RN- NCLEX QUESTIONS IMMUNITY
WITH COMPLETE ANSWERS
Which ffof ffthe fffollowing ffclients ffare ffat ffan ffincreased ffrisk ffof ffdeveloping ffKaposi's
ffsarcoma ffskin fflesions? ffSelect ffall ffthat ffapply.
ffa) ffClient ffstatus ffpost ffa ffliver fftransplant
ffb) ffClient ffwith ffacquired ffimmunodeficiency ffsyndrome ff(AIDS)
ffc) ffClient ffwith fftype ff1 ffdiabetes ffmellitus
ffd) ffFemale ffclient ffof ffEuropean ffancestry
ffe) ffMale ffclient ffof ffMediterranean/Jewish ffancestry ff- ffAnswer ffb) ff• ffClient ffwith
ffacquired ffimmunodeficiency ffsyndrome ff(AIDS)
a) ff• ffClient ffstatus ffpost ffa ffliver fftransplant
e) ff• ffMale ffclient ffof ffMediterranean/Jewish ffancestry
Explanation: ff
Clients ffwith ffa ffcompromised ffimmune ffsystem ff(such ffas fftransplant ffclients ffor ffthose
ffwith ffAIDS) ffare ffat ffan ffincreased ffrisk ffof ffdeveloping ffKaposi's ffsarcoma. ffKaposi's
ffsarcoma ffis ffalso ffmore ffprevalent ffamong ffmales ffof ffMediterranean ffor ffJewish
ffancestry, ffalthough ffin ffa ffless ffsevere ffform. ffClients ffwith fftype ff1 ffdiabetes ffmellitus
ffor fffemales ffof ffEuropean ffancestry ffare ffnot ffat ffan ffincreased ffrisk.
indirect ffCoombs' fftest ff- ffAnswer ffTo ffdetect ffmaternal ffantibodies ffagainst fffetal ffRh-
positive fffactor
An ff8-year-old ffchild ffhas ffbeen ffadmitted ffto ffthe ffoncology ffunit ffwith ffa ffsuspected
ffdiagnosis ffof ffacute fflymphoblastic ffleukemia. ffThe ffnurse ffis ffobtaining ffa ffhealth
ffhistory fffrom ffthe ffparents. ffDuring ffthe ffinterview, ffthe ffparents ffask ffthe ffnurse ffif ffany
ffof ffthe fffactors ffdiscussed ffwould ffmake fftheir ffchild ffmore ffat ffrisk fffor ffthis fftype ffof
ffleukemia. ffWhat ffinformation ffabout ffpotential ffrisk fffactors ffis ffcorrect fffor ffthe ffnurse
ffto ffshare ffwith ffthe ffparents?
ffa) ffThe ffdiagnosis ffof ffDown's ffsyndrome ffat ffbirth
ffb) ffA ffdiet ffthat ffincludes ffa fflarge ffproportion ffof ffdairy ffproducts
ffc) ffA ffweight ffthat ffis ffabove ffthe fflimit fffor ffthe ffchild's ffage
ffd) ffThe ffX-rays ffthat ffthe ffchild ffhad ffat ffage ff6 fffor ffa ffbroken ffleg ff- ffAnswer ffa) ffThe
ffdiagnosis ffof ffDown's ffsyndrome ffat ffbirth
Explanation: ff
,Children ffwith ffDown's ffsyndrome ffand ffother ffgenetic ffconditions ffhave ffan ffincreased
ffrisk ffof ffdeveloping ffacute fflymphoblastic ffleukemia. ffPrenatal ffexposure ffto ffX-rays ffis
ffactually ffa ffhigher ffconcern ffthan ffpostnatal ffexposure ffwith ffrespect ffto ffincreasing ffthe
ffrisk ffof ffdeveloping ffALL. ffThe ffexception ffwould ffbe ffpostnatal ffexposure ffto ffhigh
ffdoses ffof fftherapeutic ffradiation ffused ffas ffa fftreatment ffmodality, ffwhich ffwas ffnot
ffindicated ffhere. ffDiet ffwould ffhave fflittle ffimpact ffon ffrisk fffactors ffat ffthis ffstage ffin ffthe
ffchild's fflife.
When ffexplaining ffthe fflong-term fftoxic ffeffects ffof ffcancer fftreatments ffon ffthe ffimmune
ffsystem, ffwhat ffshould ffthe ffnurse fftell ffthe ffclient?
ffa) ffLong-term ffimmunologic ffeffects ffhave ffbeen ffstudied ffonly ffin ffclients ffwith ffbreast
ffand fflung ffcancer.
ffb) ffClients ffwith ffpersistent ffimmunologic ffabnormalities ffafter fftreatment ffare ffat ffa
ffmuch ffgreater ffrisk fffor ffinfection ffthan ffclients ffwith ffa ffhistory ffof ffsplenectomy.
ffc) ffThe ffuse ffof ffradiation ffand ffcombination ffchemotherapy ffcan ffresult ffin ffmore
fffrequent ffand ffmore ffsevere ffimmune ffsystem ffimpairment.
ffd) ffThe ffhelper ffT ffcells ffrecover ffmore ffrapidly ffthan ffthe ffsuppressor ffT ffcells, ffwhich
ffresults ffin ffpositive ffhelper ffcell ffbalance ffthat ffcan fflast ff5 ffyears. ff- ffAnswer ffc) ffThe
ffuse ffof ffradiation ffand ffcombination ffchemotherapy ffcan ffresult ffin ffmore fffrequent ffand
ffmore ffsevere ffimmune ffsystem ffimpairment.
Explanation: ff
Studies ffof fflong-term ffimmunologic ffeffects ffin ffclients fftreated fffor ffleukemia,
ffHodgkin's ffdisease, ffand ffbreast ffcancer ffreveal ffthat ffcombination fftreatments ffof
ffchemotherapy ffand ffradiation ffcan ffcause ffoverall ffbone ffmarrow ffsuppression,
ffdecreased ffleukocyte ffcounts, ffand ffprofound ffimmunosuppression. ffPersistent ffand
ffsevere ffimmunologic ffimpairment ffmay fffollow ffradiation ffand ffchemotherapy
ff(especially ffmultiagent fftherapy). ffThere ffis ffno ffevidence ffof ffgreater ffrisk ffof ffinfection
ffin ffclients ffwith ffpersistent ffimmunologic ffabnormalities. ffSuppressor ffT ffcells ffrecover
ffmore ffrapidly ffthan ffthe ffhelper ffT ffcells.
A ffchild ffwith ffDown ffsyndrome ffhas ffan ffupper ffrespiratory ffinfection ff(URI). ffWhich ffof
ffthe fffollowing ffis ffthe ffnurse's ffbest ffaction? ffSelect ffall ffthat ffapply.
ffa) ffRestricting ffvisitation ffof ffsick ffsiblings ff
ffb) ffProviding fffluids ffthat ffthe ffchild fflikes ff
ffc) ffAdministering ffoxygen ff
ffd) ffConsulting ffa ffspeech fftherapist ff
ffe) ffEnsuring ffthat ffchild ffis ffas ffactive ffas ffpossible ff- ffAnswer ff• ffProviding fffluids ffthat
ffthe ffchild fflikes ff
• ffRestricting ffvisitation ffof ffsick ffsiblings ff
• ffEnsuring ffthat ffchild ffis ffas ffactive ffas ffpossible ff
Explanation: ff
, A ffchild ffwith ffDown ffsyndrome ffhas ffdeficits ffin ffthe ffimmune ffsystem ffand ffincreased
ffmucus ffviscosity, ffwhich ffcontribute ffto ffURI. ffProviding fffluids ffthe ffchild fflikes ffwill
ffincrease ffthe ffchance ffthe ffchild ffwill ffdrink ffthe fffluid ffand ffhelp ffwith ffhydration. ffSick
ffsiblings ffshould ffnot ffvisit, ffas ffthe ffchild ffhas ffdeficits ffin ffthe ffimmune ffsystem.
ffIncreasing ffactivity ffas ffmuch ffas ffpossible ffwill ffhelp ffthe ffURI ffto ffresolve. ffSpeech
fftherapy ffand ffoxygen ffare ffnot ffroutinely ffneeded fffor ffa ffchild ffwith ffDown ffsyndrome
ffwho ffhas ffURI.
When ffpreparing ffa ffteaching ffplan fffor ffa ffclient ffwho ffis ffto ffreceive ffa ffrubella ffvaccine
ffduring ffthe ffpostpartum ffperiod, ffthe ffnurse ffshould ffinclude ffwhich ffinformation?
ffa) ffThe ffvaccine ffprevents ffa fffuture fffetus fffrom ffdeveloping ffcongenital ffanomalies. ff
ffb) ffThe ffclient ffshould ffavoid ffcontact ffwith ffchildren ffdiagnosed ffwith ffrubella. ff
ffc) ffThe ffinjection ffwill ffprovide ffimmunity ffagainst ffthe ffchickenpox.
ffd) ffPregnancy ffshould ffbe ffavoided fffor ff4 ffweeks ffafter ffthe ffimmunization. ff- ffAnswer
ffd) ffPregnancy ffshould ffbe ffavoided fffor ff4 ffweeks ffafter ffthe ffimmunization.
After ffadministration ffof ffrubella ffvaccine, ffthe ffclient ffshould ffbe ffinstructed ffto ffavoid
ffpregnancy fffor ffat ffleast ff4 ffweeks ffto ffprevent ffthe ffpossibility ffof ffthe ffvaccine's
ffteratogenic ffeffects ffto ffthe fffetus.
The ffvaccine ffdoes ffnot ffprotect ffa fffuture fffetus fffrom ffinfection. ffRather ffit ffprotects ffthe
ffwoman fffrom ffdeveloping ffthe ffinfection ffif ffexposed ffduring ffpregnancy ffand
ffsubsequently ffcausing ffharm ffto ffthe fffetus.
The ffvaccine ffwill ffprovide ffimmunity ffto ffrubella, ffalso ffknown ffas ffGerman ffmeasles.
The ffinjection ffimmunizes ffthe ffclient ffagainst ffthe ff3-day ffor ffGerman ffmeasles, ffnot
ffchickenpox.
The ffnurse ffis ffcaring fffor ffa ffclient ffbeing ffdischarged fffollowing ffkidney fftransplantation.
ffThe ffclient ffis ffordered ffmofetil ffto ffprevent fforgan ffrejection. ffWhich ffnursing
ffinstruction ffis ffessential ffregarding ffmedication ffuse?
ffa) ffAdminister ffmedication fffollowing ffbreakfast ffdaily.
ffb) ffSprinkle ffthe ffcontents ffof ffthe ffcapsule ffon fffood.
ffc) ffContact ffthe ffhealth ffcare ffprovider ffat fffirst ffsigns ffof ffan ffinfection.
ffd) ffAdminister ffthe ffmedication ffwith ffan ffantacid ffto ffprevent ffstomach ffupset. ff-
ffAnswer ffc) ffContact ffthe ffhealth ffcare ffprovider ffat fffirst ffsigns ffof ffan ffinfection.
Mofetil ffis ffan fforgan ffrejection ffmedication ffthat ffdiminishes ffthe ffbody's ffability ffto
ffidentify ffand ffeliminate ffpathogens ff(immunosuppressant). ffIdentifying ffsymptoms ffof
ffinfection ffat ffan ffearly ffstate ffis ffhelpful ffin fftreating ffthe ffinfection. ffThis ffmedication ffis
ffadministered ffon ffan ffempty ffstomach. ffTypically, ffcapsules ffwould ffnot ffbe ffopened
ffdispensing ffmedication ffat ffone fftime. ffAntacids ffmay ffdecrease ffthe ffabsorption ffof ffthe
ffmedication
WITH COMPLETE ANSWERS
Which ffof ffthe fffollowing ffclients ffare ffat ffan ffincreased ffrisk ffof ffdeveloping ffKaposi's
ffsarcoma ffskin fflesions? ffSelect ffall ffthat ffapply.
ffa) ffClient ffstatus ffpost ffa ffliver fftransplant
ffb) ffClient ffwith ffacquired ffimmunodeficiency ffsyndrome ff(AIDS)
ffc) ffClient ffwith fftype ff1 ffdiabetes ffmellitus
ffd) ffFemale ffclient ffof ffEuropean ffancestry
ffe) ffMale ffclient ffof ffMediterranean/Jewish ffancestry ff- ffAnswer ffb) ff• ffClient ffwith
ffacquired ffimmunodeficiency ffsyndrome ff(AIDS)
a) ff• ffClient ffstatus ffpost ffa ffliver fftransplant
e) ff• ffMale ffclient ffof ffMediterranean/Jewish ffancestry
Explanation: ff
Clients ffwith ffa ffcompromised ffimmune ffsystem ff(such ffas fftransplant ffclients ffor ffthose
ffwith ffAIDS) ffare ffat ffan ffincreased ffrisk ffof ffdeveloping ffKaposi's ffsarcoma. ffKaposi's
ffsarcoma ffis ffalso ffmore ffprevalent ffamong ffmales ffof ffMediterranean ffor ffJewish
ffancestry, ffalthough ffin ffa ffless ffsevere ffform. ffClients ffwith fftype ff1 ffdiabetes ffmellitus
ffor fffemales ffof ffEuropean ffancestry ffare ffnot ffat ffan ffincreased ffrisk.
indirect ffCoombs' fftest ff- ffAnswer ffTo ffdetect ffmaternal ffantibodies ffagainst fffetal ffRh-
positive fffactor
An ff8-year-old ffchild ffhas ffbeen ffadmitted ffto ffthe ffoncology ffunit ffwith ffa ffsuspected
ffdiagnosis ffof ffacute fflymphoblastic ffleukemia. ffThe ffnurse ffis ffobtaining ffa ffhealth
ffhistory fffrom ffthe ffparents. ffDuring ffthe ffinterview, ffthe ffparents ffask ffthe ffnurse ffif ffany
ffof ffthe fffactors ffdiscussed ffwould ffmake fftheir ffchild ffmore ffat ffrisk fffor ffthis fftype ffof
ffleukemia. ffWhat ffinformation ffabout ffpotential ffrisk fffactors ffis ffcorrect fffor ffthe ffnurse
ffto ffshare ffwith ffthe ffparents?
ffa) ffThe ffdiagnosis ffof ffDown's ffsyndrome ffat ffbirth
ffb) ffA ffdiet ffthat ffincludes ffa fflarge ffproportion ffof ffdairy ffproducts
ffc) ffA ffweight ffthat ffis ffabove ffthe fflimit fffor ffthe ffchild's ffage
ffd) ffThe ffX-rays ffthat ffthe ffchild ffhad ffat ffage ff6 fffor ffa ffbroken ffleg ff- ffAnswer ffa) ffThe
ffdiagnosis ffof ffDown's ffsyndrome ffat ffbirth
Explanation: ff
,Children ffwith ffDown's ffsyndrome ffand ffother ffgenetic ffconditions ffhave ffan ffincreased
ffrisk ffof ffdeveloping ffacute fflymphoblastic ffleukemia. ffPrenatal ffexposure ffto ffX-rays ffis
ffactually ffa ffhigher ffconcern ffthan ffpostnatal ffexposure ffwith ffrespect ffto ffincreasing ffthe
ffrisk ffof ffdeveloping ffALL. ffThe ffexception ffwould ffbe ffpostnatal ffexposure ffto ffhigh
ffdoses ffof fftherapeutic ffradiation ffused ffas ffa fftreatment ffmodality, ffwhich ffwas ffnot
ffindicated ffhere. ffDiet ffwould ffhave fflittle ffimpact ffon ffrisk fffactors ffat ffthis ffstage ffin ffthe
ffchild's fflife.
When ffexplaining ffthe fflong-term fftoxic ffeffects ffof ffcancer fftreatments ffon ffthe ffimmune
ffsystem, ffwhat ffshould ffthe ffnurse fftell ffthe ffclient?
ffa) ffLong-term ffimmunologic ffeffects ffhave ffbeen ffstudied ffonly ffin ffclients ffwith ffbreast
ffand fflung ffcancer.
ffb) ffClients ffwith ffpersistent ffimmunologic ffabnormalities ffafter fftreatment ffare ffat ffa
ffmuch ffgreater ffrisk fffor ffinfection ffthan ffclients ffwith ffa ffhistory ffof ffsplenectomy.
ffc) ffThe ffuse ffof ffradiation ffand ffcombination ffchemotherapy ffcan ffresult ffin ffmore
fffrequent ffand ffmore ffsevere ffimmune ffsystem ffimpairment.
ffd) ffThe ffhelper ffT ffcells ffrecover ffmore ffrapidly ffthan ffthe ffsuppressor ffT ffcells, ffwhich
ffresults ffin ffpositive ffhelper ffcell ffbalance ffthat ffcan fflast ff5 ffyears. ff- ffAnswer ffc) ffThe
ffuse ffof ffradiation ffand ffcombination ffchemotherapy ffcan ffresult ffin ffmore fffrequent ffand
ffmore ffsevere ffimmune ffsystem ffimpairment.
Explanation: ff
Studies ffof fflong-term ffimmunologic ffeffects ffin ffclients fftreated fffor ffleukemia,
ffHodgkin's ffdisease, ffand ffbreast ffcancer ffreveal ffthat ffcombination fftreatments ffof
ffchemotherapy ffand ffradiation ffcan ffcause ffoverall ffbone ffmarrow ffsuppression,
ffdecreased ffleukocyte ffcounts, ffand ffprofound ffimmunosuppression. ffPersistent ffand
ffsevere ffimmunologic ffimpairment ffmay fffollow ffradiation ffand ffchemotherapy
ff(especially ffmultiagent fftherapy). ffThere ffis ffno ffevidence ffof ffgreater ffrisk ffof ffinfection
ffin ffclients ffwith ffpersistent ffimmunologic ffabnormalities. ffSuppressor ffT ffcells ffrecover
ffmore ffrapidly ffthan ffthe ffhelper ffT ffcells.
A ffchild ffwith ffDown ffsyndrome ffhas ffan ffupper ffrespiratory ffinfection ff(URI). ffWhich ffof
ffthe fffollowing ffis ffthe ffnurse's ffbest ffaction? ffSelect ffall ffthat ffapply.
ffa) ffRestricting ffvisitation ffof ffsick ffsiblings ff
ffb) ffProviding fffluids ffthat ffthe ffchild fflikes ff
ffc) ffAdministering ffoxygen ff
ffd) ffConsulting ffa ffspeech fftherapist ff
ffe) ffEnsuring ffthat ffchild ffis ffas ffactive ffas ffpossible ff- ffAnswer ff• ffProviding fffluids ffthat
ffthe ffchild fflikes ff
• ffRestricting ffvisitation ffof ffsick ffsiblings ff
• ffEnsuring ffthat ffchild ffis ffas ffactive ffas ffpossible ff
Explanation: ff
, A ffchild ffwith ffDown ffsyndrome ffhas ffdeficits ffin ffthe ffimmune ffsystem ffand ffincreased
ffmucus ffviscosity, ffwhich ffcontribute ffto ffURI. ffProviding fffluids ffthe ffchild fflikes ffwill
ffincrease ffthe ffchance ffthe ffchild ffwill ffdrink ffthe fffluid ffand ffhelp ffwith ffhydration. ffSick
ffsiblings ffshould ffnot ffvisit, ffas ffthe ffchild ffhas ffdeficits ffin ffthe ffimmune ffsystem.
ffIncreasing ffactivity ffas ffmuch ffas ffpossible ffwill ffhelp ffthe ffURI ffto ffresolve. ffSpeech
fftherapy ffand ffoxygen ffare ffnot ffroutinely ffneeded fffor ffa ffchild ffwith ffDown ffsyndrome
ffwho ffhas ffURI.
When ffpreparing ffa ffteaching ffplan fffor ffa ffclient ffwho ffis ffto ffreceive ffa ffrubella ffvaccine
ffduring ffthe ffpostpartum ffperiod, ffthe ffnurse ffshould ffinclude ffwhich ffinformation?
ffa) ffThe ffvaccine ffprevents ffa fffuture fffetus fffrom ffdeveloping ffcongenital ffanomalies. ff
ffb) ffThe ffclient ffshould ffavoid ffcontact ffwith ffchildren ffdiagnosed ffwith ffrubella. ff
ffc) ffThe ffinjection ffwill ffprovide ffimmunity ffagainst ffthe ffchickenpox.
ffd) ffPregnancy ffshould ffbe ffavoided fffor ff4 ffweeks ffafter ffthe ffimmunization. ff- ffAnswer
ffd) ffPregnancy ffshould ffbe ffavoided fffor ff4 ffweeks ffafter ffthe ffimmunization.
After ffadministration ffof ffrubella ffvaccine, ffthe ffclient ffshould ffbe ffinstructed ffto ffavoid
ffpregnancy fffor ffat ffleast ff4 ffweeks ffto ffprevent ffthe ffpossibility ffof ffthe ffvaccine's
ffteratogenic ffeffects ffto ffthe fffetus.
The ffvaccine ffdoes ffnot ffprotect ffa fffuture fffetus fffrom ffinfection. ffRather ffit ffprotects ffthe
ffwoman fffrom ffdeveloping ffthe ffinfection ffif ffexposed ffduring ffpregnancy ffand
ffsubsequently ffcausing ffharm ffto ffthe fffetus.
The ffvaccine ffwill ffprovide ffimmunity ffto ffrubella, ffalso ffknown ffas ffGerman ffmeasles.
The ffinjection ffimmunizes ffthe ffclient ffagainst ffthe ff3-day ffor ffGerman ffmeasles, ffnot
ffchickenpox.
The ffnurse ffis ffcaring fffor ffa ffclient ffbeing ffdischarged fffollowing ffkidney fftransplantation.
ffThe ffclient ffis ffordered ffmofetil ffto ffprevent fforgan ffrejection. ffWhich ffnursing
ffinstruction ffis ffessential ffregarding ffmedication ffuse?
ffa) ffAdminister ffmedication fffollowing ffbreakfast ffdaily.
ffb) ffSprinkle ffthe ffcontents ffof ffthe ffcapsule ffon fffood.
ffc) ffContact ffthe ffhealth ffcare ffprovider ffat fffirst ffsigns ffof ffan ffinfection.
ffd) ffAdminister ffthe ffmedication ffwith ffan ffantacid ffto ffprevent ffstomach ffupset. ff-
ffAnswer ffc) ffContact ffthe ffhealth ffcare ffprovider ffat fffirst ffsigns ffof ffan ffinfection.
Mofetil ffis ffan fforgan ffrejection ffmedication ffthat ffdiminishes ffthe ffbody's ffability ffto
ffidentify ffand ffeliminate ffpathogens ff(immunosuppressant). ffIdentifying ffsymptoms ffof
ffinfection ffat ffan ffearly ffstate ffis ffhelpful ffin fftreating ffthe ffinfection. ffThis ffmedication ffis
ffadministered ffon ffan ffempty ffstomach. ffTypically, ffcapsules ffwould ffnot ffbe ffopened
ffdispensing ffmedication ffat ffone fftime. ffAntacids ffmay ffdecrease ffthe ffabsorption ffof ffthe
ffmedication
