involved in allergic reactions and defense
against parasites.
High-Yield Review Topics
WBCs & Differential
● Neutrophils (55–70%): ↑ in acute bacterial infection; ↓ in sepsis,
radiation.
● Lymphocytes (20–40%): ↑ in chronic infections, viral illness.
● Monocytes (2–8%): ↑ in chronic inflammation.
● Eosinophils (1–4%): ↑ in allergies, parasitic infections.
● Basophils (0.5–1%): ↑ in leukemia; ↓ in allergic reactions.
⚠️ Left Shift
● Increased immature neutrophils (bands) = acute infection.
● Indicates bone marrow response to infection.
Neutropenia Precautions
● ANC < 1,000 = initiate protective isolation.
● No fresh flowers, raw fruits/veggies, or sick visitors.
Allergy Testing
● Skin testing: Scratch/prick, watch for wheal/flare.
● RAST test (IgE): Safer for severe allergy hx.
HIV/AIDS
● Stages: Acute (flu-like), Chronic Asymptomatic, AIDS.
● CD4 < 200 = AIDS
● Viral load monitoring tracks disease progression.
● Antiretroviral therapy is essential—compliance critical.
Transmission of HIV
● Sexual contact (esp. receptive anal sex = highest risk)
● Blood, perinatal, breastfeeding, IV drug use
● NOT transmitted by saliva, hugging, toilet seats, or sharing utensils.
1. A nurse is reviewing a client’s lab results. Which of the following findings
should the nurse recognize as an indication of neutropenia?
A. WBC count of 6,000/mm³
B. Neutrophil count of 1,800/mm³
C. Lymphocyte count of 3,000/mm³
D. Neutrophil count of 3,000/mm³
Correct Answer: B
Rationale: Neutropenia is defined as a neutrophil count less than
2,000/mm³. This increases the client’s risk for infection.
2. A nurse is caring for a client with AIDS. Which of the following actions is a
priority?
A. Monitor for signs of infection
B. Educate about medication adherence
C. Monitor nutritional intake
D. Assess skin integrity
Correct Answer: A
Rationale: Clients with AIDS are severely immunocompromised,
placing them at highest risk for opportunistic infections. Infection
prevention and early detection is the priority.
3. Which of the following laboratory tests confirms an HIV infection after an
initial positive ELISA screening?
A. CD4 count
B. Western blot
C. PCR
D. HIV RNA viral load
Correct Answer: B
Rationale: The Western blot is the confirmatory test following a
positive ELISA for HIV.
4. A nurse is teaching a client with a new diagnosis of HIV about infection
control. Which of the following statements indicates a need for further teaching?
A. "I can get HIV from sharing needles."
B. "I should avoid getting flu and pneumonia vaccines."
C. "I should always use a condom during sex."
D. "I can still hug my grandchildren."
Correct Answer: B
Rationale: Clients with HIV should be encouraged to receive
vaccines (excluding live vaccines during immunosuppression), such as
the influenza and pneumococcal vaccines.
5. Which WBC is primarily responsible for allergic reactions and parasitic
infections?
A. Neutrophils
B. Monocytes
C. Eosinophils
D. Lymphocytes
, Correct Answer: C
Rationale: Eosinophils are involved in allergic reactions and defense
against parasites.
High-Yield Review Topics
WBCs & Differential
● Neutrophils (55–70%): ↑ in acute bacterial infection; ↓ in sepsis,
radiation.
● Lymphocytes (20–40%): ↑ in chronic infections, viral illness.
● Monocytes (2–8%): ↑ in chronic inflammation.
● Eosinophils (1–4%): ↑ in allergies, parasitic infections.
● Basophils (0.5–1%): ↑ in leukemia; ↓ in allergic reactions.
⚠️ Left Shift
● Increased immature neutrophils (bands) = acute infection.
● Indicates bone marrow response to infection.
Neutropenia Precautions
● ANC < 1,000 = initiate protective isolation.
● No fresh flowers, raw fruits/veggies, or sick visitors.
Allergy Testing
● Skin testing: Scratch/prick, watch for wheal/flare.
● RAST test (IgE): Safer for severe allergy hx.
HIV/AIDS
● Stages: Acute (flu-like), Chronic Asymptomatic, AIDS.
● CD4 < 200 = AIDS
● Viral load monitoring tracks disease progression.
● Antiretroviral therapy is essential—compliance critical.
Transmission of HIV
● Sexual contact (esp. receptive anal sex = highest risk)
● Blood, perinatal, breastfeeding, IV drug use
● NOT transmitted by saliva, hugging, toilet seats, or sharing utensils.
