Patho: Module 4 Practice Questions

The term thrombocytopenia indicates a/an: 1. Abnormally low number of thrombocytes 2. Abnormally high number of thrombocytes 3. Normal number of platelets 4. Abnormally low total white blood count

1. Abnormally low number of thrombocytes Rationale: Thrombocytopenia is a condition characterized by abnormally low levels of thrombocytes, also known as platelets, in the blood.

Which of the following can result in thrombocytopenia: (Select all that apply) 1. Disorders of the bone marrow 2. Immunotherapy 3. IV Heparin treatments 4. Gastric surgery 5. Enlarged spleen

1. Disorders of the bone marrow 3. IV Heparin treatments 5. Enlarged spleen

A patient presents with sluggishness, a reddened face, and pain in her leg. The doctor suspects this patient has a deep vein thrombosis (DVT). What do you expect is the underlying cause of the DVT? 1. Polycythemia vera 2. Porphyria 3. Thrombocytopenia 4. Aplastic anemia

1. Polycythemia vera

Which groups of individuals are at the highest risk for development of iron deficiency anemia? (Select all that apply) 1. Pregnant women 2. Impoverished individuals 3. Adolescent males 4. Children 5. Males older than 50 years old 5. Women ages 12-40

1. Pregnant women 2. Impoverished individuals 4. Children 5. Women ages 12-40

Which hormone secreted by platelets allows for vasoconstriction? 1. Thromboxane 2. ADP 3. Globulins 4. serotonin

1. Thromboxane

Which of the following are characteristics of platelets? (Select all that apply) 1. Thromboxane secretion 2. Programmed cell death 3. Biconcave shape 4. ATP storage 5. Clot formation

1. Thromboxane secretion 5. Clot formation

Why do RBC's have a biconcave shape? (Select all that apply) 1. To increase surface area 2. To help with clot formation 3. To carry more iron to the stomach 4. To better diffuse oxygen and carbon dioxide 5. To hold antibody markers for phagocytosis

1. To increase surface area 4. To better diffuse oxygen and carbon dioxide

A client with pernicious anemia asks why she must take vitamin B12 injections for the rest of her life. What is the nurse's best response? 1. "The reason for your vitamin deficiency is an inability to absorb the vitamin because the stomach is not producing sufficient acid." 2. "The reason for your vitamin deficiency is an inability to absorb the vitamin because the stomach is not producing sufficient intrinsic factor." 3. "The reason for your vitamin deficiency is an excessive excretion of the vitamin because of kidney dysfunction." 4. "The reason for your vitamin deficiency is an increased requirement for the vitamin because of rapid red blood cell production."

2. "The reason for your vitamin deficiency is an inability to absorb the vitamin because the stomach is not producing sufficient intrinsic factor."

The cheif function of the platelet is to: 1. Fight infection 2. Aid in coagulation 3. Antibody formation 4. Carry oxygen

2. Aid in coagulation

The nurse understands that _________ is the most common cause of microcytic-hypochromic anemia. 1. Lymphoma 2. Blood loss 3. Vegan diet 4. Gastric surgery

2. Blood loss

A cell has matured into a macrophage, which type of cell was it before? 1. Neutrophil 2. Monocyte 3. helper T-cell 4. Lymphocyte

2. Monocyte

Which cells are associated with Hodgkins Lymphoma? 1. Philadelphia chromosome 2. Reed Sternberg cells 3. Bronsted-Lowry cells 4. Gram negative cells

2. Reed Sternberg cells

Mr. Brown comes into the ER , he has chronic renal failure who is not on dialysis. He is fatigued and his CBC showed he is low on hemoglobin and hematocrit, but his MVC is normal. As his nurse, what kind of anemia do you expect Mr. Brown to have? 1. microcytic, iron-deficiency 2. normocytic, chronic disease 3. normocytic, hemorrhage 4. macroytic, pernicious anemia

2. normocytic, chronic disease Rationale: MVC = is a measure of the average size of your red blood cells

Which patient is most at risk for a B-12 deficiency? 1. A patient who is on "blood thinners" 2. A patient who is 10 days postpartum 3. A patient who has had gastric bypass 4. A patient who has gone gluten-free

3. A patient who has had gastric bypass Rationale: Those who receive gastric bypass lack the intrinsic factor which transports B-12 across the acidic environment of the stomach so that it can be absorbed in the small bowel and allows for the formation of RBC's

Which of these cell types can play a primary role in attacking and killing cancer cells in immunotherapy? 1. Chemotaxins 2. Helper T cells 3. Cytotoxic T cells 4. Neutrophils

3. Cytotoxic T cells Rationale: Cytotoxic T cells recognize surface markers on target cells in the body. Target cells may be cancer cells or infected cells.

Ms. Husky is a 65 year old women who presents in the ER with extreme fatigue. Her medical history shows that she has Type II diabetes and is 5 years out from a gastric bypass surgery. Her labs show that she most likely has anemia--what factor about Ms. Husky makes this likely? 1. Type II diabetes 2. Ms. Husky is a female 3. Gastric Bypass 4. Ms. Husky's age

3. Gastric Bypass

Mr. Smith is your patient who has experienced chronic blood loss from hemorrhoidal bleeding. He is fatigued and tired and his hemoglobin and hematocrit CBC came back low and his MVC showed smaller RBC's. As his nurse, what do kind of anemia do you expect Mr. Smith to have? 1. normocytic, iron-deficiency 2. macrocytic, hemolytic 3. microcytic, iron-deficiency 4. normocytic, hemorrhage

3. microcytic, iron-deficiency Rationale: MVC = is a measure of the average size of your red blood cells. Also, blood loss should always be associated with iron-defincency

A nurse has a patient with polycythemia vera, what is a critical education point the nurse should teach to the patient? 1. "You're experiencing an increase in blood viscosity which puts you at risk for occlusion of blood vessels or a deep vein thrombosis. We're going to have to keep your room isolated" 2. "Your immune system has been compromised by the lack of red blood cell production in your body. We're going to have to keep your room isolated" 3. "You have anemia due to lack of intrinsic factor in your gut which helps B-12 to be absorbed. You're going to need to receive B-12 injections for the rest of your life" 4. "You blood is thicker than it should be which puts you at risk for a blood clot. Let's make sure you do some walking and stretching to improve your circulation"

4. "You blood is thicker than it should be which puts you at risk for a blood clot. Let's make sure you do some walking and stretching to improve your circulation" Rationale: polycythemia vera is an overproduction of RBC's which caused increase in blood viscosity= creation of a hypercoagulable state= increased risk of clotting and occlusion of blood vessels. This also has easier language for the pt to understand

Which disease presents with a very high iron concentration and is treated with phlebotomy? 1. Thrombocytopenia 2. Polycythemia vera 3. Porphyria 4. Hemochromatosis

4. Hemochromatosis

A form of oncology treatment which uses the patient's own immune system to treat the cancer is known as: 1. Chemotherapy 2. Radiation Therapy 3. Innate Therapy 4. Immunotherapy

4. Immunotherapy

Macrocytic-Normochromic anemia can be another term for: 1. Iron deficient anemia 2. Aplastic anemia 3. Sickle Cell anemia 4. Pernicious anemia

4. Pernicious anemia

If a patient has stage II colon cancer, what are some of the main treatment options? 1. Inoperable, chemotherapy is needed 2. Surgical removal of polyps 3. Inoperable, radiation is needed 4. Surgical removal of the colon

4. Surgical removal of the colon

Which protein makes up most of a RBC? 1. fibrinogen 2. immunoglobulin 3. Thromboxane 4. albumin

4. albumin

When a client is diagnosed with aplastic anemia, the nurse monitors for changes in which of the following physiological functions? a. Bleeding tendencies b. Intake and output c. Peripheral sensation d. Bowel function

a. Bleeding tendencies Rationale: Aplastic anemia decreases the bone marrow production of RBCs, WBCs, and Platelets. The client is at risk for bruising and bleeding tendencies.

From the following teaching tips, choose all that are appropriate for a client with thrombocytopenia: a. Use an electric razor for shaving b. Avoid becoming chilled c. Avoid all skin or body punctures d. Do not scrub skin during bathing e. Eat low-roughage foods f. Avoid use of all aspirin products g. Avoid vigorous blowing of nose h. Use only a soft toothbrush

a. Use an electric razor for shaving c. Avoid all skin or body punctures e. Eat low-roughage foods f. Avoid use of all aspirin products g. Avoid vigorous blowing of nose h. use only a soft toothbrush Rationale: Thrombocytopenia is a lower platelet count; great concern in terms of bleeding

A patient has a folic acid deficiency related to chronic alcohol abuse. The nurse would expect a complete blood cell count (CBC) to reveal: a. macrocytic, normochromic red cells. b. normocytic, normochromic red cells. c. microcytic, hypochromic red cells. d. microcytic, normochromic red cells.

a. macrocytic, normochromic red cells. Rationale: With folic acid deficiency, the cells are larger than normal, but the iron levels are normal or elevated, leading to findings of a macrocytic, normochromic anemia.

The nurse is preparing to teach a client with microcytic hypochromic anemia about the diet to follow after discharge. Which of the following foods should be included in the diet? a. Lettuce b. Eggs c. Citrus fruits d. Cheese

b. Eggs

The nurse understands that the client with pernicious anemia will have which distinguishing laboratory findings? a. Hematocrit, elevated b. Intrinsic factor, absent c. Hemoglobin, 14 g/dL d. RBCs 5.0 million

b. Intrinsic factor, absent Rationale: The defining characteristic of pernicious anemia, a megaloblastic anemia, is lack of the intrinsic factor, which results from atrophy of the stomach wall. Without the intrinsic factor, vitamin B12 cannot be absorbed in the small intestines, and folic acid needs vitamin B12 for DNA synthesis of RBCs.

An appropriate nursing intervention for a hospitalized patient with severe hemolytic anemia is to a. provide a probiotic before bed b. alternate periods of rest and activity c. teach the patient how to avoid injury d. place the patient on protective isolation

b. alternate periods of rest and activity. Rationale: Anemia causes fatigue due to malabsorption of oxygen--nurses should make sure anemic patients are receiving adequate rest

What will caring for a patient with a diagnosis of polycythemia vera likely require the nurse to do? a. encourage deep breathing and coughing b. assist with or perform phlebotomy at the bedside c. teach the patient how to maintain a low-activity lifestyle d. perform thorough and regularly scheduled neurologic assessments

b. assist with or perform phlebotomy at the bedside Rationale: polycythemia vera often requires phlebotomy in order to reduce blood volume.

When obtaining assessment data from a patient with a microcytic, hypochromic anemia, the nurse would question the patient about: a. folic acid intake b. dietary intake of iron c. a history of gastric surgery d. a history of sickle cell anemia

b. dietary intake of iron Rationale: Iron-deficiency anemia is a microcytic, hypochromic anemia.

An individual who lives at high altitudes may normally have an increased RBC count because: a. high altitudes cause vascular fluid loss, leading to hemoconcentration b. the function of the spleen in removing old RBCs is impaired at high altitudes c. hypoxia caused by decreased atmospheric oxygen stimulates erythropoiesis d. impaired production of leukocytes and platelets leads to proportionally higher red cell counts

c. hypoxia caused by decreased atmospheric oxygen stimulates erythropoiesis Rationale: erythropoiesis = the production of RBC's (Gunther gave the example of Olympic athletes training in Denver before the games to stimulate their bodies to naturally make more RBC's because of the city's high altitudes)

Malignant disorders that arise from granulocytic cells in the bone marrow will have the primary effect of causing: a. risk for hemorrhage b. altered oxygenation c. decreased production of antibodies d. decreased phagocytosis of bacteria

d. decreased phagocytosis of bacteria Rationale: The primary function of granulocytes is phagocytosis, a process by which white blood cells (WBCs) ingest or engulf any unwanted organism, such as bacteria, and then digest and kill it. In malignant disorders, these phagocytic cells are often reduced in number and function.

A critical action by the nurse caring for a patient with an acute exacerbation of polycythemia vera is to: a. place the patient on bed rest b. administer iron supplements c. avoid use of aspirin products d. monitor fluid intake and output

d. monitor fluid intake and output Rationale: Monitoring hydration status is important during an acute exacerbation because the patient is at risk for fluid overload or underhydration. Aspirin therapy is used to decrease risk for thrombosis. The patient should be encouraged to ambulate to prevent deep vein thrombosis (DVT). Iron is contraindicated in patients with polycythemia vera.