The nurse is preparing a female client with Addison’s disease for self-care after discharge. Which is the pathophysiological basis to support the need for the client to carry a cortisol kit at all times?

Hypertensive crisis requires immediate treatment to prevent a stroke.

The drug may be needed to treat a sudden systemic allergic reaction.

Stress increases the body’s need for additional replacement hormone.

Hyperglycemia may require cortisol to lower the blood glucose level.

Answer and Explanation

The Correct Answer is C

Choice A reason: Hypertensive crisis is not a feature of Addison’s disease, which causes hypotension due to cortisol and aldosterone deficiency. Cortisol kits address adrenal insufficiency during stress, not hypertension. This choice is incorrect, as it misaligns with Addison’s pathophysiology and cortisol’s role.

Choice B reason: Cortisol is not used for systemic allergic reactions, which require antihistamines or epinephrine. Addison’s patients need cortisol for adrenal insufficiency during stress, as their bodies cannot produce it. This choice is incorrect, as cortisol kits address hypoadrenalism, not anaphylaxis.

Choice C reason: Addison’s disease involves adrenal insufficiency, impairing cortisol production. Stress increases cortisol demand, which the patient cannot meet, risking adrenal crisis. Carrying a cortisol kit allows rapid administration during stress, preventing life-threatening hypotension or shock, aligning with endocrinology evidence for Addison’s management.

Choice D reason: Hyperglycemia is unrelated to Addison’s disease, which does not typically affect glucose metabolism. Cortisol kits address adrenal insufficiency, not blood glucose. This choice is incorrect, as cortisol replacement is for stress-induced hypoadrenalism, not glycemic control, per Addison’s pathophysiological basis.

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Correct Answer is B

Explanation

Choice A reason: Macrophages, lymph, and cytokines are part of the innate immune response, acting after pathogens breach initial barriers. First-line defenses are physical and chemical barriers like mucosa and secretions, not immune cells or fluids. This choice represents secondary defenses, making it incorrect for the primary barrier role.

Choice B reason: Lung epithelium, gastric mucosa, and tears are first-line defenses, preventing pathogen entry. Lung cilia trap microbes, gastric acid kills bacteria, and tears’ lysozymes neutralize pathogens. These physical and chemical barriers form the body’s initial protection, aligning with immunology principles for primary defense against infection.

Choice C reason: Interferon, T cells, and neutrophils are part of adaptive and innate immunity, activated after pathogen penetration. First-line defenses involve barriers like mucosa, not immune mediators or cells. This choice describes secondary immune responses, making it incorrect for the initial protective structures in humans.

Choice D reason: Thymus, bone marrow, and pancreas are involved in immune cell production and metabolism, not direct pathogen defense. First-line defenses are external barriers like lung epithelium or tears. These internal organs support immunity but are not primary barriers, making this incorrect for first-line defense structures.

A. Rheumatoid arthritis. B. Emphysema. C. Addison disease. D. Type 1 diabetes mellitus. E. Guillain-Barré syndrome (GBS).

Correct Answer is ["A","D","E"]

Explanation

Choice A reason: Rheumatoid arthritis is an autoimmune disorder where the immune system attacks synovial joints, causing inflammation and destruction. This altered immune response, driven by autoantibodies like rheumatoid factor, leads to chronic joint damage, aligning with diseases involving immune dysregulation, per rheumatology evidence.

Choice B reason: Emphysema, a COPD subtype, results from alveolar destruction due to smoking or environmental exposures, not immune dysregulation. While inflammation occurs, it is not primarily autoimmune. Emphysema’s pathophysiology involves protease imbalance, not altered immunity, making it incorrect for diseases related to immune system alterations.

Choice C reason: Addison disease involves adrenal insufficiency, often autoimmune, but primarily affects hormone production, not immune system activity. The immune attack on adrenal glands is a cause, not the ongoing disease process. This makes it less directly related to altered immunity compared to RA, T1DM, or GBS.

Choice D reason: Type 1 diabetes mellitus is an autoimmune condition where the immune system destroys pancreatic beta cells, leading to insulin deficiency. This immune-mediated attack, involving T-cells and autoantibodies, directly reflects altered immunity, making it a key example of an immune-related disease, per endocrinology evidence.

Choice E reason: Guillain-Barré syndrome is an autoimmune disorder where the immune system attacks peripheral nerves, causing demyelination and weakness. This post-infectious immune dysregulation, often triggered by molecular mimicry, directly involves altered immunity, aligning with the pathophysiology of immune-related diseases, per neurological evidence.

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The nurse is preparing a female client with Addison’s disease for self-care after discharge. Which is the pathophysiological basis to support the need for the client to carry a cortisol kit at all times?

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Correct Answer is B

Explanation

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Correct Answer is ["A","D","E"]

Explanation

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