NUR 631 FINAL EXAM, PRACTICE EXAM AND STUDY

• | P a g e

NUR 631 FINAL EXAM, PRACTICE EXAM AND STUDY

GUIDE NEWEST ACTUAL EXAM 350 QUESTIONS

AND CORRECT DETAILED ANSWERS (VERIFIED

ANSWERS) |ALREADY GRADED A+

NUR 631 FINAL EXAM

Graves disease (hyperthyroidism) is an example of which type II hypersensitivity reaction?

• Modulation
• Antibody-dependent cell-mediated cytotoxicity
• Neutrophil-mediated damage

d. Complement-mediated lysis - ANSWER- ANS: A

Rationale: 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. I 1 / 4

• | P a g e

b. II c. III d. IV - ANSWER- 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. -

ANSWER- ANS: B

Rationale: 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?

• Is Rh-positive and the fetus is Rh-negative 2 / 4

• | P a g e

• Is Rh-negative and the fetus is Rh-positive
• Has type A blood and the fetus has type O

d. Has type AB blood and the fetus has type B - ANSWER- ANS: B

Rationale: 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?

• Cord blood transplantation
• Scheduled infusion of gamma globulins
• Massive blood transfusions

d. Repeated injections of Rho-GAM - ANSWER- ANS: A

Rationale: 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 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.

• / 4

• | P a g e

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 - ANSWER- ANS:

B

Rationale: 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?

• Th1 cells release cytokines that activate infiltrating macrophages, and

cytotoxic T cells directly attack the endothelial cells of the transplanted tissue.

• / 4