Chapter 7: Adaptive Immunity

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1

Which of the following is responsible for initiating clonal selection?

a. T cells

b. B cells

c. antigens

d. lymphocytes

c. antigens

The lymphocytes remain dormant until an antigen initiates clonal selection.

2

After teaching the students about B cells, which statement indicates teaching was successful? B cells are originally derived from cells of the:

a. bone marrow

b. lymph nodes

c. gut-associated lymphoid tissue

d. thymus

a. bone marrow

B cells are derived from the bone marrow.

3

A 6-year-old female is diagnosed with a bacterial infection of the respiratory system. Which of the following will most likely try to fight the antigen?

a. antibodies

b. cytotoxic T cells

c. self-antigens

d. helper T cells

a. antibodies

Antibodies are produced by plasma cells that mature from lymphocytes, called B lymphocytes (B cells), in response to an antigen.

4

When the immunoglobulin crosses the placenta, what type of immunity does the fetus receive?

a. active

b. passive

c. innate

d. cell-mediated

b. passive

Maternal antibodies that pass across the placenta into the fetus before birth provide passive systemic immunity.

5

An immunologist has isolated a molecule from the human body to study. It is found to react with antibodies on B cells. Further testing reveals that the molecule is large and chemically diverse. What type of molecule is the immunologist studying?

a. antigen

b. immunogen

c. epitope

d. paratope

a. antigen

Antibodies react with antigens.

6

Which statement indicates a correct understanding of antibodies? The most abundant class of antibody in the serum is:

a. IgG

b. IgM

c. IgA

d. IgE

a. IgG

IgG is the most abundant class of immunoglobulins, constituting 80-85% if the immunoglobulins in the blood.

7

The predominant antibody of a typical primary immune response is:

a. IgG

b. IgM

c. IgA

d. IgE

b. IgM

IgM is the largest immunoglobulin and is the first antibody produced during the initial, or primary, response to an antigen.

8

An immunology nurse is caring for a patient. While planning care, which principle will the nurse remember? The primary role of IgA1is to prevent infections in the:

a. blood

b. kidneys

c. lungs

d. mucous membranes

a. blood

IgA1 is found predominantly in the blood.

9

A 23-year-old pregnant female visits her primary care provider for her final prenatal checkup. The primary care provider determines that the fetus has developed an infection in utero. Which of the following would be increased in the fetus at birth?

a. IgG

b. IgA

c. IgM

d. IgD

c. IgM

IgM is synthesized early in neonatal life, and its synthesis may be increased as a response to infection in utero.

10

Which portion of the antibody is responsible for the biologic functions of antibodies?

a. heavy chain

b. variable region

c. Fc portion

d. epitope

c. Fc portion

The Fc portion is responsible for most of the functions of antibodies.

11

An experiment is carried out to characterize newly discovered immunoglobulins. Specificity of the amino acids within the immunoglobulin could be determined by studying the:

a. C region of the light chain

b. C region of the heavy chain

c. Complementary-determining region (CDR)

d. Framework regions

c. Complementary-determining region (CDR)

The amino acid differences are clustered into three areas in the variable region. These three areas are called CDRs>

12

A 20-year-old female is applying for nursing school and is required to be tested for immunity against several illnesses. Testing that looks at which of the following would be the best to determine immunity?

a. culture and sensitivity

b. agglutination

c. precipitation

d. titer

d. titer

The amount of antibody in a serum sample is referred to as the titer; a higher titer indicates more antibodies.

13

A 10-year-old male is stung by a bee while playing in the yard. He experiences a severe allergic reaction and has to go to the ER. The nurse providing care realizes this reaction is the result of:

a. toxoids

b. IgA

c. IgE

d. IgM

c. IgE

IgE is normally at low concentrations in the circulation. It has very specialized functions as a mediator of many common allergic responses.

14

A 25-year-old female has sexual relations with her boyfriend. Later she is told that the boyfriend is infected with Neisseria gonorrhoeae. Testing reveals that she does not have the disease. How is it possible that she did not contract the disease?

a. antibodies covered sites of attachment

b. she was vaccinated against it

c. platelets provided protection

d. IgE was released

a. antibodies covered sites of attachment

Some bacteria, such as Neisseria gonorrhoeae that causes gonorrhea, must attach to specific sites on urogenital epithelial cells. Antibodies may protect the host by covering sites on the microorganism that are needed for attachment, thereby preventing infection.

15

Which of the following characteristics is shared by both the secretory and systemic immune systems?

a. lymphocytic paths of migration

b. neutralization following antigen-antibody binding

c. timing of the response

d. location of the response

b. neutralization following antigen-antibody binding

Direct effects result from the binding of the antibody directly to a harmful antigen or infectious agent. These include inhibition of processed that are necessary for infection, such as the reaction of an infectious agent with a particular cell in the body or neutralization of harmful bacterial toxins.

16

A patient has done research on monoclonal antibodies on the internet. Which statement indicates a correct understanding? Pure monoclonal antibodies are produced by:

a. T lymphocytes

b. bone marrow

c. labs

d. fetuses

c. labs

Monoclonal antibodies are produced in the lab from one B cell that has been cloned; thus, the entire antibody is of the same class, specificity, and function.

17

An experiment is designed to determine specific cell types involved in the cell-mediated immune response. The experimenter is interested in finding cells that attack cells that have specific antigens. Which cells should be isolated?

a. lymphokine-producing cells

b. cytotoxic T cells

c. helper T cells

d. macrophages

b. cytotoxic T cells

Cell-mediated immunity is driven by T-cytotoxic (Tc) cells that attack antigens directly and destroy cells that bear foreign antigens.

18

Which of the following statements indicate more teaching is needed regarding secondary lymph organs? ________ is/are a secondary lymph organ.

a. The spleen

b. Peyer patches

c. Adenoids

d. The liver

d. The liver

The liver is NOT a secondary lymph organ.

19

After a patient is exposed to a specific antigen, B cells will differentiate into:

a. B cytotoxic cells

b. Clonal equivalents

c. Plasma cells

d. Bursal cells

c. Plasma cells

The B cell differentiates into plasma cells.

20

A macrophage was isolated and analyzed for major histocompatibility complex (MHC). Which of the following would be expected?

a. MHC I only

b. MHC II only

c. MHC I and II

d. Neither MHC I or II

c. MHC I and II

MHC I and II would be expected.

21

A cell that is produced in the thymus and interacts with MHC class II molecules would have which of the following surface proteins?

a. CD4

b. CD8

c. Th1

d. Superantigen

a. CD4

CD4-positive Th cells are restricted to interactions with cells presenting antigen by MHC class II molecules.

22

A 6-month-old infant is brought to the pediatrician for recurrent colds. The child is fed formula, and the other family members have not been ill. The PCP tells the mother that the child's immune system is not yet competent, but will be about 60% of an adult system around age_____ months.

a. 3

b. 6

c. 9

d. 12

d. 12

23

A 5-month-old child is admitted to the hospital with recurring respiratory infections. A possible cause of this condition is:

a. hypergammaglobulinemia

b. increased maternal IgG

c. immune insufficiency

d. decreased maternal antibody breakdown, resulting in hyposensitivity

c. immune insufficiency

Normal human infants are immunologically immature when born, with deficiencies in antibody production, phagocytic activity, and complement activity, especially components of alternative pathways.

24

Which patient will develop active immunity? A patient who:

a. has natural exposure to an antigen or receives an immunization

b. receives preformed antibodies or T cells from a donor

c. has T cells that become B cells

d. receives immunoglobulin

a. has natural exposure to an antigen or receives an immunization

25

A 16-year-old is bitten by a rabid dog while jogging in the park. Upon admission to the ER, the nurse will administer which of the following to help prevent infection?

a. cytotoxic T cells

b. helper T cells

c. macrophages

d. immune globulins

d. immune globulins

Unvaccinated individuals who are exposed to particular infectious agents are often given immune globulins, which are prepared from individuals who already have antibodies against that particular pathogen.

26

Self-antigens do not meet the requirements for immunogenicity because they lack which of the following?

a. foreignness

b. size

c. quantity

d. virulence

a. foreignness

Foreignness does not normally elicit an immune response.

27

A patient has a disease state that results from the secretion of toxins by bacteria. Which medical diagnosis will the nurse see documented on the chart?

a. malaria

b. tetanus

c. smallpox

d. hepatitis

b. tetanus

Some bacteria secrete toxins that harm individuals such as tetanus and diphtheria.

28

While planning care for an elderly patient, the nurse remembers that increased age is associated with:

a. increased T cell function

b. decreased immune function

c. increased production of antibodies

d. decreased numbers of circulating immune complexes

e. decreased ability to fight infection

b. decreased immune function

d. decreased numbers of circulating immune complexes

e. decreased ability to fight infection

29

When a patient asks about secondary lymph organs, how should the nurse respond? Secondary lymph organs include:

a. spleen

b. peyer patches

c. adenoids

d. liver

e. bone marrow

f. appendix

a. spleen

b. peyer patches

c. adenoids

f. appendix

30

Direct effects of antibodies include:

a. neutralization

b. agglutination

c. precipitation

d. phagocytosis

e. division

a. neutralization

b. agglutination

c. precipitation