Medsurg Blood, Lymph & Immune
- 1.Which of the following is NOT part of the lymphatic system
- A.
Lymph nodes
- B.
Spleen
- C.
Hypothalamus
- D.
Lymphatic vessels
- 2.Chemical markers that identify cells or molecules are called?
- A.
Antigens
- B.
Antibodies
- C.
Lymphocytes
- D.
Natural Killer Cells
- 3.What is true about B cells and T cells.
- A.
Both are formed in the red bone marrow, with T cells maturing in the Thymus and B cells maturing in the bone marrow.
- B.
T cells are formed in the thymus
- C.
B cells are formed in the thymus
- D.
B cells and T cells are both formed in the spleen
- 4.What are the functions of T cells in cell mediated immunity?
- A.
Helper T cells stimulate B cells
- B.
T cells attach to infected cells for transport to the kidneys in order to be excreted in urine
- C.
They alert WBCs of foreign objects
- D.
Helper T cells (CD4) stimulate Killer T cells (CD8) which are cytotoxic and lyse infected cells, malignant cells, or foreign tissue. Memory T cells remember for future invasion
- 5.What are the function of Helper T cells (CD4) in humoral immunity?
- A.
Helper T cells stimulate B cells to divide and become specialized
- B.
Helper T cells lyse infected or foreign cells
- C.
Helper T cells attach to B cells to create a super cell
- D.
Helper T cells are not involved in humoral immunity
- 6.What would be the next course of action following a positive ELISA HIV test?
- A.
Advise the patient that they should begin to see symptoms within the next 2-3 weeks
- B.
Patient is started on antiretroviral agents
- C.
Western blot test is performed
- D.
None. A positive ELISA test is good news
- 7.What would determine if a Western Blot test is positive?
- A.
Western Blot is positive only after confirmation using the ELISA test
- B.
At least one HIV antigen is present
- C.
HIV antibodies are present
- D.
The presence of two or more HIV antigens
- 8.What equipment would be needed for the administration of a blood transfusion? (select all that apply)
- A.
Normal Saline
- B.
Lactated Ringers
- C.
Tubing with a filter
- D.
#18 or #20 gauge IV catheter
- 9.A blood transfusion is ordered for a patient with a peripheral IV infusion located in the right forearm running Lactated ringers at 80ml/hour. The nurse begins to prepare another line in the left a/c for the ordered transfusion. The patient requests that the nurse use the existing site. Which statement made by the nurse is correct?
- A.
I will need to infuse the blood transfusion using a separate line
- B.
I will ask the doctor if he will approve it
- C.
That is a good idea since I won't have to stick you again
- D.
I will just wait to start the blood transfusion
- 10.A patient has an order for a unit of packed RBCs to be administered. At 0600 the transfusion is started. At 1000, it is noted that the IV line has clotted with only 80% of the transfusion complete. What intervention should the nurse take?
- A.
Call the blood bank and order another unit of blood
- B.
Flush the line with NS and continue to infuse the remaining 20%
- C.
Discontinue the blood infusion, notify the blood bank and document the findings
- D.
Start another IV line and continue to infuse the remaining 20%
- 11.Before beginning a blood transfusion what assessment of the patient will the nurse make?
- A.
Hematocrit level
- B.
Urine output
- C.
Prothrombin time
- D.
Vital signs
- 12.A blood transfusion is ordered for a patient. As the nurse explains the procedure, the patient advises that he has had an adverse reaction during a previous blood transfusion. What would be appropriate action for the nurse to take?
- A.
Inform the patient that the blood has been checked against his blood type and continue with the infusion
- B.
Hold the transfusion and inform the Doctor of previous reaction
- C.
Administer corticosteroids prior to giving the infusion
- D.
Flush the IV line with NS prior to administering the infusion
- 13.An RN requests the LPNs assistance, as policy requires two nurses be involved in the administration of a blood transfusion. The LPN observes that the patient's date of birth on the blood bag is incorrect. What would be the appropriate action for the LPN?
- A.
Inform the RN, document the discrepancy, and continue with the transfusion
- B.
Advise the RN and leave her/him to administer the transfusion alone
- C.
Throw the blood bag out and request a new unit of blood from the blood bank
- D.
Notify the RN of the discrepancy and do not administer the blood. Inform the blood bank and return the blood to the bank
- 14.The LPN requests that an RN assists in beginning a blood transfusion. After successfully identifying the patient and confirming that the information on the blood bag is correct the infusion is started. What would be the appropriate action for the LPN to take next?
- A.
Check on your other patients while the transfusion is running
- B.
Remain with patient and take vital signs 15 minutes into the transfusion, observing for adverse reactions
- C.
Advise the CNA to remain with the patient and notify you of any observed changes
- D.
Administer O2 at 2Lvia nasal cannula to ensure that the patient's oxygen saturation levels remain stable
- 15.A patient receiving a blood transfusion begins to complain of low back pain. You observe that he begins to wheeze, has chills, and is SOB. The nurse would know that this is probably what type of reaction?
- A.
A normal reaction to receiving new blood
- B.
Hemolytic transfusion reaction
- C.
The blood is cold and needs to be warmed
- D.
Anaphylactic reaction
- 16.A patient arrives to the emergency room and has a normal blood volume but has a decrease in RBCs and Hgb, What type of blood transfusion would they need?
- A.
Packed red blood cells
- B.
Platelets
- C.
Plasma
- D.
Frozen red blood cells
- 17.A patient with hemophilia would receive what type of transfusion?
- A.
Frozen red blood cells
- B.
Cryoprecipitates
- C.
Platelets
- D.
Plasma
- 18.A patient with a scheduled surgery in which blood loss is expected would most likely receive what type of blood transfusion?
- A.
Frozen red blood cells
- B.
Packed red blood cells
- C.
Plasma
- D.
Platelets
- 19.What are IgE antibodies responsible for?
- A.
Provides passive immunity in newborns
- B.
First antibodies produces during an infection
- C.
Provide immunity following a vaccination or illness
- D.
Response to allergic reactions and cause release of histamine which cause an inflammatory response
- 20.Which cells are responsible for producing antibodies?
- A.
T cells
- B.
B cells and T cells
- C.
Natural killer cells
- D.
B cells
- 21.Many studies show that breastfeeding a newborn provides them with antibodies that help protect them against infection. What type of immunity is this?
- A.
Naturally acquired passive immunity
- B.
Artificially acquired passive immunity
- C.
Naturally acquired active immunity
- D.
Artificially acquired active immunity
- 22.Exposure to a small amount of live antigens or a large number of dead antigens results in this type of immunity?
- A.
Artificially acquired passive immunity
- B.
Artificially acquired active immunity
- C.
Naturally acquired passive immunity
- D.
Naturally acquired active immunity
- 23.A 14 y/o that had chicken pox when she was 9 has developed what type of immunity?
- A.
Artificially acquired passive immunity
- B.
Naturally acquired passive immunity
- C.
Naturally acquired active immunity
- D.
Artificially acquired active immunity
- 24.How long does passive immunity last?
- A.
Temporary
- B.
For life
- C.
15 minutes
- D.
None of the above
- 25.The ability to destroy pathogens, foreign materials, or prevent future invasion by the same organism is called?
- A.
Neutralization
- B.
Auto-sensitivity
- C.
Immunity
- D.
Inflammation
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