Immune System NCLEX | Nurselytic

Questions 29

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Immune System NCLEX Questions

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Question 1 of 5

The client diagnosed with myasthenia gravis is admitted to the emergency department with a sudden exacerbation of motor weakness. Which assessment data indicate the client is experiencing a cholinergic crisis?

Correct Answer: D

Rationale: Cholinergic crisis (overdose of cholinesterase inhibitors) shows no improvement with Tensilon, unlike myasthenic crisis. Antibody levels, symptom improvement, and vital signs are not specific.

Question 2 of 5

Which sign/symptom should the nurse expect to assess in the client who is in the recovery stage of Guillain-Barré syndrome?

Correct Answer: D

Rationale: Recovery in Guillain-Barré syndrome shows descending muscle strength improvement. Reflexes improve, ptosis is unrelated, and Babinski’s is not typical.

Question 3 of 5

The nurse and a licensed practical nurse (LPN) are caring for a group of clients. Which nursing task should not be assigned to the LPN?

Correct Answer: D

Rationale: Teaching self-catheterization requires nursing judgment and patient education, outside LPN scope. Administering medications, discussing with HCP, and drawing blood are within LPN scope.

Question 4 of 5

The client diagnosed with RA who has been prescribed etanercept, a tumor necrosis factor alpha inhibitor, shows marked improvement. Which instruction regarding the use of this medication should the nurse teach?

Correct Answer: B

Rationale: Regular checkups and lab work monitor for etanercept side effects (e.g., infection). Efficacy persists, MRI is not routine, and cycling is incorrect.

Question 5 of 5

The client on a medical floor is diagnosed with HIV encephalopathy. Which client problem is priority?

Correct Answer: D

Rationale: HIV encephalopathy increases confusion and motor deficits, making risk for injury the priority. Nutrition, grieving, and knowledge are secondary.

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