NUR 376 FINAL EXAM
BLUEPRINT & STUDY GUIDE
Applied Pathophysiology - Concordia St. Paul
Pass the Exam with Confidence
➢ This Patho final is comprehensive with a high focus on modules
10-14.
➢ The test will have multiple choice, select all that apply, matching,
true/false, and sequence questions.
➢ See below for an explanation of the aptitude level of each
question.
➢ We wish you luck!
, lOMoARcPSD|51648332
NUR 376 Exam #4 [Final] Blueprint by Rhaeven Ortiz
This Patho final is comprehensive with a high focus on modules 10-14. The test will have multiple choice, select all that apply,
matching, true/false, and sequence questions. See below for an explanation of the aptitude level of each question. We wish you
luck!
M Learning Objective Topic B #
o l ?
d o s
o
m
Module 1 Immunity, Infection & Inflammation
CH 9, 10, 11
1 Differentiate between Immunodeficiency R 1
immunocompetence e
and Immunocompetence, immunosuppression, and immunodeficiency are distinct concepts m
immunosuppression related to the immune system’s function. e
m
● Immunocompetence refers to the immune system’s ability to recognize and
b
respond effectively to pathogens, maintaining normal defense mechanisms.
e
● Immunosuppression occurs when the immune response is intentionally or
r
Downloaded by Benjamin Luca () 1
, lOMoARcPSD|51648332
unintentionally reduced, such as due to medications (e.g., corticosteroids,
chemotherapy) or diseases (e.g., HIV).
● Immunodeficiency is a state where the immune system is unable to mount an
adequate response, either due to genetic conditions (primary immunodeficiency)
or acquired factors (secondary immunodeficiency).
1 Identify four types Transfusion Reaction U 1
/ of hypersensitivity n
1 reactions. Hypersensitivity reactions are exaggerated immune responses that can cause tissue d
3 damage. They are classified into four types: e
r
1. Type I (Immediate Hypersensitivity) – Mediated by IgE antibodies, this reaction
s
occurs rapidly after exposure to an allergen (e.g., anaphylaxis, allergic rhinitis).
t
2. Type II (Cytotoxic Hypersensitivity) – Involves IgG or IgM antibodies attacking
a
specific cells, leading to cell destruction (e.g., transfusion reaction, hemolytic
n
disease of the newborn).
d
3. Type III (Immune Complex Hypersensitivity) – Immune complexes deposit in
tissues, causing inflammation and damage (e.g., rheumatoid arthritis, systemic
lupus erythematosus).
4. Type IV (Delayed Hypersensitivity) – T-cell-mediated response that occurs
over time, rather than immediately (e.g., contact dermatitis, tuberculosis skin test).
—------------------------------------------------------------------------
Transfusion Reaction (Type II Hypersensitivity)
A transfusion reaction occurs when a patient receives incompatible blood, leading to an
immune-mediated attack on transfused red blood cells (RBCs). This is a classic example of
Type II (Cytotoxic) Hypersensitivity, where antibodies (IgG or IgM) target antigens on
the RBCs, triggering their destruction.
Mechanism of Transfusion Reaction
1. Antigen-Antibody Interaction
○ The recipient’s immune system recognizes incompatible donor RBC
antigens as foreign.
○ Pre-existing antibodies bind to these RBCs, leading to activation of the
complement system.
2. Hemolysis and Tissue Damage
○ Complement activation results in hemolysis (destruction of RBCs),
either intravascularly (inside blood vessels) or extravascularly (in the
spleen and liver).
○ This releases hemoglobin into the bloodstream, which can damage the
kidneys.
Downloaded by Benjamin Luca () 2
, lOMoARcPSD|51648332
3. Inflammatory Response
○ Cytokines and inflammatory mediators cause fever, chills, low blood
pressure, and shock in severe cases.
Types of Transfusion Reactions
1. Acute Hemolytic Reaction (most severe)
○ Caused by ABO incompatibility (e.g., giving type A blood to a type B
recipient).
○ Symptoms: Fever, chills, flank pain, dark urine, low blood pressure, and
potential kidney failure.
2. Delayed Hemolytic Reaction
○ Occurs days to weeks after transfusion due to low levels of pre-existing
antibodies or new antibody development.
○ Milder symptoms include low-grade fever, jaundice, and decreased
hemoglobin levels.
3. Febrile Non-Hemolytic Reaction
○ Caused by recipient antibodies reacting to donor white blood cells
(WBCs) in the transfused blood.
○ Symptoms: Fever and chills but no hemolysis.
4. Allergic Reaction
○ Caused by recipient hypersensitivity to donor plasma proteins.
○ Symptoms: Itching, rash, hives, and in severe cases, anaphylaxis.
Prevention and Management
● Blood Type Matching: Ensuring compatibility through ABO and Rh typing before
transfusion.
● Crossmatching: Testing recipient serum against donor RBCs to detect potential
reactions.
● Monitoring: Watching for signs of reaction during and after transfusion.
● Immediate Discontinuation: Stopping the transfusion if a reaction occurs and
providing supportive treatment (e.g., IV fluids, antihistamines, corticosteroids, or
oxygen).
Conclusion
A transfusion reaction is a serious immune response that can lead to severe
complications if not managed properly. Understanding the types, mechanisms, and
prevention strategies helps ensure patient safety in transfusion therapy.
Downloaded by Benjamin Luca () 3
BLUEPRINT & STUDY GUIDE
Applied Pathophysiology - Concordia St. Paul
Pass the Exam with Confidence
➢ This Patho final is comprehensive with a high focus on modules
10-14.
➢ The test will have multiple choice, select all that apply, matching,
true/false, and sequence questions.
➢ See below for an explanation of the aptitude level of each
question.
➢ We wish you luck!
, lOMoARcPSD|51648332
NUR 376 Exam #4 [Final] Blueprint by Rhaeven Ortiz
This Patho final is comprehensive with a high focus on modules 10-14. The test will have multiple choice, select all that apply,
matching, true/false, and sequence questions. See below for an explanation of the aptitude level of each question. We wish you
luck!
M Learning Objective Topic B #
o l ?
d o s
o
m
Module 1 Immunity, Infection & Inflammation
CH 9, 10, 11
1 Differentiate between Immunodeficiency R 1
immunocompetence e
and Immunocompetence, immunosuppression, and immunodeficiency are distinct concepts m
immunosuppression related to the immune system’s function. e
m
● Immunocompetence refers to the immune system’s ability to recognize and
b
respond effectively to pathogens, maintaining normal defense mechanisms.
e
● Immunosuppression occurs when the immune response is intentionally or
r
Downloaded by Benjamin Luca () 1
, lOMoARcPSD|51648332
unintentionally reduced, such as due to medications (e.g., corticosteroids,
chemotherapy) or diseases (e.g., HIV).
● Immunodeficiency is a state where the immune system is unable to mount an
adequate response, either due to genetic conditions (primary immunodeficiency)
or acquired factors (secondary immunodeficiency).
1 Identify four types Transfusion Reaction U 1
/ of hypersensitivity n
1 reactions. Hypersensitivity reactions are exaggerated immune responses that can cause tissue d
3 damage. They are classified into four types: e
r
1. Type I (Immediate Hypersensitivity) – Mediated by IgE antibodies, this reaction
s
occurs rapidly after exposure to an allergen (e.g., anaphylaxis, allergic rhinitis).
t
2. Type II (Cytotoxic Hypersensitivity) – Involves IgG or IgM antibodies attacking
a
specific cells, leading to cell destruction (e.g., transfusion reaction, hemolytic
n
disease of the newborn).
d
3. Type III (Immune Complex Hypersensitivity) – Immune complexes deposit in
tissues, causing inflammation and damage (e.g., rheumatoid arthritis, systemic
lupus erythematosus).
4. Type IV (Delayed Hypersensitivity) – T-cell-mediated response that occurs
over time, rather than immediately (e.g., contact dermatitis, tuberculosis skin test).
—------------------------------------------------------------------------
Transfusion Reaction (Type II Hypersensitivity)
A transfusion reaction occurs when a patient receives incompatible blood, leading to an
immune-mediated attack on transfused red blood cells (RBCs). This is a classic example of
Type II (Cytotoxic) Hypersensitivity, where antibodies (IgG or IgM) target antigens on
the RBCs, triggering their destruction.
Mechanism of Transfusion Reaction
1. Antigen-Antibody Interaction
○ The recipient’s immune system recognizes incompatible donor RBC
antigens as foreign.
○ Pre-existing antibodies bind to these RBCs, leading to activation of the
complement system.
2. Hemolysis and Tissue Damage
○ Complement activation results in hemolysis (destruction of RBCs),
either intravascularly (inside blood vessels) or extravascularly (in the
spleen and liver).
○ This releases hemoglobin into the bloodstream, which can damage the
kidneys.
Downloaded by Benjamin Luca () 2
, lOMoARcPSD|51648332
3. Inflammatory Response
○ Cytokines and inflammatory mediators cause fever, chills, low blood
pressure, and shock in severe cases.
Types of Transfusion Reactions
1. Acute Hemolytic Reaction (most severe)
○ Caused by ABO incompatibility (e.g., giving type A blood to a type B
recipient).
○ Symptoms: Fever, chills, flank pain, dark urine, low blood pressure, and
potential kidney failure.
2. Delayed Hemolytic Reaction
○ Occurs days to weeks after transfusion due to low levels of pre-existing
antibodies or new antibody development.
○ Milder symptoms include low-grade fever, jaundice, and decreased
hemoglobin levels.
3. Febrile Non-Hemolytic Reaction
○ Caused by recipient antibodies reacting to donor white blood cells
(WBCs) in the transfused blood.
○ Symptoms: Fever and chills but no hemolysis.
4. Allergic Reaction
○ Caused by recipient hypersensitivity to donor plasma proteins.
○ Symptoms: Itching, rash, hives, and in severe cases, anaphylaxis.
Prevention and Management
● Blood Type Matching: Ensuring compatibility through ABO and Rh typing before
transfusion.
● Crossmatching: Testing recipient serum against donor RBCs to detect potential
reactions.
● Monitoring: Watching for signs of reaction during and after transfusion.
● Immediate Discontinuation: Stopping the transfusion if a reaction occurs and
providing supportive treatment (e.g., IV fluids, antihistamines, corticosteroids, or
oxygen).
Conclusion
A transfusion reaction is a serious immune response that can lead to severe
complications if not managed properly. Understanding the types, mechanisms, and
prevention strategies helps ensure patient safety in transfusion therapy.
Downloaded by Benjamin Luca () 3
