NU216_Fall25_T3_Endocrine, Respiratory, and Immune Systems practice questions with answers

Free NU216_Fall25_T3_Endocrine, Respiratory, and Immune Systems Questions

The nurse has received a change-of-shift report about these patients with COPD. Which patient would the nurse assess first?

A A patient with peripheral edema
B A patient who has a cough productive of thick, green mucus
C A patient with a capillary refill greater than 3 seconds
D A patient with a respiratory rate of 38

Explanation

Explanation
A respiratory rate of 38 indicates severe tachypnea and possible acute respiratory distress. In COPD, this could signal worsening hypoxemia, hypercapnia, or impending respiratory failure. This patient requires immediate assessment and intervention to maintain airway and breathing, as airway and oxygenation are the top priorities in the ABCs of emergency care.
Correct Answer Is:
A patient with a respiratory rate of 38
Why the other options are incorrect:
A patient with peripheral edema
Edema indicates possible right-sided heart failure (cor pulmonale) but is a chronic complication and not immediately life-threatening compared to acute respiratory distress.
A patient who has a cough productive of thick, green mucus
This suggests a respiratory infection and needs attention but does not indicate an immediate airway emergency like severe tachypnea.
A patient with a capillary refill greater than 3 seconds
Delayed capillary refill signals poor perfusion, but it is not as immediately life-threatening as signs of acute respiratory failure in COPD.

A nurse is teaching a patient about hyperparathyroidism. Which statement indicates the need for further teaching?

The two drugs work together to block the effects of histamine on the bronchioles.
The combination of two drugs works more quickly in an acute asthma attack.
The two drugs are a combination of long-acting and slow-acting bronchodilators.
One drug decreases inflammation, and the other is a bronchodilator.

Explanation

Explanation
This statement is unrelated to hyperparathyroidism and instead describes the mechanism of antihistamines used for allergic reactions. Hyperparathyroidism teaching focuses on the effects of excess parathyroid hormone, such as hypercalcemia, bone demineralization, and kidney stone prevention — not respiratory drug actions.
Correct Answer Is:
The two drugs work together to block the effects of histamine on the bronchioles.
Why the other options are incorrect:
The combination of two drugs works more quickly in an acute asthma attack
While unrelated to hyperparathyroidism, this statement does not describe histamine blocking and is less misleading than option A in this context.
The two drugs are a combination of long-acting and slow-acting bronchodilators
This is also unrelated to hyperparathyroidism but does not directly misstate histamine-blocking as in option A.
One drug decreases inflammation, and the other is a bronchodilator
This is accurate for certain respiratory regimens (e.g., corticosteroid plus beta2 agonist) but unrelated to hyperparathyroidism teaching.

A nurse is caring for a patient who has just undergone a total thyroidectomy. Which explanation best describes the reason the nurse will monitor for signs of hypocalcemia?

A The thyroid gland regulates calcium directly through calcitonin secretion
B The parathyroid glands may have been inadvertently removed or damaged during surgery
C Calcium absorption is impaired due to decreased thyroid hormone levels
D Postoperative immobility leads to calcium redistribution from bones

Explanation

Explanation
The parathyroid glands, located behind the thyroid, regulate calcium levels by secreting parathyroid hormone (PTH). During a total thyroidectomy, these small glands can be accidentally removed or their blood supply disrupted, leading to decreased PTH secretion and resulting hypocalcemia. Monitoring for signs such as muscle cramps, tingling, or positive Chvostek’s/Trousseau’s signs is essential for early detection and treatment.
Correct Answer Is:
The parathyroid glands may have been inadvertently removed or damaged during surgery
Why the other options are incorrect:
The thyroid gland regulates calcium directly through calcitonin secretion
Although the thyroid secretes calcitonin, which lowers blood calcium, its role in calcium regulation is minor compared to PTH. Loss of calcitonin alone does not cause significant hypocalcemia.
Calcium absorption is impaired due to decreased thyroid hormone levels
Thyroid hormones primarily regulate metabolism, not calcium absorption. Calcium absorption is largely dependent on vitamin D status and parathyroid hormone activity, not thyroid hormone levels.
Postoperative immobility leads to calcium redistribution from bones
Immobility can cause calcium loss from bones over time, but this leads to hypercalcemia, not hypocalcemia, and is not an acute postoperative concern following thyroidectomy.

A patient arrives at the emergency department with severe fatigue, bradycardia (HR 48), and altered mental status. The nurse notes cold, dry skin and a puffy face. The patient's TSH is 25 mU/L (high), and T3/T4 levels are low. What is the priority nursing intervention?

A Administer IV levothyroxine
B Encourage oral fluid intake
C Monitor blood glucose levels
D Apply warming blankets

Explanation

Explanation
The patient is exhibiting signs of myxedema coma, a life-threatening complication of severe hypothyroidism. The priority intervention is rapid thyroid hormone replacement with IV levothyroxine to restore metabolic function and prevent cardiovascular collapse. Supportive measures like IV fluids and warming may follow, but hormone replacement is the definitive treatment to reverse the crisis.
Correct Answer Is:
Administer IV levothyroxine
Why the other options are incorrect:
Encourage oral fluid intake
The patient’s altered mental status makes oral intake unsafe due to aspiration risk. IV support is required instead.
Monitor blood glucose levels
While hypoglycemia can occur in hypothyroidism, monitoring glucose is supportive—not the primary lifesaving intervention in myxedema coma.
Apply warming blankets
Gradual warming is part of supportive care, but it does not address the underlying cause. Thyroid hormone replacement is the immediate priority to stabilize the patient.

A patient is admitted with symptoms of edema, bradycardia, and lethargy. The nurse understands based on these symptoms which of the following can cause myxedema coma?

A Untreated hypothyroidism
B End-stage Graves' disease
C Overdose of propylthiouracil
D Uncontrolled diabetes

Explanation

Explanation
Myxedema coma is a life-threatening complication of severe, long-standing hypothyroidism, often precipitated by infection, cold exposure, or medications. It results from profound metabolic slowing and is characterized by symptoms such as edema, bradycardia, lethargy, hypothermia, and respiratory depression. Immediate thyroid hormone replacement and supportive care are required.
Correct Answer Is:
Untreated hypothyroidism
Why the other options are incorrect:
End-stage Graves' disease
Graves’ disease is a cause of hyperthyroidism, not hypothyroidism. Its late stages can cause thyrotoxic crisis, but not myxedema coma, which is linked to low thyroid hormone levels.
Overdose of propylthiouracil
Propylthiouracil is used to treat hyperthyroidism. Overdose can cause hypothyroidism, but it is unlikely to cause myxedema coma acutely unless the hypothyroidism is prolonged and untreated.
Uncontrolled diabetes
Uncontrolled diabetes can cause diabetic ketoacidosis or hyperosmolar hyperglycemic state, but it does not cause myxedema coma, which is specific to severe hypothyroidism.

A patient is admitted with severe weight loss of 15 lbs. over the past month despite no change in activity level and an insatiable appetite. The patient is diagnosed with Graves’ disease. What other signs and symptoms would support this diagnosis? (SELECT ALL THAT APPLY)

A Protrusion of the eyeballs
B Heat intolerance
C Rapid, bounding pulse
D Nervousness
E Bradycardia
F Sleepiness

Explanation

Explanation
Protrusion of the eyeballs
Exophthalmos is a hallmark sign of Graves’ disease caused by autoimmune inflammation of orbital tissues.
Heat intolerance
Due to an increased metabolic rate, patients with hyperthyroidism are unable to tolerate warm temperatures and often feel overheated.
Rapid, bounding pulse
Hyperthyroidism increases heart rate and cardiac output, producing tachycardia and a bounding pulse.
Nervousness
Excess thyroid hormone stimulates the nervous system, leading to irritability, anxiety, and restlessness.
Correct Answer Is:
Protrusion of the eyeballs
Heat intolerance
Rapid, bounding pulse
Nervousness
Why the other options are incorrect:
Bradycardia
Hyperthyroidism typically causes tachycardia, not bradycardia.
Sleepiness
Patients with hyperthyroidism usually have insomnia and restlessness, not excessive sleepiness, which is more common in hypothyroidism.

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?

A Re-infection by bacteria
B Allergy
C Initial viral infection
D Exposure to toxic fume

Explanation

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 45-year-old patient arrives in the ED with facial swelling, tongue protrusion, and difficulty swallowing after taking an ACE inhibitor. Which nursing intervention is the highest priority?

A Administer diphenhydramine 50 mg IV
B Place patient in a high Fowler's position
C Prepare for possible intubation
D Apply a cool compress to swollen areas

Explanation

Explanation
This patient is experiencing angioedema, a potentially life-threatening reaction associated with ACE inhibitors. Swelling of the face, tongue, and airway structures can rapidly progress to complete airway obstruction. The highest priority is maintaining a patent airway, and preparing for intubation (or emergency airway management) is essential before swelling worsens.
Correct Answer Is:
Prepare for possible intubation
Why the other options are incorrect:
Administer diphenhydramine 50 mg IV
While antihistamines may help reduce swelling, they do not act quickly enough to secure the airway in an emergency. Airway management takes precedence.
Place patient in a high Fowler's position
This can aid breathing but does not address the imminent threat of airway closure. It is supportive, not the primary life-saving intervention.
Apply a cool compress to swollen areas
This may provide comfort but does not address the airway compromise, which is the critical concern in angioedema.

A patient arrives to the emergency department with complaints of a rash that "appeared about two days after doing yard work." The nurse knows that the patient is experiencing which type of hypersensitivity reaction?

A Type I Immediate Hypersensitivity Reaction
B Type II Cytotoxic / Cytolytic Reaction
C Type III Immune-Complex Reaction
D Type IV Delayed Hypersensitivity Reaction

Explanation

Explanation
The redness, inflammation, and rash on the hands—appearing 48 hours after yard work—are consistent with allergic contact dermatitis, commonly caused by plants like poison ivy or poison oak. This is a Type IV hypersensitivity reaction, mediated by sensitized T cells, which trigger inflammation after a delay of 24–72 hours.
Correct Answer Is:
Type IV Delayed Hypersensitivity Reaction
Why the other options are incorrect:
Type I Immediate Hypersensitivity Reaction
Occurs within minutes of allergen exposure, mediated by IgE, and results in hives, swelling, or anaphylaxis—not a delayed rash.
Type II Cytotoxic / Cytolytic Reaction
Involves antibody-mediated destruction of cells, such as in hemolytic anemia or transfusion reactions, not contact dermatitis.
Type III Immune-Complex Reaction
Caused by deposition of antigen-antibody complexes in tissues, leading to inflammation seen in conditions like lupus or serum sickness—not in localized delayed skin reactions.

10.

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:

NU216_Fall25_T3_Endocrine, Respiratory, and Immune Systems

NU216_Fall25_T3_Endocrine, Respiratory, and Immune Systems

NU216_Fall25_T3_Endocrine, Respiratory, and Immune Systems practice questions with answers | nursingprepplug.com

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