The parents of a child newly diagnosed with cystic fibrosis (CF) are concerned about the secretions and respiratory issues their child is experiencing. Which pathophysiological process should the nurse use to respond to the parents?

Choice A reason: Acute lymphoblastic leukemia (ALL) is an aggressive malignancy of lymphoid cells, often achieving complete remission with intensive chemotherapy, especially in children. Suppression without remission is not typical, as ALL responds well to treatment, targeting rapidly dividing blast cells. CLL, a slower-progressing disease, better fits the description of suppression without complete cure.

Choice B reason: Chronic lymphocytic leukemia (CLL) is a low-grade malignancy of mature B-lymphocytes, often managed with chemotherapy to suppress disease progression rather than achieve complete remission. CLL’s indolent nature means it can be controlled, but residual disease persists due to slow cell turnover, aligning with the question’s description of suppression.

Choice C reason: Acute myelogenous leukemia (AML) is an aggressive malignancy of myeloid cells, requiring intensive chemotherapy or stem cell transplant for potential remission. Suppression without remission is less common, as AML treatment aims for complete response. CLL’s chronic nature makes it more likely to result in disease control rather than cure.

Choice D reason: Hairy-cell leukemia is a rare, indolent B-cell malignancy highly responsive to purine analogs, often achieving long-term remission or near-cure. Suppression without remission is not characteristic, as treatment typically yields durable responses. CLL’s partial response to chemotherapy better matches the scenario of ongoing disease suppression.

Choice A reason: Macrophages, lymph, and cytokines are part of the innate immune response, acting after pathogens breach initial barriers. First-line defenses are physical and chemical barriers like mucosa and secretions, not immune cells or fluids. This choice represents secondary defenses, making it incorrect for the primary barrier role.

Choice B reason: Lung epithelium, gastric mucosa, and tears are first-line defenses, preventing pathogen entry. Lung cilia trap microbes, gastric acid kills bacteria, and tears’ lysozymes neutralize pathogens. These physical and chemical barriers form the body’s initial protection, aligning with immunology principles for primary defense against infection.

Choice C reason: Interferon, T cells, and neutrophils are part of adaptive and innate immunity, activated after pathogen penetration. First-line defenses involve barriers like mucosa, not immune mediators or cells. This choice describes secondary immune responses, making it incorrect for the initial protective structures in humans.

Choice D reason: Thymus, bone marrow, and pancreas are involved in immune cell production and metabolism, not direct pathogen defense. First-line defenses are external barriers like lung epithelium or tears. These internal organs support immunity but are not primary barriers, making this incorrect for first-line defense structures.