NU216_Fall25_T3_Endocrine, Respiratory, and Immune Systems
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Free NU216_Fall25_T3_Endocrine, Respiratory, and Immune Systems Questions
1.
A patient scheduled to receive an influenza vaccination asks the nurse, "How do those things work anyway?" What is the nurse's best response?
- A "Immunizations work to keep you from getting blood diseases. So, you need one!"
- B "Immunizations help your body to prepare antibodies against a future exposure to the same antigen."
- C "Immunizations work by activating unstimulated internal proteins which are part of the immune response."
- D "Immunizations work by giving you antibodies to stimulate immediate protection if exposed to an antigen."
Explanation
Explanation
Vaccinations introduce a weakened or inactivated form of a pathogen, or parts of it, to the immune system. This triggers the production of antibodies and memory cells without causing illness. When the body encounters the real pathogen later, it can mount a rapid and effective immune response, preventing or reducing illness severity.
Correct Answer Is:
"Immunizations help your body to prepare antibodies against a future exposure to the same antigen."
Why the other options are incorrect:
"Immunizations work to keep you from getting blood diseases. So, you need one!"
This statement is vague, inaccurate, and misleading, as vaccines prevent many types of infectious diseases, not just bloodborne ones.
"Immunizations work by activating unstimulated internal proteins which are part of the immune response."
This is unclear and does not accurately explain the immune mechanism of vaccines.
"Immunizations work by giving you antibodies to stimulate immediate protection if exposed to an antigen."
This describes passive immunity (e.g., immune globulin), not active immunity provided by most vaccines like the influenza vaccine.
Vaccinations introduce a weakened or inactivated form of a pathogen, or parts of it, to the immune system. This triggers the production of antibodies and memory cells without causing illness. When the body encounters the real pathogen later, it can mount a rapid and effective immune response, preventing or reducing illness severity.
Correct Answer Is:
"Immunizations help your body to prepare antibodies against a future exposure to the same antigen."
Why the other options are incorrect:
"Immunizations work to keep you from getting blood diseases. So, you need one!"
This statement is vague, inaccurate, and misleading, as vaccines prevent many types of infectious diseases, not just bloodborne ones.
"Immunizations work by activating unstimulated internal proteins which are part of the immune response."
This is unclear and does not accurately explain the immune mechanism of vaccines.
"Immunizations work by giving you antibodies to stimulate immediate protection if exposed to an antigen."
This describes passive immunity (e.g., immune globulin), not active immunity provided by most vaccines like the influenza vaccine.
2.
A patient with hyperthyroidism is admitted with restlessness, tachycardia (HR 145), and a temperature of 103°F (39.4°C). The patient reports severe anxiety and diaphoresis. What is the priority action?
- A Administer IV propranolol and fluids
- B Assess the patient's deep tendon reflexes
- C Administer acetaminophen and a cooling blanket
- D Check for Chvostek's and Trousseau's signs
Explanation
Explanation
The patient is exhibiting signs of thyroid storm, a life-threatening complication of hyperthyroidism characterized by hypermetabolism, hyperthermia, tachycardia, and severe anxiety. Immediate priority is to stabilize vital functions—beta-blockers like propranolol reduce heart rate and control adrenergic symptoms, while IV fluids support circulation and prevent shock.
Correct Answer Is:
Administer IV propranolol and fluids
Why the other options are incorrect:
Assess the patient's deep tendon reflexes
This is not a priority in an acute emergency. Neurological checks may be done later, but stabilizing airway, breathing, and circulation comes first.
Administer acetaminophen and a cooling blanket
Temperature control is important but secondary. Reducing cardiac workload and preventing cardiovascular collapse takes precedence in thyroid storm management.
Check for Chvostek's and Trousseau's signs
These assess hypocalcemia, which can occur post-thyroidectomy, but are not relevant for an acute thyroid storm scenario in this patient.
The patient is exhibiting signs of thyroid storm, a life-threatening complication of hyperthyroidism characterized by hypermetabolism, hyperthermia, tachycardia, and severe anxiety. Immediate priority is to stabilize vital functions—beta-blockers like propranolol reduce heart rate and control adrenergic symptoms, while IV fluids support circulation and prevent shock.
Correct Answer Is:
Administer IV propranolol and fluids
Why the other options are incorrect:
Assess the patient's deep tendon reflexes
This is not a priority in an acute emergency. Neurological checks may be done later, but stabilizing airway, breathing, and circulation comes first.
Administer acetaminophen and a cooling blanket
Temperature control is important but secondary. Reducing cardiac workload and preventing cardiovascular collapse takes precedence in thyroid storm management.
Check for Chvostek's and Trousseau's signs
These assess hypocalcemia, which can occur post-thyroidectomy, but are not relevant for an acute thyroid storm scenario in this patient.
3.
During cardiopulmonary rehabilitation for a patient with COPD, the nurse teaches the patient how to perform pursed-lip breathing. This technique is used primarily for which benefit?
- A Prevents typically moist mucosa from drying out so shrinks airways.
- B Keeps airways open longer increasing oxygenation.
- C Increases respiratory muscle strength causing fatigue.
- D Promotes relaxation of abdominal muscles and all membranes.
Explanation
Explanation
Pursed-lip breathing slows exhalation and creates back pressure in the airways, preventing premature airway collapse. This helps improve gas exchange, increase oxygenation, and reduce the feeling of breathlessness in patients with COPD. It also promotes better control over breathing patterns.
Correct Answer Is:
Keeps airways open longer increasing oxygenation.
Why the other options are incorrect:
Prevents typically moist mucosa from drying out so shrinks airways
Pursed-lip breathing does not function to moisturize or dry the airway mucosa.
Increases respiratory muscle strength causing fatigue
This technique is not primarily for muscle strengthening and should not cause fatigue when done correctly.
Promotes relaxation of abdominal muscles and all membranes
While it may reduce anxiety and promote relaxation, its main purpose is to improve oxygenation by keeping airways open longer.
Pursed-lip breathing slows exhalation and creates back pressure in the airways, preventing premature airway collapse. This helps improve gas exchange, increase oxygenation, and reduce the feeling of breathlessness in patients with COPD. It also promotes better control over breathing patterns.
Correct Answer Is:
Keeps airways open longer increasing oxygenation.
Why the other options are incorrect:
Prevents typically moist mucosa from drying out so shrinks airways
Pursed-lip breathing does not function to moisturize or dry the airway mucosa.
Increases respiratory muscle strength causing fatigue
This technique is not primarily for muscle strengthening and should not cause fatigue when done correctly.
Promotes relaxation of abdominal muscles and all membranes
While it may reduce anxiety and promote relaxation, its main purpose is to improve oxygenation by keeping airways open longer.
4.
A nurse is caring for a patient with hyperthyroidism. Which interventions should be included in the care plan? (SELECT ALL THAT APPLY)
- A Monitor for tachycardia and hypertension
- B Encourage high-iodine foods
- C Provide a cool, quiet environment
- D Administer beta-blockers as prescribed
- E Educate about radioactive iodine therapy
Explanation
Explanation
Monitor for tachycardia and hypertension
Hyperthyroidism increases metabolic rate, which overstimulates the cardiovascular system. Monitoring for tachycardia and hypertension allows early detection of complications like arrhythmias or thyroid storm, enabling timely intervention to prevent deterioration.
Provide a cool, quiet environment
Patients with hyperthyroidism often have heat intolerance and heightened nervous system activity. A cool, quiet environment helps reduce body temperature, minimize stress, and limit stimulation that could exacerbate symptoms.
Administer beta-blockers as prescribed
Beta-blockers help control symptoms such as tachycardia, palpitations, and tremors by blocking adrenergic effects. They provide symptomatic relief while definitive treatment for hyperthyroidism is being implemented.
Educate about radioactive iodine therapy
Radioactive iodine is a common treatment to destroy overactive thyroid tissue. Patient education includes preparation, possible side effects, and post-treatment precautions to ensure safety and compliance with therapy.
Correct Answer Is:
Monitor for tachycardia and hypertension
Provide a cool, quiet environment
Administer beta-blockers as prescribed
Educate about radioactive iodine therapy
Why the other options are incorrect:
Monitor for tachycardia and hypertension
Hyperthyroidism increases metabolic rate, which overstimulates the cardiovascular system. Monitoring for tachycardia and hypertension allows early detection of complications like arrhythmias or thyroid storm, enabling timely intervention to prevent deterioration.
Provide a cool, quiet environment
Patients with hyperthyroidism often have heat intolerance and heightened nervous system activity. A cool, quiet environment helps reduce body temperature, minimize stress, and limit stimulation that could exacerbate symptoms.
Administer beta-blockers as prescribed
Beta-blockers help control symptoms such as tachycardia, palpitations, and tremors by blocking adrenergic effects. They provide symptomatic relief while definitive treatment for hyperthyroidism is being implemented.
Educate about radioactive iodine therapy
Radioactive iodine is a common treatment to destroy overactive thyroid tissue. Patient education includes preparation, possible side effects, and post-treatment precautions to ensure safety and compliance with therapy.
Correct Answer Is:
Monitor for tachycardia and hypertension
Provide a cool, quiet environment
Administer beta-blockers as prescribed
Educate about radioactive iodine therapy
Why the other options are incorrect:
5.
A patient is admitted to the emergency department with status asthmaticus. The patient is using accessory muscles to breathe, has diminished breath sounds, and is not responding to repeated doses of inhaled albuterol. What is the nurse's priority action?
- A Administer IV corticosteroids as prescribed
- B Prepare for intubation and mechanical ventilation
- C Encourage pursed-lip breathing
- D Obtain a sputum culture
Explanation
Explanation
Status asthmaticus is a severe, life-threatening asthma exacerbation unresponsive to standard bronchodilator therapy. Diminished breath sounds in this context indicate severely limited airflow and possible impending respiratory arrest. The priority is to secure the airway and ensure adequate oxygenation and ventilation by preparing for intubation and mechanical ventilation.
Correct Answer Is:
Prepare for intubation and mechanical ventilation
Why the other options are incorrect:
Administer IV corticosteroids as prescribed
Steroids reduce airway inflammation but take hours to work, so they are not the immediate life-saving intervention.
Encourage pursed-lip breathing
This is useful for chronic COPD management, not for a patient in acute, life-threatening respiratory failure.
Obtain a sputum culture
Identifying infectious organisms is not a priority when the patient has impending respiratory arrest; airway management comes first.
Status asthmaticus is a severe, life-threatening asthma exacerbation unresponsive to standard bronchodilator therapy. Diminished breath sounds in this context indicate severely limited airflow and possible impending respiratory arrest. The priority is to secure the airway and ensure adequate oxygenation and ventilation by preparing for intubation and mechanical ventilation.
Correct Answer Is:
Prepare for intubation and mechanical ventilation
Why the other options are incorrect:
Administer IV corticosteroids as prescribed
Steroids reduce airway inflammation but take hours to work, so they are not the immediate life-saving intervention.
Encourage pursed-lip breathing
This is useful for chronic COPD management, not for a patient in acute, life-threatening respiratory failure.
Obtain a sputum culture
Identifying infectious organisms is not a priority when the patient has impending respiratory arrest; airway management comes first.
6.
A patient is prescribed an epinephrine auto-injector pen for a severe allergy. What instructions should the nurse provide? (SELECT ALL THAT APPLY)
- A "Call 911 immediately after using the injector"
- B "Inject into the outer thigh and hold for 10 seconds"
- C "Store the injector at room temperature and check the expiration date."
- D "Massage the injection site vigorously after administration."
- E "You may need a second dose if symptoms do not improve."
Explanation
Explanation
Call 911 immediately after using the injector
Epinephrine provides temporary relief from severe allergic reactions, but emergency medical care is still required as symptoms can return.
Inject into the outer thigh and hold for 10 seconds
The correct site for administration is the mid-outer thigh, even through clothing if necessary. Holding for 10 seconds ensures full medication delivery.
Store the injector at room temperature and check the expiration date.
Proper storage maintains drug potency, and expired injectors may not be effective during an emergency.
You may need a second dose if symptoms do not improve.
If symptoms persist or recur before emergency help arrives, a second dose can be given according to provider or manufacturer instructions.
Correct Answer Is:
"Call 911 immediately after using the injector"
"Inject into the outer thigh and hold for 10 seconds"
"Store the injector at room temperature and check the expiration date."
"You may need a second dose if symptoms do not improve."
Why the other options are incorrect:
Massage the injection site vigorously after administration
Massaging is no longer recommended as it can cause local irritation and is unnecessary for drug absorption.
Call 911 immediately after using the injector
Epinephrine provides temporary relief from severe allergic reactions, but emergency medical care is still required as symptoms can return.
Inject into the outer thigh and hold for 10 seconds
The correct site for administration is the mid-outer thigh, even through clothing if necessary. Holding for 10 seconds ensures full medication delivery.
Store the injector at room temperature and check the expiration date.
Proper storage maintains drug potency, and expired injectors may not be effective during an emergency.
You may need a second dose if symptoms do not improve.
If symptoms persist or recur before emergency help arrives, a second dose can be given according to provider or manufacturer instructions.
Correct Answer Is:
"Call 911 immediately after using the injector"
"Inject into the outer thigh and hold for 10 seconds"
"Store the injector at room temperature and check the expiration date."
"You may need a second dose if symptoms do not improve."
Why the other options are incorrect:
Massage the injection site vigorously after administration
Massaging is no longer recommended as it can cause local irritation and is unnecessary for drug absorption.
7.
The nurse is reviewing laboratory results for a patient diagnosed with hyperparathyroidism. Which lab values would the nurse expect to find?
- A Increased serum calcium, increased serum phosphate
- B Decreased serum calcium, decreased serum phosphate
- C Increased serum calcium, decreased serum phosphate
- D Decreased serum calcium, increased serum phosphate
Explanation
Explanation
In hyperparathyroidism, excess parathyroid hormone (PTH) increases calcium release from bones, enhances calcium absorption from the gut, and reduces renal excretion of calcium—leading to hypercalcemia. PTH also promotes phosphate excretion by the kidneys, resulting in hypophosphatemia. This combination is the hallmark laboratory finding in primary hyperparathyroidism.
Correct Answer Is:
Increased serum calcium, decreased serum phosphate
Why the other options are incorrect:
Increased serum calcium, increased serum phosphate
High phosphate is not expected; PTH causes phosphate loss in the urine.
Decreased serum calcium, decreased serum phosphate
This would be seen in conditions like malnutrition or vitamin D deficiency, not hyperparathyroidism.
Decreased serum calcium, increased serum phosphate
This is characteristic of hypoparathyroidism, where PTH levels are low, not high.
In hyperparathyroidism, excess parathyroid hormone (PTH) increases calcium release from bones, enhances calcium absorption from the gut, and reduces renal excretion of calcium—leading to hypercalcemia. PTH also promotes phosphate excretion by the kidneys, resulting in hypophosphatemia. This combination is the hallmark laboratory finding in primary hyperparathyroidism.
Correct Answer Is:
Increased serum calcium, decreased serum phosphate
Why the other options are incorrect:
Increased serum calcium, increased serum phosphate
High phosphate is not expected; PTH causes phosphate loss in the urine.
Decreased serum calcium, decreased serum phosphate
This would be seen in conditions like malnutrition or vitamin D deficiency, not hyperparathyroidism.
Decreased serum calcium, increased serum phosphate
This is characteristic of hypoparathyroidism, where PTH levels are low, not high.
8.
A patient with Graves' disease is prepared for a subtotal thyroidectomy with drug therapy of iodine before surgery. When teaching the patient about the drugs, the nurse explains that this drug is administered preoperatively to perform which function?
- A Assist in differentiating the thyroid and parathyroid glands during surgery.
- B Decrease the size and vascularity of the thyroid gland.
- C Eliminate the risk for tetany during the postoperative period.
- D Decrease the risk of hypometabolism during and after the surgery.
Explanation
Explanation
Preoperative iodine therapy (e.g., Lugol’s solution or potassium iodide) temporarily reduces thyroid hormone release and decreases the gland’s vascularity and size. This helps minimize blood loss during surgery and makes the gland easier to remove. It also reduces the risk of thyroid storm during the perioperative period.
Correct Answer Is:
Decrease the size and vascularity of the thyroid gland
Why the other options are incorrect:
Assist in differentiating the thyroid and parathyroid glands during surgery
Iodine does not help in identifying gland structures during surgery.
Eliminate the risk for tetany during the postoperative period
Postoperative tetany is caused by hypocalcemia from parathyroid injury or removal, not by a lack of iodine preparation.
Decrease the risk of hypometabolism during and after the surgery
Iodine reduces thyroid activity, but hypometabolism is more of a postoperative concern if too much thyroid tissue is removed—not something iodine prevents.
Preoperative iodine therapy (e.g., Lugol’s solution or potassium iodide) temporarily reduces thyroid hormone release and decreases the gland’s vascularity and size. This helps minimize blood loss during surgery and makes the gland easier to remove. It also reduces the risk of thyroid storm during the perioperative period.
Correct Answer Is:
Decrease the size and vascularity of the thyroid gland
Why the other options are incorrect:
Assist in differentiating the thyroid and parathyroid glands during surgery
Iodine does not help in identifying gland structures during surgery.
Eliminate the risk for tetany during the postoperative period
Postoperative tetany is caused by hypocalcemia from parathyroid injury or removal, not by a lack of iodine preparation.
Decrease the risk of hypometabolism during and after the surgery
Iodine reduces thyroid activity, but hypometabolism is more of a postoperative concern if too much thyroid tissue is removed—not something iodine prevents.
9.
A patient with asthma is experiencing wheezing and shortness of breath. The nurse administers a prescribed short-acting beta-agonist. Which finding indicates the medication is effective?
- A Increased oxygen saturation
- B Productive cough
- C Decreased wheezing
- D Decreased respiratory rate
Explanation
Explanation
Short-acting beta-agonists (e.g., albuterol) cause bronchodilation, relaxing airway smooth muscles and improving airflow. A reduction in wheezing after administration indicates that airflow through the bronchi has improved, confirming the medication’s effectiveness.
Correct Answer Is:
Decreased wheezing
Why the other options are incorrect:
Increased oxygen saturation
While this may occur with improved ventilation, it is not the most direct or immediate indicator of bronchodilator effectiveness.
Productive cough
A productive cough is not a primary indicator of short-acting beta-agonist effectiveness and may relate to other conditions.
Decreased respiratory rate
A lower respiratory rate may happen after symptom relief, but the clearest sign of improved airway patency is the reduction in wheezing.
Short-acting beta-agonists (e.g., albuterol) cause bronchodilation, relaxing airway smooth muscles and improving airflow. A reduction in wheezing after administration indicates that airflow through the bronchi has improved, confirming the medication’s effectiveness.
Correct Answer Is:
Decreased wheezing
Why the other options are incorrect:
Increased oxygen saturation
While this may occur with improved ventilation, it is not the most direct or immediate indicator of bronchodilator effectiveness.
Productive cough
A productive cough is not a primary indicator of short-acting beta-agonist effectiveness and may relate to other conditions.
Decreased respiratory rate
A lower respiratory rate may happen after symptom relief, but the clearest sign of improved airway patency is the reduction in wheezing.
10.
A patient diagnosed with COPD with a long smoking history. Which statement by the patient indicates effective teaching about this respiratory disease process?
- "Infection and inflammation are responsible for lung damage."
- "COPD is a result of air trapped in sacs in my lungs."
- "There is swelling in my airways."
- "I know this disease is caused by a lot of mucus in my lungs."
Explanation
Explanation
COPD is driven primarily by chronic airway inflammation from long-term exposure to noxious particles (most commonly cigarette smoke). This inflammation causes airway wall edema, narrowing, and remodeling, which increase airflow resistance and make exhalation difficult. Mucus hypersecretion and, in many patients, emphysematous destruction with air-trapping also occur, but the central pathologic process is persistent airway inflammation (“swelling in my airways”). Recognizing inflammation as the core mechanism reflects accurate understanding of COPD.
Correct Answer Is:
There is swelling in my airways.
Why the other options are incorrect:
"Infection and inflammation are responsible for lung damage."
Infections frequently trigger exacerbations and can worsen lung function, but they are not the primary cause of COPD. The disease arises from chronic inflammation due to inhaled irritants (e.g., tobacco smoke), not from recurrent infections themselves.
"COPD is a result of air trapped in sacs in my lungs."
Air-trapping (from loss of elastic recoil and small-airway collapse in emphysema) is common, but COPD is broader than emphysema alone. Limiting the explanation to air-trapping overlooks the central, ever-present airway inflammation and narrowing that define COPD—even in patients without marked emphysema.
"I know this disease is caused by a lot of mucus in my lungs."
Excess mucus (chronic bronchitis phenotype) contributes to symptoms and airflow obstruction, but COPD is not “caused” by mucus alone. It results from chronic inflammatory injury with airway remodeling; mucus hypersecretion is one component rather than the root cause.
COPD is driven primarily by chronic airway inflammation from long-term exposure to noxious particles (most commonly cigarette smoke). This inflammation causes airway wall edema, narrowing, and remodeling, which increase airflow resistance and make exhalation difficult. Mucus hypersecretion and, in many patients, emphysematous destruction with air-trapping also occur, but the central pathologic process is persistent airway inflammation (“swelling in my airways”). Recognizing inflammation as the core mechanism reflects accurate understanding of COPD.
Correct Answer Is:
There is swelling in my airways.
Why the other options are incorrect:
"Infection and inflammation are responsible for lung damage."
Infections frequently trigger exacerbations and can worsen lung function, but they are not the primary cause of COPD. The disease arises from chronic inflammation due to inhaled irritants (e.g., tobacco smoke), not from recurrent infections themselves.
"COPD is a result of air trapped in sacs in my lungs."
Air-trapping (from loss of elastic recoil and small-airway collapse in emphysema) is common, but COPD is broader than emphysema alone. Limiting the explanation to air-trapping overlooks the central, ever-present airway inflammation and narrowing that define COPD—even in patients without marked emphysema.
"I know this disease is caused by a lot of mucus in my lungs."
Excess mucus (chronic bronchitis phenotype) contributes to symptoms and airflow obstruction, but COPD is not “caused” by mucus alone. It results from chronic inflammatory injury with airway remodeling; mucus hypersecretion is one component rather than the root cause.
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