[Ex4] - C22 - AP

Question 1

22-1. While checking lab results, the nurse remembers that the normal leukocyte count is:
a. 1000–2000 per cubic millimeter.
b. 5000–10,000 per cubic millimeter.
c. 4.2–6.2 million per cubic millimeter.
d. 1.2–2.2 million per cubic millimeter.

Answer 1

ANS: B
5000–10,000 per cubic millimeter is the normal leukocyte count. 1000–2000 per cubic
millimeter is an abnormally low leukocyte count. 4.2–6.2 million per cubic millimeter is the
normal erythrocyte count. 1.2–2.2 million per cubic millimeter would indicate anemia.

Question 2

22-2. While reviewing lab results, the nurse recalls that the most abundant cells in the blood are:
a. leukocytes.
b. lymphocytes.
c. erythrocytes.
d. thrombocytes.

Answer 2

ANS: C
Erythrocytes (red blood cells) are the most abundant cells of the blood, occupying
approximately 48% of the blood in men, and 42% in women.

Question 3

22-3. An adult patient’s blood sample is analyzed in a laboratory. Assuming a normal sample,
which type of white blood cell accounts for the highest percentage?
a. Neutrophil
b. Eosinophil
c. Basophil
d. Lymphocyte

Answer 3

ANS: A
Neutrophils constitute about 65–75 of the total leukocyte count in adults. The eosinophils,
which have large, coarse granules, constitute only 2%–5% of the normal leukocyte count in
adults. Basophils make up less than 1% of the leukocytes. Lymphocytes constitute
approximately 36% of the total leukocyte count.

Question 4

22-4. A group of cells isolated in the laboratory have membrane-bound granules in their cytoplasm,
and they show phagocytic activity. Which of the following cells is most similar?
a. Monocyte
b. Macrophage
c. Lymphocyte
d. Eosinophil

Answer 4

ANS: D
Eosinophils, which have large, coarse granules, are capable of ameboid movement and
phagocytosis. Monocytes help fight infection. Macrophages are mature monocytes.
Lymphocytes are the primary cells of the immune response.

Question 5

22-5. The predominant phagocyte of early inflammation is the:
a. eosinophil.
b. lymphocyte.
c. macrophage.
d. neutrophil.

Answer 5

ANS: D
Neutrophils are the chief phagocytes of early inflammation. Eosinophils ingest
antigen-antibody complexes and are induced by IgE-mediated hypersensitivity reactions to
attack parasites. Most lymphocytes transiently circulate in the blood and eventually reside in
lymphoid tissues as mature T cells, B cells, or plasma cells. Macrophages migrate out of the
vessels in response to infection or inflammation but are not the early responders.

Question 6

22-6. Which type of white blood cell contains preformed granules of vasoactive amines?
a. Neutrophil
b. Eosinophil
c. Monocyte
d. Basophil

Answer 6

ANS: D
Basophils have cytoplasmic granules that contain vasoactive amines (e.g., histamine) and an
anticoagulant (heparin). Their function is similar to tissue mast cells. Neutrophils are the chief
phagocytes of early inflammation. Eosinophils ingest antigen-antibody complexes and are
induced by IgE-mediated hypersensitivity reactions to attack parasites. Monocytes do not
have amines, and their job is to help fight infection.

Question 7

22-7. Monocytes are blood cells that mature (differentiate) into:
a. macrophages.
b. neutrophils.
c. eosinophils.
d. mast cells.

Answer 7

ANS: A
Monocytes mature into macrophages, not neutrophils, eosinophils, or mast cells.

Question 8

22-8. In addition to playing a role in hemostasis, platelets have the ability to:
a. stimulate bone marrow production of erythrocytes.
b. release biochemical mediators of inflammation.
c. undergo cell division in response to bleeding.
d. activate a humoral response.

Answer 8

ANS: B
Platelets contain cytoplasmic granules capable of releasing proinflammatory biochemical
mediators when stimulated by injury to a blood vessel. Platelets assist with inflammation; they
do not produce erythrocytes, undergo cell division in response to bleeding, or activate the
humoral response.

Question 9

22-9. While planning care for a newborn, the pediatric nurse recalls that the site of hematopoiesis in
the fetus is the:
a. bone marrow
b. kidney.
c. lymph nodes.
d. spleen.

Answer 9

ANS: D
Hematopoiesis is constantly ongoing, occurring in the liver and spleen of the fetus and only in
bone marrow (medullary hematopoiesis) after birth. Fetal hematopoiesis does not occur in the
bone marrow, kidney, or lymph nodes.

Question 10

22-10. Which of the following assessment findings is most likely to occur following a splenectomy?
a. Leukocytosis
b. Hypoglycemia
c. Decreased red blood cell count
d. Decreased platelets

Answer 10

ANS: A
Leukocytosis often occurs after splenectomy. A splenectomy is not a trigger for hypoglycemia
or decreased levels of either red blood cells or platelets.

Question 11

22-11. During an infection, lymph nodes enlarge and become tender because:
a. lymphocytes are rapidly dividing.
b. edema accumulates within the fibrous capsule.
c. microorganisms are accumulating.
d. the nodes are not functioning properly.

Answer 11

ANS: A
During an infection, the rate of proliferation of lymphocytes within the nodes is so great that
the nodes enlarge and become tender. Edema may be present, but the tenderness is due to
proliferation of lymphocytes and is a normal function of the nodes. The tenderness is not due
to the microorganisms.

Question 12

22-12. After birth, red blood cells are normally made only in the:
a. liver.
b. spleen.
c. bone marrow.
d. kidney.

Answer 12

ANS: C
Red blood cells are produced in the bone marrow, not the liver, spleen, or kidney.

Question 13

22-13. A nurse is discussing a cell that can differentiate into any tissue type. Which term is the nurse
describing?
a. Hematopoietic
b. Pluripotent
c. Blastocyst
d. Progenitor

Answer 13

ANS: B
A pluripotent cell can grow into different kinds of tissue: blood, nerves, heart, bone, and so
forth. Hematopoietic cells are not capable of such differentia. A blastocyst is an embryonic
cell. A progenitor becomes a hematologic cell.

Question 14

22-14. Which cytokines participate in hematopoiesis?
a. Stimulating factors (CSFs)
b. Eosinophils
c. Basophils
d. Neutrophils

Answer 14

ANS: A
Several cytokines participate in hematopoiesis, particularly CSFs (or hematopoietic growth
factors). Neither eosinophils, basophils, nor neutrophils play a role in hematopoiesis.

Question 15

22-15. Erythropoietin is produced in the:
a. liver.
b. bone marrow.
c. kidneys.
d. spleen.

Answer 15

ANS: C
Erythropoietin is produced in the kidneys, not the liver, bone marrow, or spleen.

Question 16

22-16. Which condition will cause a patient to secrete erythropoietin?
a. Low blood pressure
b. Hypercarbia
c. Inflammation
d. Hypoxia

Answer 16

ANS: D
Hypoxia stimulates production of erythropoietin. Erythropoietin is not secreted in response to
low blood pressure, hypercarbia, or inflammation.

Question 17

22-17. An unstable type of hemoglobin that cannot bind with oxygen is termed:
a. deoxyhemoglobin.
b. oxyhemoglobin.
c. methemoglobin.
d. glycosylated hemoglobin.

Answer 17

ANS: C
Without reactivation, the Fe3+-containing hemoglobin (methemoglobin) cannot bind with
oxygen. Deoxyhemoglobin is reactivated hemoglobin whose oxygen has been released.
Binding of oxygen to ferrous iron temporally oxidizes Fe2+ to Fe3+ as in oxyhemoglobin.
Glycosylated hemoglobin is glucose bound to hemoglobin.

Question 18

22-18. The greatest proportion of total body iron is located in the:
a. erythrocytes.
b. spleen pulp.
c. bone marrow.
d. liver tissue.

Answer 18

ANS: A
Approximately 67% of total body iron is bound to heme in erythrocytes (hemoglobin) and
muscle cells (myoglobin).

Question 19

22-19. Which of the following nutritional components will the nurse encourage a patient to consume
as it is needed for erythropoiesis?
a. Vitamin B12
b. Vitamin B1
c. Vitamin D
d. Zinc

Answer 19

ANS: A
Vitamin B12 is necessary for erythropoiesis, not vitamin B1. Erythropoiesis is not dependent
on vitamin D or zinc.

Question 20

22-20. Which electrolyte will the nurse check to ensure normal platelet functioning?
a. Sodium
b. Potassium
c. Magnesium
d. Calcium

Answer 20

ANS: D
Calcium is necessary for many of the intracellular signaling mechanisms that control platelet
activation. Control of platelet activation is not associated with sodium, potassium, or
magnesium.

Question 21

22-21. A nurse is caring for a patient who cannot clot. Which end product of the clotting cascade is
this patient unable to make?
a. Collagen
b. Fibrinogen
c. Thrombin
d. Fibrin

Answer 21

ANS: D
Fibrin is the end product of the coagulation cascade. While involved in the coagulation
cascade, neither collagen, fibrinogen, nor thrombin is considered the end product of the
coagulation cascade.

Question 22

22-22. Fibrinolysis is mediated by:
a. heparin.
b. fibrinogen.
c. plasmin.
d. albumin.

Answer 22

ANS: C
Plasmin is an enzyme that promotes fibrinolysis by degrading fibrin and fibrinogen into fibrin
degradation products. Neither heparin, fibrinogen, nor albumin plays this role in the process
of fibrinolysis.