The mechanism responsible for the rejection of transplanted tissue and the destruction of single malignant cells is known as immunosurveillance. The nurse understands that this is a function of:
a. helper T lymphocytes.
b. suppressor T lymphocytes.
c. T4 lymphocytes.
d. killer T lymphocytes.
D
Cytotoxic or killer T cells (CD8 marker) participate directly in the destruction of antigens by binding to and altering the intracellular environment, which ultimately destroys the cell. Killer cells also release cytotoxic substances into the antigen cell that cause cell lysis. Killer T cells additionally provide the body with immunosurveillance capabilities that monitor for abnormal cells or tissue. This mechanism is responsible for the rejection of transplanted tissue and the destruction of single malignant cells. Helper T cells (also known as T4 cells because they carry a CD4 marker) enhance the humoral immune response by stimulating B cells to differentiate and produce antibodies. Suppressor T cells downgrade and suppress the humoral and cell-mediated responses.
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The nurse is planning care for four infants who were born on this shift. The infant who will require the most detailed assessment is the one whose mother:
1. Has a history of obsessive-compulsive disorder (OCD). 2. Has chlamydia. 3. Has delivered six other children by cesarean section. 4. Has a urinary tract infection (UTI).
A parent of a 3-year-old boy states that she is concerned because he was potty trained long be-fore hospitalization but now refuses to use the toilet. What is the correct response by the nurse?
1. "Your son is probably feeling neglected, and you should make an effort to spend more time with him." 2. "This is common behavior that is expressed when the hospitalized child is stressed or anxious." 3. "You may need to include discipline because children easily lose the ability to be toilet trained during hospitalization." 4. "Your son was probably not ready to be potty trained, and you may want to con-tinue the training for the next 6 months."
When interacting with people who are hearing impaired, you should:
A. Speak loudly without shouting B. Exaggerate your lip movement to facilitate lip reading by the patient C. Use low-pitched sounds that are directed into the patient's ear canal D. Delay communication attempts until an interpreter is available
A patient who has received lithium for 3 weeks to control acute mania has the following symptoms: coarse hand tremor, diarrhea, vomiting, lethargy, and mild confusion. The pri-ority nursing action should be to:
a. Administer prn Cogentin to relieve the symptoms. b. Provide reassurance that the symptoms are transient. c. Obtain a stat lithium level; hold lithium pending results. d. Assist the patient to decrease the sodium in their daily diet.