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NUR 5461 Advanced Pathophysiology — Module 2 Concepts and Alterations
of the Cardiovascular and Hematologic Systems: Quiz Bank




Course: NUR 5461 Advanced Pathophysiology
Institution: William Paterson University — Department of
Nursing
Module: 2 of 7
Required Text: McCance, K. L., Huether, S. E., Brashers, V. L., &
Rote, N. S. (2019/2023). Pathophysiology: The biologic basis for
disease in adults and children (8th/9th ed.). Mosby Elsevier


Module 2 Overview: This module covers the pathophysiology
of the cardiovascular and hematologic systems, including the
structure and function of blood, anemias, coagulopathies,
leukemias, atherosclerosis, hypertension, heart failure, ischemic
heart disease, valvular disorders, and infective endocarditis.
Students must understand the mechanisms of disease, clinical
manifestations, and diagnostic findings for these conditions.


SECTION A: HEMATOLOGIC SYSTEM
1. Which statement is true regarding the constituents of blood?
A) Plasma is made up of 90% dissolved substances and 10%
water
B) Plasma is made up of approximately 90% water and 10%

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dissolved substances
C) Plasma contains only electrolytes and no proteins
D) Plasma makes up less than 30% of total blood volume
Answer: B
Rationale: Plasma is approximately 90% water and 10%
dissolved substances, including plasma proteins (albumin,
globulins, fibrinogen), electrolytes, nutrients, hormones, and
waste products. Plasma constitutes approximately 55% of total
blood volume. Option A reverses the proportions; option C
incorrectly excludes proteins; option D underestimates plasma
volume.
2. What are blood cells that differentiate into macrophages
known as?
A) Neutrophils
B) Monocytes
C) Lymphocytes
D) Eosinophils
Answer: B
Rationale: Monocytes circulate in the blood and differentiate
into macrophages when they migrate into tissues. Neutrophils
are short-lived phagocytes; lymphocytes mediate adaptive
immunity; eosinophils are involved in parasitic infections and
allergic reactions.

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3. Which of the following is a primary function of erythrocytes?
A) Initiate blood clotting
B) Tissue oxygenation
C) Synthesize immunoglobulins
D) Regulate blood pressure directly
Answer: B
Rationale: Erythrocytes contain hemoglobin, which binds
oxygen in the lungs and delivers it to tissues throughout the
body. Tissue oxygenation is their primary physiologic function.
Clotting is the function of platelets and coagulation factors;
immunoglobulins are produced by plasma cells; blood pressure
regulation involves multiple systems.
4. Which of these is classified as a megaloblastic anemia?
A) Iron deficiency anemia
B) Pernicious anemia
C) Anemia of chronic disease
D) Hemolytic anemia
Answer: B
Rationale: Megaloblastic anemias are characterized by impaired
DNA synthesis and enlarged RBC precursors. Pernicious anemia
results from vitamin B₁₂ deficiency due to lack of intrinsic factor,
leading to megaloblastic changes in the bone marrow and
macrocytic RBCs.

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5. After a person has a subtotal gastrectomy for chronic
gastritis, which type of anemia will result?
A) Iron deficiency anemia
B) Aplastic anemia
C) Vitamin B₁₂ deficiency anemia
D) Hemolytic anemia
Answer: C
Rationale: Subtotal gastrectomy removes the gastric parietal
cells that produce intrinsic factor, which is essential for vitamin
B₁₂ absorption in the ileum. This leads to pernicious anemia
(vitamin B₁₂ deficiency anemia), a megaloblastic anemia.
6. Which of the following is a characteristic of anemia of chronic
disease?
A) Microcytic, hypochromic RBCs
B) Normocytic, normochromic RBCs with low iron and low TIBC
C) Macrocytic RBCs with hypersegmented neutrophils
D) Hemolytic RBCs with spherocytes
Answer: B
Rationale: Anemia of chronic disease is typically normocytic,
normochromic, with low serum iron, low TIBC, and normal or
increased ferritin. It is mediated by hepcidin, which sequesters
iron and impairs erythropoiesis. Microcytic hypochromic is iron
deficiency; macrocytic is B₁₂/folate deficiency.

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