Galen College NSG 3850 Exam 1 (V2) Pathophysiology II | Complete Q&A Review | 100% Correct | Updated 2026/27.

Galen College NSG 3850 Exam 1 (V2) Pathophysiology II | Complete Q&A Review | 100% Correct | Updated 2026/27. ### 1. A nurse is reviewing body-fluid compartments. Which statement best describes extracellular fluid (ECF)? A. It includes interstitial, vascular, and transcellular fluid. B. It is found only inside blood vessels. C. It is the fluid located only within cells. D. It is composed primarily of intracellular potassium and phosphate. ### 2. Which electrolyte pattern is characteristic of the intracellular compartment? A. High sodium, chloride, and bicarbonate with low potassium. B. High sodium and calcium with low phosphate. C. High chloride and bicarbonate with very high extracellular proteins. D. High potassium, magnesium, proteins, and phosphates with relatively low sodium and chloride. ### 3. Which composition is most consistent with extracellular fluid? A. Relatively high potassium, magnesium, and phosphate with low sodium. B. Predominantly proteins and potassium with little chloride. C. Relatively high sodium, chloride, and bicarbonate with lower potassium, magnesium, and phosphate. D. Equal concentrations of every electrolyte inside and outside cells. ### 4. A student asks why total body water is generally lower in women and in adults with obesity. Which explanation is supported by the notes? A. Women excrete more water through the kidneys at baseline. B. Extracellular sodium is normally lower in women. C. A larger proportion of body fat is associated with a lower percentage of body weight as water. D. Adipose tissue contains more water than lean tissue. ### 5. Which finding is listed as a physiologic trigger for thirst? A. Decreased extracellular fluid osmolality. B. Increased extracellular fluid osmolality. C. Increased circulating blood volume. D. Increased moisture of the oral mucous membranes. ### 6. An older adult rarely feels thirsty despite reduced fluid intake. Which age-related change best explains this finding? A. Older adults have a consistently increased total body-water percentage. B. The thirst response diminishes with aging. C. Aging increases the kidney's ability to concentrate urine. D. Older adults have a stronger osmoreceptor response to rising osmolality. ### 7. The osmolality of interstitial fluid rises above that inside the cells. What movement of water should occur? A. Water moves from the interstitial fluid into the cells. B. Water remains fixed because osmosis occurs only in capillaries. C. Water moves from the cells into the interstitial fluid until osmotic pressures move toward equality. D. Protein moves into cells and pulls water with it. ### 8. Which route normally accounts for the largest volume of fluid excretion in most circumstances? A. Visible sweat. B. Feces. C. Exhaled water through the lungs. D. Urine. ### 9. Which group of hormones is specifically listed as regulating urinary fluid excretion? A. Insulin, erythropoietin, and intrinsic factor. B. Parathyroid hormone, calcitonin, and vitamin B12. C. ADH, aldosterone, and natriuretic peptides. D. Hemoglobin, albumin, and bicarbonate. ### 10. A patient with inflammation develops localized edema. Which mechanism in the notes directly promotes increased interstitial oncotic pressure? A. Decreased capillary blood flow prevents protein movement. B. Increased lymphatic removal of interstitial protein. C. Increased vascular permeability allows proteins to leak into the interstitial fluid. D. A fall in interstitial protein concentration. ### 11. Which statement best defines uncomplicated extracellular fluid volume deficit? A. The ECF contains excess free water and a low sodium concentration. B. The ECF concentration is always hypertonic. C. Only intracellular water is lost while vascular volume is preserved. D. The amount of ECF is decreased while its concentration and serum sodium may remain normal. ### 12. Which patient history is most consistent with extracellular fluid volume deficit? A. Repeated vomiting and diarrhea with poor replacement of sodium-containing fluid. B. Excessive infusion of isotonic saline. C. Hyperaldosteronism with sodium retention. D. Chronic retention of isotonic fluid from heart failure. ### 13. Which assessment change is identified as the most sensitive indicator of acute extracellular fluid volume deficit? A. New pitting edema. B. Sudden weight loss. C. Bounding peripheral pulses. D. Neck-vein distention. ### 14. A previously supine patient stands and develops a postural blood-pressure drop with an increased heart rate. The notes interpret this combination as a useful indicator of what problem? A. Intracellular fluid excess. B. Fluid-volume depletion in the vascular space. C. Hypercalcemia. D. Increased interstitial oncotic pressure. ### 15. Which assessment finding is more consistent with slowly developing ECV deficit? A. Bounding pulses and distended neck veins. B. Acute pulmonary crackles with frothy sputum. C. Dry oral mucous membranes, poor skin turgor, hard stools, and sunken eyes. D. Rapid overnight weight gain and generalized edema. ### 16. Which condition is a listed cause of extracellular fluid volume excess? A. Severe diarrhea with sodium-containing fluid loss. B. GI suction with poor intake. C. Massive diaphoresis without replacement. D. Hyperaldosteronism causing sodium and fluid retention. ### 17. Which finding is identified as the most sensitive indicator of acute extracellular fluid volume excess? A. Flat neck veins. B. Sunken eyeballs. C. Longitudinal furrows of the tongue. D. Sudden weight gain. ### 18. A patient has bounding pulses, neck-vein distention, crackles, dyspnea, orthopnea, and frothy sputum. Which fluid disorder best matches the source material? A. Uncomplicated ECV deficit. B. Extracellular fluid volume excess with circulatory overload. C. Depletional hyponatremia without volume excess. D. Clinical dehydration. ### 19. Hyponatremia is best described in the uploaded notes as which type of problem? A. A pure increase in total-body sodium with no water change. B. An osmolality imbalance in which the ECF has too much water relative to sodium. C. A disorder caused only by intracellular potassium loss. D. An ECV volume disorder that always has normal sodium concentration. ### 20. Which condition can cause dilutional hyponatremia by increasing renal water retention? A. Diabetes insipidus. B. Limited access to water. C. Hyperventilation with water loss. D. Excessive ADH activity. ### 21. Why can profound hyponatremia become rapidly life-threatening? A. Water leaves brain cells and produces cellular shrinkage. B. Potassium moves out of neurons and always causes cardiac arrest first. C. Sodium crystallizes in cerebral vessels. D. Water moves into brain cells, causing swelling that can progress to cerebral herniation. ### 22. Which serum sodium value is consistent with hypernatremia in the uploaded materials? A. A sodium concentration greater than 145 mEq/L. B. A sodium concentration less than 135 mEq/L. C. A sodium concentration of 135 to 145 mEq/L. D. A sodium concentration less than 3.5 mEq/L. ### 23. A patient receives concentrated tube feedings without adequate free-water flushes. Which imbalance is specifically associated with this situation? A. Hyponatremia. B. Hypocalcemia. C. Hypomagnesemia. D. Hypernatremia. ### 24. What cellular change occurs when extracellular osmolality rises in hypernatremia? A. Water moves into cells, causing swelling. B. Sodium moves completely into cells, eliminating the gradient. C. Water moves out of cells, causing cellular shrinkage. D. Cells remain unchanged because sodium does not affect water movement. ### 25. Which group of manifestations is most consistent with hypernatremia? A. Pica, spoon-shaped nails, and blue sclerae. B. Tetany with positive Chvostek and Trousseau signs only. C. Thirst, dry mucous membranes, irritability/confusion, weight loss, and possible seizures. D. Pitting edema with frothy sputum and neck-vein distention. ### 26. Which situation is a listed cause of hypokalemia? A. Renal failure with decreased potassium excretion. B. Potassium-sparing diuretic therapy. C. Crushing injury with potassium movement from ICF to ECF. D. Potassium-wasting diuretics with gastrointestinal losses such as vomiting or diarrhea. ### 27. Which ECG pattern is associated with hypokalemia in the uploaded review? A. Peaked T waves with a shortened QT interval. B. Prolonged QT interval with torsades as the defining potassium pattern. C. No ECG changes are expected. D. Flattened or dampened T waves with prominent U waves. ### 28. Which gastrointestinal finding is consistent with hypokalemia? A. Hyperactive bowel sounds with diarrhea. B. Decreased bowel sounds with abdominal distention or paralytic ileus. C. Severe hematemesis. D. Painless jaundice. ### 29. A patient with renal failure develops peaked T waves and flaccid weakness. Which electrolyte disorder best fits the source material? A. Hypokalemia. B. Hypocalcemia. C. Hyperkalemia. D. Hypernatremia. ### 30. Which medication in the review is used to shift potassium into cells during hyperkalemia treatment? A. Kayexalate, which shifts potassium directly into cells. B. Calcium gluconate, which removes potassium through the GI tract. C. Furosemide, which protects the myocardium without changing potassium. D. Insulin. ### 31. Which finding most strongly supports hypocalcemia? A. Constipation, low reflexes, and renal stones. B. Peaked T waves and flaccid paralysis. C. Positive Chvostek and Trousseau signs with tetany and paresthesias. D. Bounding pulses and neck-vein distention. ### 32. Which condition is listed as a cause of hypercalcemia? A. Hyperparathyroidism. B. Hypoparathyroidism. C. Vitamin D deficiency. D. Large transfusion of citrated blood. ### 33. Which assessment cluster is most consistent with hypercalcemia? A. Tetany, carpopedal spasm, and hyperreflexia. B. U waves, paralytic ileus, and decreased potassium. C. Muscle weakness, constipation, decreased reflexes, polyuria/polydipsia, and kidney stones. D. Confusion with severe brain-cell swelling from low sodium. ### 34. A patient with chronic alcohol use has hypomagnesemia. Which additional electrolyte problem does the review specifically link to magnesium deficiency? A. Hyperkalemia caused by decreased urinary potassium excretion. B. Hypokalemia caused by increased urinary potassium excretion. C. Hypercalcemia caused by increased PTH secretion. D. Hypernatremia caused by sodium retention. ### 35. Which manifestations are most consistent with hypomagnesemia? A. Hyperreflexia, muscle cramps, tremors, seizures, and possible dysrhythmias. B. Bradycardia, reduced respirations, and profound hyporeflexia only. C. Constipation, renal stones, and decreased reflexes. D. Flat neck veins, oliguria, and acute weight loss only. ### 36. Which set of arterial blood gas values is listed as normal in the Unit 2 materials? A. pH 7.35–7.45, PaCO₂ 35–45 mmHg, and HCO₃ 22–28 mEq/L. B. pH 7.25–7.35, PaCO₂ 20–30 mmHg, HCO₃ 10–18 mEq/L. C. pH 7.45–7.55, PaCO₂ 50–60 mmHg, HCO₃ 30–40 mEq/L. D. pH 6.9–7.0, PaCO₂ 35–45 mmHg, HCO₃ 22–28 mEq/L. ### 37. Which interpretation rule is correct according to the review? A. A low pH indicates alkalosis. B. A low pH indicates acidosis. C. A high PaCO₂ indicates alkalosis. D. A low bicarbonate indicates alkalosis. ### 38. Which acid-base component is described as acidic in the review? A. Bicarbonate. B. Carbon dioxide/carbonic acid. C. Folate. D. Erythropoietin. ### 39. A patient has diabetic ketoacidosis. Which primary acid-base disorder is supported by the notes? A. Metabolic alkalosis caused by loss of acid. B. Respiratory acidosis caused by carbon dioxide retention. C. Respiratory alkalosis caused by excessive ventilation. D. Metabolic acidosis caused by increased metabolic acid. ### 40. A patient has severe, prolonged diarrhea. Which mechanism can produce metabolic acidosis? A. Excessive loss of carbon dioxide through the lungs. B. Excessive retention of bicarbonate from antacid use. C. Excessive loss of bicarbonate-rich intestinal secretions. D. Loss of gastric hydrochloric acid. ### 41. Which clinical finding is associated with metabolic acidosis? A. Postural hypotension with tetany as the defining pattern of alkalosis only. B. Headache, abdominal pain, confusion/lethargy, tachycardia, and dehydration. C. Paresthesia and carpopedal spasm from hyperventilation only. D. Ruddy facial color with thrombosis. ### 42. What respiratory compensation is expected for metabolic acidosis in the uploaded notes? A. Hypoventilation to retain carbon dioxide. B. Apnea to preserve bicarbonate. C. Hyperventilation to excrete more carbon dioxide/carbonic acid. D. No respiratory response occurs. ### 43. An uncompensated metabolic acidosis would be expected to show which primary ABG change? A. High bicarbonate with a high pH. B. Low bicarbonate with a low pH. C. High PaCO₂ with a low pH as the primary change. D. Low PaCO₂ with a high pH as the primary change. ### 44. Which condition is listed as a cause of metabolic alkalosis? A. Severe diarrhea with bicarbonate loss. B. Diabetic ketoacidosis. C. Repeated vomiting or gastric suction with loss of acid. D. Tissue anoxia. ### 45. A patient overuses bicarbonate-containing antacids. Which acid-base disorder may result? A. Metabolic acidosis. B. Respiratory acidosis. C. Metabolic alkalosis. D. Respiratory alkalosis. ### 46. Which electrolyte disturbance frequently coexists with metabolic alkalosis according to the notes? A. Hypokalemia. B. Hyperkalemia. C. Hypermagnesemia. D. Hyperphosphatemia. ### 47. What is the compensatory respiratory response to metabolic alkalosis? A. Hyperventilation to eliminate carbon dioxide. B. Kussmaul respirations to remove bicarbonate. C. Hypoventilation to retain carbon dioxide/carbonic acid. D. No respiratory compensation is described. ### 48. Which ABG pattern is described for compensated metabolic alkalosis? A. Decreased bicarbonate, decreased PaCO₂, and decreased pH. B. Increased PaCO₂ with decreased pH and normal bicarbonate. C. Decreased PaCO₂ with increased pH and decreased bicarbonate as the primary disorder. D. Increased bicarbonate, increased PaCO₂, and an increased pH. ### 49. Which condition is listed as a cause of respiratory acidosis? A. COPD with impaired carbon dioxide elimination. B. Hyperventilation from anxiety. C. Prolonged crying. D. Excessive vomiting. ### 50. Which ABG direction is most consistent with respiratory acidosis? A. High PaCO₂ with a low pH. B. Low PaCO₂ with a high pH. C. Low bicarbonate with a low pH as the primary change. D. High bicarbonate with a high pH as the primary change. ### 51. What is the primary goal described for respiratory-acidosis management? A. Induce hypoventilation to retain more carbon dioxide. B. Increase bicarbonate loss through diarrhea. C. Improve ventilation so excess carbon dioxide can be eliminated. D. Restrict all respiratory effort. ### 52. Which condition is listed as a cause of respiratory alkalosis? A. Hyperventilation from severe anxiety. B. COPD with CO₂ retention. C. Gastric suction. D. Renal failure with retained metabolic acid. ### 53. Which manifestations are associated with respiratory alkalosis? A. Peaked T waves and flaccid paralysis. B. Paresthesias, carpal/pedal spasms, confusion, lightheadedness, and hypocalcemia-related neuromuscular excitability. C. Pica and spoon-shaped nails. D. Frothy sputum and neck-vein distention. ### 54. How does the body compensate for respiratory alkalosis according to the review? A. The kidneys retain additional bicarbonate. B. The kidneys reduce bicarbonate to help move pH back toward balance. C. The lungs deliberately retain more oxygen by apnea. D. The bone marrow increases erythropoietin. ### 55. A patient has pH 7.30 and PaCO₂ 52 mmHg. Which disorder best matches the source interpretation rules? A. Respiratory alkalosis. B. Metabolic alkalosis. C. Respiratory acidosis. D. Metabolic acidosis caused by low bicarbonate. ### 56. Which hormone stimulates red-cell development from pluripotential stem cells in the bone marrow? A. Erythropoietin. B. Aldosterone. C. ADH. D. Parathyroid hormone. ### 57. What physiologic condition stimulates kidney cells to secrete erythropoietin? A. High serum calcium. B. High extracellular sodium. C. Low oxygen tension in the blood. D. Increased gastric intrinsic factor. ### 58. Which nutrients are highlighted as particularly important for red-cell production? A. Sodium, chloride, and bicarbonate. B. Iron, vitamin B12, and folate. C. Calcium, magnesium, and phosphate only. D. Vitamin K, sodium, and potassium. ### 59. Why does lack of intrinsic factor increase the risk for anemia? A. It prevents absorption of iron from the stomach. B. It suppresses erythropoietin release from the kidney. C. It increases red-cell destruction in the spleen. D. It inhibits absorption of vitamin B12 from the small intestine. ### 60. Folate and vitamin B12 deficiency impair erythrocyte development primarily through what mechanism? A. Excessive sodium loss from erythrocytes. B. Impaired DNA synthesis in erythroid cells. C. Increased platelet production. D. Suppression of plasma oncotic pressure. ### 61. Which description best captures the basic pathophysiology of anemia in the uploaded materials? A. Increased RBC mass causing hyperviscosity. B. Primary sodium loss causing low plasma volume. C. Excessive platelet formation causing thrombosis. D. Reduced oxygen-carrying capacity leading to tissue hypoxia and compensatory responses. ### 62. Which cardiovascular adaptation to anemia is described in the notes? A. Decreased heart rate to reduce oxygen extraction. B. Reduced blood flow to vital organs. C. Suppressed pulmonary function. D. Increased heart rate and cardiac output to improve oxygenated blood flow. ### 63. Which symptom pattern is most typical of mild-to-moderate anemia in the source? A. Fatigue, generalized weakness, loss of stamina, followed by tachycardia and exertional dyspnea. B. Severe thrombosis with ruddy skin as the earliest presentation. C. Tetany and carpopedal spasm. D. Profound edema and frothy sputum. ### 64. Which group of findings is associated with moderate-to-severe anemia? A. Hyperreflexia, tetany, and positive Chvostek sign. B. Peaked T waves and diarrhea. C. Ruddy complexion and hyperviscosity. D. Pallor, tachypnea, dyspnea, tachycardia, angina, lightheadedness, and possible heart failure. ### 65. Which finding most specifically suggests iron-deficiency anemia rather than anemia in general? A. Exertional dyspnea. B. Fatigue. C. Tachycardia. D. Pica. ### 66. Which laboratory pattern supports iron-deficiency anemia in the uploaded review? A. Low serum ferritin and low serum iron with increased total iron-binding capacity. B. High ferritin with high serum iron and low TIBC. C. Low B12 with high MCV as the defining pattern. D. Pancytopenia with fatty marrow replacement. ### 67. Which change in the red cells is associated with iron-deficiency anemia in the notes? A. Macrocytic megaloblasts. B. Microcytic red cells. C. Marked erythrocytosis. D. Sickled cells caused by HbS. ### 68. Which history is a listed cause or risk for iron-deficiency anemia? A. Excess intrinsic factor. B. Chronic blood loss or increased demand such as pregnancy. C. Neoplastic overproduction of RBCs. D. Excessive vitamin B12 absorption. ### 69. Which instruction about oral iron therapy is supported by the uploaded notes? A. Vitamin C can enhance iron absorption. B. Take iron with calcium to block absorption. C. Black stools always indicate internal bleeding and therapy should stop. D. Iron should be avoided in all menstruating patients. ### 70. Which additional manifestation is associated with iron-deficiency anemia? A. Koilonychia (spoon-shaped nails). B. Ruddy facial color. C. Carpopedal spasm. D. Peaked T waves. ### 71. A patient has macrocytic/megaloblastic red cells because of a vitamin deficiency. Which two deficiencies can produce essentially similar marrow and peripheral blood changes? A. Iron and sodium deficiency. B. Calcium and magnesium deficiency. C. Vitamin D and potassium deficiency. D. Vitamin B12 deficiency and folate deficiency. ### 72. Which finding favors vitamin B12/pernicious anemia over isolated folate deficiency? A. Smooth red tongue. B. Pallor. C. Peripheral neurologic changes such as paresthesia, gait instability, or loss of position sense. D. Mild diarrhea. ### 73. What is the key mechanism of pernicious anemia described in the notes? A. Lack of erythropoietin leads to iron deficiency. B. Lack of intrinsic factor leads to vitamin B12 deficiency. C. Excess folate causes macrocytosis. D. Excess intrinsic factor causes RBC destruction. ### 74. Which diagnostic test in the review is designed to evaluate how well a patient absorbs vitamin B12? A. Trousseau test. B. Chvostek test. C. Serum sodium challenge. D. Schilling test. ### 75. Which oral finding is associated with vitamin B12/pernicious anemia? A. A blue tongue from sodium depletion. B. Black hairy tongue as the defining sign. C. Tongue edema caused only by hypernatremia. D. A smooth, sore, red or beefy tongue. ### 76. Which treatment principle is emphasized for pernicious anemia? A. Vitamin B12 replacement is ongoing/lifelong when intrinsic-factor deficiency prevents normal absorption. B. Stop vitamin B12 once hemoglobin improves. C. Treat only with iron because B12 does not affect DNA synthesis. D. Use phlebotomy to reduce hematocrit. ### 77. Which history is associated with folate-deficiency anemia in the uploaded notes? A. Hyperaldosteronism only. B. Excessive iron supplementation. C. Alcoholism, cirrhosis, pregnancy, poor/fad diet, or malabsorption. D. High-altitude residence. ### 78. Which statement best differentiates pure folate deficiency from vitamin B12 deficiency in the course review? A. Folate deficiency always causes sickled RBCs. B. Pure folate deficiency is described without the neurologic manifestations typical of B12 deficiency. C. Folate deficiency causes erythrocytosis rather than anemia. D. Folate deficiency is defined by excessive intrinsic factor. ### 79. A patient has decreased RBCs, WBCs, and platelets because of bone-marrow stem-cell failure. Which disorder best matches the notes? A. Aplastic anemia. B. Iron-deficiency anemia. C. Polycythemia vera. D. Uncomplicated folate deficiency. ### 80. Which mechanism is described in aplastic anemia? A. Excess erythropoietin stimulates all marrow cell lines. B. Abnormal HbS polymerization causes vaso-occlusion. C. Toxic, radiation, or immune injury to marrow stem cells with reduced hematopoiesis and fatty marrow replacement. D. Excess intrinsic factor causes megaloblastic cells. ### 81. Which diagnostic study is specifically associated with aplastic anemia? A. Schilling test alone. B. Bone marrow biopsy. C. Serum sodium osmolality only. D. ABG analysis as the definitive test. ### 82. Which risk is directly related to thrombocytopenia in aplastic anemia? A. Bleeding. B. Vaso-occlusive crisis. C. Severe hypernatremia. D. Carbon dioxide retention. ### 83. Which risk is directly related to neutropenia in aplastic anemia? A. Hyperviscosity. B. Renal calculi. C. Metabolic alkalosis. D. Infection. ### 84. Which nursing approach is supported for a patient with aplastic anemia and severe pancytopenia? A. Encourage exposure to crowds to build immunity. B. Administer iron routinely to increase all cell lines. C. Use phlebotomy to lower hematocrit. D. Use infection/neutropenic and bleeding precautions while monitoring for infection and hemorrhage. ### 85. Which statement best describes thalassemia in the uploaded notes? A. An acquired disorder caused by excess intrinsic factor. B. An inherited hemolytic disorder with deficient globin-chain production, reduced hemoglobin synthesis, and premature RBC destruction. C. A disorder of excess RBC production from a neoplastic marrow clone. D. A sodium-concentration disorder that causes RBC lysis. ### 86. Which laboratory finding is expected when bone marrow responds to chronic hemolysis in thalassemia? A. Reticulocytosis. B. Absent reticulocytes in all cases. C. Markedly increased serum sodium. D. Persistently normal marrow activity. ### 87. Why is iron overload a concern in thalassemia according to the source? A. Patients may have increased intestinal iron absorption and may also require frequent transfusions. B. Thalassemia blocks all iron absorption. C. Iron overload results only from dehydration. D. Intrinsic factor directly converts B12 into iron. ### 88. Which treatment is listed for reducing excess iron in thalassemia? A. Phlebotomy as the universal first-line therapy for thalassemia. B. Bicarbonate therapy. C. Chelation therapy. D. ADH administration. ### 89. Which statement best describes the primary defect in sickle cell anemia? A. An acquired intrinsic-factor deficiency. B. Neoplastic overproduction of normal RBCs. C. Isolated iron deficiency causing microcytosis. D. A genetically determined hemoglobin-synthesis defect producing unstable, poorly soluble hemoglobin S and sickling under low oxygen tension. ### 90. Which factors are listed as triggers or risks for sickling episodes? A. Low oxygen, dehydration, cold weather, and stress. B. High calcium, increased intrinsic factor, and alkalosis only. C. Excess folate and warm temperature. D. Increased total body water alone. ### 91. Which is identified as the most dangerous feature of sickle cell disease in the review? A. Acute crisis episodes caused by sickling and vascular occlusion. B. Mild isolated macrocytosis without symptoms. C. Chronic hypernatremia. D. Increased intrinsic-factor production. ### 92. Which assessment finding commonly reflects chronic hemolysis in sickle cell anemia? A. Positive Trousseau sign. B. Jaundice. C. U waves. D. Ruddy facial complexion from erythrocytosis. ### 93. During a painful sickle cell crisis, which set of priorities is explicitly emphasized in the uploaded notes? A. Hydration, oxygenation, pain relief, and keeping the patient warm. B. Fluid restriction, cooling, and phlebotomy. C. Calcium restriction and hypoventilation. D. Iron loading and dehydration. ### 94. A sickle cell patient develops severe pain after dehydration. Which pathophysiologic link best explains the event according to the notes? A. Dehydration increases intrinsic factor and causes macrocytosis. B. Dehydration prevents hemolysis and raises oxygen delivery. C. Dehydration lowers blood viscosity and prevents vessel obstruction. D. Dehydration promotes sickling, increasing vascular occlusion and reducing tissue perfusion. ### 95. Which treatment is listed as decreasing the formation of sickled cells? A. Aldosterone. B. Intrinsic factor. C. Hydroxyurea. D. Calcitonin. ### 96. Which test confirms sickle cell disease according to the hematology notes? A. Hemoglobin electrophoresis. B. Schilling test. C. Bone density scan. D. Serum osmolality. ### 97. Which statement best describes polycythemia vera? A. A nutritional anemia caused by iron deficiency. B. A myeloproliferative/neoplastic bone-marrow stem-cell disorder producing excessive RBC mass and increased blood viscosity. C. A megaloblastic anemia caused by B12 deficiency. D. An inherited hemolytic anemia caused by HbS. ### 98. Which laboratory pattern is most consistent with polycythemia vera? A. Low RBCs, low WBCs, and low platelets. B. Low ferritin, low iron, and increased TIBC only. C. Increased RBC mass and hematocrit with leukocytosis and thrombocytosis. D. Low sodium and low serum osmolality. ### 99. Which treatment is described as the mainstay of therapy for polycythemia vera? A. Monthly vitamin B12 injections. B. Phlebotomy to reduce blood viscosity and maintain hematocrit below the target stated in the notes. C. Frequent iron supplementation. D. Routine isotonic fluid loading as the definitive therapy. ### 100. Which patient statement indicates a need for further teaching about polycythemia vera? A. “I should take extra iron supplements to help my blood production.” B. “I should avoid smoking.” C. “I should avoid restrictive clothing and crossing my legs.” D. “I should recognize that thrombosis is an important risk.”