SAN ANTONIO COLLEGE
RNSG 1128: Introduction to Health Care Concepts
EXAM 1 2026/2027.
Student Name: __________________________ Date: ________________________
Student ID: ____________________________ Score: ________ / 50 (100%)
EXAMINATION INSTRUCTIONS:
1. This examination consists of 50 multiple-choice questions covering RNSG 1128 Exam 1 concepts (Immunity &
Gas Exchange).
2. Read each stem carefully and select the single BEST answer choice (A, B, C, or D).
3. Every item is grounded strictly in San Antonio College course blueprints and reflection materials.
_________________________________________________________________________________
Question 1. A nurse is reviewing the function of the immune system. Which cell type is recognized as
the first granular leukocyte to arrive at the site of inflammation to perform phagocytosis?
A. Basophils
B. Eosinophils
C. Neutrophils
D. Monocytes
✔ Correct Answer: Option C — Neutrophils
Rationale: Neutrophils are granular leukocytes (accounting for 60-70% of WBCs) and are the very first cells to arrive
at the site where inflammation occurs to perform phagocytosis. Monocytes are nongranular leukocytes that arrive
first among nongranular cells.
Question 2. During an assessment of a newborn, the mother asks why her baby has protection against
infections immediately at birth without prior contact with pathogens. Which immune response should
the nurse explain?
A. Artificially acquired passive immunity
B. Natural innate immunity
C. Cell-mediated acquired immunity
D. Humoral active immunity
✔ Correct Answer: Option B — Natural innate immunity
Rationale: Natural (innate) immunity is present at birth and serves as the first line of host defense following antigen
exposure without remembering prior contact with an infectious agent.
RNSG 1128 Exam 1 | Page 1
,Question 3. A patient asks the nurse where T lymphocytes mature in the human body. Which primary
lymphoid organ should the nurse identify?
A. Spleen
B. Tonsils
C. Thymus gland
D. Red bone marrow
✔ Correct Answer: Option C — Thymus gland
Rationale: Primary lymphoid tissues consist of the red bone marrow (where blood and immune cells are produced)
and the thymus (where T lymphocytes mature).
Question 4. A nurse is evaluating a differential WBC count for a patient with a chronic bacterial
infection. Which leukocyte percentage increase would the nurse expect to observe?
A. Eosinophils 1–4%
B. Lymphocytes 20–40%
C. Monocytes 2–8%
D. Basophils 0.5–1%
✔ Correct Answer: Option B — Lymphocytes 20–40%
Rationale: Lymphocytes normally make up 20–40% of the WBC count and increase during chronic bacterial and
viral infections. Neutrophils increase during acute infections that produce pus.
Question 5. A patient experiencing an acute allergic response shows an elevated basophil count. Which
chemical mediators released by basophils contribute to allergic and stress responses?
A. Antihistamines and lysozyme
B. Histamine and heparin
C. Cytokines and lymphokines
D. Destructive enzymes and IgE
✔ Correct Answer: Option B — Histamine and heparin
Rationale: Basophils (0.5–1% of WBCs) increase during allergic reactions and stress responses by releasing
histamine and heparin. Eosinophils secrete antihistamines.
RNSG 1128 Exam 1 | Page 2
, Question 6. Using the 'ACID' mnemonic for hypersensitivity reactions, a nurse identifies a blood
transfusion reaction involving AB or Rh factor incompatibility as which type of hypersensitivity?
A. Type I Allergic reaction
B. Type II Cytotoxic reaction
C. Type IV Delayed reaction
D. Type III Immune complex reaction
✔ Correct Answer: Option B — Type II Cytotoxic reaction
Rationale: Type II is Cytotoxic (C in ACID), mediated by IgG or IgM binding to antigens on self-cells, activating the
complement system and causing phagocytosis or cell destruction (e.g., blood transfusion reactions, Graves disease,
Myasthenia gravis).
Question 7. A nurse is administering a tuberculin skin test (PPD) to a healthcare worker. This diagnostic
test evaluates which type of hypersensitivity reaction?
A. Type I Anaphylactic reaction
B. Type IV Delayed reaction
C. Type II Cytotoxic reaction
D. Type III Immune complex reaction
✔ Correct Answer: Option B — Type IV Delayed reaction
Rationale: Type IV is a Delayed reaction (D in ACID) involving T cells, monocytes, and macrophages that takes
several days to develop, as seen in the tuberculin skin test, contact dermatitis, and viral reactions.
Question 8. An older adult patient in a long-term care facility has decreased gastric secretions and GI
motility. The nurse recognizes that this age-related change increases the patient's risk for which
condition?
A. Impaired ciliary clearance
B. Urinary stasis and UTIs
C. Pressure ulcer development
D. Gastroenteritis and diarrhea
✔ Correct Answer: Option D — Gastroenteritis and diarrhea
Rationale: Age-related GI changes include decreased gastric secretions and motility, allowing intestinal organisms
to thrive and increasing the incidence of gastroenteritis and diarrhea.
RNSG 1128 Exam 1 | Page 3
RNSG 1128: Introduction to Health Care Concepts
EXAM 1 2026/2027.
Student Name: __________________________ Date: ________________________
Student ID: ____________________________ Score: ________ / 50 (100%)
EXAMINATION INSTRUCTIONS:
1. This examination consists of 50 multiple-choice questions covering RNSG 1128 Exam 1 concepts (Immunity &
Gas Exchange).
2. Read each stem carefully and select the single BEST answer choice (A, B, C, or D).
3. Every item is grounded strictly in San Antonio College course blueprints and reflection materials.
_________________________________________________________________________________
Question 1. A nurse is reviewing the function of the immune system. Which cell type is recognized as
the first granular leukocyte to arrive at the site of inflammation to perform phagocytosis?
A. Basophils
B. Eosinophils
C. Neutrophils
D. Monocytes
✔ Correct Answer: Option C — Neutrophils
Rationale: Neutrophils are granular leukocytes (accounting for 60-70% of WBCs) and are the very first cells to arrive
at the site where inflammation occurs to perform phagocytosis. Monocytes are nongranular leukocytes that arrive
first among nongranular cells.
Question 2. During an assessment of a newborn, the mother asks why her baby has protection against
infections immediately at birth without prior contact with pathogens. Which immune response should
the nurse explain?
A. Artificially acquired passive immunity
B. Natural innate immunity
C. Cell-mediated acquired immunity
D. Humoral active immunity
✔ Correct Answer: Option B — Natural innate immunity
Rationale: Natural (innate) immunity is present at birth and serves as the first line of host defense following antigen
exposure without remembering prior contact with an infectious agent.
RNSG 1128 Exam 1 | Page 1
,Question 3. A patient asks the nurse where T lymphocytes mature in the human body. Which primary
lymphoid organ should the nurse identify?
A. Spleen
B. Tonsils
C. Thymus gland
D. Red bone marrow
✔ Correct Answer: Option C — Thymus gland
Rationale: Primary lymphoid tissues consist of the red bone marrow (where blood and immune cells are produced)
and the thymus (where T lymphocytes mature).
Question 4. A nurse is evaluating a differential WBC count for a patient with a chronic bacterial
infection. Which leukocyte percentage increase would the nurse expect to observe?
A. Eosinophils 1–4%
B. Lymphocytes 20–40%
C. Monocytes 2–8%
D. Basophils 0.5–1%
✔ Correct Answer: Option B — Lymphocytes 20–40%
Rationale: Lymphocytes normally make up 20–40% of the WBC count and increase during chronic bacterial and
viral infections. Neutrophils increase during acute infections that produce pus.
Question 5. A patient experiencing an acute allergic response shows an elevated basophil count. Which
chemical mediators released by basophils contribute to allergic and stress responses?
A. Antihistamines and lysozyme
B. Histamine and heparin
C. Cytokines and lymphokines
D. Destructive enzymes and IgE
✔ Correct Answer: Option B — Histamine and heparin
Rationale: Basophils (0.5–1% of WBCs) increase during allergic reactions and stress responses by releasing
histamine and heparin. Eosinophils secrete antihistamines.
RNSG 1128 Exam 1 | Page 2
, Question 6. Using the 'ACID' mnemonic for hypersensitivity reactions, a nurse identifies a blood
transfusion reaction involving AB or Rh factor incompatibility as which type of hypersensitivity?
A. Type I Allergic reaction
B. Type II Cytotoxic reaction
C. Type IV Delayed reaction
D. Type III Immune complex reaction
✔ Correct Answer: Option B — Type II Cytotoxic reaction
Rationale: Type II is Cytotoxic (C in ACID), mediated by IgG or IgM binding to antigens on self-cells, activating the
complement system and causing phagocytosis or cell destruction (e.g., blood transfusion reactions, Graves disease,
Myasthenia gravis).
Question 7. A nurse is administering a tuberculin skin test (PPD) to a healthcare worker. This diagnostic
test evaluates which type of hypersensitivity reaction?
A. Type I Anaphylactic reaction
B. Type IV Delayed reaction
C. Type II Cytotoxic reaction
D. Type III Immune complex reaction
✔ Correct Answer: Option B — Type IV Delayed reaction
Rationale: Type IV is a Delayed reaction (D in ACID) involving T cells, monocytes, and macrophages that takes
several days to develop, as seen in the tuberculin skin test, contact dermatitis, and viral reactions.
Question 8. An older adult patient in a long-term care facility has decreased gastric secretions and GI
motility. The nurse recognizes that this age-related change increases the patient's risk for which
condition?
A. Impaired ciliary clearance
B. Urinary stasis and UTIs
C. Pressure ulcer development
D. Gastroenteritis and diarrhea
✔ Correct Answer: Option D — Gastroenteritis and diarrhea
Rationale: Age-related GI changes include decreased gastric secretions and motility, allowing intestinal organisms
to thrive and increasing the incidence of gastroenteritis and diarrhea.
RNSG 1128 Exam 1 | Page 3
