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NUR 631 FINAL EXAMS, STUDY GUIDE AND
PRACTICE EXAMS WITH ACTUAL CORRECT
QUESTIONS AND VERIFIED DETAILED
RATIONALES ANSWERS 2024(NEWEST)
ALREADY GRADED A+
NUR 631 FINAL EXAMS
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
ANS: D
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.
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
ANS: A
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.
Immunoglobulin E (IgE) is associated with which type of hypersensitivity reaction a.ib. II c. III d. IV
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ANS: A
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.
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?
It provides protection against infection from poor immunity in the baby.
It prevents alloimmunity and hemolytic anemia of the newborn.
It provides necessary antibodies in case the mother doesn't breastfeed.
It causes the intestinal tract of the newborn to produce antibodies.
ANS: B
Alloimmunity occurs when an individual's immune system reacts against antigens on the tissues of
other members of the same species. This can occur when a woman is Rh-negative and gives birth to
an Rh-positive baby, leading to hemolytic anemia of the newborn. Rho[D] immunoglobulin does not
provide protection against infection, provide antibodies to a bottle-fed baby, or cause the intestine to
produce antibodies.
Which mother does the healthcare professional prepare to administer Rh immune globulin (Rho- GAM)
to?
a. Is Rh-positive and the fetus is Rh-negative
b. Is Rh-negative and the fetus is Rh-positive
c. Has type A blood and the fetus has type O
d. Has type AB blood and the fetus has type B
ANS: B
Hemolytic disease of the fetus and newborn (HDFN) can occur only if antigens on fetal erythrocytes
differ from antigens on maternal erythrocytes. Maternal-fetal incompatibility exists only if the mother
and fetus differ in ABO blood type or if the fetus is Rh-positive and the mother is Rh-negative. The
healthcare professional would plan to administer Rho-GAM to the mother who is Rh-negative whose
baby is Rh positive.
A patient has microcytic, hypochromic anemia. Which type of treatment or procedure does the
healthcare professional discuss as a potential cure with the patient?
a. Cord blood transplantation
b. Scheduled infusion of gamma globulins
c. Massive blood transfusions
d. Repeated injections of Rho-GAM
ANS: A
Microcytic, hypochromic anemia is one manifestation of thalassemia. The only definitive cures for this
disorder are allogeneic hematopoietic stem cell transplantation (HSCT) from a matched family or
unrelated donor or cord blood transplantation from a related donor. Gamma globulins protect the
body against infectious diseases. Blood transfusions can be used to correct low hemoglobin. Rho-GAM
,3|Page
is used in postpartum women who are Rh-negative after delivering an Rh-positive baby to prevent
development of maternal antibodies against the baby's blood.
An infant was born with hemolytic disease of the fetus and newborn (HDFN). What treatment does the
healthcare professional anticipate for this baby?
Administration of intravenous fluids to dilute the blood
Replacement transfusion of Rh-positive blood not contaminated with anti-Rh
antibodies
Performance of a splenectomy to prevent the destruction of abnormal erythrocytes
Replacement transfusion of Rh-negative erythrocytes
ANS: B
If antigenic incompatibility of the mother's erythrocytes is not discovered in time to administer Rh
immunoglobulin and the child is born with HDFN, then the treatment consists of exchange
transfusions in which the neonate's blood is replaced with new Rh-positive blood that is not
contaminated with anti-Rh antibodies. This treatment is administered during the first 24 hours of
extrauterine life to prevent kernicterus. Kernicterus is not prevented by diluting the blood with IV
fluids, splenectomy, or by giving Rh-negative blood.
A patient asks the healthcare professional why tissue damage occurs in acute rejection after organ
transplantation. What response by the professional is best?
a. Th1 cells release cytokines that activate infiltrating macrophages, and cytotoxic T cells directly attack
the endothelial cells of the transplanted tissue.
b. Circulating immune complexes are deposited in the endothelial cells of
transplanted tissue, where the complement cascade lyses tissue.
c. Receptors on natural killer cells recognize antigens on the cell surface of transplanted tissue, which
releases lysosomal enzymes that destroy tissue.
d. Antibodies coat the surface of transplanted tissue to which mast cells bind and
liberate preformed chemical mediators that destroy tissue.
ANS: A
The recipient's lymphocytes interacting with the donor's dendritic cells within the transplanted tissue
usually initiate sensitization, resulting in the induction of recipient Th1 and Tc cells against the donor's
antigens. The Th1 cells release cytokines that activate infiltrating macrophages, and the Tc cells
directly attack the endothelial cells in the transplanted tissue. The other options do not accurately
describe how acute rejection after organ transplantation results in tissue damage.
Which statements best define acute rejection? (Select all that apply.)
Acute rejection is a cell-mediated immune response.
Acute rejection is usually a type III rejection.
Immunosuppressive drugs delay or lessen the intensity of an acute rejection.
Acute rejection is associated with the body's response to an organ transplant.
Acute rejection is a response against unmatched human leukocyte antigens (HLAs).
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ANS: A, C, D, E
Acute rejection is primarily a cell-mediated immune response that occurs within days to months after
transplantation. This type of rejection occurs when the recipient develops an immune response
against unmatched HLAs after transplantation. A biopsy of the rejected organ usually shows an
infiltration of lymphocytes and macrophages characteristic of a type IV reaction. Immunosuppressive
drugs may delay or lessen the intensity of an acute rejection.
A student asks the healthcare professional to describe exotoxins. Which statement by the professional is
best?
a. Exotoxins are contained in cell walls of gram-negative bacteria.
b. Exotoxins are released during the lysis of bacteria.
c. Exotoxins are able to initiate the complement and coagulation cascades.
d. Exotoxins are released during bacterial growth.
ANS: D
Exotoxins are proteins released during bacterial growth. Exotoxins are not contained in cell walls of
gram-negative bacteria, released during lysis of bacterial, or able to initiate the complement and
coagulation cascades.
A severely stressed patient has hypoglycemia each time the patient's blood glucose is checked. The
healthcare professional should order laboratory tests to measure which hormone in the patient's blood?
a. Epinephrine
b. Norepinephrine
c. Cortisol
d. Growth hormone
ANS: C
One of the primary effects of cortisol is the stimulation of gluconeogenesis or the formation of glucose
from noncarbohydrate sources, such as amino or free fatty acids in the liver. Neither reaction is a
result of the effects of any of the other hormones.
Which hormone prompts increased anxiety, vigilance, and arousal during a stress response?
a. Norepinephrine
b. Epinephrine
c. Cortisol
d. Adrenocorticotropic hormone (ACTH)
ANS: A
The release of norepinephrine promotes arousal, increased vigilance, increased anxiety, and other
protective emotional responses. Epinephrine's effects are primarily on the cardiovascular system.
Cortisol's chief effects involve metabolic processes. By inhibiting the use of metabolic substances
while promoting their formation, cortisol mobilizes glucose, amino acids, lipids, and fatty acids and
delivers them to the bloodstream. ACTH binds with specific receptors on the adrenal glands which
causes the release of the glucocorticoids.
Stress-induced sympathetic stimulation of the adrenal medulla causes the secretion of what?
NUR 631 FINAL EXAMS, STUDY GUIDE AND
PRACTICE EXAMS WITH ACTUAL CORRECT
QUESTIONS AND VERIFIED DETAILED
RATIONALES ANSWERS 2024(NEWEST)
ALREADY GRADED A+
NUR 631 FINAL EXAMS
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
ANS: D
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.
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
ANS: A
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.
Immunoglobulin E (IgE) is associated with which type of hypersensitivity reaction a.ib. II c. III d. IV
,2|Page
ANS: A
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.
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?
It provides protection against infection from poor immunity in the baby.
It prevents alloimmunity and hemolytic anemia of the newborn.
It provides necessary antibodies in case the mother doesn't breastfeed.
It causes the intestinal tract of the newborn to produce antibodies.
ANS: B
Alloimmunity occurs when an individual's immune system reacts against antigens on the tissues of
other members of the same species. This can occur when a woman is Rh-negative and gives birth to
an Rh-positive baby, leading to hemolytic anemia of the newborn. Rho[D] immunoglobulin does not
provide protection against infection, provide antibodies to a bottle-fed baby, or cause the intestine to
produce antibodies.
Which mother does the healthcare professional prepare to administer Rh immune globulin (Rho- GAM)
to?
a. Is Rh-positive and the fetus is Rh-negative
b. Is Rh-negative and the fetus is Rh-positive
c. Has type A blood and the fetus has type O
d. Has type AB blood and the fetus has type B
ANS: B
Hemolytic disease of the fetus and newborn (HDFN) can occur only if antigens on fetal erythrocytes
differ from antigens on maternal erythrocytes. Maternal-fetal incompatibility exists only if the mother
and fetus differ in ABO blood type or if the fetus is Rh-positive and the mother is Rh-negative. The
healthcare professional would plan to administer Rho-GAM to the mother who is Rh-negative whose
baby is Rh positive.
A patient has microcytic, hypochromic anemia. Which type of treatment or procedure does the
healthcare professional discuss as a potential cure with the patient?
a. Cord blood transplantation
b. Scheduled infusion of gamma globulins
c. Massive blood transfusions
d. Repeated injections of Rho-GAM
ANS: A
Microcytic, hypochromic anemia is one manifestation of thalassemia. The only definitive cures for this
disorder are allogeneic hematopoietic stem cell transplantation (HSCT) from a matched family or
unrelated donor or cord blood transplantation from a related donor. Gamma globulins protect the
body against infectious diseases. Blood transfusions can be used to correct low hemoglobin. Rho-GAM
,3|Page
is used in postpartum women who are Rh-negative after delivering an Rh-positive baby to prevent
development of maternal antibodies against the baby's blood.
An infant was born with hemolytic disease of the fetus and newborn (HDFN). What treatment does the
healthcare professional anticipate for this baby?
Administration of intravenous fluids to dilute the blood
Replacement transfusion of Rh-positive blood not contaminated with anti-Rh
antibodies
Performance of a splenectomy to prevent the destruction of abnormal erythrocytes
Replacement transfusion of Rh-negative erythrocytes
ANS: B
If antigenic incompatibility of the mother's erythrocytes is not discovered in time to administer Rh
immunoglobulin and the child is born with HDFN, then the treatment consists of exchange
transfusions in which the neonate's blood is replaced with new Rh-positive blood that is not
contaminated with anti-Rh antibodies. This treatment is administered during the first 24 hours of
extrauterine life to prevent kernicterus. Kernicterus is not prevented by diluting the blood with IV
fluids, splenectomy, or by giving Rh-negative blood.
A patient asks the healthcare professional why tissue damage occurs in acute rejection after organ
transplantation. What response by the professional is best?
a. Th1 cells release cytokines that activate infiltrating macrophages, and cytotoxic T cells directly attack
the endothelial cells of the transplanted tissue.
b. Circulating immune complexes are deposited in the endothelial cells of
transplanted tissue, where the complement cascade lyses tissue.
c. Receptors on natural killer cells recognize antigens on the cell surface of transplanted tissue, which
releases lysosomal enzymes that destroy tissue.
d. Antibodies coat the surface of transplanted tissue to which mast cells bind and
liberate preformed chemical mediators that destroy tissue.
ANS: A
The recipient's lymphocytes interacting with the donor's dendritic cells within the transplanted tissue
usually initiate sensitization, resulting in the induction of recipient Th1 and Tc cells against the donor's
antigens. The Th1 cells release cytokines that activate infiltrating macrophages, and the Tc cells
directly attack the endothelial cells in the transplanted tissue. The other options do not accurately
describe how acute rejection after organ transplantation results in tissue damage.
Which statements best define acute rejection? (Select all that apply.)
Acute rejection is a cell-mediated immune response.
Acute rejection is usually a type III rejection.
Immunosuppressive drugs delay or lessen the intensity of an acute rejection.
Acute rejection is associated with the body's response to an organ transplant.
Acute rejection is a response against unmatched human leukocyte antigens (HLAs).
, 4|Page
ANS: A, C, D, E
Acute rejection is primarily a cell-mediated immune response that occurs within days to months after
transplantation. This type of rejection occurs when the recipient develops an immune response
against unmatched HLAs after transplantation. A biopsy of the rejected organ usually shows an
infiltration of lymphocytes and macrophages characteristic of a type IV reaction. Immunosuppressive
drugs may delay or lessen the intensity of an acute rejection.
A student asks the healthcare professional to describe exotoxins. Which statement by the professional is
best?
a. Exotoxins are contained in cell walls of gram-negative bacteria.
b. Exotoxins are released during the lysis of bacteria.
c. Exotoxins are able to initiate the complement and coagulation cascades.
d. Exotoxins are released during bacterial growth.
ANS: D
Exotoxins are proteins released during bacterial growth. Exotoxins are not contained in cell walls of
gram-negative bacteria, released during lysis of bacterial, or able to initiate the complement and
coagulation cascades.
A severely stressed patient has hypoglycemia each time the patient's blood glucose is checked. The
healthcare professional should order laboratory tests to measure which hormone in the patient's blood?
a. Epinephrine
b. Norepinephrine
c. Cortisol
d. Growth hormone
ANS: C
One of the primary effects of cortisol is the stimulation of gluconeogenesis or the formation of glucose
from noncarbohydrate sources, such as amino or free fatty acids in the liver. Neither reaction is a
result of the effects of any of the other hormones.
Which hormone prompts increased anxiety, vigilance, and arousal during a stress response?
a. Norepinephrine
b. Epinephrine
c. Cortisol
d. Adrenocorticotropic hormone (ACTH)
ANS: A
The release of norepinephrine promotes arousal, increased vigilance, increased anxiety, and other
protective emotional responses. Epinephrine's effects are primarily on the cardiovascular system.
Cortisol's chief effects involve metabolic processes. By inhibiting the use of metabolic substances
while promoting their formation, cortisol mobilizes glucose, amino acids, lipids, and fatty acids and
delivers them to the bloodstream. ACTH binds with specific receptors on the adrenal glands which
causes the release of the glucocorticoids.
Stress-induced sympathetic stimulation of the adrenal medulla causes the secretion of what?
