Chapter 17: Hematological and Immune Disorders

Chapter 17: Hematological and Immune Disorders

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. Of the four major blood components, plasma

a.	is made up of circulating ions.
b.	comprises about 55% of blood volume.
c.	is transported to the cells by serum proteins.
d.	comprises about 45% of blood volume.

 

 

ANS:   B

Blood has four major components: (1) a fluid component called plasma, (2) circulating solutes such as ions, (3) serum proteins, and (4) cells. Plasma comprises about 55% of blood volume and is the transportation medium for important serum proteins such as albumin, globulin, fibrinogen, prothrombin, and plasminogen. The hematopoietic cells comprise the remaining 45% of blood volume.

 

DIF:    Cognitive Level: Remember/Knowledge                              REF:    p. 441

OBJ:    Explain the normal anatomy and physiology of the hematological and immune systems.    TOP:            Nursing Process Step: Assessment

MSC:   NCLEX Client Needs Category: Physiological Integrity

 

2. Erythrocytes (RBCs) are flexible biconcave disks without nuclei whose primary component is an oxygen-carrying molecule called

a.	erythropoietin.
b.	a reticulocyte.
c.	hemoglobin.
d.	2,3-DPG

 

 

ANS:   C

Erythrocytes (RBCs) are flexible biconcave disks without nuclei whose primary component is an oxygen-carrying molecule called hemoglobin. RBCs are generated from precursor stem cells under the influence of a growth factor called erythropoietin. Erythropoietin is secreted by the kidney in response to a perceived decrease in perfusion or tissue hypoxia. Reticulocytes are immature RBCs that may be released when there is a demand for RBCs that exceeds the number of available mature cells. The oxygen affinity for hemoglobin is modulated primarily by the concentration of 2,3-diphosphoglycerate (2,3-DPG) and depends on the blood pH and body temperature.

 

DIF:    Cognitive Level: Remember/Knowledge                              REF:    p. 441

OBJ:    Explain the normal anatomy and physiology of the hematological and immune systems.    TOP:            Nursing Process Step: Assessment

MSC:   NCLEX Client Needs Category: Physiological Integrity

 

3. Erythrocytes (RBCs) are generated from precursor stem cells under the influence of a growth factor called

a.	reticulocytes.
b.	hemoglobin.
c.	2,3-DPG.
d.	erythropoietin.

 

 

ANS:   D

RBCs are generated from precursor stem cells under the influence of a growth factor called erythropoietin. Erythropoietin is secreted by the kidney in response to a perceived decrease in perfusion or tissue hypoxia. Reticulocytes are immature RBCs that may be released when there is a demand for RBCs that exceeds the number of available mature cells. The RBC transports hemoglobin, whose function is the transport of oxygen and carbon dioxide. Hemoglobin binds with oxygen in the lungs and transports it to the tissues. The oxygen affinity for hemoglobin is modulated primarily by the concentration of 2,3-diphosphoglycerate (2,3-DPG) and depends on the blood pH and body temperature.

 

DIF:    Cognitive Level: Remember/Knowledge                              REF:    p. 441

OBJ:    Explain the normal anatomy and physiology of the hematological and immune systems.    TOP:            Nursing Process Step: Assessment

MSC:   NCLEX Client Needs Category: Physiological Integrity

 

4. The nurse is caring for a patient who has undergone a splenectomy and notices that the patient’s platelet count has increased. The nurse realizes that the increase is due to

a.	platelet response to infection.
b.	stimulation secondary to erythropoietin.
c.	the patient’s inability to store platelets.
d.	the platelet’s 120-day life cycle.

 

 

ANS:   C

Two thirds of the platelets circulate in the blood. The spleen stores the remaining third and may become enlarged if excess or rapid platelet removal occurs. In patients who have had a splenectomy, 100% of the platelets remain in circulation. Platelets are the first responders in the clotting response (not infection), and they form a platelet plug that temporarily repairs an injured vessel. RBCs (not platelets) are generated from precursor stem cells under the influence of a growth factor called erythropoietin. Platelets have a life span of 8 to 12 days, but they may be used more rapidly if there are many vascular injuries or clotting stimuli. Maturation of RBCs takes 4 to 5 days, and their life span is about 120 days.

 

DIF:    Cognitive Level: Understand/Comprehension                      REF:    p. 444

OBJ:    Explain the normal anatomy and physiology of the hematological and immune systems.    TOP:            Nursing Process Step: Assessment

MSC:   NCLEX Client Needs Category: Physiological Integrity