SAN ANTONIO COLLEGE
RNSG 1128: INTRODUCTION TO HEALTH CARE CONCEPTS
COMPREHENSIVE FINAL EXAMINATION
Student Name: Date: Score _____ / 100
Q1. A nursing student is reviewing the mechanisms of immunity. Which defense mechanism represents the immune
system's second line of defense, often termed the antibody response?
A. Nonspecific innate barrier response involving skin and gastric acid
B. Phagocytic immune response involving granulocytes and monocytes
C. Cellular immune response involving T-cell attack
D. Humoral immune response involving B lymphocytes
[✔] Correct Answer: D — Humoral immune response involving B lymphocytes
Clinical Rationale: According to the RNSG 1128 study blueprint, the humoral response is the immune system's 2nd line of defense,
involving B lymphocytes that manufacture antibodies. The cellular response is the 3rd line of defense involving T cells.
Q2. The nurse is caring for a patient who was recently exposed to a live viral pathogen and subsequently developed
antibodies against the infection. How should the nurse classify this type of immunity?
A. Active natural immunity
B. Passive artificial immunity
C. Passive natural immunity
D. Active artificial immunity
[✔] Correct Answer: A — Active natural immunity
Clinical Rationale: Active natural immunity occurs when the body produces antibodies in response to exposure to a live pathogen.
Active artificial comes from vaccines, passive natural from maternal placenta/breastmilk, and passive artificial from injected
immunoglobulins.
Q3. A nurse is evaluating a complete blood count (CBC) for a patient with acute localized inflammation. Which white
blood cell type is known to be the first to arrive at the site of inflammation?
A. Neutrophils
B. Macrophages
C. T Lymphocytes
D. Eosinophils
[✔] Correct Answer: A — Neutrophils
Clinical Rationale: Source documentation explicitly states that neutrophils are the first cells to arrive at the site of inflammation,
followed later by macrophages and T lymphocytes.
SAN ANTONIO COLLEGE | RNSG 1128 FINAL EXAM MASTER BLUEPRINT Page 1
, Q4. When interpreting a Purified Protein Derivative (PPD) tuberculin skin test for a patient with HIV, which induration
measurement does the nurse recognize as a positive result?
A. 0 to 4 mm
B. 15 mm or greater
C. 5 mm or greater
D. 10 mm or greater
[✔] Correct Answer: C — 5 mm or greater
Clinical Rationale: A PPD induration of 0 to 4 mm is considered not significant. An induration of 5 mm or greater is classified as
positive for high-risk patients, including those with HIV or direct contact with active TB cases.
Q5. A patient diagnosed with active Tuberculosis (TB) is admitted to the medical unit. What isolation precautions and
room placement must the nurse implement?
A. Contact precautions with standard room ventilation
B. Protective environment with positive airflow
C. Droplet precautions with a positive-pressure room
D. Airborne precautions with a private negative-pressure room
[✔] Correct Answer: D — Airborne precautions with a private negative-pressure room
Clinical Rationale: TB spreads via airborne transmission. Nursing guidelines require airborne isolation precautions, including
placement in a private room with negative pressure ventilation and the use of N95 respirators.
Q6. A nurse is reviewing warning signs for primary immunodeficiency in a pediatric patient. According to course
standards, how many ear infections in one year serve as a warning sign?
A. 1 severe ear infection within 1 year
B. 2 or more ear infections within 1 year
C. 4 or more ear infections within 1 year
D. 6 or more ear infections within 2 years
[✔] Correct Answer: C — 4 or more ear infections within 1 year
Clinical Rationale: Ten warning signs for primary immunodeficiency include 4 or more new ear infections within 1 year, 2 or more
serious sinus infections within 1 year, and 2 or more pneumonias within 1 year.
Q7. A patient experiences a severe allergic reaction to a bee sting, resulting in localized edema, wheezing, and
hypotension. The nurse recognizes this as which type of hypersensitivity reaction?
A. Type IV cell-mediated delayed hypersensitivity reaction
B. Type II IgG/IgM cytotoxic reaction
C. Type I IgE-mediated hypersensitivity reaction
D. Type III immune complex-mediated reaction
[✔] Correct Answer: C — Type I IgE-mediated hypersensitivity reaction
Clinical Rationale: Type I hypersensitivity is IgE-mediated, immediate, or atopic (e.g., bee sting anaphylaxis or asthma). Type II is
cytotoxic, Type III is immune complex (Lupus), and Type IV is delayed cell-mediated (poison ivy).
SAN ANTONIO COLLEGE | RNSG 1128 FINAL EXAM MASTER BLUEPRINT Page 2
, Q8. A nurse is preparing emergency pharmacotherapy for a patient experiencing systemic anaphylaxis from an
exaggerated immune response. Which medication is the immediate first-line drug of choice?
A. Subcutaneous or intramuscular Epinephrine
B. Inhaled Albuterol
C. Intravenous Diphenhydramine
D. Oral Prednisone
[✔] Correct Answer: A — Subcutaneous or intramuscular Epinephrine
Clinical Rationale: Clinical management guidelines for Type I anaphylaxis specify subcutaneous or intramuscular Epinephrine as the
immediate priority medication to support airway, breathing, and circulation.
Q9. Which condition serves as an exemplar of a Type III immune complex-mediated exaggerated immune response?
A. Poison ivy contact dermatitis
B. Systemic Lupus Erythematosus (SLE)
C. Transfusion reaction
D. Anaphylactic reaction to penicillin
[✔] Correct Answer: B — Systemic Lupus Erythematosus (SLE)
Clinical Rationale: Systemic Lupus Erythematosus (SLE) is a classic Type III IgG and IgM immune complex-mediated hypersensitivity
reaction. Poison ivy is Type IV, transfusion reaction is Type II, and anaphylaxis is Type I.
Q10. What is the normal laboratory reference range for total white blood cell (leukocyte) count in an adult?
A. 1,500 to 4,500 / mm³
B. 3,500 to 7,500 / mm³
C. 5,000 to 10,000 / mm³
D. 10,000 to 15,000 / mm³
[✔] Correct Answer: C — 5,000 to 10,000 / mm³
Clinical Rationale: The standard reference range for total WBC (leukocyte) count as cited in the RNSG 1128 blueprint is 5,000 to
10,000 / mm³.
Q11. A nurse is evaluating an older adult patient for age-related immune changes. What anatomical change in the
lymphatic system contributes significantly to decreased immune effectiveness in elderly adults?
A. Hypertrophy of bone marrow yellow fat cells
B. Shrinking of the thymus gland to approximately 15% of its maximum size
C. Enlargement of the spleen resulting in sequestered leukocytes
D. Complete calcification of all peripheral lymph nodes
[✔] Correct Answer: B — Shrinking of the thymus gland to approximately 15% of its maximum size
Clinical Rationale: Physiological aging causes shrinking of the thymus gland, leaving it at approximately 15% of its maximum size by
middle age, which reduces T-cell maturation and immune efficacy.
Q12. A patient with systemic lupus erythematosus asks why women are more commonly affected. Based on source
statistics, what is the female-to-male ratio for SLE prevalence?
A. 20 : 1 female-to-male ratio
B. 2 : 1 female-to-male ratio
C. 10 : 1 female-to-male ratio
D. 5 : 1 female-to-male ratio
[✔] Correct Answer: C — 10 : 1 female-to-male ratio
Clinical Rationale: Course materials note that gender is an unmodifiable risk factor for exaggerated immune response, with SLE
occurring 10 times more often in women than in men (10:1 ratio).
SAN ANTONIO COLLEGE | RNSG 1128 FINAL EXAM MASTER BLUEPRINT Page 3
RNSG 1128: INTRODUCTION TO HEALTH CARE CONCEPTS
COMPREHENSIVE FINAL EXAMINATION
Student Name: Date: Score _____ / 100
Q1. A nursing student is reviewing the mechanisms of immunity. Which defense mechanism represents the immune
system's second line of defense, often termed the antibody response?
A. Nonspecific innate barrier response involving skin and gastric acid
B. Phagocytic immune response involving granulocytes and monocytes
C. Cellular immune response involving T-cell attack
D. Humoral immune response involving B lymphocytes
[✔] Correct Answer: D — Humoral immune response involving B lymphocytes
Clinical Rationale: According to the RNSG 1128 study blueprint, the humoral response is the immune system's 2nd line of defense,
involving B lymphocytes that manufacture antibodies. The cellular response is the 3rd line of defense involving T cells.
Q2. The nurse is caring for a patient who was recently exposed to a live viral pathogen and subsequently developed
antibodies against the infection. How should the nurse classify this type of immunity?
A. Active natural immunity
B. Passive artificial immunity
C. Passive natural immunity
D. Active artificial immunity
[✔] Correct Answer: A — Active natural immunity
Clinical Rationale: Active natural immunity occurs when the body produces antibodies in response to exposure to a live pathogen.
Active artificial comes from vaccines, passive natural from maternal placenta/breastmilk, and passive artificial from injected
immunoglobulins.
Q3. A nurse is evaluating a complete blood count (CBC) for a patient with acute localized inflammation. Which white
blood cell type is known to be the first to arrive at the site of inflammation?
A. Neutrophils
B. Macrophages
C. T Lymphocytes
D. Eosinophils
[✔] Correct Answer: A — Neutrophils
Clinical Rationale: Source documentation explicitly states that neutrophils are the first cells to arrive at the site of inflammation,
followed later by macrophages and T lymphocytes.
SAN ANTONIO COLLEGE | RNSG 1128 FINAL EXAM MASTER BLUEPRINT Page 1
, Q4. When interpreting a Purified Protein Derivative (PPD) tuberculin skin test for a patient with HIV, which induration
measurement does the nurse recognize as a positive result?
A. 0 to 4 mm
B. 15 mm or greater
C. 5 mm or greater
D. 10 mm or greater
[✔] Correct Answer: C — 5 mm or greater
Clinical Rationale: A PPD induration of 0 to 4 mm is considered not significant. An induration of 5 mm or greater is classified as
positive for high-risk patients, including those with HIV or direct contact with active TB cases.
Q5. A patient diagnosed with active Tuberculosis (TB) is admitted to the medical unit. What isolation precautions and
room placement must the nurse implement?
A. Contact precautions with standard room ventilation
B. Protective environment with positive airflow
C. Droplet precautions with a positive-pressure room
D. Airborne precautions with a private negative-pressure room
[✔] Correct Answer: D — Airborne precautions with a private negative-pressure room
Clinical Rationale: TB spreads via airborne transmission. Nursing guidelines require airborne isolation precautions, including
placement in a private room with negative pressure ventilation and the use of N95 respirators.
Q6. A nurse is reviewing warning signs for primary immunodeficiency in a pediatric patient. According to course
standards, how many ear infections in one year serve as a warning sign?
A. 1 severe ear infection within 1 year
B. 2 or more ear infections within 1 year
C. 4 or more ear infections within 1 year
D. 6 or more ear infections within 2 years
[✔] Correct Answer: C — 4 or more ear infections within 1 year
Clinical Rationale: Ten warning signs for primary immunodeficiency include 4 or more new ear infections within 1 year, 2 or more
serious sinus infections within 1 year, and 2 or more pneumonias within 1 year.
Q7. A patient experiences a severe allergic reaction to a bee sting, resulting in localized edema, wheezing, and
hypotension. The nurse recognizes this as which type of hypersensitivity reaction?
A. Type IV cell-mediated delayed hypersensitivity reaction
B. Type II IgG/IgM cytotoxic reaction
C. Type I IgE-mediated hypersensitivity reaction
D. Type III immune complex-mediated reaction
[✔] Correct Answer: C — Type I IgE-mediated hypersensitivity reaction
Clinical Rationale: Type I hypersensitivity is IgE-mediated, immediate, or atopic (e.g., bee sting anaphylaxis or asthma). Type II is
cytotoxic, Type III is immune complex (Lupus), and Type IV is delayed cell-mediated (poison ivy).
SAN ANTONIO COLLEGE | RNSG 1128 FINAL EXAM MASTER BLUEPRINT Page 2
, Q8. A nurse is preparing emergency pharmacotherapy for a patient experiencing systemic anaphylaxis from an
exaggerated immune response. Which medication is the immediate first-line drug of choice?
A. Subcutaneous or intramuscular Epinephrine
B. Inhaled Albuterol
C. Intravenous Diphenhydramine
D. Oral Prednisone
[✔] Correct Answer: A — Subcutaneous or intramuscular Epinephrine
Clinical Rationale: Clinical management guidelines for Type I anaphylaxis specify subcutaneous or intramuscular Epinephrine as the
immediate priority medication to support airway, breathing, and circulation.
Q9. Which condition serves as an exemplar of a Type III immune complex-mediated exaggerated immune response?
A. Poison ivy contact dermatitis
B. Systemic Lupus Erythematosus (SLE)
C. Transfusion reaction
D. Anaphylactic reaction to penicillin
[✔] Correct Answer: B — Systemic Lupus Erythematosus (SLE)
Clinical Rationale: Systemic Lupus Erythematosus (SLE) is a classic Type III IgG and IgM immune complex-mediated hypersensitivity
reaction. Poison ivy is Type IV, transfusion reaction is Type II, and anaphylaxis is Type I.
Q10. What is the normal laboratory reference range for total white blood cell (leukocyte) count in an adult?
A. 1,500 to 4,500 / mm³
B. 3,500 to 7,500 / mm³
C. 5,000 to 10,000 / mm³
D. 10,000 to 15,000 / mm³
[✔] Correct Answer: C — 5,000 to 10,000 / mm³
Clinical Rationale: The standard reference range for total WBC (leukocyte) count as cited in the RNSG 1128 blueprint is 5,000 to
10,000 / mm³.
Q11. A nurse is evaluating an older adult patient for age-related immune changes. What anatomical change in the
lymphatic system contributes significantly to decreased immune effectiveness in elderly adults?
A. Hypertrophy of bone marrow yellow fat cells
B. Shrinking of the thymus gland to approximately 15% of its maximum size
C. Enlargement of the spleen resulting in sequestered leukocytes
D. Complete calcification of all peripheral lymph nodes
[✔] Correct Answer: B — Shrinking of the thymus gland to approximately 15% of its maximum size
Clinical Rationale: Physiological aging causes shrinking of the thymus gland, leaving it at approximately 15% of its maximum size by
middle age, which reduces T-cell maturation and immune efficacy.
Q12. A patient with systemic lupus erythematosus asks why women are more commonly affected. Based on source
statistics, what is the female-to-male ratio for SLE prevalence?
A. 20 : 1 female-to-male ratio
B. 2 : 1 female-to-male ratio
C. 10 : 1 female-to-male ratio
D. 5 : 1 female-to-male ratio
[✔] Correct Answer: C — 10 : 1 female-to-male ratio
Clinical Rationale: Course materials note that gender is an unmodifiable risk factor for exaggerated immune response, with SLE
occurring 10 times more often in women than in men (10:1 ratio).
SAN ANTONIO COLLEGE | RNSG 1128 FINAL EXAM MASTER BLUEPRINT Page 3
