Quiz 2
Vaccination for pneumococcal pneumonia should be performed before 1 year of age in patients with sickle cell anemia.
False
Thalassemia may be confused with iron-deficiency anemia, because they are both a. hyperchromic. b. microcytic. c. genetic. d. responsive to iron therapy.
microcytic
Which diseases may be associated with a bleeding problem? (Select all that apply.) a. Urinary retention b. Renal failure c. Cirrhosis d. Systemic lupus erythematosus e. Ovarian cancer
Renal failure Cirrhosis Systemic lupus erythematosus Ovarian cancer
Secondary immune deficiency problems may be caused by (Select all that apply.) a. surgery. b. high blood sugar. c. corticosteroids. d. genetic disorders. e. low protein level.
Surgery, high blood sugar, corticosteroids, low protein level
A patient is diagnosed with a tortuous blood vessel of the right hand that bleeds spontaneously. This patient presents with a. petechiae. b. purpura. c. telangiectasia. d. thrombocytosis.
telangiectasia.
The activated partial thromboplastin time (aPTT) is a measure of the integrity of a. the extrinsic pathway. b. the intrinsic pathway. c. factor VIII synthesis. d. plasminogen.
the intrinsic pathway
Activation of the extrinsic pathway of coagulation is initiated by a. platelet factors. b. collagen exposure. c. tissue thromboplastin. d. factor VII.
tissue thromboplastin.
Disseminated intravascular coagulation may be treated with heparin therapy to a. enhance fibrinolysis. b. inhibit clotting factor consumption. c. activate platelets. d. enhance liver synthesis of clotting factors.
inhibit clotting factor consumption.
Pernicious anemia is caused by a lack of a. iron. b. intrinsic factor. c. folate. d. erythropoietin.
intrinsic factor
What is necessary for red blood cell production? a. Phosphate b. Iron c. Magnesium d. Calcium
iron
Dramatic hypotension sometimes accompanies type I hypersensitivity reactions, because a. massive histamine release from mast cells leads to vasodilation. b. toxins released into the blood interfere with cardiac function. c. anaphylaxis results in large volume losses secondary to sweating. d. hypoxia resulting from bronchoconstriction impairs cardiac function.
massive histamine release from mast cells leads to vasodilation.
The arterial oxygen content (CaO2) for a patient with PaO2 100 mm Hg, SaO2 95%, and hemoglobin 15 g/dL is _____ mL oxygen/dL. a. 19.4 b. 1909.8 c. 210 d. 21.05
19.4
Red blood cells obtain nearly all their energy from metabolism of a. glucose. b. fats. c. proteins. d. acetyl coenzyme A
glucose
While in the hospital for management of acute lymphoid leukemia (ALL), a patient develops severe thrombocytopenia. The most appropriate action for this condition is a. anticoagulant therapy. b. chemotherapy. c. activity restriction. d. isolation.
activity restriction
An important mediator of a type I hypersensitivity reaction is a. complement. b. antigen-antibody immune complexes. c. T cells. d. histamine.
histamine.
Myasthenia gravis is a type II hypersensitivity disorder that involves a. impaired muscle function. b. symptoms of hyperthyroidism. c. symptoms of arthritis or polyarthralgia. d. symptoms of glomerular disease.
impaired muscle function.
Which vessel normally demonstrates the most rapid blood flow? a. An arteriole b. A capillary c. A venule d. The vena cava
The vena cava
The anemia resulting from a deficiency of either vitamin B12 (cobalamin) or folate is caused by a disruption in DNA synthesis of the blast cells in the bone marrow that produces very large abnormal bone marrow cells called megaloblasts.
True
The effects of histamine release include a. vasoconstriction. b. bronchodilation. c. increased vascular permeability. d. decreased gut permeability.
increased vascular permeability.
A patient is diagnosed with CML (chronic myeloid leukemia). The patient may experience which of these symptoms? (Select all that apply.) a. Fatigue b. Weight loss c. Abdominal discomfort d. Joint pain e. Sweats
Fatigue, weight loss, abdominal discomfort, sweats
Which disorder is considered a primary immunodeficiency disease? a. HIV/AIDS b. Malnutrition immunodeficiency c. Cancer immunodeficiency d. Radiation immunodeficiency
HIV/AIDS
The Philadelphia chromosome is a balanced chromosome translocation that forms a new gene called a. bcr-abl. b. Rb. c. p53. d. ARA-c.
bcr-abl.
Most carbon dioxide is transported in the bloodstream as a. carboxyhemoglobin. b. bicarbonate ion. c. dissolved carbon dioxide. d. carbonic acid.
bicarbonate ion
Excessive red cell lysis can be detected by measuring the serum a. hemoglobin. b. methemoglobin. c. bilirubin. d. erythropoietin.
bilirubin
A normal bleeding time in association with normal platelet count, and increased prothrombin time (PT) and INR, is indicative of a. vitamin K deficiency. b. hemophilia B. c. hemophilia A. d. idiopathic thrombocytopenia.
vitamin K deficiency.
A 58-year-old woman is seen in the clinic for reports of severe back pain. Her chest x-ray demonstrates generalized bone demineralization and compression fracture. Blood studies demonstrate elevated calcium levels. The most likely diagnosis is a. leukemia. b. myeloma. c. Hodgkin disease. d. back trauma.
myeloma
Renal insufficiency is a common complication of which disease? a. Chronic myeloid leukemia (CML) b. Chronic lymphoid leukemia (CLL) c. Myeloma d. Hodgkin disease
myeloma
RhoGAM (an Rh antibody) would be appropriate in an Rh-_____ woman with an _____ Rh-_____ antibody titer carrying an Rh-_____ fetus. a. negative; positive; positive b. positive; negative; negative c. negative; negative; positive d. negative; negative; negative
negative; negative; positive
Autoimmune diseases result from (Select all that apply.) a. overactive immune function. b. increase in self-tolerance. c. failure of the immune system to differentiate self and nonself molecules. d. communicable infections.
-overactive immune function -Failure of the immune system j=to differentiate self and non-self molecule
A patient presents to the physician's office with pinpoint hemorrhages on the skin. The patient is most likely between the ages of _____ years. a. 6 months and 2 b. 4 and 7 c. 15 and 18 d. 25 and 45
4 and 7
A 5-year-old patient's parents report loss of appetite and fatigue in their child. The parents also state that the child refuses to walk as a result of pain. The child's most likely diagnosis is a. ALL (acute lymphoid leukemia) b. CLL (chronic lymphoid leukemia) c. AML (acute myeloid leukemia) d. CML (chronic myeloid leukemia)
ALL (acute lymphoid leukemia)
Which type of leukemia primarily affects children? a. ALL (acute lymphoid leukemia) b. CLL (chronic lymphoid leukemia) c. AML (acute myeloid leukemia) d. CML (chronic myeloid leukemia) ANS: A
ALL (acute lymphoid leukemia)
In general, the best prognosis for long-term disease-free survival occurs with a. ALL (acute lymphoid leukemia). b. CLL (chronic lymphoid leukemia). c. AML (acute myeloid leukemia). d. CML (chronic myeloid leukemia).
ALL (acute lymphoid leukemia).
A diagnostic laboratory finding in myeloma is a. Bence Jones proteins in the urine. b. decreased platelet count. c. increased IgM antibody titer. d. elevated blood glucose levels.
Bence Jones proteins in the urine.
Burkitt lymphoma is most closely associated with a. Epstein-Barr virus. b. radiation exposure. c. immunodeficiency syndromes. d. history of cigarette smoking.
Epstein-Barr virus.
Which viruses have been implicated as cancer-causing agents? (Select all that apply.) a. Epstein-Barr b. Human T-cell leukemia c. Human immunodeficiency d. Herpes e. Shingles
Epstein-Barr, Human T-Call leukemia, Human Immunodeficiency
What is involved in the release of plasminogen activators? (Select all that apply.) a. Factor X b. Factor XII c. HMWK d. Kallikrein e. Thrombin
Factor XII HMWK Kallikrein Thrombin
Seasonal allergic rhinitis is most involved in type II hypersensitivity reactions.
False
Certain autoimmune diseases are associated with the presence of specific proteins on a person's cells. These proteins are called ________ proteins. a. complement b. antibody receptor c. HLA or MHC d. TCR or BCR
HLA or MHC
A male patient involved in a motor vehicle accident is brought to the emergency department with acute flank pain. What additional signs of bleeding may the patient exhibit? (Select all that apply.) a. Hematuria b. Melena c. Hematemesis d. Menorrhagia e. Hemoptysis
Hematuria Melena Hematemesis hemoptysis
Anaphylaxis may occur in certain hypersensitivity reactions, including type (Select all that apply.) a. I. b. II. c. III. d. IV.
I, II
A child with a history of recent strep throat infection develops glomerulonephritis. This is most likely a type _____ hypersensitivity reaction. a. I b. II c. III d. IV
III
The hypersensitivity reaction that does not involve antibody production is type a. I. b. II. c. III. d. IV.
IV
The principle Ig mediator of type I hypersensitivity reactions is a. IgA. b. IgG. c. IgM. d. IgE
IgE
A low mean corpuscular hemoglobin concentration (MCHC) and mean corpuscular volume (MCV) are characteristic of which type of anemia? a. Vitamin B12 deficiency b. Folate deficiency c. Iron deficiency d. Erythropoietin deficiency
Iron deficiency
A patient is diagnosed with myeloma. The nurse teaches the patient about the multiple tumor sites that can develop with this cancer. The possible tumor sites in myeloma include the (Select all that apply.) a. liver. b. spleen. c. stomach. d. pancreas. e. kidneys.
Liver, spleen, kidney
Regarding iron-deficiency anemia, what laboratory features are typically decreased? (Select all that apply.) a. MCV b. MCH c. MCHC d. WBC e. Thrombocytes
MCV, MCH, MCHC
The final step in clot formation is a. conversion of prothrombin to thrombin. b. platelet degranulation and adhesion. c. conversion of fibrinogen to fibrin. d. clot retraction.
clot retraction.
The prothrombin time (PT) and INR (international normalized ratio) measure the integrity of a. platelet function. b. extrinsic pathway. c. intrinsic pathway. d. fibrinolysis.
extrinsic pathway.
Treatment for hemophilia A includes a. heparin administration. b. factor IX replacement. c. factor VIII replacement. d. platelet transfusion.
factor VIII replacement
The conversion of plasminogen to plasmin results in a. clot retraction. b. fibrinolysis. c. platelet aggregation. d. activation of thrombin.
fibrinolysis.
Patients who experience anemic episodes when exposed to certain drugs most likely have a. thalassemia. b. spherocytosis. c. sickle cell anemia. d. glucose-6-phosphate dehydrogenase deficiency.
glucose-6-phosphate dehydrogenase deficiency
A patient is diagnosed with hairy cell leukemia. The patient's laboratory results would most likely indicate a decrease in (Select all that apply.) a. granulocytes. b. platelets. c. white blood cells. d. red blood cells. e. melanocytes.
granulocytes, platelets, red blood cell
Red blood cells differ from other cell types in the body, because they a. contain cytoplasmic proteins. b. have no cytoplasmic organelles. c. have a longer life span. d. contain glycolytic enzymes.
have no cytoplasmic organelles.
Which condition is associated with an elevated reticulocyte count? a. Renal disease b. Aplastic anemia c. Hypertension d. Hemolytic anemia
hemolytic anemia
A 3-year-old boy who exhibits prolonged bleeding after minor trauma and a prolonged aPTT, but a normal platelet count, is likely to be diagnosed with a. hemophilia. b. liver dysfunction. c. disseminated intravascular coagulation. d. thrombocytopenia.
hemophilia.
The patient is a 12-year-old boy diagnosed with acute lymphoid leukemia (ALL). As part of treatment, the patient must undergo several weeks of chemotherapy. The most serious complication of chemotherapy is a. vomiting. b. anemia. c. alopecia. d. infection.
infection
1. The major cause of death from leukemic disease is a. infection. b. malnutrition. c. hypovolemic shock. d. kidney failure.
infection
Hemophilia B is also known as Christmas disease.
true
The nurse is educating a patient diagnosed with anemia of chronic renal failure about the disease. Which statements made by the nurse are correct regarding the patient's treatment? (Select all that apply.) a. "Since your glomerular filtration is 13 mL/min, you'll be started on dialysis." b. "Your hematocrit is 29%, so you're going to start on erythropoietin therapy." c. "Your hemoglobin is 9 g/dL, so you'll need erythropoietin therapy." d. "We need to get your hemoglobin up to at least 15 g/dL" e. "You're going to need iron, folate, and B12 therapy to help improve your blood
"Since your glomerular filtration is 13 mL/min, you'll be started on dialysis.", "Your hematocrit is 29%, so you're going to start on erythropoietin therapy." "Your hemoglobin is 9 g/dL, so you'll need erythropoietin therapy." "You're going to need iron, folate, and B12 therapy to help improve your blood
The patient is a 12-year-old boy with acute lymphoblastic leukemia (ALL). Manifestations of the patient's leukemia prior to treatment may include (Select all that apply.) a. anemia. b. leukocytosis. c. leukopenia. d. thrombocytopenia. e. anuria.
Anemia, leukocytosis, thrombocytopenia
Which involves bleeding associated with vascular or platelet defects? (Select all that apply.) a. Bleeding that occurs immediately after trauma b. Bleeding that involves skin or mucous membranes c. Bleeding that is brief in duration d. Bleeding that is delayed e. Bleeding into muscles or joints
Bleeding that occurs immediately after trauma Bleeding that involves skin or mucous membranes Bleeding that is brief in duration
Which form of leukemia demonstrates the presence of the Philadelphia chromosome? a. ALL (acute lymphoid leukemia) b. CLL (chronic lymphoid leukemia) c. AML (acute myeloid leukemia) d. CML (chronic myeloid leukemia)
CML (chronic myeloid leukemia)
What is the correct definition of complete remission (CR) of leukemia? a. CR is the absence of leukemic cells in the blood. b. CR is less than 5% blasts in marrow and normal CBC values. c. CR is absence of leukemic cells regardless of CBC values. d. CR is less than 5% leukemic cells in the blood.
CR is less than 5% blasts in marrow and normal CBC values.
Which causes vasoconstriction? a. Norepinephrine b. Calcium channel blocker c. α-Adrenergic antagonist d. Acetylcholine
Norepinephrine
Which group of clinical findings describes the typical presentation of ALL (acute lymphoid leukemia)? a. Pain in long bones, infection, fever, bruising b. Vertebral fracture, hypercalcemia, bone pain c. Elevated WBC count found on routine examination, asymptomatic d. Painless enlarged cervical lymph node, fever, weight loss
Pain in long bones, infection, fever, bruising
What laboratory finding is usually found in aplastic anemia? a. Leukocytosis b. Thrombocythemia c. Neutrophilia d. Pancytopenia
Pancytopenia
A patient is diagnosed with stage IIA Hodgkin disease. This patient's clinical stage was most likely determined by (Select all that apply.) a. patient history. b. lymph node biopsy. c. laparotomy results. d. CT scan. e. physical examination.
Patient history, CT scan, Physical examination
Hapten mechanisms are found in which medications? (Select all that apply.) a. Ibuprofen b. Narcotics c. Penicillin d. Cephalosporins e. Tetracycline
Penicillin Cephalosporins Tetracycline
A newborn patient is diagnosed with hemolytic disease. The nurse may expect to find what signs and symptoms? (Select all that apply.) a. Petechial hemorrhages b. Hepatomegaly c. Splenomegaly d. Kernicterus e. Erythema
Petechial hemorrhages Hepatomegaly Splenomegaly Kernicterus
Anemia related to vitamin B12 or folate deficiency is characterized by what laboratory features? (Select all that apply.) a. RBC counts of 775,000 to 900,000 cells/mm3 b. RBC counts of 500,000 to 750,000 cells/mm3 c. WBC counts of 3000 to 4000 cells/mm3 d. WBC counts of 4000 to 5000 cells/mm3 e. Platelet counts of 60,000 cells/mm3
RBC counts of 500,000 to 750,000 cells/mm3 WBC counts of 4000 to 5000 cells/mm3
A patient is diagnosed with stage III non-Hodgkin lymphoma and is preparing to undergo treatment. Which treatments may be used to treat this patient's cancer? (Select all that apply.) a. Radiation b. Bone marrow transplant c. Chemotherapy d. Lymph node transplant e. Monoclonal antibody therapy
Radiation, bone marrow transplant, chemotherapy, monoclonal antibody therapy
Which disorder is associated with a type III hypersensitivity mechanism of injury? a. Systemic lupus erythematosus b. Graves disease c. Erythroblastosis fetalis d. Seasonal allergic rhinitis
Systemic lupus erythematosus
The liver is responsible for the synthesis of coagulation factors, with the exception of part of VIII.
True
The only known curative treatment for CML is allogeneic bone marrow transplantation from a suitable donor.
True
Two of the most serious oncology emergencies associated with non-Hodgkin lymphoma are obstruction of the superior vena cava and compression of the spinal cord.
True
A commonly ingested substance associated with prolongation of the bleeding time is a. acetaminophen. b. tobacco. c. caffeine. d. aspirin.
aspirin
A cause of thrombocytopenia includes a. hypoxemia. b. reduced erythropoietin. c. chemotherapy. d. secondary polycythemia.
chemotherapy
Severe combined immunodeficiency (SCID) syndrome is an example of a(n) a. deficient immune response. b. excessive immune response. c. primary acquired immunodeficiency. d. hypersensitivity reaction.
deficient immune response.
Patients with immunodeficiency disorders are usually first identified because they a. run high fevers. b. have unusually high WBC counts. c. develop brain infections. d. develop recurrent infections.
develop recurrent infections.
Widespread activation of the clotting cascade secondary to massive trauma is called a. hemophilia B. b. disseminated intravascular coagulation (DIC). c. Hageman disease. d. idiopathic thrombocytopenia purpura.
disseminated intravascular coagulation (DIC)
A laboratory test finding helpful in confirming the diagnosis of iron-deficiency anemia is a. elevated total iron-binding capacity. b. elevated MCHC and MCV. c. elevated total and indirect bilirubin. d. positive direct or indirect Coombs test.
elevated total iron-binding capacity
The most effective therapy for anemia associated with kidney failure is a. iron administration. b. high-protein diet. c. erythropoietin administration. d. vitamin B12 and folate administration.
erythropoietin administration
The cause of the most common form of anemia is a. acute bleeding. b. iron deficiency. c. protein malnutrition. d. chronic disease.
iron deficiency
Which characteristic is indicative of hemolytic anemia? a. Increased total iron-binding capacity b. Increased heart rate c. Hypovolemia d. Jaundice
jandice
The primary source of erythropoietin is provided by the a. bone marrow. b. kidney. c. lung. d. liver.
kidney
A patient is diagnosed with aplastic anemia. The nurse expects to find what patient symptoms upon assessment? (Select all that apply.) a. Lethargy b. Heart palpitations c. Transient murmurs d. Bradycardia e. Orthopnea
lethergy, heart palpitations, transient murmurs
Dysfunction of which organ would lead to clotting factor deficiency? a. Liver b. Kidney c. Spleen d. Pancreas
liver
A primary effector cell of the type I hypersensitivity response is a. monocytes. b. mast cells. c. neutrophils. d. cytotoxic cells.
mast cells.
The most appropriate treatment for secondary polycythemia is a. volume expansion with saline. b. measured to improve oxygenation. c. phlebotomy. d. chemotherapy.
measured to improve oxygenation
The strength of the bond between oxygen and hemoglobin is known as the a. Bohr effect. b. oxygen-hemoglobin affinity. c. dissociation curve. d. hemoglobin synthesis.
oxygen-hemoglobin affinity.
A deficiency of von Willebrand factor impairs a. activation of the coagulation cascade. b. platelet aggregation. c. platelet adhesion to injured tissue. d. platelet production.
platelet adhesion to injured tissue.
The megakaryocyte is a precursor to a. factor IX. b. white blood cells. c. red blood cells. d. platelets.
platelets
Transfusion reactions involve RBC destruction caused by a. donor antigens. b. recipient antibodies. c. donor T cells. d. recipient T cells.
recipient antibodies
The movement of blood through the vascular system is opposed by the force of a. viscosity. b. the vessel length. c. the vessel radius. d. resistance.
resistance.
The most common primary immune deficiency that affects only B cells is a. DiGeorge. b. Bruton agammaglobulinemia. c. Wiskott-Aldrich. d. selective IgA.
selective IgA.
An increase in hemoglobin affinity for oxygen occurs with a. hyperthermia. b. shift to the right. c. elevated PCO2. d. shift to the left.
shift to the left.
One of the cardinal features of sickle cell anemia includes acute and chronic dysfunction of which organs? (Select all that apply.) a. Spleen b. Bones c. Brain d. Lungs e. Stomach
spleen, bone, brain, lungs
Autologous stem cell transplantation is a procedure in which a. there is a high rejection rate. b. stem cells are transferred to the patient from an HLA-matched donor. c. stem cells are transferred to the patient from an identical twin. d. stem cells are harvested from the patient and then returned to the same patient.
stem cells are harvested from the patient and then returned to the same patient.
A newborn has melena, bleeding from the umbilicus, and hematuria. The newborn most likely experiencing a. vitamin K deficiency bleeding. b. acquired vitamin K deficiency. c. von Willebrand disease. d. disseminated intravascular coagulation.
vitamin K deficiency bleeding.
