NU216_Fall25_T3_Endocrine, Respiratory, and Immune Systems
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Free NU216_Fall25_T3_Endocrine, Respiratory, and Immune Systems Questions
A patient with a sore throat and rhinitis has an elevated level of IgG in the blood. The nurse explains that the patient's symptoms are most likely from which cause?
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A Re-infection by bacteria
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B Allergy
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C Initial viral infection
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D Exposure to toxic fume
Explanation
IgG is the most abundant antibody in the blood and tissues and is primarily responsible for long-term immunity after infection or vaccination. Elevated IgG suggests a secondary immune response, meaning the body has encountered the pathogen before. A re-infection by bacteria would trigger IgG production quickly and strongly due to memory cell activation.
Correct Answer Is:
Re-infection by bacteria
Why the other options are incorrect:
Allergy
Allergic reactions primarily involve IgE, not IgG, as the main immunoglobulin.
Initial viral infection
An initial infection—viral or bacterial—would show elevated IgM first, as it is the antibody produced during the primary immune response.
Exposure to toxic fume
This causes irritation or inflammation, but it does not stimulate an adaptive immune response or increase IgG levels.
A nurse received an order to administer a tetanus vaccine to a patient who sustained a foot wound from a nail. The nurse is aware that this vaccine will cause the patient to develop which type of immunity?
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A Active natural
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B Passive natural
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C Active artificial
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D Passive artificial
Explanation
A tetanus vaccine stimulates the body’s immune system to produce antibodies and memory cells against the tetanus toxin without causing disease. Because the immunity is acquired through intentional exposure to an antigen via vaccination, it is considered active artificial immunity. Protection develops over time and is long-lasting.
Correct Answer Is:
Active artificial
Why the other options are incorrect:
Active natural
This occurs when immunity develops after direct exposure to a pathogen through natural infection, such as chickenpox after contact with an infected person—not through vaccination.
Passive natural
This occurs when antibodies are transferred naturally from mother to child, either through the placenta (IgG) or breast milk (IgA). It does not involve vaccines.
Passive artificial
This involves giving preformed antibodies, such as immune globulin injections, for immediate but short-term protection—not stimulating the body to make its own antibodies.
Which symptom should the nurse monitor in a patient with hypoparathyroidism?
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A Increased deep tendon reflexes
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B Hypercalcemia
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C Tetany and muscle cramps
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D Hypotension and bradycardia
Explanation
Hypoparathyroidism leads to decreased secretion of parathyroid hormone (PTH), resulting in hypocalcemia. Low calcium levels increase neuromuscular excitability, causing tetany, muscle cramps, tingling in the extremities, and possible positive Chvostek’s and Trousseau’s signs. Monitoring for these symptoms helps detect worsening hypocalcemia early and prevent complications such as laryngospasm or seizures.
Correct Answer Is:
Tetany and muscle cramps
Why the other options are incorrect:
Increased deep tendon reflexes
While hypocalcemia can cause hyperreflexia, tetany and muscle cramps are more significant and specific early signs to monitor in hypoparathyroidism.
Hypercalcemia
Hypoparathyroidism causes low calcium levels, not high. Hypercalcemia is more likely in hyperparathyroidism.
Hypotension and bradycardia
These may occur in severe electrolyte imbalances but are not the primary or most characteristic signs of hypoparathyroidism.
Which of the following nursing actions and patient education points are appropriate regarding leukotriene receptor antagonists? Select each response as appropriate or not appropriate.
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Utilize a spacer when taking this medication
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Teach patient to rinse their mouth after taking this medication
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Use for acute asthma attacks
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Teach patient that it helps reduce inflammation
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Administer medication in the morning
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Reinforce daily use even when asymptomatic
Explanation
Teach patient that it helps reduce inflammation – Appropriate
Leukotriene receptor antagonists block leukotrienes, which cause airway inflammation, bronchoconstriction, and mucus production.
Reinforce daily use even when asymptomatic – Appropriate
These medications are for long-term control and prevention, so they should be taken daily, even when the patient feels well, to maintain airway stability.
Correct Answer Is:
Teach patient that it helps reduce inflammation
Reinforce daily use even when asymptomatic
Why the other options are incorrect:
Utilize a spacer when taking this medication – Not Appropriate
Leukotriene receptor antagonists (e.g., montelukast) are oral medications, not inhaled, so a spacer is not needed.
Teach patient to rinse their mouth after taking this medication – Not Appropriate
Rinsing the mouth is important after inhaled corticosteroids to prevent oral thrush, but it is not required for oral leukotriene receptor antagonists.
Use for acute asthma attacks – Not Appropriate
These medications are maintenance therapy for prevention of asthma symptoms, not for relief of acute bronchospasm.
Administer medication in the morning – Not Appropriate
They are typically administered in the evening, as leukotrienes are released more during the night, and this timing improves efficacy in preventing nocturnal asthma symptoms.
The nurse is providing teaching for a patient receiving radioactive iodine therapy (RAI). What information should be included in this teaching session? (SELECT ALL THAT APPLY)
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A Avoid pregnant women and children for a minimum 5 days after therapy
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B Visitors are allowed after the first follow-up care with HCP.
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C Avoid preparing meals for others using bare hands.
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D Perform oral care two to three times daily with a salt and soda solution.
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E Use a private toilet and flush at least 3 times after each use.
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F Notify the provider if extreme fatigue and shortness of breath occur
Explanation
Avoid pregnant women and children for a minimum 5 days after therapy
Radioactive iodine emits radiation that can be harmful to developing fetuses and children. Close contact should be avoided for at least 5 days to minimize radiation exposure.
Avoid preparing meals for others using bare hands
Saliva and sweat can contain small amounts of radioiodine, so using utensils or gloves while preparing food helps prevent radiation exposure to others.
Perform oral care two to three times daily with a salt and soda solution
RAI can cause inflammation of salivary glands and dry mouth. Salt and soda rinses help keep the mouth clean and reduce discomfort.
Use a private toilet and flush at least 3 times after each use
Radioactive iodine is excreted in urine and other body fluids. Multiple flushes help reduce contamination and protect others from radiation exposure.
Notify the provider if extreme fatigue and shortness of breath occur
These symptoms may indicate hypothyroidism or other complications after RAI and require prompt evaluation and treatment.
Correct Answer Is:
Avoid pregnant women and children for a minimum 5 days after therapy
Avoid preparing meals for others using bare hands
Perform oral care two to three times daily with a salt and soda solution
Use a private toilet and flush at least 3 times after each use
Notify the provider if extreme fatigue and shortness of breath occur
Why the other options are incorrect:
Visitors are allowed after the first follow-up care with HCP
This is incorrect. Restrictions on visitors, especially pregnant women and children, are based on radiation safety timelines, not on follow-up visits. Close contact precautions typically apply immediately after treatment and for several days, not only after follow-up.
A post-operative patient develops a pulmonary embolism. Which immediate nursing management is required? (SELECT ALL THAT APPLY)
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Semi-Fowler's position
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Blood transfusion
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Oxygen
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IV fluids
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Anticoagulation
Explanation
Semi-Fowler's position
Placing the patient in a Semi-Fowler’s position facilitates lung expansion by reducing pressure on the diaphragm. This positioning improves oxygen exchange and reduces the work of breathing, which is critical during the acute respiratory distress caused by a pulmonary embolism.
Oxygen
A pulmonary embolism reduces blood flow to parts of the lung, causing hypoxemia. Administering supplemental oxygen increases arterial oxygen saturation, helps correct the oxygen deficit, and prevents further tissue damage while other treatments are initiated.
Anticoagulation
Rapid initiation of anticoagulant therapy, such as intravenous heparin, prevents the existing clot from enlarging and reduces the risk of new clot formation. Although anticoagulants do not dissolve the clot, they are essential in preventing further embolic events.
Correct Answer Is:
Semi-Fowler's position
Oxygen
Anticoagulation
Why the other options are incorrect:
A nurse is assessing a patient who presents with a red, itchy rash 48 hours after hiking. The patient reports contact with poison ivy. Which type of hypersensitivity reaction is the nurse most likely observing?
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A Type I - Immediate hypersensitivity
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B Type II - Cytotoxic hypersensitivity
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C Type III - Immune complex hypersensitivity
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D Type IV - Delayed cell-mediated hypersensitivity
Explanation
Poison ivy reactions are classic examples of Type IV hypersensitivity, which is mediated by T lymphocytes rather than antibodies. This reaction develops 24–72 hours after exposure and involves localized inflammation, redness, and itching. The delay occurs because T cells must recognize the antigen and release cytokines that recruit immune cells, causing the skin reaction.
Correct Answer Is:
Type IV - Delayed cell-mediated hypersensitivity
Why the other options are incorrect:
Type I - Immediate hypersensitivity
This is IgE-mediated and occurs within minutes of exposure to allergens like pollen or insect venom, causing symptoms such as hives, anaphylaxis, or asthma—not a delayed rash.
Type II - Cytotoxic hypersensitivity
This involves IgG or IgM antibodies binding to cell surfaces, leading to cell destruction. Examples include hemolytic anemia or transfusion reactions, not contact dermatitis.
Type III - Immune complex hypersensitivity
This occurs when antigen-antibody complexes deposit in tissues, leading to inflammation, such as in lupus or serum sickness, not in poison ivy reactions.
A patient scheduled to receive an influenza vaccination asks the nurse, "How do those things work anyway?" What is the nurse's best response?
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A "Immunizations work to keep you from getting blood diseases. So, you need one!"
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B "Immunizations help your body to prepare antibodies against a future exposure to the same antigen."
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C "Immunizations work by activating unstimulated internal proteins which are part of the immune response."
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D "Immunizations work by giving you antibodies to stimulate immediate protection if exposed to an antigen."
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.
When a patient with COPD is receiving oxygen, which is the best action by the nurse?
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A Maintain pulse oximetry between 89% and 92%.
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B Increase oxygen to 8 liters/minute or when the patient is comfortable.
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C Administer oxygen according to the patient's request.
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D Increase rate of administration of oxygen up to 16 liters/min via high-flow ventimask.
Explanation
In patients with COPD, especially those with chronic CO₂ retention, high oxygen levels can reduce the hypoxic drive to breathe, leading to worsening hypercapnia and respiratory acidosis. The goal is to provide enough oxygen to maintain safe saturation — typically 88–92% — without causing oxygen-induced hypoventilation. Oxygen is administered via the lowest flow rate necessary to achieve this target, and continuous monitoring with pulse oximetry is essential.
Correct Answer Is:
Maintain pulse oximetry between 89% and 92%.
Why the other options are incorrect:
Increase oxygen to 8 liters/minute or when the patient is comfortable
Increasing oxygen purely for comfort without monitoring risks causing CO₂ retention and respiratory depression in COPD patients.
Administer oxygen according to the patient’s request
Oxygen administration should be based on clinical need and monitored oxygen saturation, not patient request alone.
Increase rate of administration of oxygen up to 16 liters/min via high-flow ventimask
Such high oxygen levels can be dangerous in COPD patients with chronic hypercapnia and are generally reserved for acute emergencies with severe hypoxemia under close monitoring.
A patient is prescribed an epinephrine auto-injector pen for a severe allergy. What instructions should the nurse provide? (SELECT ALL THAT APPLY)
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A "Call 911 immediately after using the injector"
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B "Inject into the outer thigh and hold for 10 seconds"
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C "Store the injector at room temperature and check the expiration date."
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D "Massage the injection site vigorously after administration."
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E "You may need a second dose if symptoms do not improve."
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.
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