The nurse should recognize which pathophysiologic disease process(es) is/are related to an altered immune system? (Select all that apply)

Rheumatoid arthritis.

Emphysema.

Addison disease.

Type 1 diabetes mellitus.

Guillain-Barré syndrome (GBS).

Answer and Explanation

Correct Answer : A,D,E

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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Correct Answer is A

Explanation

Choice A reason: Acute asthma exacerbations involve bronchospasms, airway edema, and excessive mucus production, narrowing airways and causing wheezing and dyspnea. These reversible inflammatory responses are triggered by allergens or irritants, aligning with asthma’s pathophysiology. This accurately describes the acute obstructive process, per respiratory medicine evidence.

Choice B reason: Thick exudates blocking airways are characteristic of conditions like pneumonia, not asthma. Asthma involves bronchospasms, edema, and mucus, not dense exudate. This choice misrepresents asthma’s acute inflammatory process, which is reversible and driven by smooth muscle contraction and mucosal swelling, making it incorrect.

Choice C reason: Chronic inflammation of the bronchi/trachea from infection suggests chronic bronchitis or tracheitis, not asthma. Asthma exacerbations are acute, triggered by non-infectious stimuli, causing spasms and edema. This chronic infectious process does not align with asthma’s reversible, allergic pathophysiology, making it an incorrect description.

Choice D reason: Reduced lung surface area from alveolar damage occurs in emphysema, not asthma. Asthma affects airways via spasms and inflammation, not alveoli. This choice describes a different obstructive disease, unrelated to asthma’s acute, reversible airway pathology, making it incorrect for an exacerbation’s pathophysiological mechanism.

A. Had a cerebrovascular hemorrhage 2 months ago. B. Treats type 2 diabetes with an oral hypoglycemic agent. C. Client’s current age is 65 and the father died of a myocardial infarction (MI) at 55. D. Reports being intolerant to medications containing aspirin.

Correct Answer is A

Explanation

Choice A reason: A history of cerebrovascular hemorrhage is an absolute contraindication for tPA, as it increases the risk of recurrent bleeding. tPA’s thrombolytic action can exacerbate intracranial hemorrhage, posing a life-threatening risk. This recent event (2 months ago) prohibits tPA use, per cardiology and stroke guidelines.

Choice B reason: Type 2 diabetes treated with oral hypoglycemics is not a contraindication for tPA. Diabetes may increase cardiovascular risk, but it does not affect tPA’s bleeding risk. This history is irrelevant to tPA administration safety, making it incorrect for contraindicating thrombolytic therapy in AMI.

Choice C reason: Age 65 and a family history of MI at 55 are risk factors for AMI but not contraindications for tPA. tPA is safe within age limits, and family history does not increase bleeding risk. This choice is incorrect, as these factors do not preclude thrombolytic therapy.

Choice D reason: Aspirin intolerance is not a contraindication for tPA, though aspirin is often co-administered. tPA’s bleeding risk is unrelated to aspirin sensitivity. Alternative antiplatelets can be used if needed, making this incorrect, as intolerance does not prohibit tPA use in acute myocardial infarction.

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The nurse should recognize which pathophysiologic disease process(es) is/are related to an altered immune system? (Select all that apply)

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Explanation

Correct Answer is A

Explanation

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