NUR-631 FINAL EXAM 2026-
2027 QUESTIONS AND
ANSWERS WITH RATIONALES-
GRAND CANYON UNIVERSITY
QUESTION 1
In which structure does B lymphocytes mature and undergo changes that commit
them to becoming B cells?
a. Thymus gland
b. Regional lymph nodes
c. Bone marrow
d. Spleen
Correct Answer: c. Bone marrow
Rationale: B lymphocytes mature and become B cells in specialized (primary)
lymphoid organs—the thymus gland for T cells and the bone marrow for B cells.
Neither regional lymph nodes nor the spleen are involved in changing B
lymphocytes into B cells.
QUESTION 2
An individual's acquired immunity is dependent on the function of which cells?
(Select all that apply.)
a. T lymphocytes
b. B lymphocytes
c. Macrophages
d. Opsonins
e. Neutrophils
Correct Answer: a, b, c
Rationale: T lymphocytes, B lymphocytes, macrophages, and dendritic cells are
involved in acquired immunity. Opsonins are molecules that tag microorganisms
for destruction by cells of the inflammatory system; these cells are primarily
neutrophils. Neutrophils are white blood cells.
,QUESTION 3
The common hay fever allergy is expressed through a reaction that is mediated by
which class of immunoglobulins?
a. IgE
b. IgG
c. IgM
d. T cells
Correct Answer: a. IgE
Rationale: Type I reactions are mediated by antigen-specific IgE and the
products of tissue mast cells. The most common allergies (e.g., pollen allergies)
are type I reactions. In addition, most type I reactions occur against
environmental antigens and are therefore allergic. Hay fever allergy is not
mediated by IgG, IgM, or T cells.
QUESTION 4
During an IgE-mediated hypersensitivity reaction, which leukocyte is activated?
a. Neutrophils
b. Monocytes
c. Eosinophils
d. T lymphocytes
Correct Answer: c. Eosinophils
Rationale: Of the options provided, only eosinophils are activated during IgE-
mediated hypersensitivity reactions.
QUESTION 5
During an IgE-mediated hypersensitivity reaction, what causes bronchospasm?
a. Bronchial edema caused by the chemotactic factor of anaphylaxis
b. Bronchial edema caused by binding of the cytotoxic antibody
c. Smooth muscle contraction caused by histamine bound to H1 receptors
d. Smooth muscle contraction caused by histamine bound to H2 receptors
Correct Answer: c. Smooth muscle contraction caused by histamine bound to H1
receptors
Rationale: During an IgE-mediated hypersensitivity reaction, smooth muscle
contraction caused by histamine bound to H1 receptors results in
bronchospasms. The bronchospasm is not caused by edema or by histamine
binding to H2 receptors.
QUESTION 6
A patient is having an IgE-mediated hypersensitivity reaction. What action by the
healthcare professional is best?
,a. Give the patient an antihistamine.
b. Prepare to give the patient a blood transfusion.
c. Ask the patient is he/she is having pain at the site.
d. Apply warm, moist heat to the affected area.
Correct Answer: a. Give the patient an antihistamine.
Rationale: Histamine is the most potent mediator in an IgE-mediated
hypersensitivity reaction (Type I). Histamine bound to H2 results in the
degranulation of mast cells with the release of histamine. Blocking histamine
receptors with antihistamines can control some type I responses. The healthcare
professional would not need to give the patient blood; warm, moist heat; or ask
about pain.
QUESTION 7
A student asks about the mechanism that results in type II hypersensitivity reactions.
What description by the professor is best?
a. Antibodies coat mast cells by binding to receptors that signal its degranulation,
followed by a discharge of preformed mediators.
b. Antibodies bind to soluble antigens that were released into body fluids, and the
immune complexes are then deposited in the tissues.
c. Cytotoxic T lymphocytes or lymphokine-producing helper T1 cells directly attack
and destroy cellular targets.
d. Antibodies bind to the antigens on the cell surface.
Correct Answer: d. Antibodies bind to the antigens on the cell surface.
Rationale: The mechanism that results in a type II hypersensitivity reaction
begins with antibody binding to tissue-specific antigens or antigens that have
attached to particular tissues. The cell can be destroyed by antibody IgG or IgM
and activation of the complement cascade through the classical pathway.
QUESTION 8
How are target cells destroyed in a type II hypersensitivity reaction?
a. Tissue damage from mast cell degranulation
b. Antigen-antibody complexes deposited in vessel walls
c. Cytotoxic T lymphocytes attack the cell directly.
d. Natural killer cells
Correct Answer: d. Natural killer cells
Rationale: The mechanism that results in a type II hypersensitivity reaction
involves a subpopulation of cytotoxic cells that are not antigen specific (natural
killer [NK] cells). Antibody on the target cell is recognized by Fc receptors on the
NK cells, which releases toxic substances that destroy the target cell. Tissue
damage from mast cell degranulation occurs in type I hypersensitivity reactions.
Antigen-antibody complexes are active in type III hypersensitivity responses.
Cytotoxic lymphocytes are involved in type IV hypersensitivity responses.
, QUESTION 9
Graves disease (hyperthyroidism) is an example of which type II hypersensitivity
reaction?
a. Modulation
b. Antibody-dependent cell-mediated cytotoxicity
c. Neutrophil-mediated damage
d. Complement-mediated lysis
Correct Answer: a. Modulation
Rationale: The antibody reacts with the receptors on the target cell surface and
modulates the function of the receptor by preventing interactions with their
normal ligands, replacing the ligand and inappropriately stimulating the
receptor or destroying the receptor. For example, in the hyperthyroidism
(excessive thyroid activity) of Graves disease, autoantibody binds to and
activates receptors for thyroid-stimulating hormone (TSH) (a pituitary hormone
that controls the production of the hormone thyroxine by the thyroid). Graves
disease is not a result of cell-mediated cytotoxicity, neutrophil-mediated damage,
or complement-mediated lysis.
QUESTION 10
Immunoglobulin E (IgE) is associated with which type of hypersensitivity reaction?
a. I
b. II
c. III
d. IV
Correct Answer: a. I
Rationale: Hypersensitivity reactions have been divided into four distinct types:
type I (IgE-mediated) hypersensitivity reactions, type II (tissue-specific)
hypersensitivity reactions, type III (immune complex-mediated) hypersensitivity
reactions, and type IV (cell-mediated) hypersensitivity reactions.
QUESTION 11
A Rh-negative woman gave birth to a Rh-positive baby. When discussing Rho(D)
immunoglobulin with her, what information should the healthcare professional
provide?
a. It provides protection against infection from poor immunity in the baby.
b. It prevents alloimmunity and hemolytic anemia of the newborn.
c. It provides necessary antibodies in case the mother doesn't breastfeed.
d. It causes the intestinal tract of the newborn to produce antibodies.
Correct Answer: b. It prevents alloimmunity and hemolytic anemia of the
newborn.
2027 QUESTIONS AND
ANSWERS WITH RATIONALES-
GRAND CANYON UNIVERSITY
QUESTION 1
In which structure does B lymphocytes mature and undergo changes that commit
them to becoming B cells?
a. Thymus gland
b. Regional lymph nodes
c. Bone marrow
d. Spleen
Correct Answer: c. Bone marrow
Rationale: B lymphocytes mature and become B cells in specialized (primary)
lymphoid organs—the thymus gland for T cells and the bone marrow for B cells.
Neither regional lymph nodes nor the spleen are involved in changing B
lymphocytes into B cells.
QUESTION 2
An individual's acquired immunity is dependent on the function of which cells?
(Select all that apply.)
a. T lymphocytes
b. B lymphocytes
c. Macrophages
d. Opsonins
e. Neutrophils
Correct Answer: a, b, c
Rationale: T lymphocytes, B lymphocytes, macrophages, and dendritic cells are
involved in acquired immunity. Opsonins are molecules that tag microorganisms
for destruction by cells of the inflammatory system; these cells are primarily
neutrophils. Neutrophils are white blood cells.
,QUESTION 3
The common hay fever allergy is expressed through a reaction that is mediated by
which class of immunoglobulins?
a. IgE
b. IgG
c. IgM
d. T cells
Correct Answer: a. IgE
Rationale: Type I reactions are mediated by antigen-specific IgE and the
products of tissue mast cells. The most common allergies (e.g., pollen allergies)
are type I reactions. In addition, most type I reactions occur against
environmental antigens and are therefore allergic. Hay fever allergy is not
mediated by IgG, IgM, or T cells.
QUESTION 4
During an IgE-mediated hypersensitivity reaction, which leukocyte is activated?
a. Neutrophils
b. Monocytes
c. Eosinophils
d. T lymphocytes
Correct Answer: c. Eosinophils
Rationale: Of the options provided, only eosinophils are activated during IgE-
mediated hypersensitivity reactions.
QUESTION 5
During an IgE-mediated hypersensitivity reaction, what causes bronchospasm?
a. Bronchial edema caused by the chemotactic factor of anaphylaxis
b. Bronchial edema caused by binding of the cytotoxic antibody
c. Smooth muscle contraction caused by histamine bound to H1 receptors
d. Smooth muscle contraction caused by histamine bound to H2 receptors
Correct Answer: c. Smooth muscle contraction caused by histamine bound to H1
receptors
Rationale: During an IgE-mediated hypersensitivity reaction, smooth muscle
contraction caused by histamine bound to H1 receptors results in
bronchospasms. The bronchospasm is not caused by edema or by histamine
binding to H2 receptors.
QUESTION 6
A patient is having an IgE-mediated hypersensitivity reaction. What action by the
healthcare professional is best?
,a. Give the patient an antihistamine.
b. Prepare to give the patient a blood transfusion.
c. Ask the patient is he/she is having pain at the site.
d. Apply warm, moist heat to the affected area.
Correct Answer: a. Give the patient an antihistamine.
Rationale: Histamine is the most potent mediator in an IgE-mediated
hypersensitivity reaction (Type I). Histamine bound to H2 results in the
degranulation of mast cells with the release of histamine. Blocking histamine
receptors with antihistamines can control some type I responses. The healthcare
professional would not need to give the patient blood; warm, moist heat; or ask
about pain.
QUESTION 7
A student asks about the mechanism that results in type II hypersensitivity reactions.
What description by the professor is best?
a. Antibodies coat mast cells by binding to receptors that signal its degranulation,
followed by a discharge of preformed mediators.
b. Antibodies bind to soluble antigens that were released into body fluids, and the
immune complexes are then deposited in the tissues.
c. Cytotoxic T lymphocytes or lymphokine-producing helper T1 cells directly attack
and destroy cellular targets.
d. Antibodies bind to the antigens on the cell surface.
Correct Answer: d. Antibodies bind to the antigens on the cell surface.
Rationale: The mechanism that results in a type II hypersensitivity reaction
begins with antibody binding to tissue-specific antigens or antigens that have
attached to particular tissues. The cell can be destroyed by antibody IgG or IgM
and activation of the complement cascade through the classical pathway.
QUESTION 8
How are target cells destroyed in a type II hypersensitivity reaction?
a. Tissue damage from mast cell degranulation
b. Antigen-antibody complexes deposited in vessel walls
c. Cytotoxic T lymphocytes attack the cell directly.
d. Natural killer cells
Correct Answer: d. Natural killer cells
Rationale: The mechanism that results in a type II hypersensitivity reaction
involves a subpopulation of cytotoxic cells that are not antigen specific (natural
killer [NK] cells). Antibody on the target cell is recognized by Fc receptors on the
NK cells, which releases toxic substances that destroy the target cell. Tissue
damage from mast cell degranulation occurs in type I hypersensitivity reactions.
Antigen-antibody complexes are active in type III hypersensitivity responses.
Cytotoxic lymphocytes are involved in type IV hypersensitivity responses.
, QUESTION 9
Graves disease (hyperthyroidism) is an example of which type II hypersensitivity
reaction?
a. Modulation
b. Antibody-dependent cell-mediated cytotoxicity
c. Neutrophil-mediated damage
d. Complement-mediated lysis
Correct Answer: a. Modulation
Rationale: The antibody reacts with the receptors on the target cell surface and
modulates the function of the receptor by preventing interactions with their
normal ligands, replacing the ligand and inappropriately stimulating the
receptor or destroying the receptor. For example, in the hyperthyroidism
(excessive thyroid activity) of Graves disease, autoantibody binds to and
activates receptors for thyroid-stimulating hormone (TSH) (a pituitary hormone
that controls the production of the hormone thyroxine by the thyroid). Graves
disease is not a result of cell-mediated cytotoxicity, neutrophil-mediated damage,
or complement-mediated lysis.
QUESTION 10
Immunoglobulin E (IgE) is associated with which type of hypersensitivity reaction?
a. I
b. II
c. III
d. IV
Correct Answer: a. I
Rationale: Hypersensitivity reactions have been divided into four distinct types:
type I (IgE-mediated) hypersensitivity reactions, type II (tissue-specific)
hypersensitivity reactions, type III (immune complex-mediated) hypersensitivity
reactions, and type IV (cell-mediated) hypersensitivity reactions.
QUESTION 11
A Rh-negative woman gave birth to a Rh-positive baby. When discussing Rho(D)
immunoglobulin with her, what information should the healthcare professional
provide?
a. It provides protection against infection from poor immunity in the baby.
b. It prevents alloimmunity and hemolytic anemia of the newborn.
c. It provides necessary antibodies in case the mother doesn't breastfeed.
d. It causes the intestinal tract of the newborn to produce antibodies.
Correct Answer: b. It prevents alloimmunity and hemolytic anemia of the
newborn.
