NURS 6512 Final Exam 7 Preparation Guide (2026): Systematic Physical Assessment Review with Practice Quizzes

The normal white blood cell (WBC) level in a newborn up to 2 weeks of age is: A. 3.4–9.6 billion cells/L B. 4–11 billion cells/L C. 6–15 billion cells/L D. 9–30 billion cells/L Rationale: Newborns normally have higher WBC counts due to physiologic stress at birth. Adult ranges apply later in life, making the other options incorrect. The normal WBC range for adults is: A. 1–4 billion cells/L B. 6–15 billion cells/L C. 10–30 billion cells/L D. 3.4–9.6 billion cells/L Which list correctly identifies the five types of white blood cells? A. Neutrophils, erythrocytes, platelets, monocytes, lymphocytes B. Basophils, eosinophils, neutrophils, erythrocytes, plasma cells C. Lymphocytes, neutrophils, platelets, monocytes, basophils D. Neutrophils, lymphocytes, monocytes, eosinophils, basophils Rationale: These five cells make up the leukocyte differential. RBCs and platelets are not white blood cells. Which white blood cell is usually the largest in circulation? A. Lymphocyte B. Basophil C. Monocyte Which white blood cell predominates in newborns until approximately 8 years of age? A. Neutrophils B. Monocytes C. Eosinophils A. Greater than 11,000 cells/µL B. Less than 9,000 cells/µL C. Less than 10,000 cells/µL A. Less than 3,000 cells/µL B. Less than 1,000 cells/µL C. Less than 2,000 cells/µL D. Less than 500 cells/µL Rationale: Counts below 500 severely compromise immunity, placing patients at risk for fatal infections. Leukocytosis is commonly seen during pregnancy because of increased: A. Lymphocytes B. Eosinophils C. Monocytes Which white blood cell increases during allergic reactions? A. Neutrophils B. Lymphocytes C. Monocytes Which WBC elevations are associated with infection? A. Viral—neutrophils; bacterial—lymphocytes B. Viral—eosinophils; bacterial—monocytes C. Viral—basophils; bacterial—eosinophils D. Viral—lymphocytes; bacterial—neutrophils A. Prevent bleeding B. Transport carbon dioxide C. Regulate blood pH A. Tertiary protein with one globin chain B. Lipid-based transport molecule C. Binary protein without iron D. Quaternary structure with four globular proteins containing iron Rationale: Hemoglobin consists of two alpha and two beta chains with iron centers for oxygen binding. Erythrocytosis refers to: A. Decreased RBC production B. Increased plasma volume C. Decreased hemoglobin D. Elevated hemoglobin concentration Rationale: Erythrocytosis is an increase in RBC mass or hemoglobin, often due to hypoxia or dehydration. Which condition is NOT a cause of erythrocytosis? A. COPD B. High altitude C. Dehydration D. Iron deficiency anemia Rationale: Iron deficiency causes anemia, not elevated hemoglobin. The other conditions increase RBC production or concentration. Anemia is best defined as: A. Elevated hematocrit B. Increased RBC count C. Normal hemoglobin with low plasma D. Low hemoglobin concentration Rationale: Anemia reflects reduced oxygen-carrying capacity due to low hemoglobin, regardless of cause. Which of the following is a normal hemoglobin range? A. 8.0–10.0 g/dL B. 9.5–12.0 g/dL C. 16.6–20.0 g/dL D. 11.6–16.6 g/dL Rationale: This range represents normal adult hemoglobin. Lower or higher values indicate pathology. Abnormal hemoglobin levels are most concerning because they affect: A. Blood viscosity B. Immune response C. Clotting ability D. Oxygen-carrying capacity Rationale: Hemoglobin’s main role is oxygen delivery; abnormalities impair tissue oxygenation. Hematocrit is best described as: A. Total RBC count B. Hemoglobin concentration C. Plasma protein percentage D. Percentage of packed red blood cells Rationale: Hematocrit reflects the proportion of blood volume occupied by RBCs. The normal hematocrit range is: A. 20–30% B. 25–35% C. 45–60% D. 35.5–48.6% Rationale: Values outside this range indicate anemia or polycythemia. The relationship between hemoglobin and hematocrit is best expressed as: A. Hgb = Hct ÷ 3 B. Hgb = Hct × 2 C. Hct = Hgb ÷ 3 D. Hct ≈ Hgb × 3 Rationale: Hematocrit is approximately three times the hemoglobin value. Loss of plasma volume from the vascular space causes hematocrit to: A. Decrease B. Normalize C. Remain unchanged D. Increase Rationale: Plasma loss concentrates RBCs, falsely elevating hematocrit, as seen in dehydration. Immediately after acute hemorrhage, hematocrit initially: A. Increases B. Decreases sharply C. Reflects anemia D. Remains unchanged Rationale: Both plasma and RBCs are lost equally at first; dilution occurs later when fluid shifts occur. Bone marrow typically requires how long to produce new red blood cells? A. 24 hours B. 3 days C. 14 days D. 7 days Rationale: Erythropoiesis takes about one week under normal conditions. Acute blood loss carries a higher risk of hypovolemic shock because: A. RBCs regenerate slowly B. Plasma loss is permanent C. Platelets decrease immediately D. There is no time for physiologic compensation Rationale: Rapid loss overwhelms compensatory mechanisms, unlike chronic losses. A hematocrit less than 15% is associated with: A. Stroke B. Renal failure C. Respiratory alkalosis D. Cardiac failure Rationale: Extremely low hematocrit severely compromises oxygen delivery, stressing the heart. A hematocrit greater than 60% increases the risk of: A. Hemorrhage B. Infection C. Hypotension D. Spontaneous blood clots Rationale: High hematocrit increases blood viscosity, promoting clot formation. During pregnancy, hematocrit typically: A. Increases steadily B. Remains unchanged C. Peaks in the first trimester D. Decreases in the last trimester due to plasma expansion Rationale: Plasma volume increases more than RBC mass, causing dilutional anemia. Normal platelet count and function are best described as: A. 50–100 billion/L; oxygen transport B. 100–150 billion/L; immunity C. 400–600 billion/L; hormone release D. 135–371 billion/L; prevention of bleeding Rationale: Platelets function in clot formation. Other options list incorrect values or functions. Decreased platelet levels place a patient at risk for: A. Hypertension B. Infection C. Anemia D. Bleeding Rationale: Low platelets impair clot formation, increasing bleeding risk.