N618 Exam 2
1. Abnormal Blood Test and Anticoagulants:
a. 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? The bottom
layer of blood in the tube accounts for around one third of the total volume.
2. RBC Characteristics:
a. Which of the following statements best conveys a characteristic of red blood cells?
They contribute to the maintenance of blood pH.
b. An example of a single hormone that can exert effects in different tissues,
erythropoietin, made in the kidney stimulates the bone marrow to produce? RBC
c. RBCs are microscopic & have the shape of a flat disk/doughnut, which is round w/an
indentation in the center but isn’t hollow.
d. Do not contain a Nucleus, allows RBCs to change shape and move throughout the body
easier. Do not have organelles, and thrombocytes are just cell fragments.
e. RBCs are erythrocytes, carry oxygen to all cells in the body. Oxygen is carried on a
protein called Hemoglobin. Hemoglobin is what makes blood red.
f. Life span is approximately 120 days. 90% of aged RBCs are phagocytosed in the Bone
Marrow, Spleen, & Liver. To maintain sufficient # of RBC’s, the Bone Marrow continually
releases new RBCs (old/damaged RBCs are removed from circulation).
g. RBCs contributes to CO2 transport for excretion and to regulate Acid-Base Balance.
h. RBCs are formed in the Red Bone Marrow from Hematopoietic Stem Cells in a process
called Erythropoiesis.
3. Hematopoietic Factor Growth Factors: possible
a. A nurse is providing care for several patients on an acute medical unit of a hospital.
Which of the following patients would be most likely to benefit from hematopoietic
growth factors? A 61yo female patient with end-stage renal cancer.
b. Hematopoietic growth factors are commonly used in cases of kidney dx & cancer.
c. In diseases such as polycythemia vera, leukemia, and other blood cancers, inappropriate
production of growth factors does occur.
4. Extremity Capillary Pressure: possible
a. A patient asks the health care provider why his lower legs look purple. The health care
provider will base her response on which pathological principle? The bruising around
the ankles is due to the fact that it is a dependent area where the capillary pressure is
higher.
5. ITP in pediatrics:
a. Following a course of measles, a 5yo girl developed scattered bruising over numerous
body surfaces and was diagnosed with immune thrombocytopenia purpura (ITP). As
part of her diagnostic workup, blood work was performed. Which of the following
results is most likely considered unexpected by the health care team? Increased
thrombopoietin levels (in ITP they are not elevated) Dr. Fletcher says (decrease platelet
count.)
1
, 6. Long term Corticosteroid use: possible
a. A 66yo female patient has presented to the emergency department because of several
months of intermittent bloody stool that has recently become worse. The woman has
since been diagnosed with a gastrointestinal bleed secondary to overuse of
nonsteroidal anti-inflammatory drugs that she takes for her arthritis. The health care
team would realize that which of the following situations is most likely to occur? She
will have iron deficiency anemia due to depletion of iron stores.
b. Long-term corticosteroid use may be associated with more serious sequel, including
osteoporosis, aseptic joint necrosis, adrenal insufficiency, gastrointestinal, hepatic, and
ophthalmologic effects, hyperlipidemia, growth suppression, and possible congenital
malformations.
c. Corticosteroids increase HEMOGLOBIN & RBC content of blood
erythrophagocytosis; This effect is demonstrated by the occurrence of POLYCYTHEMIA
in CUSHING dx and mild normochromic anemia in ADDISON’S dx.
d. Corticosteroids shortening of the clotting time!! Also, causes adrenal insufficiency.
Vascular defects also occur in the course of DIC or as a result of microthrombi and
corticosteroid therapy. (pg. 633, Chp. 22).
7. CBC interpretation. Specifically, Hematocrit: possible
a. A client with a diagnosis of hemolytic anemia has gone to a community-based
laboratory for follow-up blood work. The lab technician confirms with the client that
hematocrit is one of the components of the blood work. The client replies, “I thought
the point of the blood work was to see how many red blood cells I have today.” How
would the technician best respond to the client’s statement? “The hematocrit
measures the mass that your red blood cells account for in a quantity of your blood.”
i. Dr. Fletcher says: “This result will tell your health care provider about the
number of red blood cells in a given quantity of your blood plasma.”
8. Nutritional importance for Newborns: possible.
a. A community health nurse is conducting a class on the nutritional component for new
mothers. Which of the following teaching points would be most justified? “If you
choose to feed your baby with formula, ensure that it is iron fortified.”
9. Iron Deficiency Anemia and Diet: possible.
a. A 22yo female who adheres to a vegan diet has been diagnosed with iron deficiency
anemia. Which of the following components of her diagnostic blood work would be
most likely to necessitate further investigation? Decreased erythropoietin levels.
10. Glycoproteins and treatment of Bone Marrow Failure and Cancers:
a. Which of the following glycoproteins is responsible for treating such diseases as bone
marrow failure following chemotherapy and hematopoietic neoplasms such as
leukemia? Growth factors and Cytokines
11. Mononucleosis and Diagnosis:
a. A 14yo boy has been diagnosed with infectious mononucleosis. Which of the following
pathophysiological phenomena is most responsible for his symptoms? Viruses are
killing some of his B cells and becoming incorporated into the genome of others.
2
1. Abnormal Blood Test and Anticoagulants:
a. 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? The bottom
layer of blood in the tube accounts for around one third of the total volume.
2. RBC Characteristics:
a. Which of the following statements best conveys a characteristic of red blood cells?
They contribute to the maintenance of blood pH.
b. An example of a single hormone that can exert effects in different tissues,
erythropoietin, made in the kidney stimulates the bone marrow to produce? RBC
c. RBCs are microscopic & have the shape of a flat disk/doughnut, which is round w/an
indentation in the center but isn’t hollow.
d. Do not contain a Nucleus, allows RBCs to change shape and move throughout the body
easier. Do not have organelles, and thrombocytes are just cell fragments.
e. RBCs are erythrocytes, carry oxygen to all cells in the body. Oxygen is carried on a
protein called Hemoglobin. Hemoglobin is what makes blood red.
f. Life span is approximately 120 days. 90% of aged RBCs are phagocytosed in the Bone
Marrow, Spleen, & Liver. To maintain sufficient # of RBC’s, the Bone Marrow continually
releases new RBCs (old/damaged RBCs are removed from circulation).
g. RBCs contributes to CO2 transport for excretion and to regulate Acid-Base Balance.
h. RBCs are formed in the Red Bone Marrow from Hematopoietic Stem Cells in a process
called Erythropoiesis.
3. Hematopoietic Factor Growth Factors: possible
a. A nurse is providing care for several patients on an acute medical unit of a hospital.
Which of the following patients would be most likely to benefit from hematopoietic
growth factors? A 61yo female patient with end-stage renal cancer.
b. Hematopoietic growth factors are commonly used in cases of kidney dx & cancer.
c. In diseases such as polycythemia vera, leukemia, and other blood cancers, inappropriate
production of growth factors does occur.
4. Extremity Capillary Pressure: possible
a. A patient asks the health care provider why his lower legs look purple. The health care
provider will base her response on which pathological principle? The bruising around
the ankles is due to the fact that it is a dependent area where the capillary pressure is
higher.
5. ITP in pediatrics:
a. Following a course of measles, a 5yo girl developed scattered bruising over numerous
body surfaces and was diagnosed with immune thrombocytopenia purpura (ITP). As
part of her diagnostic workup, blood work was performed. Which of the following
results is most likely considered unexpected by the health care team? Increased
thrombopoietin levels (in ITP they are not elevated) Dr. Fletcher says (decrease platelet
count.)
1
, 6. Long term Corticosteroid use: possible
a. A 66yo female patient has presented to the emergency department because of several
months of intermittent bloody stool that has recently become worse. The woman has
since been diagnosed with a gastrointestinal bleed secondary to overuse of
nonsteroidal anti-inflammatory drugs that she takes for her arthritis. The health care
team would realize that which of the following situations is most likely to occur? She
will have iron deficiency anemia due to depletion of iron stores.
b. Long-term corticosteroid use may be associated with more serious sequel, including
osteoporosis, aseptic joint necrosis, adrenal insufficiency, gastrointestinal, hepatic, and
ophthalmologic effects, hyperlipidemia, growth suppression, and possible congenital
malformations.
c. Corticosteroids increase HEMOGLOBIN & RBC content of blood
erythrophagocytosis; This effect is demonstrated by the occurrence of POLYCYTHEMIA
in CUSHING dx and mild normochromic anemia in ADDISON’S dx.
d. Corticosteroids shortening of the clotting time!! Also, causes adrenal insufficiency.
Vascular defects also occur in the course of DIC or as a result of microthrombi and
corticosteroid therapy. (pg. 633, Chp. 22).
7. CBC interpretation. Specifically, Hematocrit: possible
a. A client with a diagnosis of hemolytic anemia has gone to a community-based
laboratory for follow-up blood work. The lab technician confirms with the client that
hematocrit is one of the components of the blood work. The client replies, “I thought
the point of the blood work was to see how many red blood cells I have today.” How
would the technician best respond to the client’s statement? “The hematocrit
measures the mass that your red blood cells account for in a quantity of your blood.”
i. Dr. Fletcher says: “This result will tell your health care provider about the
number of red blood cells in a given quantity of your blood plasma.”
8. Nutritional importance for Newborns: possible.
a. A community health nurse is conducting a class on the nutritional component for new
mothers. Which of the following teaching points would be most justified? “If you
choose to feed your baby with formula, ensure that it is iron fortified.”
9. Iron Deficiency Anemia and Diet: possible.
a. A 22yo female who adheres to a vegan diet has been diagnosed with iron deficiency
anemia. Which of the following components of her diagnostic blood work would be
most likely to necessitate further investigation? Decreased erythropoietin levels.
10. Glycoproteins and treatment of Bone Marrow Failure and Cancers:
a. Which of the following glycoproteins is responsible for treating such diseases as bone
marrow failure following chemotherapy and hematopoietic neoplasms such as
leukemia? Growth factors and Cytokines
11. Mononucleosis and Diagnosis:
a. A 14yo boy has been diagnosed with infectious mononucleosis. Which of the following
pathophysiological phenomena is most responsible for his symptoms? Viruses are
killing some of his B cells and becoming incorporated into the genome of others.
2
