NCLEX-RN
Immunity NCLEX Questions Questions
Question 1 of 5
The nurse is planning a staff development conference about anaphylaxis. Which of the following information should the nurse include?
Correct Answer: A
Rationale: 0.9% saline infusion (
A) is critical in anaphylaxis to restore volume in shock. Epinephrine, not diphenhydramine (
B), is the initial treatment. Clients carry epinephrine (not hydrocortisone,
C) in auto-injectors. Reverse Trendelenburg (
D) is incorrect; flat or leg-elevated positioning is preferred.
Question 2 of 5
The nurse is caring for a client with Guillain-Barré syndrome (GBS). The nurse plans on taking which priority action?
Correct Answer: A
Rationale: Frequent respiratory status assessment (
A) is the priority in GBS due to the risk of respiratory muscle paralysis. IVIG (
B) is a treatment, not a nursing action priority. Range of motion exercises (
C) and autonomic dysreflexia monitoring (
D) are secondary concerns.
Question 3 of 5
The intensive care unit (ICU) nurse is preparing to admit a client with Guillain-Barre syndrome. Which of the following items is essential for the nurse to have at the client's bedside?
Correct Answer: C
Rationale: Guillain-Barré syndrome can cause respiratory muscle weakness, making oral intubation equipment (
C) essential for potential respiratory failure. Blood pressure cuff (
A), pulse oximeter (
B), and ABG supplies (
D) are important but less critical than intubation readiness.
Question 4 of 5
The nurse in the emergency department (ED) is assessing a client with anaphylactic shock. Which of the following findings would support a diagnosis of anaphylactic shock?
Correct Answer: C,D
Rationale: Anaphylactic shock is characterized by cutaneous cyanosis (
C) from poor perfusion and pruritus (
D) from histamine release. Hypertension (
A) is not typical, as hypotension is expected. Crackles (
B) suggest pulmonary edema, not a primary feature of anaphylaxis.
Question 5 of 5
The nurse is discussing the underlying mechanism of psoriasis with a client recently diagnosed with the condition. The nurse explains that psoriasis is primarily associated with?
Correct Answer: A
Rationale: Psoriasis is caused by overactivity of the immune system, particularly T cells, attacking healthy skin cells (
A), leading to rapid skin turnover and plaques. T lymphocyte deficiency (
B) is unrelated, melanocyte issues (
C) cause pigmentation changes, and excessive sebum (
D) is linked to acne.