PATHO: CH 21 quiz: Blood cells and the hematopoietic system

An adult female, newly diagnosed with possible leukemia, arrives for a bone marrow biopsy. The admission laboratory work includes: red blood cell count (RBC): 3.4 ×106/μL (3.4 ×1012/L); white blood cell count (WBC): 2,500/μL (2.5 ×109/L); platelet count of 80 ×103/μL (80 ×109/L); all below normal values. What assessment is the highest priority for this client? (a) Monitoring for any type of bleeding. (b) Forcing fluids to maintain renal function. (c) Assessing heart sounds for any new murmurs. (d) Checking breath sounds twice a day for signs of pneumonia.

(a) Monitoring for any type of bleeding.

Which statement best conveys a characteristic of red blood cells? (a) They contribute to the maintenance of blood pH. (b) They lack organelles and soluble enzymes. (c) They help maintain the body's fluid balance. (d) They are self-replicating.

(a) They contribute to the maintenance of blood pH.

A fifth-grade elementary student asks the school nurse how much blood is in an entire body. The nurse should respond that the average grown-up adult has: (a) 3 pints of blood total (b) 5 to 6 liters of blood throughout the body (c) 3 to 4 quarts of blood in the body (d) 2 to 4 cups of blood in the body

(b) 5 to 6 liters of blood throughout the body

A nurse practitioner is providing care for a client with low levels of the plasma protein gamma globulin. The nurse would recognize that the client is at risk of developing which health problem? (a) Jaundice (b) Infections (c) Anemia (d) Blood clots

(b) Infections

A client has been suffering from fatigue and the health care provider suspects anemia. Which test results will the health care provider consult when investigating the cause of the anemia? (a) Red blood cell (RBC) (b) RBC indices (c) Hemoglobin (d) Hematocrit

(b) RBC indices

A geriatrician is following a number of clients on a subacute geriatric medical unit, some of whom require diagnostic blood work. Which client would be most likely to have an erythrocyte sedimentation rate (ESR) screening test ordered? An adult with: (a) congestive heart failure. (b) systemic lupus erythematosus. (c) orthostatic hypotension and syncopal episodes. (d) a diagnosis of Alzheimer disease and depression.

(b) systemic lupus erythematosus.

Which statements best captures an aspect of the process of hematopoiesis? (a) Various subtypes of pluripotent stem cells eventually differentiate into the cellular components of blood. (b) Self-replicating precursor cells differentiate into specific CSFs. (c) Progenitor cells differentiate into precursor cells. (d) Colony-stimulating factors (CSFs) produce cytokines that activate progenitor cells.

(c) Progenitor cells differentiate into precursor cells.

A 5-year-old needs to undergo a bone marrow biopsy. When educating the parents, which site should the nurse state is the most commonly used? (a) anterior iliac crest (b) sternum (c) posterior iliac crest (d) spinous

(c) posterior iliac crest

When looking at a granulocyte under a microscope, the anatomy student would describe it as: (a) lacking granules. (b) having a kidney-shaped nucleus. (c) shaped like a sphere with multilobar nuclei. (d) having no nuclei.

(c) shaped like a sphere with multilobar nuclei.

When talking about the lifespan of various blood components, the students should know that once a neutrophil moves into tissue, it lives approximately how long? (a) 2 days. (b) 24 hours. (c) 12 hours. (d) 4 days.

(d) 4 days.

Following a bone marrow biopsy, which assessment would indicate the client is experiencing a complication as a result of this diagnostic procedure? (a) BP 130/80, oxygen saturation 95%, crackles heard on inspiration. (b) Respiratory rate 24, complaining of pain at insertion site. (c) Heart rate regular 64 bpm, temperature 99.6°F (37.5°C) orally. (d) BP 90/60, heart rate 132, excess bleeding, and hematoma noted at insertion site.

(d) BP 90/60, heart rate 132, excess bleeding, and hematoma noted at insertion site.

During science class, a student asks, "What is the difference between plasma and serum in the blood?" The nurse responds that the primary difference between plasma and serum is that plasma contains: (a) Heparin (b) White blood cells (c) Hydrogen ions (d) Fibrinogen

(d) Fibrinogen

A blood sample is ordered to be collected in a plasma-separator tube, but the nurse can only find serum-separator tubes available. The nurse should be most concerned about the accuracy of which results if the serum-separator tube is used? (a) Albumin and total protein levels (b) Immunoglobulin analysis (c) Electrolyte measurements (d) Fibrinogen and clotting factor levels

(d) Fibrinogen and clotting factor levels

The blood work of a 44-year-old male client with a diagnosis of liver disease secondary to alcohol abuse indicates low levels of albumin. Which phenomenon would a clinician be most justified in anticipating? (a) Impaired thermoregulation (b) Impaired immune function (c) Acid-base imbalances (d) Fluid imbalances

(d) Fluid imbalances

A 29-year-old construction worker got a sliver under his fingernail 4 days ago. The affected finger is now reddened, painful, swollen, and warm to the touch. Which of the following hematologic processes is most likely occurring in the bone marrow in response to the infection? (a) High circulatory levels of myeloblasts (b) Phagocytosis by myelocytes (c) Increased segmented neutrophil production (d) Proliferation of immature neutrophils

(d) Proliferation of immature neutrophils

A hospital laboratory technician performing routine blood analysis as part of an inpatient's assessment is examining the sample in a test tube following processing in a centrifuge and the addition of an anticoagulant. Which observation would the technician most likely interpret as an anomaly? (a) the middle layer of cells appears white to grey in color (b) the top layer of cells is too thing to visualized without microscopy (c) the yellowish fluid on the top of the sample appears to constitute around one-quarter of the total volume (d) the bottom layer of blood in the tube accounts for around 40% to 45% of the total volume

(d) the bottom layer of blood in the tube accounts for around 40% to 45% of the total volume

The nurse is counseling a client who is going for major surgery and must stop taking aspirin to reduce the risk for bleeding. The nurse knows aspirin decreases platelet activity for the duration of the platelet's lifespan. How many days prior to the surgery should the nurse tell the client to stop taking aspirin? (a) 10 (b) 14 (c) 2 (d) 5

(a) 10

When talking about the various types of granulocytes, which granule contains heparin, an anticoagulant? (a) Basophils. (b) Eosinophils. (c) Neutrophils. (d) Lymphocytes.

(a) Basophils.

The health care provider is ordering a complete blood count (CBC). What information should the nurse expect to be able to gather from the results? Select all that apply. (1) If the client is deficient in clotting factors (2) Presence of thrombocytopenia (3) The presence of leukocytosis (4) If there are common vitamin deficiencies (5) If the client has anemia

(2) Presence of thrombocytopenia (3) The presence of leukocytosis (5) If the client has anemia

Following an injury resulting in a small cut from a knife, the first cells to go to the area of the cut would be the: (1) Basophils (2) Albumin (3) Erythrocytes (4) Neutrophils

(4) Neutrophils

A student makes the statement to a colleague, "Blood plasma is essentially just a carrier for the formed cells like red blood cells and white blood cells." What would be the most accurate response to this statement? (a) "Actually, plasma plays a significant role in nutrient and waste transport." (b) "Not really. Plasma also contributes to the processes of protein synthesis and hematopoiesis." (c) "Actually, plasma is integral to the proper function of the liver and maintenance of acid-base balance." (d) "That's not really true. Plasma is crucial in the immune and inflammatory responses."

(a) "Actually, plasma plays a significant role in nutrient and waste transport."

The nurse notes eosinophilia on the client's laboratory results. The nurse should interview the client about a history of which conditions? Select all that apply. (1) Allergic reactions (2) Bacterial infection (3) Viral infection (4) Asthma (5) Exposure to parasites

(1) Allergic reactions (4) Asthma (5) Exposure to parasites

A client with severe anemia asks, "What happens if my bone marrow cannot produce sufficient numbers of red blood cells due to my bleeding?" Which response(s) by the nurse correctly identifies the organs that can resume hematopoiesis? Select all that apply. (1) Spleen (2) Kidneys (3) Liver (4) Gall bladder (5) Pancreas

(1) Spleen (3) Liver

A client arrives for a scheduled bone marrow aspiration and biopsy. The nurse explains to the client that which position(s) is best for accessing the posterior iliac crest for aspiration? Select all that apply. (1) Legs extended (2) Lateral decubitus (3) Supine (4) Prone (5) Trendelenburg

(2) Lateral decubitus (4) Prone