NUR 631 FINAL ACTUAL EXAM, PRACTICE
EXAM, STUDY GUIDE AND REVIEW
UPDATED 2024 WITH ALL QUESTIONS
AND WELL ELABORATED ANSWERS
(GRADED AND
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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. - ANSWER-ANS: A
Histamine is the most potent mediator in an IgE-mediated hypersensitivity reaction
(Type 1). 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.
What characteristic do atopic individuals have that make them genetically predisposed
to develop allergies?
a. Greater quantities of histamine
b. More histamine receptors
c. Greater quantities of IgE
d. A deficiency in epinephrine - ANSWER-ANS: C
Atopic individuals tend to produce higher quantities of IgE and to have more crystalline
fragment (Fc) receptors for IgE on their mast cells. Greater quantities of histamine,
more histamine receptors, and a deficiency in epinephrine do not lead to a genetic
predisposition to allergies.
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 T 1 cells directly attack and
destroy cellular targets.
d. Antibodies bind to the antigens on the cell surface. - ANSWER-ANS: D
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.
How is hypersensitivity best defined?
a. A disturbance in the immunologic tolerance of self-antigens
b. An immunologic reaction of one person to the tissue of another person
c. An altered immunologic response to an antigen that results in disease
d. An undetectable immune response in the presence of antigens - ANSWER-ANS: C
Hypersensitivity is an altered immunologic response to an antigen that results in
disease or damage to the host. Autoimmunity is a disturbance in the immunologic
tolerance of self-antigens. Alloimmunity is the immunologic reaction of one person to the
tissue of another person. An immune deficiency of some type would cause undetectable
immune response in the presence of antigens.
What is a hypersensitivity reaction that produces an allergic response called?
a. Hemolytic shock
b. Anaphylaxis
c. Necrotizing vasculitis
d. Systemic erythematosus - ANSWER-ANS: B
Examples of systemic anaphylaxis are allergic reactions to beestings, peanuts, and fish.
Hemolytic shock would be a state in which erythrocytes are destroyed by complementmediated lysis to the point of causing a state of shock. Necrotizing vasculitis is
inflammation of blood vessel walls that limits perfusion. Systemic lupus erythematosus
(SLE) is a chronic, multisystem, inflammatory disease and is one of the most common,
complex, and serious of the autoimmune disorders.
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 - ANSWER-ANS: A
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.
What are blood transfusion reactions an example of?
a. Autoimmunity
b. Alloimmunity
c. Homoimmunity
d. Hypersensitivity - ANSWER-ANS: B
Alloimmunity (also termed isoimmunity) occurs when the immune system of one
individual produces an immunologic reaction against tissues of another individual.
Autoimmunity is a disturbance in the immunologic tolerance of self-antigens.
Homoimmunity refers to the resistance of a lysogenic bacterium that is carrying a phage
to an infection by the same type of phage. Hypersensitivity is an altered immunologic
response to an antigen that results in disease or damage to the host.
During an IgE-mediated hypersensitivity reaction, which leukocyte is activated?
a. Neutrophils
b. Monocytes
c. Eosinophils
d. T lymphocytes - ANSWER-ANS: C
Of the options provided, only eosinophils are activated during IgE-mediated
hypersensitivity reactions.
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 cytotropic antibody
c. Smooth muscle contraction caused by histamine bound to H1 receptors
d. Smooth muscle contraction caused by histamine bound to H2 receptors - ANSWERANS: C
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 [Show Less]