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BRUNNER & SUDDARTH'S TEXTBOOK OF MEDICAL-SURGICAL
NURSING 2024/2025 ACTUAL EXAM COMPLETE QUESTIONS
AND CORRECT DETAILED ANSWERS
A patient with cystic fibrosis has received a double lung transplant and is now experiencing signs
of rejection. What is the immune response that predominates in this situation?
A) Humoral
B) Nonspecific
C) Cellular
D) Mitigated - ANSWER-Ans: C
Feedback:
Most immune responses to antigens involve both humoral and cellular responses, although only
one predominates. During transplantation rejection, the cellular response predominates over
the humoral response. Neither a mitigated nor nonspecific cell response is noted in this
situation.
A patient is being treated for bacterial pneumonia. In the first stages of illness, the patients
dyspnea was accompanied by a high fever. Currently, the patient claims to be feeling better and
is afebrile. The patient is most likely in which stage of the immune response?
A) Recognition stage
B) Proliferation stage
C) Response stage
D) Effector stage - ANSWER-Ans: D
Feedback:
The immune response culminates with the effector stage, during which offending
microorganisms are killed by the various actions of the immune system. The patients
improvement in health status is likely the result of this final stage in the immune response.
,2|Page
The nurse is providing care for a patient who has multiple sclerosis. The nurse recognizes the
autoimmune etiology of this disease and the potential benefits of what treatment?
A) Stem cell transplantation
B) Serial immunizations
C) Immunosuppression
D) Genetic engineering - ANSWER-Ans: A
Feedback:
Clinical trials using stem cells are under way in patients with a variety of disorders having an
autoimmune component, including multiple sclerosis. Immunizations and genetic engineering
are not used to treat multiple sclerosis. Immunosuppression would exacerbate symptoms of
MS.
A patients injury has initiated an immune response that involves inflammation. What are the
first cells to arrive at a site of inflammation?
A) Eosinophils
B) Red blood cells
C) Lymphocytes
D) Neutrophils - ANSWER-Ans: D
Feedback:
Neutrophils are the first cells to arrive at the site where inflammation occurs. Eosinophils
increase in number during allergic reactions and stress responses, but are not always present
during inflammation. RBCs do not migrate during an immune response. Lymphocytes become
active but do not migrate to the site of inflammation.
A nurse is planning a patients care and is relating it to normal immune response. During what
stage of the immune response should the nurse know that antibodies or cytotoxic T cells
combine and destroy the invading microbes?
A) Recognition stageT
B) Proliferation stage
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C) Response stage
D) Effector stage - ANSWER-Ans: D
Feedback:
In the effector stage, either the antibody of the humoral response or the cytotoxic (killer) T cell
of the cellular response reaches and couples with the antigen on the surface of the foreign
invader. The coupling initiates a series of events that in most instances results in total
destruction of the invading microbes or the complete neutralization of the toxin. This does not
take place during the three preceding stages.
The nurse should recognize a patients risk for impaired immune function if the patient has
undergone surgical removal of which of the following?
A) Thyroid gland
B) Spleen
C) Kidney
D) Pancreas - ANSWER-Ans: B
Feedback:
A history of surgical removal of the spleen, lymph nodes, or thymus may place the patient at
risk for impaired immune function. Removal of the thyroid, kidney, or pancreas would not
directly lead to impairment of the immune system.
A nurse is admitting a patient who exhibits signs and symptoms of a nutritional deficit.
Inadequate intake of what nutrient increases a patients susceptibility to infection?
A) Vitamin B12
B) Unsaturated fats
C) Proteins
D) Complex carbohydrates - ANSWER-Ans: C
Feedback:
Depletion of protein reserves results in atrophy of lymphoid tissues, depression of antibody
response, reduction in the number of circulating T cells, and impaired phagocytic function. As a
, 4|Page
result, the patient has an increased susceptibility to infection. Low intake of fat and vitamin
B12affects health, but is not noted to directly create a risk for infection. Low intake of complex
carbohydrates is not noted to constitute a direct risk factor for infection.
A nurse has admitted a patient who has been diagnosed with urosepsis. What immune response
predominates in sepsis?
A) Mitigated
B) Nonspecific
C) Cellular
D) Humoral - ANSWER-Ans: D
Feedback:
Most immune responses to antigens involve both humoral and cellular responses, although only
one predominates. For example, during transplantation rejection, the cellular response
predominates, whereas in the bacterial pneumonias and sepsis, the humoral response plays the
dominant role. Neither mitigated nor nonspecific cell response is noted in this situation.
A patient is admitted with cellulitis and experiences a consequent increase in white blood cell
count. The nurse is aware that during the immune response, pathogens are engulfed by white
blood cells that ingest foreign particles. What is this process known as?
A) Apoptosis
B) Phagocytosis
C) Antibody response
D) Cellular immune response - ANSWER-Ans: B
A nurse is reviewing a patients medication administration record in an effort to identify drugs
that may contribute to the patients recent immunosuppression. What drug is most likely to
have this effect?
A) An antibiotic
B)A nonsteroidal anti-inflammatory drug (NSAID)
BRUNNER & SUDDARTH'S TEXTBOOK OF MEDICAL-SURGICAL
NURSING 2024/2025 ACTUAL EXAM COMPLETE QUESTIONS
AND CORRECT DETAILED ANSWERS
A patient with cystic fibrosis has received a double lung transplant and is now experiencing signs
of rejection. What is the immune response that predominates in this situation?
A) Humoral
B) Nonspecific
C) Cellular
D) Mitigated - ANSWER-Ans: C
Feedback:
Most immune responses to antigens involve both humoral and cellular responses, although only
one predominates. During transplantation rejection, the cellular response predominates over
the humoral response. Neither a mitigated nor nonspecific cell response is noted in this
situation.
A patient is being treated for bacterial pneumonia. In the first stages of illness, the patients
dyspnea was accompanied by a high fever. Currently, the patient claims to be feeling better and
is afebrile. The patient is most likely in which stage of the immune response?
A) Recognition stage
B) Proliferation stage
C) Response stage
D) Effector stage - ANSWER-Ans: D
Feedback:
The immune response culminates with the effector stage, during which offending
microorganisms are killed by the various actions of the immune system. The patients
improvement in health status is likely the result of this final stage in the immune response.
,2|Page
The nurse is providing care for a patient who has multiple sclerosis. The nurse recognizes the
autoimmune etiology of this disease and the potential benefits of what treatment?
A) Stem cell transplantation
B) Serial immunizations
C) Immunosuppression
D) Genetic engineering - ANSWER-Ans: A
Feedback:
Clinical trials using stem cells are under way in patients with a variety of disorders having an
autoimmune component, including multiple sclerosis. Immunizations and genetic engineering
are not used to treat multiple sclerosis. Immunosuppression would exacerbate symptoms of
MS.
A patients injury has initiated an immune response that involves inflammation. What are the
first cells to arrive at a site of inflammation?
A) Eosinophils
B) Red blood cells
C) Lymphocytes
D) Neutrophils - ANSWER-Ans: D
Feedback:
Neutrophils are the first cells to arrive at the site where inflammation occurs. Eosinophils
increase in number during allergic reactions and stress responses, but are not always present
during inflammation. RBCs do not migrate during an immune response. Lymphocytes become
active but do not migrate to the site of inflammation.
A nurse is planning a patients care and is relating it to normal immune response. During what
stage of the immune response should the nurse know that antibodies or cytotoxic T cells
combine and destroy the invading microbes?
A) Recognition stageT
B) Proliferation stage
,3|Page
C) Response stage
D) Effector stage - ANSWER-Ans: D
Feedback:
In the effector stage, either the antibody of the humoral response or the cytotoxic (killer) T cell
of the cellular response reaches and couples with the antigen on the surface of the foreign
invader. The coupling initiates a series of events that in most instances results in total
destruction of the invading microbes or the complete neutralization of the toxin. This does not
take place during the three preceding stages.
The nurse should recognize a patients risk for impaired immune function if the patient has
undergone surgical removal of which of the following?
A) Thyroid gland
B) Spleen
C) Kidney
D) Pancreas - ANSWER-Ans: B
Feedback:
A history of surgical removal of the spleen, lymph nodes, or thymus may place the patient at
risk for impaired immune function. Removal of the thyroid, kidney, or pancreas would not
directly lead to impairment of the immune system.
A nurse is admitting a patient who exhibits signs and symptoms of a nutritional deficit.
Inadequate intake of what nutrient increases a patients susceptibility to infection?
A) Vitamin B12
B) Unsaturated fats
C) Proteins
D) Complex carbohydrates - ANSWER-Ans: C
Feedback:
Depletion of protein reserves results in atrophy of lymphoid tissues, depression of antibody
response, reduction in the number of circulating T cells, and impaired phagocytic function. As a
, 4|Page
result, the patient has an increased susceptibility to infection. Low intake of fat and vitamin
B12affects health, but is not noted to directly create a risk for infection. Low intake of complex
carbohydrates is not noted to constitute a direct risk factor for infection.
A nurse has admitted a patient who has been diagnosed with urosepsis. What immune response
predominates in sepsis?
A) Mitigated
B) Nonspecific
C) Cellular
D) Humoral - ANSWER-Ans: D
Feedback:
Most immune responses to antigens involve both humoral and cellular responses, although only
one predominates. For example, during transplantation rejection, the cellular response
predominates, whereas in the bacterial pneumonias and sepsis, the humoral response plays the
dominant role. Neither mitigated nor nonspecific cell response is noted in this situation.
A patient is admitted with cellulitis and experiences a consequent increase in white blood cell
count. The nurse is aware that during the immune response, pathogens are engulfed by white
blood cells that ingest foreign particles. What is this process known as?
A) Apoptosis
B) Phagocytosis
C) Antibody response
D) Cellular immune response - ANSWER-Ans: B
A nurse is reviewing a patients medication administration record in an effort to identify drugs
that may contribute to the patients recent immunosuppression. What drug is most likely to
have this effect?
A) An antibiotic
B)A nonsteroidal anti-inflammatory drug (NSAID)
