Medical-Surgical Nursing: Immunology Practice Questions
Test yourself on Immunology with 12 original NCLEX-RN practice questions. Pick an answer to see instant feedback and a full explanation.
Free original practice questions for study purposes. Open Exam Prep is an independent study resource and is not affiliated with, endorsed by, or sponsored by the makers of NCLEX-RN.
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Answer the questions below — you get instant feedback and a full explanation for each.
1. A client receiving long-term corticosteroid therapy asks why the dose should not be stopped suddenly. Which response is best?
Explanation. Long-term corticosteroid use can suppress adrenal function. The dose is usually tapered as prescribed to reduce the risk of adrenal insufficiency, which may include weakness, hypotension, nausea, or shock-like symptoms.
2. The nurse is caring for a client who develops wheezing, facial swelling, and hypotension shortly after an antibiotic infusion begins. Which action is the priority?
Explanation. Wheezing, facial swelling, and hypotension after medication exposure suggest anaphylaxis. The priority is to stop the suspected trigger, call for help, maintain airway and circulation support, and follow emergency protocol.
3. A client taking an immunosuppressant after kidney transplant reports a fever of 100.8 F (38.2 C) and burning with urination. What should the nurse teach?
Explanation. Immunosuppressed clients may have blunted or subtle infection signs, and infection can become serious quickly. They should report fever, urinary symptoms, cough, wound changes, or unusual fatigue promptly and should not self-adjust transplant medications.
4. The nurse is teaching a client with systemic lupus erythematosus. Which statement indicates correct understanding?
Explanation. Lupus can flare with sun exposure and may affect joints, skin, kidneys, blood, lungs, or heart. Clients should use sun protection, recognize flare symptoms, take medicines as prescribed, and discuss vaccine timing and type with the care team.
5. A client with rheumatoid arthritis has morning stiffness and swollen hand joints. Which nursing recommendation is most appropriate?
Explanation. Warmth can reduce morning stiffness, and gentle range-of-motion or low-impact activity helps preserve function. Rest is balanced with activity. Disease-modifying medicines should be taken as prescribed, and prolonged direct ice can injure skin.
6. The nurse is reviewing teaching for a client newly prescribed methotrexate for an autoimmune condition. Which client statement requires follow-up?
Explanation. Methotrexate can affect the liver, bone marrow, and other systems, so lab monitoring and symptom reporting are important. Heavy alcohol use can increase liver risk and should be discussed with the provider.
7. A client with HIV has a CD4 count of 180 cells/mm3. Which teaching point is most important?
Explanation. A low CD4 count increases risk for opportunistic infections. Clients should continue antiretroviral therapy as prescribed, avoid blood exposure through shared razors or needles, and report infection or neurologic symptoms promptly.
8. The nurse is teaching a client with a severe latex allergy. Which action best reduces exposure risk during a clinic visit?
Explanation. Latex allergy should be clearly communicated before care so latex-free gloves, equipment, and supplies can be used. Powdered latex products can increase airborne exposure and are not safer for a latex-allergic client.
9. A client asks about signs of acute organ transplant rejection. Which finding should the nurse include as reportable?
Explanation. Possible rejection signs vary by organ but may include fever, malaise, pain or tenderness near the transplanted organ, swelling, reduced function, or abnormal labs. These findings require prompt contact with the transplant team.
10. A client with multiple allergies is prescribed a new medication. Which nursing action is most appropriate before administering the first dose?
Explanation. Safe medication administration includes checking allergies, reaction type, cross-sensitivity risk when relevant, and the order before giving the medication. Unclear allergy histories should be clarified rather than ignored or deleted.
11. The nurse is caring for a client receiving biologic therapy for an autoimmune disorder. Which pre-treatment question is most relevant?
Explanation. Biologic immune-modifying therapy can increase infection risk. Screening for current infection symptoms, exposure, vaccination status, and required baseline testing supports safer treatment decisions.
12. A client with chronic immunosuppression is planning home care after discharge. Which instruction has the highest priority?
Explanation. Hand hygiene, avoiding sick contacts, safe food handling, prompt symptom reporting, and medication adherence are practical infection-prevention measures. Extreme cleaning, unsafe diet restrictions, or self-starting antibiotics are not appropriate.
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FAQ
What immunology topics are high yield for NCLEX med-surg?
Focus on anaphylaxis, infection prevention during immunosuppression, transplant rejection cues, corticosteroid tapering, autoimmune flare recognition, HIV opportunistic infection risk, medication safety, and biologic therapy screening.
How should I prioritize immunology questions?
Prioritize airway, breathing, and circulation first. Wheezing, swelling, hypotension, fever during immunosuppression, suspected rejection, or severe medication reactions usually need prompt action before routine teaching.
Are these NCLEX immunology questions medical advice?
No. They are study practice questions for exam preparation and are not clinical guidance. Real patient decisions require a licensed healthcare professional and local protocols.