STUDY GUIDE TEST 2
NU618
1.Anticoagulant therapy
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?
A) The bottom layer of blood in the tube accounts for around one third of the total volume.
B) The middle layer of cells appears white to gray in color.
C) The top layer of cells is too thin to visualize without microscopy.
D) The yellowish fluid on the top of the sample appears to constitute around one half of the total
volume.
Ans: A
Feedback:
The body layer of cells in a centrifuged blood sample consists of erythrocytes and should constitute
around 42% to 47% of the total blood volume. The middle cell layer of leukocytes should appear
whitish gray, and the thrombocytes above that layer are frequently not discernable. The plasma layer
should account for around 55% of the total blood volume.
A medical student is working with a 61-year-old male client in the hospital who has presented with a
new onset of atrial fibrillation. Which of the following courses of treatment will the student most
likely expect the attending physician to initiate?
A) Immediate cardioversion followed by surgery to correct the atrial defect B) Anticoagulants and
beta-blockers to control rate
C) Antihypertensives and constant cardiac monitoring in a high acuity unit D) Diuretics, total bed
rest, and cardioversion if necessary
Ans: B
Feedback:
Atrial fibrillation is most often treated with anticoagulants to prevent embolic events as well as beta-
blockers and digoxin. Cardioversion would not be a first-line intervention, and antihypertensives and
diuretics would be unlikely treatments of choice.
2.Neurohormonal response to congestive heart failure (CHF)
Which of the following statements about mesangial cells within the glomerulus is accurate? Select
all that apply. Mesangial cells
A) cover the entire amount of endothelial cells contained within the capillaries.
B) have phagocytic properties that remove macromolecular materials.
C) exhibit vasodilator properties to assist with increase in blood flow in times of stress. D) enlarge
(hyperplasia) in response to glomerular diseases.
E) are coiled and drain Bowman capsule.
Ans: B, D
Feedback:
Mesangial cells possess phagocytic properties and remove macromolecular materials that enter the
intercapillary spaces. Mesangial cells also exhibit contractile properties in response to
neurohumoral substances and are thought to contribute to the regulation of blood flow through the
glomerulus. Mesangial hyperplasia and increased mesangial matrix occur in a number of glomerular
diseases. The nephron tubule, called the proximal convoluted tubule, is coiled and drains the
Bowman capsule
, 3.Atherosclerotic process
A patient is reading a brochure on atherosclerosis while in the waiting room of medical clinic. Which
of the following excerpts from the educational brochure warrants correction?
A) “Because smoking causes a permanent increase in your risk of heart disease, it's best not to
start.”
B) “All things being equal, men have a higher risk of coronary heart disease than perimenopausal
women.”
C) “High blood pressure often accompanies, or even causes, clogging of the arteries.”
D) “Every bit that you can lower your cholesterol means that you'll have a lower risk of developing
heart disease.”
Ans: A
Feedback:
Cessation of smoking is associated with a decrease in the risk of CHD. Males have an increased risk
of atherosclerosis. Atherosclerosis is often associated with hypertension. Lowering cholesterol
levels brings a commensurate reduction in risk of CHD.
4. Oxy-hemoglobin dissociation curve
A nurse in a respiratory unit of a hospital is providing care for a client with end- stage lung disease.
Consequently, measurement of the client's arterial blood gases indicates increased PCO2. Which of
the following associated consequences would the nurse anticipate?
A) A shift to the left of the oxygen–hemoglobin dissociation curve B) Lower than normal production
of HCO3
C) Higher than normal production of H+
D) An absence of carbaminohemoglobin
Ans: C
Feedback:
As a result of the combination of water and carbon dioxide, hydrogen ions are produced along with
bicarbonate. This would be associated with a shift to the right of the oxygen–hemoglobin
dissociation curve, increased bicarbonate output, and higher than normal levels of
carbaminohemoglobin.
5. Relationship of pH,Pco2, HCO3, in metabolic or respiratory acidosis
Which of the following situations is most likely to result in an increased binding affinity of
hemoglobin for oxygen?
A) A client is in respiratory acidosis, with a low pH.
B) Three of four binding sites on a client's hemoglobin molecule are occupied by oxygen.
C) A client's body temperature is elevated as a result of an infectious process. D) An increase in 2,3-
diphosphoglycerate enhances the loading of oxygen.
Ans: B
Feedback:
As each binding site on a hemoglobin molecule is occupied, the affinity of the remaining sites for
oxygen binding is increased. Increased affinity is associated with alkalosis, not acidosis, and fever
causes reduced affinity. Exercise increases the unloading of oxygen, a situation characterized by low
affinity.
6.Anti-hypertensive and diuretics in patients with normal and compromised renal function
7. Angiotensin-renin-aldosterone relationships
Which of the following individuals is most likely to be experiencing vasodilation?
NU618
1.Anticoagulant therapy
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?
A) The bottom layer of blood in the tube accounts for around one third of the total volume.
B) The middle layer of cells appears white to gray in color.
C) The top layer of cells is too thin to visualize without microscopy.
D) The yellowish fluid on the top of the sample appears to constitute around one half of the total
volume.
Ans: A
Feedback:
The body layer of cells in a centrifuged blood sample consists of erythrocytes and should constitute
around 42% to 47% of the total blood volume. The middle cell layer of leukocytes should appear
whitish gray, and the thrombocytes above that layer are frequently not discernable. The plasma layer
should account for around 55% of the total blood volume.
A medical student is working with a 61-year-old male client in the hospital who has presented with a
new onset of atrial fibrillation. Which of the following courses of treatment will the student most
likely expect the attending physician to initiate?
A) Immediate cardioversion followed by surgery to correct the atrial defect B) Anticoagulants and
beta-blockers to control rate
C) Antihypertensives and constant cardiac monitoring in a high acuity unit D) Diuretics, total bed
rest, and cardioversion if necessary
Ans: B
Feedback:
Atrial fibrillation is most often treated with anticoagulants to prevent embolic events as well as beta-
blockers and digoxin. Cardioversion would not be a first-line intervention, and antihypertensives and
diuretics would be unlikely treatments of choice.
2.Neurohormonal response to congestive heart failure (CHF)
Which of the following statements about mesangial cells within the glomerulus is accurate? Select
all that apply. Mesangial cells
A) cover the entire amount of endothelial cells contained within the capillaries.
B) have phagocytic properties that remove macromolecular materials.
C) exhibit vasodilator properties to assist with increase in blood flow in times of stress. D) enlarge
(hyperplasia) in response to glomerular diseases.
E) are coiled and drain Bowman capsule.
Ans: B, D
Feedback:
Mesangial cells possess phagocytic properties and remove macromolecular materials that enter the
intercapillary spaces. Mesangial cells also exhibit contractile properties in response to
neurohumoral substances and are thought to contribute to the regulation of blood flow through the
glomerulus. Mesangial hyperplasia and increased mesangial matrix occur in a number of glomerular
diseases. The nephron tubule, called the proximal convoluted tubule, is coiled and drains the
Bowman capsule
, 3.Atherosclerotic process
A patient is reading a brochure on atherosclerosis while in the waiting room of medical clinic. Which
of the following excerpts from the educational brochure warrants correction?
A) “Because smoking causes a permanent increase in your risk of heart disease, it's best not to
start.”
B) “All things being equal, men have a higher risk of coronary heart disease than perimenopausal
women.”
C) “High blood pressure often accompanies, or even causes, clogging of the arteries.”
D) “Every bit that you can lower your cholesterol means that you'll have a lower risk of developing
heart disease.”
Ans: A
Feedback:
Cessation of smoking is associated with a decrease in the risk of CHD. Males have an increased risk
of atherosclerosis. Atherosclerosis is often associated with hypertension. Lowering cholesterol
levels brings a commensurate reduction in risk of CHD.
4. Oxy-hemoglobin dissociation curve
A nurse in a respiratory unit of a hospital is providing care for a client with end- stage lung disease.
Consequently, measurement of the client's arterial blood gases indicates increased PCO2. Which of
the following associated consequences would the nurse anticipate?
A) A shift to the left of the oxygen–hemoglobin dissociation curve B) Lower than normal production
of HCO3
C) Higher than normal production of H+
D) An absence of carbaminohemoglobin
Ans: C
Feedback:
As a result of the combination of water and carbon dioxide, hydrogen ions are produced along with
bicarbonate. This would be associated with a shift to the right of the oxygen–hemoglobin
dissociation curve, increased bicarbonate output, and higher than normal levels of
carbaminohemoglobin.
5. Relationship of pH,Pco2, HCO3, in metabolic or respiratory acidosis
Which of the following situations is most likely to result in an increased binding affinity of
hemoglobin for oxygen?
A) A client is in respiratory acidosis, with a low pH.
B) Three of four binding sites on a client's hemoglobin molecule are occupied by oxygen.
C) A client's body temperature is elevated as a result of an infectious process. D) An increase in 2,3-
diphosphoglycerate enhances the loading of oxygen.
Ans: B
Feedback:
As each binding site on a hemoglobin molecule is occupied, the affinity of the remaining sites for
oxygen binding is increased. Increased affinity is associated with alkalosis, not acidosis, and fever
causes reduced affinity. Exercise increases the unloading of oxygen, a situation characterized by low
affinity.
6.Anti-hypertensive and diuretics in patients with normal and compromised renal function
7. Angiotensin-renin-aldosterone relationships
Which of the following individuals is most likely to be experiencing vasodilation?
