Chapter 25
Which of the following types of lymphocyte is involved with humoral-mediated immunity? Helper T cells T lymphocytes B lymphocytes Natural killer cells (NKC)
B lymphocytes Explanation: B lymphocytes differentiate to form antibody-producing plasma cells and are involved in humoral-mediated immunity. T lymphocytes (helper T cells) activate other cells in the immune system and are involved in cell-mediated immunity. NKCs participate in innate or natural immunity.
Which of the following is the main job of lymphocytes? Degranulation Phagocytosis Immune reaction Apoptosis
Immune reaction Explanation: Immune reaction is the main job of lymphocytes.
Chronic leukemias are malignancies involving what type of abnormal blood cells in the marrow? Production of undifferentiated cells Proliferation of well-differentiated cells Uncontrolled growth of immature cells Replication of pluripotent precursor cells
Proliferation of well-differentiated cells Explanation: Chronic leukemias involve abnormal proliferation and growth of well-differentiated blood cell types. Acute leukemias are associated with proliferation of undifferentiated, immature, and precursor blood cells.
A nurse is assessing a patient presenting with symptoms of fatigue, fever, severe joint pain, and headache. Laboratory results reveal an erythrocyte sedimentation rate (ESR) rate of 60 mm/hour. The patient asks what the blood test results mean. Which of the following is the most appropriate explanation for the nurse to provide? "The ESR tests for the presence of inflammation in the body." "Your ESR is high; this means you have an inflammatory disease." "I will ask your doctor to explain what the ESR test is used for." "The ESR tests for the presence of white blood cells in your body which can indicate an infection."
"The ESR tests for the presence of inflammation in the body." Explanation: In anticoagulated blood, red blood cells aggregate and are deposited to the bottom of a tube. The rate of fall is often increased in inflammatory diseases. Normal values are 0-15 mm/hour for men and 1-20 mm/hour for women. Increased sedimentation rate indicates inflammation and is used as a baseline and trend indicator in managing inflammatory disorders. The nurse can explain the purpose of the test but cannot medically diagnose a patient.
The leukemia most commonly found in children and adolescents is recognized as: Acute myeloid leukemia (AML) Acute lymphocytic leukemia (ALL) Chronic lymphocytic leukemia (CLL) Chronic myelocytic leukemia (CML)
Acute lymphocytic leukemia (ALL) Explanation: Among children and adolescents, ALL is the most common type, accounting for 75% of leukemia cases. In adults 20 years of age and older, the most common types are CLL (38%) and AML (30%).
A patient comes to the clinic with a runny nose and scratchy throat. The nurse is evaluating the white blood cell count, which shows an elevated number of white blood cells and an increased percentage of eosinophils. Which of the following is the most likely cause of the symptoms? Allergic reaction Viral infection Fungal infection Bacterial infection
Allergic reaction Explanation: Eosinophils increase in number during allergic reactions and parasitic infections.
The globulins that make up part of the plasma of the blood have three distinct purposes. What are the gamma globulins? Antibodies of the immune system Transporters of iron and copper Transporters of bilirubin and steroids Autoantibodies of the immune system
Antibodies of the immune system Explanation: There are three types of globulins: the alpha globulins that transport bilirubin and steroids, the beta globulins that transport iron and copper, and the gamma globulins that constitute the antibodies of the immune system. Alpha globulins transport bilirubin and steroids. Beta globulins transport iron and copper. Autoantibodies are immunoglobulins that recognize an antigen on that person's own tissue.
The nurse is reviewing the laboratory results of a newborn. The infant has anemia, thrombocytopenia, and granulocytopenia (pancytopenia). Based on these results, the nurse anticipates the diagnosis of which type of anemia? Aplastic anemia Hemolytic anemia Sickle cell anemia Iron deficiency anemia
Aplastic anemia Explanation: Aplastic anemia develops when the multipotent stem cells fail to grow and provide cells for differentiation. The result is concomitant anemia, thrombocytopenia, and granulocytopenia (pancytopenia).
The cloning of the genes for most of the hematopoietic growth factors has been accomplished. The recombinant proteins that are produced are used in a wide range of clinical problems. What diseases have these proteins been used to fight? AIDS and autoimmune disorders Aplastic anemia and the anemia of kidney failure Anemia of cancer and Parkinson disease Aplastic anemia and the anemia of Huntington disease
Aplastic anemia and the anemia of kidney failure Explanation: The genes for most hematopoietic growth factors have been cloned, and their recombinant proteins have been generated for use in a wide range of clinical problems. They are used to treat bone marrow failure caused by chemotherapy or aplastic anemia, the anemia of kidney failure and cancer, hematopoietic neoplasms, infectious diseases such as AIDS, and congenital and myeloproliferative disorders. Autoimmune disorders, Parkinson disease, and Huntington disease are not anemic disorders, so the recombinant proteins have not been used in the treatment of these diseases.
A client asks, "What do these basophils and mast cells do in the body?" The health care provider responds that they: Are involved when you have an allergic reaction Stiffen your cell membranes so bacteria cannot enter Help your body to eliminate parasitic infections Help your body produce immune responses
Are involved when you have an allergic reaction Explanation: The basophil, which is a blood cell, is related to the connective tissue mast cell that contains similar granules. Both the basophils and mast cells are thought to be involved in allergic and hypersensitivity reactions. These cells do not stiffen the cell membranes. In parasitic infections, the eosinophils use surface markers to attach themselves to the parasite and then release hydrolytic enzymes that kill it. Lymphocytes migrate through the peripheral lymphoid organs, where they recognize antigens and participate in immune responses.
A patient comes to the clinic following exposure to chicken pox. The patient states he had chicken pox as a child but was worried about getting sick again. Which of the following statements best explains humoral-mediated immunity to the patient? The body has natural immunity to prevent active diseases from occurring following expose to a pathogen. B lymphocytes (B cells) in the body produce antibodies to fight infections. Once exposed, the cells retain memory and are able to quickly fight off pathogens during re-exposure and prevent the disease from reoccurring. T cells in the body are natural killer cells that quickly attack and kill antigens in order to prevent infections. Monocytes in the body are activated in the presence of pathogens. They quickly engulf and destroy invading organisms, preventing infections from occurring.
B lymphocytes (B cells) in the body produce antibodies to fight infections. Once exposed, the cells retain memory and are able to quickly fight off pathogens during re-exposure and prevent the disease from reoccurring. Explanation: The B lymphocytes (B cells) differentiate to form antibody-producing plasma cells that retain memory and are involved in humoral-mediated immunity.
Which of the following types of white blood cells are related to the connective tissue mast cells and respond in allergic and hypersensitivity reactions? B lymphocytes Granulocytes Neutrophils Basophils
Basophils Explanation: The basophil is related to connective tissue mast cell because they contain similar granules and are believed to be involved in allergic and hypersensitivity reactions. Neutrophils, granulocytes, and B lymphocytes are not identified as being similar to mast cells.
A client presents to the emergency clinic not feeling well. Which of the following complaints leads the health care provider to suspect the client may have acute leukemia? Frequent nausea and vomiting for past week Bleeding from the gums, not related to brushing the teeth Muscle aches and pains in large muscle groups, especially while lying in bed Severe headache with associated photophobia
Bleeding from the gums, not related to brushing the teeth Explanation: Although ALL and AML are distinct disorders, they typically present with similar clinical features. Both are characterized by an abrupt onset of symptoms, including fatigue resulting from anemia; low-grade fever, night sweats, and weight loss due to the rapid proliferation and hypermetabolism of the leukemic cells; bleeding due to a decreased platelet count; and bone pain and tenderness due to bone marrow expansion. Nausea and vomiting, muscle aches, and headaches could be associated with other diagnoses like influenza.
Select the option that best describes the production of T lymphocytes. Bone marrow - thymus - lymph nodes Bone marrow - plasma cells - lymph nodes Plasma cells - lymph nodes - arteries Myocardial tissue - bone marrow - lymph nodes
Bone marrow - thymus - lymph nodes Explanation: T lymphocytes leave the bone marrow as precursor T lymphocytes and travel to the thymus, where they differentiate into CD4 helper T cells and CD8 cytotoxic T cells. T lymphocytes also travel to the lymph nodes. The first option describes the production of B lymphocytes. The other options do not describe B- or T-lymphocyte production.
T-cell lymphocytes leave the bone marrow and travel to the thymus. If successful, they differentiate into which of the following cells? Select all that apply. Epstein-Barr virus (EBV) CD8+ cytotoxic T cells CD4+ helper T cells Kupffer cells Hematopoietic stem cell
CD4+ helper T cells CD8+ cytotoxic T cells Explanation: The body's lymphatic system consists of the lymphatic vessels, lymphoid tissue, and lymph nodes, thymus, and spleen. T lymphocytes leave the bone marrow as precursor T lymphocytes travel to the thymus, where they differentiate into CD4+ helper T cells and CD8+ cytotoxic T cells, after which many of them move to lymph nodes, where they undergo further proliferation. Infectious mononucleosis is a self-limiting lymphoproliferative disorder caused by the Epstein-Barr virus (EBV), a member of the herpesvirus family. Kupffer cells of the liver are not a component of the lymphatic system. The human T-cell lymphotropic virus (HTLV-1), which is endemic in the southwestern islands of Japan, has been associated with adult T-cell leukemia/lymphoma.
What do patients with acute lymphocytic leukemia (ALL) involving the brain or spinal cord usually receive? CNS prophylaxis Induction therapy Consolidation therapy Maintenance therapy
CNS prophylaxis Explanation: CNS prophylaxis involves high doses of chemotherapeutic agents or cranial irradiation.
A client has a lymphoma that carries a risk of CNS involvement. The nurse anticipates the health care provider will prescribe: CNS prophylaxis Antibiotic therapy Antiseizure therapy Antiviral prophylaxis
CNS prophylaxis Explanation: Persons with lymphomas that carry a risk of CNS involvement usually receive CNS prophylaxis with high doses of chemotherapeutic agents or cranial irradiation. The other options would not benefit the client.
The nurse's review of a client's laboratory results indicates that inflammation is absent and platelet levels are low. Which test was performed to provide the platelet count? Bone marrow aspiration Hematocrit Sedimentation rate Complete blood count
Complete blood count Explanation: The complete blood count provides the number and characteristics of red blood cells, leukocytes, and platelets. Hematocrit is simply the percentage of RBCs and sedimentation rate indicates inflammation. Bone marrow aspiration is used to examine the stem cells.
Although the usual site for a bone marrow test is the posterior iliac crest, other sites include the anterior iliac crest and the sternum. What are the dangers of using the sternum for a bone marrow test in children? Potential for hemorrhage Danger of perforating the mediastinum and heart Potential for infection in the chest cavity ' Danger of perforating the lungs
Danger of perforating the mediastinum and heart Explanation: Usually, the posterior iliac crest is used in all persons older than 12 to 18 months of age. Other sites include the anterior iliac crest, sternum, and spinous processes T10 through L4. The sternum is not commonly used in children because the cavity is too shallow, and there is danger of mediastinal and cardiac perforation.
What are the components of blood? (Select all that apply.) Electrolytes Enzymes Ascites Bile
Electrolytes Enzymes Explanation: Blood is made up of plasma, plasma proteins, fixed elements or blood cells, and substances such as hormones, enzymes, electrolytes, and by-products of cellular waste. Ascites is an accumulation of intraperitoneal fluid containing large amounts of protein and electrolytes. Bile is a secretion of the liver that is stored in the gallbladder.
A nurse is evaluating laboratory results of a patient diagnosed with a parasitic infection. The tests reveal a large group of cells that are membrane bound with granules in their cytoplasm that are aiding in the destruction of the parasite. Which of the following cells is the nurse evaluating? Monocyte Lymphocyte Macrophage Eosinophil
Eosinophil Explanation: People who have helminthic parasites will have an increase in eosinophils in their complete blood count. The specific cytoplasmic granules of the eosinophils stain red with the acidic dye eosin. In parasitic infections, the eosinophils use surface markers to attach themselves to the parasite and then release hydrolytic enzymes that kill it.
Leukocytes consist of three categories of cells that have different roles in the inflammatory and immune responses. Which of the following leukocytes is correctly matched with its function? Monocytes—release heparin Eosinophils—allergic reactions Lymphocyte—phagocytosis Basophils—engulf antigens
Eosinophils—allergic reactions Explanation: Eosinophils, a type of granulocyte, increase in number during allergic reactions. Lymphocytes (agranulocytes) consist of three cell types that are not phagocytes but do have an important role in the immune response. Basophils and mast cells release heparin and histamine in response to allergens. Monocytes and macrophages are phagocytes that engulf antigens.
A patient being treated for polymyalgia rheumatica (PMR) comes to the clinic for a follow-up visit. The current erythrocyte sedimentation rate (ESR) rate has decreased from 60 mm/hour to 30 mm/hour and the patient is afebrile, denies any headaches, and reports a decrease in joint pain and fatigue. Based on these findings, the nurse anticipates which of the following changes to the treatment plan? Gradually decrease the current dosage of prednisone and repeat ESR in 2 weeks. No change of treatment; continue to monitor the patient with a follow-up visit in 1 month. Discontinue the current prednisone prescription and start an anti-inflammatory drug such as naproxen. Repeat ESR in 2weeks. The patient is cured, and no further treatment is necessary.
Gradually decrease the current dosage of prednisone and repeat ESR in 2 weeks. Explanation: The ESR is a screening test for monitoring the fluctuations in the clinical course of a disease such as PMR. Symptoms of this inflammatory disorder include fatigue, fever, pain, and headache, which are all a result of the systemic effects of cytokine release. An individual who is diagnosed with PMR will have an initial ESR drawn. If the ESR is >60, the person is diagnosed with a severe PMR. Generally, the person is prescribed prednisone, and then at follow-up visits, the dose of prednisone will be gradually decreased depending on the ESR and the person's symptoms.
A patient who has received chemotherapy has a steadily decreasing white blood cell count. The nurse anticipates administering which of the following to increase the neutrophil count? Mmacrophage colony-stimulating factor Thrombopoietin Erythropoietin Granulocyte colony-stimulating factor
Granulocyte colony-stimulating factor Explanation: Administration of granulocyte colony-stimulating factor promotes the proliferation of all neutrophils.
A client with acute leukemia has developed gout. The nurse is aware that this results from: Hyperuricemia Diet Alcohol Anorexia
Hyperuricemia Explanation: Hyperuricemia occurs as the result of increased proliferation or increased breakdown of purine nucleotides secondary to leukemic cell death that results from chemotherapy. It may increase before and during treatment. Prophylactic therapy with allopurinol, a drug that inhibits uric acid synthesis, is routinely administered. Diet will contribute to gout.
A patient is admitted to the emergency department with a diagnosis of polycythemia. The nurse plans to assess for symptoms related to which of the following problems? Increased risk of infection Inability to form blood clots Increased blood viscosity Decreased ability to carry oxygen to the cells
Increased blood viscosity Explanation: Unregulated overproduction of the red cell mass is termed polycythemia, which causes a thickening of the blood and an increased risk of blood clots.
A nurse observes a thin gray line between the red blood cells and the plasma in a centrifuged sample of blood. What is the nurse's best understanding of this phenomenon? It is the location of the white blood cells are in a spun sample. It is the border between RBCs and plasma in a spun sample. The line is the location of proteins in a spun sample. The line consists of hemolysed RBCs.
It is the location of the white blood cells are in a spun sample. Explanation: The buffy coat or thin gray line between the plasma and packed RBCs is the layer where WBCs reside in a spun sample (and is why they are called white blood cells). There is no blurry border between the layers in a spun sample. Proteins will not be visible and will not precipitate at the velocity a blood sample would be spun.
Which type of macrophages are found in the liver? Histiocytes Kupffer cells Microglial cells Monocytes
Kupffer cells Explanation: Rationale: Macrophages found in the liver are known as Kupffer cells. Histiocytes are macrophages found loose in connective tissue, and microglial cells are brain macrophages. Monocytes are referred to macrophages when they enter the tissues.
Which of the following is the most common leukocyte in normal blood? Neutrophilic granulocyte Lymphocyte Monocyte Platelet
Neutrophilic granulocyte Explanation: Neutrophilic granulocyte is the most common leukocyte in normal blood.
A nurse sends a blood sample to the lab for analysis. Assuming the sample is normal, the nurse anticipates which of the following white blood cells (WBCs) will account for the highest percentage? Neutrophils Eosinophils Monocytes Lymphocytes
Neutrophils Explanation: Neutrophils constitute 55-65% of the total WBCs.
A patient is admitted to the hospital with an elevated temperature and flank pain. When reviewing the complete blood count (CBC), which of the following levels is the most important for the nurse to communicate to the health care provider? Neutrophils 85% Hemoglobin 12.6 g/dL Platelets 150,000/mL Monocytes 3%
Neutrophils 85% Explanation: Neutrophils are very mobile and are the first cells to go to an area of tissue damage. The elevation in neutrophils indicates that the patient has an acute infection (such as pyelonephritis) that is causing the temperature elevation and flank pain.
A 16-year-old girl has been brought to her primary care provider by her mother due to the daughter's recent malaise and lethargy. Which of the following assessments should the clinician perform in an effort to confirm or rule out infectious mononucleosis? Auscultating the client's lungs Palpating the client's lymph nodes Assessing the client's cranial nerve reflexes Assessing the client for bone pain
Palpating the client's lymph nodes Explanation: In cases of infectious mononucleosis, the lymph nodes are typically enlarged throughout the body, particularly in the cervical, axillary, and groin areas. Palpation of these nodes is a priority assessment in cases of suspected mononucleosis. Bone pain, adventitious lungs sounds, and abnormal cranial nerve reflexes do not accompany mononucleosis.
A nurse is reviewing a client's complete blood count (CBC) which indicates thrombocytopenia. Based on this result which action should the nurse include in the plan of care? Place the client on bleeding precautions. Encourage increased oral fluids. Place the client on contact isolation. Increase intake of iron-rich foods.
Place the client on bleeding precautions. Explanation: Thrombocytopenia is a decreased number of platelets, which places the patient at high risk for bleeding.
The nurse is caring for a client with leukemia that is having difficulty with blood clotting after having several transfusions with packed red blood cells. What does the nurse anticipate infusing for this client to assist with controlling the bleeding? Whole blood Platelets Ringers Lactate solution Albumin
Platelets Explanation: Thrombocytes, or platelets, are circulating cell fragments of the large megakaryocytes that are derived from the myeloid stem cell. They function to form the platelet plug to help control bleeding after injury to a vessel wall. Their cytoplasmic granules release mediators required for the blood coagulation process. Thrombocytes have a membrane but no nucleus, cannot replicate, and, if not used, last approximately 10 days in the circulation before the phagocytic cells of the spleen remove them.
Cytokines that affect hematopoiesis in bone marrow are called colony-stimulating factors (CSFs) based on their ability to: Differentiate red cells Regulate blood cells Support lymphocytes Stimulate lymphocytes
Regulate blood cells Explanation: CSFs stimulate and regulate the growth of hematopoietic cell colonies from bone marrow precursors. Interleukins support the development of lymphocytes. CSFs do not have a role in differentiation. Lymphocyte stimulation occurs in the lymphoid tissues.
A 26-year-old female client has a neutrophil count of less than 500 ?L. The nurse would interpret this as: Severe neutropenia Moderate neutropenia Mild neutropenia Normal neutrophil count
Severe neutropenia Explanation: A moderate neutropenia diagnosis would be consistent with a count of 500 to 1000 ?L. Normal count would be 5000 to 10,000 ?L. Mild neutropenia would be 1000 ?L and severe neutropenia at less than 500 ?L.
A client diagnosed with pancytopenia due to aplastic anemia is scheduled for which of the following treatments that can correct bone marrow deficiencies? Whole blood transfusion Complete blood count (CBC) Stem cell transplant Bone marrow biopsy
Stem cell transplant Explanation: Aplastic anemia develops when the multipotent stem cells fail to grow and provide cells for differentiation. The result is concomitant anemia, thrombocytopenia, and granulocytopenia (pancytopenia). Potential cures for these and many other disorders use hematopoietic stem cells as part of the treatment. Stem cell transplants focus on correcting bone marrow failure, immunodeficiencies, hematologic defects and malignancies, and inherited errors of metabolism.
A patient is diagnosed with acute leukemia. Which of the following treatment therapies can be used to correct bone marrow failure and treat malignancies? Chemotherapy Radiation therapy Immunotherapy Stem cell transplant
Stem cell transplant Explanation: Many people with leukemia obtain stem cell transplants that greatly impact their ability to have a remission. Stem cell transplants focus on correcting bone marrow failure, immunodeficiencies, hematologic defects and malignancies, and inherited errors of metabolism.
When a white blood cell with differential count reveals an acute infection, which of the following is correct regarding the client's neutrophils? Neutrophils are not present during an acute infection that produces fever. Neutrophils are the first white blood cell to elevate in an acute infection. There are fewer neutrophils in the blood than other white blood cells. Neutrophils are only responsive in an allergic or parasitic infection.
There are fewer neutrophils in the blood than other white blood cells. Explanation: Neutrophils constitute 55% to 65% of the total numbers of white blood cells and are primarily responsible for maintaining normal host defenses against invading fever producing bacteria and fungi, cell debris, and a variety of foreign substances. Eosinophils are white blood cells that are responsive in an allergic or parasitic infection.
A 6-year-old child is having a stem cell transplant using umbilical cord blood. What benefit does the nurse understand that this type of transplant will have for the child? There are no side effects to this type of transplant. This type of transplant does not require an inpatient stay in the hospital. The child will not have to take any form of chemotherapy. This type of transplant creates less risk of graft-versus host disease
This type of transplant creates less risk of graft-versus host disease Explanation: Umbilical cord blood from HLA-matched donors is a transplant option for children and carries less risk of graft-versus-host disease. Stem cell transplants focus on correcting bone marrow failure, immunodeficiencies, hematologic defects and malignancies, and inherited errors of metabolism. Sources of the stem cells include bone marrow and umbilical cord blood, which replenish the recipient with a normal population of pluripotent stem cells. Stem cell transplants may be derived from the client (autologous) or from a histocompatible donor (allogeneic). Autologous transplants are often used to replenish stem cells after high-dose chemotherapy or irradiation
Stem cell transplantation has been shown to provide potential cures for diseases such as aplastic anemia and the leukemias. What are the sources of stem cells used for transplant? Peripheral blood cells and immature embryonic cells Bone marrow and immature neural cells Peripheral blood and yellow bone marrow Umbilical cord blood and bone marrow
Umbilical cord blood and bone marrow Explanation: Sources of the stem cells include bone marrow and umbilical cord blood. All replenish the recipient with a normal population of pluripotent stem cells. Immature embryonic cells do not necessarily contain stem cells. Immature neural cells are not stem cells. Yellow bone marrow does not make blood cells, so it would not contain stem cells.
A nurse is reviewing laboratory data for an elderly patient. Which of the following laboratory values should the nurse be most concerned about? Platelets 400,000/mL White blood cell (WBC) count 3500/mL Hematocrit 37% Hemoglobin 11.8 g/dL
White blood cell (WBC) count 3500/mL Explanation: Normal WBC count is 4.8-10.8 × 103/µL. The total WBC count is not usually affected by aging, and the low WBC here would indicate that the patient's immune function may be compromised. The platelet count is normal for an older patient. The slight decrease in hemoglobin and hematocrit are not unusual for an older patient.
A nurse is reviewing the laboratory data for a hospitalized client. The nurse would be most concerned about which finding? Eosinophils 1.5/ µL Red blood cells 4.0/µL Platelet count of 200,000/µL White blood cell (WBC) count of 2800/µL
White blood cell (WBC) count of 2800/µL Explanation: Leukocytes are crucial to our defense against disease. The low WBC count in this patient would indicate that the patient's immune function may be compromised and the underlying cause of the problem needs to be investigated.
The nurse is reviewing the complete blood count (CBC) and white blood cell (WBC) differential of a client admitted with lower right abdominal pain. Which laboratory results are the most important for the nurse to communicate to the health care provider? Monocytes 4% Basophils 2/µL Platelet count 168,000/µL White blood cells (WBCs) 18,500/µL
White blood cells (WBCs) 18,500/µL Explanation: Leukocytes are crucial to our defense against disease. The high WBC count in this would indicate that the patient has an inflammatory or infectious process ongoing, which may be the cause of the patient's pain, and that further diagnostic testing is needed.
Which of the following diagnostic test results are abnormal? Select all that apply. White blood cells: 3.8 × 109/L Platelets: 500 × 103 Red blood cells: 6.6 × 1012/L Bands: 4 Basophils: 1
White blood cells: 3.8 × 109/L Platelets: 500 × 103 Red blood cells: 6.6 × 1012/L Explanation: Normal ranges are white blood cell range from 4.8-10.8 × 103/μL (4.8-10.8 × 109/L); Platelets range from 150-400 × 103 while red blood cells range from 4.2-5.4 × 106/μL (4.2-5.4 × 1012/L) for males and 3.6-5.0 × 106/μL (3.6-5.0 × 1012/L) for females. The other options are within normal ranges.
A nurse on an oncology floor is treating a client who is anemic following chemotherapy. The drugs being administered are designed to increase the number of red blood cells in circulation. These drugs are likely agonists of: trophic hormones. lymphokines. secondary hormones. cytokines.
cytokines. Explanation: RBC production is directed by cytokines and growth factors. Lymphokines are used for communication between lymphocytes, and trophic and secondary hormones are too broad an answer to this question.