Chapter 42 The Child with an Immunologic Alteration

Chapter 42  The Child with an Immunologic Alteration

Complete Chapter Questions And Answers
 

Sample Questions

MULTIPLE CHOICE

1. A nurse in a well-child clinic is teaching parents about their child’s immune system. Which

statement by the nurse is correct?
a. The immune system distinguishes and actively protects the body’s own cells from

foreign substances.
b. The immune system is fully developed by 1 year of age.
c. The immune system protects the child against communicable diseases in the first 6

years of life.
d. The immune system responds to an offending agent by producing antigens.

ANS: A
The immune system responds to foreign substances, or antigens, by producing antibodies
and storing information. Intact skin, mucous membranes, and processes such as coughing,
sneezing, and tearing help maintain internal homeostasis. Children up to age 6 or 7 years
have limited antibodies against common bacteria. The immunoglobulins reach adult levels
at different ages. Immunization is the basis from which the immune system activates
protection against some communicable diseases. Antibodies are produced by the immune
system against invading agents, or antigens.

PTS: 1 DIF: Cognitive Level: Comprehension/Understanding
REF: p. 932 OBJ: Integrated Process: Teaching-Learning
MSC: Client Needs: Physiologic Integrity

2. A nurse is teaching parents about the importance of immunizations for infants because of

immaturity of the immune system. The parents demonstrate that they understand the
teaching if they make which statement?
a. “We plan to opt out of most childhood vaccinations.”
b. “There are only a few diseases that have effective immunizations.”
c. “Babies are born with a sophisticated immune system so they need few, if any,

immunizations.”
d. “Newborns have a hard time fighting infection so they need vaccinations.”

ANS: D
Immaturity of the immune system places an infant and young child a greater risk of
infection, so they need protection through a scheduled series of immunizations. Parents can
opt out of many vaccinations, but the nurse should investigate why they plan to do so. Most
communicable disease of childhood have immunizations.

PTS: 1 DIF: Cognitive Level: Evaluation/Evaluating
REF: p. 935 | Pediatric Differences Box OBJ: Nursing Process: Evaluation
MSC: Client Needs: Health Promotion and Maintenance

3. Which organs and tissues control the two types of specific immune functions?

a. The spleen and mucous membranes
b. Upper and lower intestinal lymphoid tissue

c. The skin and lymph nodes
d. The thymus and bone marrow

ANS: D
The thymus controls cell-mediated immunity (cells that mature into T lymphocytes). The
bone marrow controls humoral immunity (stem cells for B lymphocytes). Both the spleen
and mucous membranes are secondary organs of the immune system that act as filters to
remove debris and antigens and foster contact with T lymphocytes. Gut-associated lymphoid
tissue is a secondary organ of the immune system. This tissue filters antigens entering the
gastrointestinal tract. The skin and lymph nodes are secondary organs of the immune
system.

PTS: 1 DIF: Cognitive Level: Knowledge/Remembering
REF: p. 932 OBJ: Nursing Process: Assessment
MSC: Client Needs: Physiologic Integrity

4. The nursing student learns how infants acquire immunity. Which statement about this

process is correct?
a. The infant acquires humoral and cell-mediated immunity in response to infections

and immunizations.
b. The infant acquires maternal antibodies that ensure immunity up to 12 months age.
c. Active immunity is acquired from the mother and lasts 6 to 7 months.
d. Passive immunity develops in response to immunizations.

ANS: A
Infants acquire long-term active immunity from exposure to antigens and vaccines.
Immunity is acquired actively and passively. The term infant’s passive immunity is acquired
from the mother and begins to dissipate during the first 6 to 8 months of life. Passive
immunity is acquired from the mother. Active immunity develops in response to
immunizations.

PTS: 1 DIF: Cognitive Level: Knowledge/Remembering
REF: p. 933 OBJ: Integrated Process: Teaching-Learning
MSC: Client Needs: Physiologic Integrity

5. What is the most common mode of transmission of human immunodeficiency virus (HIV)

in the pediatric population?
a. Perinatal transmission
b. Sexual abuse
c. Blood transfusions
d. Poor handwashing

ANS: A

Perinatal transmission accounts for the highest percentage (91%) of HIV infections in
children. Infected women can transmit the virus to their infants across the placenta during
pregnancy, at delivery, and through breastfeeding. Cases of HIV infection from sexual
abuse have been reported; however, perinatal transmission accounts for most pediatric HIV
infections. Although in the past some children became infected with HIV through blood
transfusions, improved laboratory screening has significantly reduced the probability of
contracting HIV from blood products. Poor handwashing is not an etiology of HIV
infection.

PTS: 1 DIF: Cognitive Level: Knowledge/Remembering
REF: p. 938 OBJ: Nursing Process: Assessment
MSC: Client Needs: Physiologic Integrity