NR507 Midterm( Week 1-4) Exam Study Guide |Question With
Answers And Rationale Updated 2026
THIS EXAM INCLUDES:
Week 1: Immunology (Questions 1-25)
Week 2: Hematology & Cardiovascular (Questions 26-55)
Week 3: Pulmonary (Questions 56-75)
Week 4: Renal (Questions 76-100)
,https://www.stuvia.com/user/NursePrepHub
Week 1: Immunology (Questions 1-25)
Question 1
A 22-year-old female develops urticaria, wheezing, and hypotension within 10 minutes of
receiving intravenous contrast dye. Which type of hypersensitivity reaction is occurring?
A. Type I
B. Type II
C. Type III
D. Type IV
Answer: A (Type I)
Rationale: Type I hypersensitivity is IgE-mediated and occurs within minutes of antigen exposure.
Mast cell degranulation releases histamine and other mediators causing vasodilation,
bronchoconstriction, and increased vascular permeability.
Question 2
A patient with Graves' disease exhibits hyperthyroidism due to antibodies that stimulate the
TSH receptor. This is an example of which hypersensitivity type?
A. Type I
B. Type II
C. Type III
D. Type IV
Answer: B (Type II)
Rationale: Type II hypersensitivity involves antibody-mediated cell dysfunction or destruction. In
Graves' disease, IgG antibodies bind to and stimulate TSH receptors, causing excessive thyroid
hormone production without cell destruction.
Question 3
A 35-year-old with systemic lupus erythematosus (SLE) develops glomerulonephritis. What is
the underlying mechanism?
A. IgE-mediated mast cell activation
B. Antibody-dependent cell-mediated cytotoxicity
C. Immune complex deposition in glomerular basement membrane
D. T-cell mediated delayed hypersensitivity
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Answer: C (Type III)
Rationale: SLE is a classic Type III hypersensitivity disorder where circulating immune complexes
deposit in tissues (kidneys, joints, skin), activating complement and causing inflammation.
Question 4
A patient develops a rash 48 hours after applying a new topical antibiotic. The rash is pruritic
with vesicles at the application site. This reaction is mediated by:
A. IgE antibodies
B. IgG antibodies
C. Immune complexes
D. Sensitized T lymphocytes
Answer: D (Type IV)
*Rationale: Type IV hypersensitivity is delayed (24-72 hours), cell-mediated, and involves
sensitized T lymphocytes. Contact dermatitis is a classic example.*
Question 5
Which immunoglobulin is primarily responsible for the immediate hypersensitivity reaction in
allergic rhinitis?
A. IgA
B. IgD
C. IgE
D. IgG
Answer: C (IgE)
Rationale: IgE binds to high-affinity receptors on mast cells and basophils. Cross-linking by
allergen triggers degranulation and release of histamine and other mediators.
Question 6
A patient with hemolytic anemia develops jaundice and elevated indirect bilirubin after
receiving a blood transfusion. This is an example of:
A. Type I hypersensitivity
B. Type II hypersensitivity
C. Type III hypersensitivity
D. Type IV hypersensitivity
, https://www.stuvia.com/user/NursePrepHub
Answer: B (Type II)
Rationale: Transfusion reactions involve IgG or IgM antibodies targeting RBC antigens, leading
to complement-mediated cell lysis—a classic Type II mechanism.
Question 7
A child with recurrent bacterial infections, low T-cell count, and absent thymic shadow on chest
X-ray is diagnosed with DiGeorge syndrome. This is a:
A. Primary immunodeficiency affecting B cells
B. Primary immunodeficiency affecting T cells
C. Secondary immunodeficiency
D. Autoimmune disorder
Answer: B (Primary immunodeficiency affecting T cells)
Rationale: DiGeorge syndrome results from failure of third and fourth pharyngeal pouch
development, leading to thymic aplasia and T-cell deficiency.
Question 8
A patient with rheumatoid arthritis has joint inflammation mediated by immune complex
deposition in synovial tissue. This is primarily which type of hypersensitivity?
A. Type I
B. Type II
C. Type III
D. Type IV
Answer: C (Type III)
Rationale: Rheumatoid arthritis involves immune complex deposition in joints, activating
complement and recruiting neutrophils, leading to synovitis and joint destruction.
Question 9
Which cytokine is primarily responsible for the systemic manifestations of anaphylaxis, including
vasodilation and increased vascular permeability?
A. Interleukin-2
B. Interferon-gamma
C. Histamine
D. Tumor necrosis factor-alpha
Answers And Rationale Updated 2026
THIS EXAM INCLUDES:
Week 1: Immunology (Questions 1-25)
Week 2: Hematology & Cardiovascular (Questions 26-55)
Week 3: Pulmonary (Questions 56-75)
Week 4: Renal (Questions 76-100)
,https://www.stuvia.com/user/NursePrepHub
Week 1: Immunology (Questions 1-25)
Question 1
A 22-year-old female develops urticaria, wheezing, and hypotension within 10 minutes of
receiving intravenous contrast dye. Which type of hypersensitivity reaction is occurring?
A. Type I
B. Type II
C. Type III
D. Type IV
Answer: A (Type I)
Rationale: Type I hypersensitivity is IgE-mediated and occurs within minutes of antigen exposure.
Mast cell degranulation releases histamine and other mediators causing vasodilation,
bronchoconstriction, and increased vascular permeability.
Question 2
A patient with Graves' disease exhibits hyperthyroidism due to antibodies that stimulate the
TSH receptor. This is an example of which hypersensitivity type?
A. Type I
B. Type II
C. Type III
D. Type IV
Answer: B (Type II)
Rationale: Type II hypersensitivity involves antibody-mediated cell dysfunction or destruction. In
Graves' disease, IgG antibodies bind to and stimulate TSH receptors, causing excessive thyroid
hormone production without cell destruction.
Question 3
A 35-year-old with systemic lupus erythematosus (SLE) develops glomerulonephritis. What is
the underlying mechanism?
A. IgE-mediated mast cell activation
B. Antibody-dependent cell-mediated cytotoxicity
C. Immune complex deposition in glomerular basement membrane
D. T-cell mediated delayed hypersensitivity
,https://www.stuvia.com/user/NursePrepHub
Answer: C (Type III)
Rationale: SLE is a classic Type III hypersensitivity disorder where circulating immune complexes
deposit in tissues (kidneys, joints, skin), activating complement and causing inflammation.
Question 4
A patient develops a rash 48 hours after applying a new topical antibiotic. The rash is pruritic
with vesicles at the application site. This reaction is mediated by:
A. IgE antibodies
B. IgG antibodies
C. Immune complexes
D. Sensitized T lymphocytes
Answer: D (Type IV)
*Rationale: Type IV hypersensitivity is delayed (24-72 hours), cell-mediated, and involves
sensitized T lymphocytes. Contact dermatitis is a classic example.*
Question 5
Which immunoglobulin is primarily responsible for the immediate hypersensitivity reaction in
allergic rhinitis?
A. IgA
B. IgD
C. IgE
D. IgG
Answer: C (IgE)
Rationale: IgE binds to high-affinity receptors on mast cells and basophils. Cross-linking by
allergen triggers degranulation and release of histamine and other mediators.
Question 6
A patient with hemolytic anemia develops jaundice and elevated indirect bilirubin after
receiving a blood transfusion. This is an example of:
A. Type I hypersensitivity
B. Type II hypersensitivity
C. Type III hypersensitivity
D. Type IV hypersensitivity
, https://www.stuvia.com/user/NursePrepHub
Answer: B (Type II)
Rationale: Transfusion reactions involve IgG or IgM antibodies targeting RBC antigens, leading
to complement-mediated cell lysis—a classic Type II mechanism.
Question 7
A child with recurrent bacterial infections, low T-cell count, and absent thymic shadow on chest
X-ray is diagnosed with DiGeorge syndrome. This is a:
A. Primary immunodeficiency affecting B cells
B. Primary immunodeficiency affecting T cells
C. Secondary immunodeficiency
D. Autoimmune disorder
Answer: B (Primary immunodeficiency affecting T cells)
Rationale: DiGeorge syndrome results from failure of third and fourth pharyngeal pouch
development, leading to thymic aplasia and T-cell deficiency.
Question 8
A patient with rheumatoid arthritis has joint inflammation mediated by immune complex
deposition in synovial tissue. This is primarily which type of hypersensitivity?
A. Type I
B. Type II
C. Type III
D. Type IV
Answer: C (Type III)
Rationale: Rheumatoid arthritis involves immune complex deposition in joints, activating
complement and recruiting neutrophils, leading to synovitis and joint destruction.
Question 9
Which cytokine is primarily responsible for the systemic manifestations of anaphylaxis, including
vasodilation and increased vascular permeability?
A. Interleukin-2
B. Interferon-gamma
C. Histamine
D. Tumor necrosis factor-alpha
