Florida NCLEX Exam: Immune System Disorders Updated Exam
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1. A nurse is caring for a client with systemic lupus erythematosus (SLE). Which
assessment finding should the nurse recognize as a common manifestation of this
disorder?
A. Bradycardia and hypertension
B. Butterfly-shaped rash across the cheeks and nose
C. Productive cough with green sputum
D. Unilateral facial paralysis
Answer: B. Butterfly-shaped rash across the cheeks and nose
Rationale: Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that affects
multiple body systems. One of its hallmark manifestations is a malar or butterfly-shaped rash
extending across the bridge of the nose and cheeks. Other common findings include
photosensitivity, joint pain, fatigue, oral ulcers, fever, and kidney involvement. Bradycardia and
hypertension are not characteristic findings, while productive cough and facial paralysis are
associated with other medical conditions.
2. A client with rheumatoid arthritis asks why the disease affects multiple joints.
Which response by the nurse is most accurate?
A. The disease results from bacterial infection of the joints.
B. Rheumatoid arthritis is an autoimmune disease that causes inflammation of the synovial
membranes.
C. The disorder occurs because calcium is deposited in the joints.
D. Rheumatoid arthritis develops only after severe joint trauma.
Answer: B. Rheumatoid arthritis is an autoimmune disease that causes inflammation of the
synovial membranes.
Rationale: Rheumatoid arthritis (RA) is an autoimmune disorder in which the immune system
attacks the synovial lining of joints, leading to chronic inflammation, pain, swelling, stiffness,
,and eventual joint deformity. The disease commonly affects joints symmetrically. It is not caused
by bacteria, calcium deposits, or trauma.
3. Which laboratory result is most concerning in a client receiving chemotherapy
for leukemia?
A. Hemoglobin 13.8 g/dL
B. Platelet count 210,000/mm³
C. Absolute neutrophil count (ANC) 400/mm³
D. Sodium 138 mEq/L
Answer: C. Absolute neutrophil count (ANC) 400/mm³
Rationale: An ANC below 500/mm³ indicates severe neutropenia, placing the client at extremely
high risk for life-threatening infections. Protective precautions, close monitoring, and prompt
treatment of fever are essential. The remaining laboratory values are within normal limits.
4. A nurse is teaching a client with HIV about preventing opportunistic
infections. Which client statement indicates correct understanding?
A. "I should stop taking my medications when I feel better."
B. "I should avoid all vaccinations."
C. "I will take my antiretroviral medications exactly as prescribed."
D. "I no longer need regular medical appointments."
Answer: C. "I will take my antiretroviral medications exactly as prescribed."
Rationale: Strict adherence to antiretroviral therapy suppresses viral replication, improves
immune function, reduces the risk of opportunistic infections, and decreases HIV transmission.
Clients should continue therapy even when feeling well and attend regular follow-up
appointments. Many vaccinations remain recommended, although certain live vaccines may be
contraindicated depending on immune status.
5. A client diagnosed with anaphylaxis develops severe wheezing and hypotension
after receiving an antibiotic. Which medication should the nurse administer
first?
A. Diphenhydramine
B. Acetaminophen
, C. Epinephrine
D. Prednisone
Answer: C. Epinephrine
Rationale: Epinephrine is the first-line treatment for anaphylaxis because it rapidly reverses
airway edema, bronchospasm, and hypotension through alpha- and beta-adrenergic stimulation.
Antihistamines and corticosteroids are useful adjuncts but should never delay epinephrine
administration. Acetaminophen has no role in treating anaphylaxis.
6. Which assessment finding is most consistent with a severe allergic reaction?
A. Localized redness at the injection site
B. Generalized urticaria, wheezing, and facial swelling
C. Mild headache after eating
D. Dry skin on the elbows
Answer: B. Generalized urticaria, wheezing, and facial swelling
Rationale: Generalized hives, bronchospasm, facial or tongue swelling, hypotension, and
respiratory distress are classic signs of a severe systemic allergic reaction that may progress to
anaphylaxis. Prompt recognition and emergency treatment are critical. Local redness, mild
headache, and dry skin do not indicate a severe allergic response.
7. A client with systemic lupus erythematosus reports increased fatigue after
spending the day outdoors. Which nursing instruction is most appropriate?
A. Increase sun exposure daily.
B. Avoid sunscreen because it interferes with vitamin D production.
C. Limit sun exposure and wear protective clothing.
D. Exercise outdoors during midday.
Answer: C. Limit sun exposure and wear protective clothing.
Rationale: Photosensitivity is common in clients with SLE, and ultraviolet light can trigger
disease flare-ups. Clients should use sunscreen with a high SPF, wear hats and protective
clothing, and avoid prolonged exposure during peak sunlight hours. Increased sun exposure may
worsen symptoms.
8. Which client is at greatest risk for developing an opportunistic infection?
2026 WITH Recent Newest Verified And Well Analyzed Exam
Questions (Actual Exam 2026-2027) Correct Detailed &
Verified ANSWERS (100% Accurate Solutions) ALREADY
GRADED A+||NEWEST VERSION Of The Exam Guarantee Pass!!
1. A nurse is caring for a client with systemic lupus erythematosus (SLE). Which
assessment finding should the nurse recognize as a common manifestation of this
disorder?
A. Bradycardia and hypertension
B. Butterfly-shaped rash across the cheeks and nose
C. Productive cough with green sputum
D. Unilateral facial paralysis
Answer: B. Butterfly-shaped rash across the cheeks and nose
Rationale: Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that affects
multiple body systems. One of its hallmark manifestations is a malar or butterfly-shaped rash
extending across the bridge of the nose and cheeks. Other common findings include
photosensitivity, joint pain, fatigue, oral ulcers, fever, and kidney involvement. Bradycardia and
hypertension are not characteristic findings, while productive cough and facial paralysis are
associated with other medical conditions.
2. A client with rheumatoid arthritis asks why the disease affects multiple joints.
Which response by the nurse is most accurate?
A. The disease results from bacterial infection of the joints.
B. Rheumatoid arthritis is an autoimmune disease that causes inflammation of the synovial
membranes.
C. The disorder occurs because calcium is deposited in the joints.
D. Rheumatoid arthritis develops only after severe joint trauma.
Answer: B. Rheumatoid arthritis is an autoimmune disease that causes inflammation of the
synovial membranes.
Rationale: Rheumatoid arthritis (RA) is an autoimmune disorder in which the immune system
attacks the synovial lining of joints, leading to chronic inflammation, pain, swelling, stiffness,
,and eventual joint deformity. The disease commonly affects joints symmetrically. It is not caused
by bacteria, calcium deposits, or trauma.
3. Which laboratory result is most concerning in a client receiving chemotherapy
for leukemia?
A. Hemoglobin 13.8 g/dL
B. Platelet count 210,000/mm³
C. Absolute neutrophil count (ANC) 400/mm³
D. Sodium 138 mEq/L
Answer: C. Absolute neutrophil count (ANC) 400/mm³
Rationale: An ANC below 500/mm³ indicates severe neutropenia, placing the client at extremely
high risk for life-threatening infections. Protective precautions, close monitoring, and prompt
treatment of fever are essential. The remaining laboratory values are within normal limits.
4. A nurse is teaching a client with HIV about preventing opportunistic
infections. Which client statement indicates correct understanding?
A. "I should stop taking my medications when I feel better."
B. "I should avoid all vaccinations."
C. "I will take my antiretroviral medications exactly as prescribed."
D. "I no longer need regular medical appointments."
Answer: C. "I will take my antiretroviral medications exactly as prescribed."
Rationale: Strict adherence to antiretroviral therapy suppresses viral replication, improves
immune function, reduces the risk of opportunistic infections, and decreases HIV transmission.
Clients should continue therapy even when feeling well and attend regular follow-up
appointments. Many vaccinations remain recommended, although certain live vaccines may be
contraindicated depending on immune status.
5. A client diagnosed with anaphylaxis develops severe wheezing and hypotension
after receiving an antibiotic. Which medication should the nurse administer
first?
A. Diphenhydramine
B. Acetaminophen
, C. Epinephrine
D. Prednisone
Answer: C. Epinephrine
Rationale: Epinephrine is the first-line treatment for anaphylaxis because it rapidly reverses
airway edema, bronchospasm, and hypotension through alpha- and beta-adrenergic stimulation.
Antihistamines and corticosteroids are useful adjuncts but should never delay epinephrine
administration. Acetaminophen has no role in treating anaphylaxis.
6. Which assessment finding is most consistent with a severe allergic reaction?
A. Localized redness at the injection site
B. Generalized urticaria, wheezing, and facial swelling
C. Mild headache after eating
D. Dry skin on the elbows
Answer: B. Generalized urticaria, wheezing, and facial swelling
Rationale: Generalized hives, bronchospasm, facial or tongue swelling, hypotension, and
respiratory distress are classic signs of a severe systemic allergic reaction that may progress to
anaphylaxis. Prompt recognition and emergency treatment are critical. Local redness, mild
headache, and dry skin do not indicate a severe allergic response.
7. A client with systemic lupus erythematosus reports increased fatigue after
spending the day outdoors. Which nursing instruction is most appropriate?
A. Increase sun exposure daily.
B. Avoid sunscreen because it interferes with vitamin D production.
C. Limit sun exposure and wear protective clothing.
D. Exercise outdoors during midday.
Answer: C. Limit sun exposure and wear protective clothing.
Rationale: Photosensitivity is common in clients with SLE, and ultraviolet light can trigger
disease flare-ups. Clients should use sunscreen with a high SPF, wear hats and protective
clothing, and avoid prolonged exposure during peak sunlight hours. Increased sun exposure may
worsen symptoms.
8. Which client is at greatest risk for developing an opportunistic infection?
