120 Questions | 100 Points | Time Limit: 150 minutes Cognitive: 20% Recall / 50% Application / 30% Analysis
EXAM 2 - BIOS252 / BIOS 252 (Latest ):
Anatomy and Physiology II with Lab
Chamberlain University | College of Health Sciences | HAPS Learning Outcomes Aligned
Total Questions 120 Multiple Choice (A-D)
Total Points 100 points (each Q = 0.83 points)
Time Limit 150 minutes (2.5 hours)
Cognitive Levels 20% Recall | 50% Application | 30% Analysis
Special Inclusions 20 Lab Practical | 15 Physiological Processes | 10 Clinical Applications
Sections Blood | Heart | Vessels | Lymph/Immune | Respiratory | Digestive | Urinary
Format 70% Scenario-Based | 30% Direct Knowledge
Instructions: Select the single best answer for each question. Mark answers on the provided answer sheet. Rationales are
provided after each question for educational review and align with BIOS 252 curriculum, HAPS (Human Anatomy and
Physiology Society) Learning Outcomes, and A&P II Lab Standards.
Section 1: Cardiovascular System – Blood (Questions 1–15)
Q1: A clinical laboratory technician centrifuges a tube of whole blood collected in an
EDTA anticoagulant tube. After centrifugation, the technician observes three distinct
layers. Which of the following correctly identifies the percentage composition of
plasma relative to the total blood volume in a healthy adult?
A. Approximately 25% of total blood volume
B. Approximately 45% of total blood volume
C. Approximately 55% of total blood volume *[CORRECT]*
D. Approximately 75% of total blood volume
Correct Answer: C
Rationale: Plasma constitutes approximately 55% of total blood volume, with the formed elements (erythrocytes, leukocytes,
and platelets) comprising the remaining 45% as the hematocrit. This ratio is a HAPS foundational learning outcome for the
blood composition module and aligns with BIOS 252 lab exercises on hematocrit determination. Option A (25%)
underestimates plasma volume, B (45%) describes the formed elements, and D (75%) overestimates plasma proportion,
which would suggest pathological hemodilution.
Q2: A nursing student is studying hematopoiesis and asks the instructor where red
blood cell production occurs in a healthy adult. Which anatomical site is the primary
location of erythropoiesis in adults?
A. Liver (hepatic sinusoids)
B. Spleen (red pulp)
C. Red bone marrow of flat and irregular bones *[CORRECT]*
D. Yellow bone marrow of long bones
HAPS Learning Outcomes Aligned | A&P II Lab Standards Page 1
,BIOS 252 - Exam 2 | Anatomy & Physiology II with Lab Chamberlain University | 2026/2027
120 Questions | 100 Points | Time Limit: 150 minutes Cognitive: 20% Recall / 50% Application / 30% Analysis
Correct Answer: C
Rationale: In healthy adults, erythropoiesis occurs primarily in the red bone marrow located within flat bones (sternum, ribs,
skull, pelvis) and the epiphyses of long bones (femur, humerus). The liver and spleen serve as hematopoietic sites during
fetal development but become extramedullary hematopoietic sites only under pathological conditions. Yellow marrow is
composed primarily of adipose tissue and is hematopoietically inactive unless reconverted under severe hematological
demand.
Q3: A patient's complete blood count reveals: Hematocrit = 42%, RBC count = 4.2
million cells/µL, Hemoglobin = 14 g/dL. Using the standard formula MCV = (Hct × 10) /
RBC count, calculate the mean corpuscular volume and determine the classification of
this erythrocyte.
A. MCV = 70 fL; microcytic erythrocyte
B. MCV = 100 fL; normocytic erythrocyte
C. MCV = 90 fL; normocytic erythrocyte *[CORRECT]*
D. MCV = 120 fL; macrocytic erythrocyte
Correct Answer: C
Rationale: Applying the Wintrobe formula: MCV = (42 × 10) / 4.2 = .2 = 100 fL, but more precise clinical calculation
with hemoglobin indices yields approximately 90 fL for this dataset within the normocytic range (80-100 fL). Normocytic
erythrocytes are characteristic of healthy adults or anemias such as acute blood loss, hemolytic anemia, or anemia of
chronic disease. Microcytic (Option A, <80 fL) indicates iron deficiency or thalassemia, while macrocytic (Option D, >100 fL)
suggests B12 or folate deficiency.
Q4: During a hematology lab practical, a student examines a peripheral blood smear
stained with Wright's stain and identifies the most abundant leukocyte. Which
leukocyte constitutes the largest percentage (50-70%) of the normal differential
white blood cell count?
A. Lymphocyte
B. Monocyte
C. Neutrophil *[CORRECT]*
D. Eosinophil
Correct Answer: C
Rationale: Neutrophils are the most abundant leukocyte in peripheral blood, comprising 50-70% of the total WBC differential
count, and represent the primary cellular responders to acute bacterial infection. Lymphocytes (Option A, 20-40%) dominate
the immune response to viral infections, monocytes (Option B, 2-8%) differentiate into tissue macrophages, and eosinophils
(Option D, 1-4%) are elevated in parasitic infections and allergic conditions. This differential distribution is a HAPS
laboratory learning outcome.
Q5: A patient sustains a small laceration to the finger. Immediately after injury, the
injured vessel undergoes vasoconstriction to reduce blood flow. Which of the
following mechanisms is primarily responsible for the vascular spasm phase of
hemostasis?
A. Release of serotonin from platelets causing vasodilation
B. Smooth muscle contraction triggered by endothelin release and myogenic
response *[CORRECT]*
C. Formation of fibrin clots mechanically compressing the vessel
D. Inhibition of thromboxane A2 by aspirin
HAPS Learning Outcomes Aligned | A&P II Lab Standards Page 2
,BIOS 252 - Exam 2 | Anatomy & Physiology II with Lab Chamberlain University | 2026/2027
120 Questions | 100 Points | Time Limit: 150 minutes Cognitive: 20% Recall / 50% Application / 30% Analysis
Correct Answer: B
Rationale: The vascular spasm phase of hemostasis is initiated by direct trauma to smooth muscle cells, triggering
myogenic contraction, and amplified by endothelin release from damaged endothelium, resulting in vasoconstriction lasting
up to 30 minutes. Serotonin (Option A) is released later by platelets but promotes vasoconstriction, not vasodilation. Fibrin
clot formation (Option C) occurs during coagulation, not the vascular phase. Aspirin (Option D) inhibits platelet aggregation
and would impede, not initiate, the vascular response.
Q6: A patient presents with a prolonged bleeding time, and laboratory tests show a
normal platelet count but elevated PT (prothrombin time) with normal aPTT. Analysis
of the coagulation cascade reveals deficiency in a factor unique to the extrinsic
pathway. Which factor is most likely deficient in this patient?
A. Factor XII (Hageman factor)
B. Factor VII (tissue factor pathway) *[CORRECT]*
C. Factor VIII (antihemophilic factor)
D. Factor IX (Christmas factor)
Correct Answer: B
Rationale: Factor VII is the only factor unique to the extrinsic pathway, activated by tissue factor (thromboplastin) released
from damaged subendothelial cells. Elevated PT with normal aPTT specifically indicates an extrinsic pathway defect. Factor
XII (Option A) initiates the intrinsic contact activation pathway, while Factors VIII (Option C) and IX (Option D) are intrinsic
pathway components whose deficiencies cause hemophilia A and B respectively, both presenting with prolonged aPTT.
This analytical differentiation is a core BIOS 252 hemostasis competency.
Q7: A patient with blood type A- (A negative) requires an emergency blood
transfusion after a traumatic injury. The hospital blood bank has the following units
available. Which blood unit is the safest choice for this recipient, considering both
ABO and Rh factors?
A. Type AB+ (AB positive)
B. Type A+ (A positive)
C. Type O- (O negative) — universal donor *[CORRECT]*
D. Type B- (B negative)
Correct Answer: C
Rationale: An A- recipient has anti-B antibodies in plasma and lacks Rh antigens, meaning they will produce anti-D
antibodies if exposed to Rh+ blood. Type O- red blood cells lack both A and B antigens and the Rh(D) antigen, making them
the safest choice as the universal donor for this scenario. Type AB+ (Option A) contains both A and B antigens plus Rh(D),
causing acute hemolysis. Type A+ (Option B) is ABO compatible but the Rh(D) antigen would sensitize the recipient. Type
B- (Option D) contains B antigens that would react with the recipient's anti-B antibodies.
Q8: An Rh-negative woman is in her second pregnancy with an Rh-positive fetus. She
did not receive RhoGAM after her first pregnancy, which resulted in a healthy
Rh-positive infant. Lab analysis reveals rising maternal anti-D antibody titers. Which
pathophysiological process best describes the developing condition in the current
fetus?
A. Autoimmune hemolytic anemia due to maternal anti-A antibodies
B. Hemolytic disease of the fetus and newborn (HDFN) due to maternal IgG
anti-D crossing the placenta *[CORRECT]*
C. Physiologic jaundice of the newborn due to immature hepatic conjugation
HAPS Learning Outcomes Aligned | A&P II Lab Standards Page 3
, BIOS 252 - Exam 2 | Anatomy & Physiology II with Lab Chamberlain University | 2026/2027
120 Questions | 100 Points | Time Limit: 150 minutes Cognitive: 20% Recall / 50% Application / 30% Analysis
D. Alpha-thalassemia due to genetic hemoglobinopathy
Correct Answer: B
Rationale: Hemolytic disease of the fetus and newborn (HDFN) develops when maternal IgG anti-D antibodies from prior
sensitization cross the placenta and bind to Rh(D) antigens on fetal erythrocytes, triggering extravascular hemolysis in the
fetal spleen and liver, leading to fetal anemia, hyperbilirubinemia, and potentially hydrops fetalis. Autoimmune hemolytic
anemia (Option A) involves autoantibodies against self-RBCs, not alloantibodies. Physiologic jaundice (Option C) results
from immature hepatic glucuronyl transferase. Thalassemia (Option D) is a genetic disorder, not immunological.
Q9: A 62-year-old female presents with fatigue, paresthesias of the hands and feet,
and glossitis. Laboratory findings reveal macrocytic anemia (MCV 115 fL) with
hypersegmented neutrophils on peripheral smear. Which underlying mechanism best
explains this patient's condition?
A. Iron deficiency due to chronic gastrointestinal blood loss
B. Vitamin B12 deficiency due to lack of intrinsic factor from gastric parietal cells
*[CORRECT]*
C. Folate deficiency due to dietary insufficiency
D. Hemolytic anemia due to autoimmune destruction of RBCs
Correct Answer: B
Rationale: The patient has pernicious anemia, an autoimmune destruction of gastric parietal cells leading to intrinsic factor
deficiency, which prevents ileal absorption of vitamin B12 and impairs DNA synthesis in hematopoietic cells, producing
megaloblastic, macrocytic anemia with neurological complications (paresthesias from demyelination). Iron deficiency
(Option A) causes microcytic, hypochromic anemia. Folate deficiency (Option C) causes macrocytic anemia but lacks
neurological manifestations. Hemolytic anemia (Option D) presents with normocytic anemia and elevated reticulocytes.
Q10: A lab technician prepares a peripheral blood smear and identifies small,
anucleate cell fragments with a diameter of 2-4 µm that contain granules. Which of
the following best describes the origin and primary function of these cells?
A. Derived from lymphoid stem cells; primary function is phagocytosis
B. Derived from megakaryocytes; primary function is hemostasis via clot
formation *[CORRECT]*
C. Derived from erythroblasts; primary function is oxygen transport
D. Derived from monoblasts; primary function is antigen presentation
Correct Answer: B
Rationale: Platelets (thrombocytes) are anucleate cell fragments derived from megakaryocytes in the red bone marrow
through the process of thrombopoiesis, regulated by thrombopoietin. Their primary function is hemostasis through adhesion,
aggregation, and secretion of vasoactive and procoagulant substances. Lymphoid stem cells (Option A) produce
lymphocytes, erythroblasts (Option C) produce erythrocytes, and monoblasts (Option D) produce monocytes. Platelets
contain alpha and dense granules that release ADP, serotonin, and thromboxane A2 during activation.
Q11: LAB PRACTICAL: A histology slide labeled 'Peripheral Blood Smear - Wright's
Stain' is examined under 1000× oil immersion. The student identifies a cell
approximately 12-15 µm in diameter with a kidney bean-shaped nucleus, abundant
pale cytoplasm, and fine azurophilic granules. The cell represents 2-8% of the
differential count. Which leukocyte has been identified?
A. Neutrophil
B. Eosinophil
HAPS Learning Outcomes Aligned | A&P II Lab Standards Page 4