Exam 2 Questions and Answers Best
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N618 Exam 2
1. Abnormal Blood Test and Anticoagulants:
a. A hospital laboratory technician is performing routine blood
analysis as part of an inpatient’s assessment and is examining
the sample in a test tube following processing in a centrifuge
and the addition of an anticoagulant. Which of the following
observations would the technician most likely interpret as an
anomaly? The bottom layer of blood in the tube accounts for
around one third of the total volume.
2. RBC Characteristics:
a. Which of the following statements best conveys a
characteristic of red blood cells? They contribute to the
maintenance of blood pH.
b. An example of a single hormone that can exert effects in
different tissues, erythropoietin, made in the kidney
stimulates the bone marrow to produce? RBC
c. RBCs are microscopic & have the shape of a flat
disk/doughnut, which is round w/an indentation in the
center but isn’t hollow.
d. Do not contain a Nucleus, allows RBCs to change shape and
move throughout the body easier. Do not have organelles,
and thrombocytes are just cell fragments.
e. RBCs are erythrocytes, carry oxygen to all cells in the body.
Oxygen is carried on a protein called Hemoglobin.
Hemoglobin is what makes blood red.
f. Life span is approximately 120 days. 90% of aged RBCs are
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, phagocytosed in the Bone Marrow, Spleen, & Liver. To
maintain sufficient # of RBC’s, the Bone Marrow continually
releases new RBCs (old/damaged RBCs are removed from
circulation).
g. RBCs contributes to CO2 transport for excretion and to regulate
Acid-Base Balance.
h. RBCs are formed in the Red Bone Marrow from
Hematopoietic Stem Cells in a process called Erythropoiesis.
3. Hematopoietic Factor Growth Factors: possible
a. A nurse is providing care for several patients on an acute
medical unit of a hospital. Which of the following patients
would be most likely to benefit from hematopoietic growth
factors? A 61yo female patient with end-stage renal cancer.
b. Hematopoietic growth factors are commonly used in cases of
kidney dx & cancer.
c. In diseases such as polycythemia vera, leukemia, and other
blood cancers, inappropriate production of growth factors does
occur.
4. Extremity Capillary Pressure: possible
a. A patient asks the health care provider why his lower legs look
purple. The health care provider will base her response on
which pathological principle? The bruising around the ankles is
due to the fact that it is a dependent area where the capillary
pressure is higher.
5. ITP in pediatrics:
a. Following a course of measles, a 5yo girl developed scattered
bruising over numerous body surfaces and was diagnosed with
immune thrombocytopenia purpura (ITP). As part of her
diagnostic workup, blood work was performed. Which of the
following results is most likely considered unexpected by the
health care team? Increased thrombopoietin levels (in ITP they
are not elevated) Dr. Fletcher says (decrease platelet count.)
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, 6. Long term Corticosteroid use: possible
a. A 66yo female patient has presented to the emergency
department because of several months of intermittent bloody
stool that has recently become worse. The woman has since
been diagnosed with a gastrointestinal bleed secondary to
overuse of nonsteroidal anti-inflammatory drugs that she
takes for her arthritis. The health care team would realize that
which of the following situations is most likely to occur? She will
have iron deficiency anemia due to depletion of iron stores.
b. Long-term corticosteroid use may be associated with more
serious sequel, including osteoporosis, aseptic joint necrosis,
adrenal insufficiency, gastrointestinal, hepatic, and
ophthalmologic effects, hyperlipidemia, growth suppression,
and possible congenital malformations.
c. Corticosteroids increase HEMOGLOBIN & RBC content of
blood erythrophagocytosis; This effect is demonstrated by the
occurrence of POLYCYTHEMIA in CUSHING dx and mild
normochromic anemia in ADDISON’S dx.
d. Corticosteroids shortening of the clotting time!! Also, causes
adrenal insufficiency. Vascular defects also occur in the course
of DIC or as a result of microthrombi and corticosteroid
therapy. (pg. 633, Chp. 22).
7. CBC interpretation. Specifically, Hematocrit: possible
a. A client with a diagnosis of hemolytic anemia has gone to a
community-based laboratory for follow-up blood work. The
lab technician confirms with the client that hematocrit is one
of the components of the blood work. The client replies, “I
thought the point of the blood work was to see how many red
blood cells I have today.” How would the technician best
respond to the client’s statement? “The hematocrit measures
the mass that your red blood cells account for in a quantity of
your blood.”
i. Dr. Fletcher says: “This result will tell your health care
provider about the number of red blood cells in a
given quantity of your blood plasma.”
8. Nutritional importance for Newborns: possible.
a. A community health nurse is conducting a class on the
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