,NSG 533 Exam 4 | Advanced Pharmacology | Wilkes
University | Q & A | 2026/2027 Edition (PDF)
1. Which of the following best describes the composition of normal adult blood?
A) 4.5–5.5 L total volume, with 40–45% plasma and 55–60% formed elements
B) 5.5 L total volume, with 50–55% plasma and 45–50% formed elements
C) 6.0 L total volume, with 60% plasma and 40% formed elements
D) 5.0 L total volume, with 45% plasma and 55% formed elements
Correct Answer: 5.5 L total volume, with 50–55% plasma and 45–50% formed elements
Expert Rationale: Normal adult blood volume is approximately 5.5 L. Plasma constitutes 50–55% of total
blood volume and is about 90% water. The remaining 45–50% is formed elements (erythrocytes,
leukocytes, and thrombocytes). This distribution is essential for maintaining oncotic pressure, viscosity,
and oxygen-carrying capacity.
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2. What is the primary function of erythropoietin in the regulation of erythropoiesis?
A) Stimulation of platelet production in the bone marrow
B) Stimulation of red blood cell production in the bone marrow
C) Inhibition of leukocyte production during infection
D) Regulation of iron absorption in the gastrointestinal tract
Correct Answer: Stimulation of red blood cell production in the bone marrow
Expert Rationale: Erythropoietin is a glycoprotein hormone produced primarily by the kidneys in
response to hypoxia. It stimulates the bone marrow to increase red blood cell production
(erythropoiesis). This process ensures adequate oxygen delivery to tissues and is the primary regulator
of erythrocyte mass.
,---
3. According to the pathophysiology of anemia, which of the following is the most accurate definition of
this condition?
A) A decrease in circulating white blood cells, as reflected by a reduction in leukocyte count
B) A decrease in circulating red blood cells, as reflected by a reduction in hemoglobin, hematocrit,
and/or RBC count
C) An increase in platelet count leading to hypercoagulability
D) A decrease in plasma volume leading to hemoconcentration
Correct Answer: A decrease in circulating red blood cells, as reflected by a reduction in hemoglobin,
hematocrit, and/or RBC count
Expert Rationale: Anemia is defined as a reduction in the number of circulating red blood cells, which is
reflected by decreased hemoglobin, hematocrit, or red blood cell count. Normal hemoglobin is >13 g/dL
in men and >12 g/dL in women. Anemia impairs oxygen delivery to tissues and can lead to fatigue,
pallor, and organ dysfunction.
---
4. Which type of hemoglobin constitutes approximately 97% of circulating hemoglobin in a healthy
adult?
A) Hemoglobin A (HbA)
B) Hemoglobin A2 (HbA2)
C) Hemoglobin F (HbF)
D) Hemoglobin S (HbS)
Correct Answer: Hemoglobin A (HbA)
Expert Rationale: Hemoglobin A (HbA) is the major adult hemoglobin, comprising about 97% of
circulating hemoglobin. It is composed of two alpha and two beta globin chains. HbA2 (2–3%) consists of
, two alpha and two delta chains, while HbF (fetal hemoglobin) has two alpha and two gamma chains and
is replaced by HbA within six months after birth.
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5. Which hemoglobin type has a greater affinity for oxygen and binds more readily, making it
advantageous for fetal growth and metabolism?
A) Hemoglobin A (HbA)
B) Hemoglobin A2 (HbA2)
C) Hemoglobin F (HbF)
D) Hemoglobin S (HbS)
Correct Answer: Hemoglobin F (HbF)
Expert Rationale: Fetal hemoglobin (HbF) consists of two alpha and two gamma chains and has a greater
affinity for oxygen than adult hemoglobin. This allows the fetus to extract oxygen from maternal
circulation across the placenta. HbF is gradually replaced by HbA within the first six months of life.
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6. A patient is diagnosed with sickle cell disease. Which hemoglobin variant is most likely present in this
patient?
A) Hemoglobin A (HbA)
B) Hemoglobin A2 (HbA2)
C) Hemoglobin F (HbF)
D) Hemoglobin S (HbS)
Correct Answer: Hemoglobin S (HbS)
Expert Rationale: Hemoglobin S (HbS) is the abnormal hemoglobin found in sickle cell disease. It results
from a point mutation in the beta-globin gene, causing valine to replace glutamic acid at position 6. This
University | Q & A | 2026/2027 Edition (PDF)
1. Which of the following best describes the composition of normal adult blood?
A) 4.5–5.5 L total volume, with 40–45% plasma and 55–60% formed elements
B) 5.5 L total volume, with 50–55% plasma and 45–50% formed elements
C) 6.0 L total volume, with 60% plasma and 40% formed elements
D) 5.0 L total volume, with 45% plasma and 55% formed elements
Correct Answer: 5.5 L total volume, with 50–55% plasma and 45–50% formed elements
Expert Rationale: Normal adult blood volume is approximately 5.5 L. Plasma constitutes 50–55% of total
blood volume and is about 90% water. The remaining 45–50% is formed elements (erythrocytes,
leukocytes, and thrombocytes). This distribution is essential for maintaining oncotic pressure, viscosity,
and oxygen-carrying capacity.
---
2. What is the primary function of erythropoietin in the regulation of erythropoiesis?
A) Stimulation of platelet production in the bone marrow
B) Stimulation of red blood cell production in the bone marrow
C) Inhibition of leukocyte production during infection
D) Regulation of iron absorption in the gastrointestinal tract
Correct Answer: Stimulation of red blood cell production in the bone marrow
Expert Rationale: Erythropoietin is a glycoprotein hormone produced primarily by the kidneys in
response to hypoxia. It stimulates the bone marrow to increase red blood cell production
(erythropoiesis). This process ensures adequate oxygen delivery to tissues and is the primary regulator
of erythrocyte mass.
,---
3. According to the pathophysiology of anemia, which of the following is the most accurate definition of
this condition?
A) A decrease in circulating white blood cells, as reflected by a reduction in leukocyte count
B) A decrease in circulating red blood cells, as reflected by a reduction in hemoglobin, hematocrit,
and/or RBC count
C) An increase in platelet count leading to hypercoagulability
D) A decrease in plasma volume leading to hemoconcentration
Correct Answer: A decrease in circulating red blood cells, as reflected by a reduction in hemoglobin,
hematocrit, and/or RBC count
Expert Rationale: Anemia is defined as a reduction in the number of circulating red blood cells, which is
reflected by decreased hemoglobin, hematocrit, or red blood cell count. Normal hemoglobin is >13 g/dL
in men and >12 g/dL in women. Anemia impairs oxygen delivery to tissues and can lead to fatigue,
pallor, and organ dysfunction.
---
4. Which type of hemoglobin constitutes approximately 97% of circulating hemoglobin in a healthy
adult?
A) Hemoglobin A (HbA)
B) Hemoglobin A2 (HbA2)
C) Hemoglobin F (HbF)
D) Hemoglobin S (HbS)
Correct Answer: Hemoglobin A (HbA)
Expert Rationale: Hemoglobin A (HbA) is the major adult hemoglobin, comprising about 97% of
circulating hemoglobin. It is composed of two alpha and two beta globin chains. HbA2 (2–3%) consists of
, two alpha and two delta chains, while HbF (fetal hemoglobin) has two alpha and two gamma chains and
is replaced by HbA within six months after birth.
---
5. Which hemoglobin type has a greater affinity for oxygen and binds more readily, making it
advantageous for fetal growth and metabolism?
A) Hemoglobin A (HbA)
B) Hemoglobin A2 (HbA2)
C) Hemoglobin F (HbF)
D) Hemoglobin S (HbS)
Correct Answer: Hemoglobin F (HbF)
Expert Rationale: Fetal hemoglobin (HbF) consists of two alpha and two gamma chains and has a greater
affinity for oxygen than adult hemoglobin. This allows the fetus to extract oxygen from maternal
circulation across the placenta. HbF is gradually replaced by HbA within the first six months of life.
---
6. A patient is diagnosed with sickle cell disease. Which hemoglobin variant is most likely present in this
patient?
A) Hemoglobin A (HbA)
B) Hemoglobin A2 (HbA2)
C) Hemoglobin F (HbF)
D) Hemoglobin S (HbS)
Correct Answer: Hemoglobin S (HbS)
Expert Rationale: Hemoglobin S (HbS) is the abnormal hemoglobin found in sickle cell disease. It results
from a point mutation in the beta-globin gene, causing valine to replace glutamic acid at position 6. This
