NURSING PATHOPHYSIOLOGY EXAM #5B: ALTERATIONS IN INFLAMMATION &
INFECTIOUS FUNCTION (2026/2027) | CASE STUDY & STANDARD QUESTIONS WITH
CORRECT ANSWERS
Advanced Pathophysiology Examination: Focus on Immune, Inflammatory, & Infectious Processes |
Core Domains: Acute/Chronic Inflammation, Hypersensitivity, Autoimmunity, Immunodeficiency,
Microbial Pathogenesis, Sepsis, and Wound Healing | Graduate-Level Nursing Focus | Case Study &
Clinical Application Exam Format
Exam Structure
This exam for the 2026/2027 cycle is a 60-question assessment that includes unfolding case studies (e.g.,
patient developing septic shock, autoimmune flare-up) to test the ability to differentiate maladaptive
immune responses and trace the pathogenesis from microbial exposure or immune dysregulation to
systemic disease.
Answer Format
All correct answers must be presented in bold and green, followed by rationales that explain the specific
immune mechanisms, inflammatory pathways, or microbial virulence factors responsible for the clinical
scenario presented in the case studies and questions.
Questions (60 Total)
1.
A patient develops hives, wheezing, and hypotension within minutes of receiving penicillin.
What type of hypersensitivity reaction is this?
A. Type II
B. Type I
C. Type III
D. Type IV
Type I (immediate) hypersensitivity involves IgE binding to mast cells/basophils, causing degranulation
and release of histamine—leading to anaphylaxis within minutes of re-exposure.
2.
A patient presents with malar rash, photosensitivity, joint pain, and positive ANA and anti-dsDNA
antibodies.
,What condition is most likely?
A. Rheumatoid arthritis
B. Systemic lupus erythematosus (SLE)
C. Sjögren’s syndrome
D. Scleroderma
SLE is a Type III hypersensitivity disorder involving immune complex deposition in tissues like kidneys
and skin. Anti-dsDNA is highly specific for SLE.
3.
A patient with HIV has a CD4+ count of 150 cells/μL and presents with white plaques on the tongue that
cannot be scraped off.
What opportunistic infection is present?
A. Herpes simplex
B. Oral candidiasis (thrush)
C. Cytomegalovirus
D. Kaposi sarcoma
Oral thrush is a common fungal infection in immunocompromised patients, especially when CD4+
<200. It appears as adherent white plaques on the tongue and buccal mucosa.
4.
A patient with pneumonia has fever, WBC 22,000/mm³, lactate 4.8 mmol/L, and hypotension requiring
vasopressors.
What is the diagnosis?
A. SIRS
B. Septic shock
C. UTI
D. Viral syndrome
, Septic shock is defined as sepsis (infection + organ dysfunction) with persistent hypotension requiring
vasopressors and serum lactate >2 mmol/L despite adequate fluid resuscitation.
5.
A patient develops watery diarrhea after taking antibiotics. Stool PCR is positive for toxin B.
What organism is responsible?
A. Escherichia coli
B. Clostridioides difficile
C. Salmonella
D. Shigella
C. diff produces toxins A and B that cause pseudomembranous colitis. Antibiotic use disrupts normal
flora, allowing C. diff overgrowth. Toxin B is cytotoxic to colonic epithelium.
6.
A patient has redness, heat, swelling, and pain at a surgical incision site on postoperative day 2.
What phase of healing is this?
A. Proliferative
B. Inflammatory
C. Remodeling
D. Maturation
The inflammatory phase (days 1–4) involves vasodilation, increased permeability, and neutrophil
infiltration—causing classic signs of inflammation. This clears debris and prepares for tissue repair.
7.
A patient develops hives, wheezing, and hypotension within minutes of receiving penicillin.
What type of hypersensitivity reaction is this?
A. Type II
INFECTIOUS FUNCTION (2026/2027) | CASE STUDY & STANDARD QUESTIONS WITH
CORRECT ANSWERS
Advanced Pathophysiology Examination: Focus on Immune, Inflammatory, & Infectious Processes |
Core Domains: Acute/Chronic Inflammation, Hypersensitivity, Autoimmunity, Immunodeficiency,
Microbial Pathogenesis, Sepsis, and Wound Healing | Graduate-Level Nursing Focus | Case Study &
Clinical Application Exam Format
Exam Structure
This exam for the 2026/2027 cycle is a 60-question assessment that includes unfolding case studies (e.g.,
patient developing septic shock, autoimmune flare-up) to test the ability to differentiate maladaptive
immune responses and trace the pathogenesis from microbial exposure or immune dysregulation to
systemic disease.
Answer Format
All correct answers must be presented in bold and green, followed by rationales that explain the specific
immune mechanisms, inflammatory pathways, or microbial virulence factors responsible for the clinical
scenario presented in the case studies and questions.
Questions (60 Total)
1.
A patient develops hives, wheezing, and hypotension within minutes of receiving penicillin.
What type of hypersensitivity reaction is this?
A. Type II
B. Type I
C. Type III
D. Type IV
Type I (immediate) hypersensitivity involves IgE binding to mast cells/basophils, causing degranulation
and release of histamine—leading to anaphylaxis within minutes of re-exposure.
2.
A patient presents with malar rash, photosensitivity, joint pain, and positive ANA and anti-dsDNA
antibodies.
,What condition is most likely?
A. Rheumatoid arthritis
B. Systemic lupus erythematosus (SLE)
C. Sjögren’s syndrome
D. Scleroderma
SLE is a Type III hypersensitivity disorder involving immune complex deposition in tissues like kidneys
and skin. Anti-dsDNA is highly specific for SLE.
3.
A patient with HIV has a CD4+ count of 150 cells/μL and presents with white plaques on the tongue that
cannot be scraped off.
What opportunistic infection is present?
A. Herpes simplex
B. Oral candidiasis (thrush)
C. Cytomegalovirus
D. Kaposi sarcoma
Oral thrush is a common fungal infection in immunocompromised patients, especially when CD4+
<200. It appears as adherent white plaques on the tongue and buccal mucosa.
4.
A patient with pneumonia has fever, WBC 22,000/mm³, lactate 4.8 mmol/L, and hypotension requiring
vasopressors.
What is the diagnosis?
A. SIRS
B. Septic shock
C. UTI
D. Viral syndrome
, Septic shock is defined as sepsis (infection + organ dysfunction) with persistent hypotension requiring
vasopressors and serum lactate >2 mmol/L despite adequate fluid resuscitation.
5.
A patient develops watery diarrhea after taking antibiotics. Stool PCR is positive for toxin B.
What organism is responsible?
A. Escherichia coli
B. Clostridioides difficile
C. Salmonella
D. Shigella
C. diff produces toxins A and B that cause pseudomembranous colitis. Antibiotic use disrupts normal
flora, allowing C. diff overgrowth. Toxin B is cytotoxic to colonic epithelium.
6.
A patient has redness, heat, swelling, and pain at a surgical incision site on postoperative day 2.
What phase of healing is this?
A. Proliferative
B. Inflammatory
C. Remodeling
D. Maturation
The inflammatory phase (days 1–4) involves vasodilation, increased permeability, and neutrophil
infiltration—causing classic signs of inflammation. This clears debris and prepares for tissue repair.
7.
A patient develops hives, wheezing, and hypotension within minutes of receiving penicillin.
What type of hypersensitivity reaction is this?
A. Type II
