Chapter_13-_Disorders_of_Red_Blood_Cells My Nursing Test Banks

 

1.

Sue is fatigued and some blood tests are done. Her results include Hct 40%; Hgb 8g/dL; WBC 8,000; platelets 175,000. The nurse should interpret Sues blood work as indicative of:

A)

high platelets/thrombocytosis.

B)

low WBC count/granulocytopenia.

C)

low hemoglobin/anemia.

D)

high hematocrit/polycythemia.

2.

Manifestations of anemia that are directly due to the diminished oxygen-carrying capacity of hemoglobin include:

A)

fatigue.

B)

bleeding.

C)

bone pain.

D)

pale skin.

3.

When an Rh-negative mother has been sensitized and is pregnant with an Rh-positive fetus, what happens to the fetus?

A)

Bilirubin deficiency

B)

Nothing, this is normal

C)

Plasma volume depletion

D)

Profound red cell hemolysis

4.

The patient is an average-sized adult and has abnormal microcytic hypochromic red blood cells due to a long-term, chronic disease. Which of the following CBC results is characteristic of her type of anemia?

A)

Hematocrit 44%

B)

Reticulocytes 1.5%

C)

Band cells 3,000/mL

D)

Hemoglobin 8 g/dL

5.

Megaloblastic anemias caused by folic acid or vitamin B12 deficiencies can seriously affect RBC production. This is because both are necessary for _______ synthesis and _______.

A)

iron; hemoglobin adhesion

B)

DNA; red blood cell maturation

C)

thrombin; platelet aggregation

D)

protein; reticulocyte maturation

6.

Polycythemia develops in patients with lung disease as a result of:

A)

hyperventilation.

B)

chronic hypoxia.

C)

decreased blood viscosity.

D)

excessive respiratory fluid loss.

7.

Which of the following types and characteristics of anemia are correctly matched?

A)

Hemolytic; abnormal iron uptake

B)

Iron deficiency; early RBC death

C)

Folate; decreased erythropoiesis

D)

Blood loss; bone marrow expansion

8.

Conditions that predispose to sickling of hemoglobin in persons with sickle cell anemia include:

A)

impaired red blood cell maturation.

B)

increased iron content of blood.

C)

decreased oxygen saturation.

D)

increased intravascular volume.

9.

An elevated level of unconjugated bilirubin, due to hemolysis of RBCs, results in a high level of iron released and:

A)

diarrhea.

B)

cyanosis.

C)

numbness.

D)

jaundice.

10.

Hemolytic anemia is characterized by excessive red blood cell destruction and compensatory:

A)

hypoactive bone marrow.

B)

increased erythropoiesis.

C)

iron retention in the body.

D)

shrinkage of the spleen.

11.

A 48-year-old male patient, who normally enjoys good health, has been admitted to the hospital for the treatment of polycythemia vera. The nurse who is providing care for the patient should prioritize assessments aimed at the early identification of which of the following health problems?

A)

Orthostatic hypotension

B)

Hyperventilation and respiratory alkalosis

C)

Vasculitis

D)

Thromboembolism

12.

Which of the following patients is most susceptible to experiencing the effects of inadequate erythropoiesis?

A)

A patient who has developed renal failure as a result of longstanding hypertension

B)

A patient who recently experienced an ischemic stroke and who remains bedridden

C)

A patient whose heavy alcohol use has culminated in a diagnosis of pancreatitis

D)

A patient whose estimated blood loss during recent surgery was 700 mL.

13.

A 72-year-old woman with complaints of increasing fatigue has completed a series of fecal occult blood tests that indicate the presence of blood in her stool. Which of the following health problems is likely to accompany this patients gastrointestinal bleed?

A)

Hemolytic anemia

B)

Aplastic anemia

C)

Iron-deficiency anemia

D)

Megaloblastic anemia

14.

Hemoglobin solubility results and hemoglobin electrophoresis have resulted in a diagnosis of sickle cell anemia in an African American infant. The parents of the child should be aware that their child is at a significant risk for which of the following health problems? Select all that apply.

A)

Acute pain

B)

Stroke

C)

Respiratory disease

D)

Autoimmune diseases

E)

Fractures

15.

The pathologic effects of the thalassemias are primarily due to which of the following pathophysiologic processes?

A)

Impaired hemoglobin synthesis

B)

Impaired folic acid absorption

C)

Erythropoietin deficiency

D)

Loss of iron

16.

Which of the following individuals likely faces the highest risk of megaloblastic anemia?

A)

A 69-year-old woman who takes ASA four times daily to treat her arthritis

B)

A 44-year-old man who lost approximately 500 mL of blood in a workplace accident

C)

A 21-year-old college student who lives a vegan lifestyle

D)

An infant who is exclusively fed commercial baby formula

17.

For which of the following health problems is stem cell transplantation likely to be of therapeutic benefit?

A)

Aplastic anemia

B)

b-Thalassemias

C)

Chronic disease anemias

D)

Secondary polycythemia

18.

A 68-year-old patient with an 80 pack/year history of smoking was diagnosed with emphysema 18 months ago. The patients most recent scheduled blood work showed red blood cell indices, a problem that suggests the need for which of the following interventions?

A)

Vitamin B12 supplements

B)

Increased supplementary oxygen therapy

C)

Hemodialysis or peritoneal dialysis

D)

Scheduled erythropoietin injections

19.

Which of the following trends in the hematologic status of a 6-week-old infant most clearly warrants medical intervention?

A)

Decreasing red blood cell counts

B)

Increasing HgA levels

C)

Decreasing hematocrit and mean corpuscular volume (MCV)

D)

Increasing white blood cell counts

20.

A mother has brought her 2-week-old infant to the emergency department due to the babys persistent and increasing jaundice. Blood testing reveals that the infants unconjugated bilirubin level is 28 mg/dL and assessment does not reveal neurologic deficits. The infants weight is normal and the mother claims to have had no significant difficulty feeding the infant. The most likely treatment for this infant will be:

A)

phototherapy.

B)

packed red blood cell transfusion.

C)

phlebotomy.

D)

intravenous antibiotics.

Answer Key

1.

C

2.

A

3.

D

4.

D

5.

B

6.

B

7.

C

8.

C

9.

D

10.

B

11.

D

12.

A

13.

C

14.

A, B, C

15.

A

16.

C

17.

A

18.

B

19.

D

20.

A

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