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UT Arlington NURS 5315 - Chapter 28 Exam

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Copyright © 2019, Elsevier Inc. All Rights Reserved. 1Chapter 28: Structure and Function of the Hematologic SystemMcCance/Huether: Pathophysiology: The Biologic Basis of Disease in Adults and Children, 8th EditionMULTIPLE CHOICE 1. What is the most abundant class of plasma protein?a. Globulinb. Albuminc. Clotting factorsd. Complement proteinsANS: BAlbumin (approximately 60% of total plasma protein at a concentration of about 4 g/dL) is the most abundant plasma protein.PTS: 1 DIF: Cognitive Level: Remembering 2. What is the effect of low plasma albumin?a. Clotting factors decrease, thus increasing the chance of prolonged bleeding.b. Fewer immunoglobulins are synthesized, thus impairing the immune function.c. Less iron is stored, thus increasing the incidence of iron deficiency anemia.d. Osmotic pressure decreases; thus water moves from the capillaries to the interstitium.ANS: DIn the case of decreased production (e.g., cirrhosis, other diffuse liver diseases, protein malnutrition) or excessive loss of albumin (e.g., certain kidney diseases, extensive burns), the reduced oncotic pressure leads to excessive movement of fluid and solutes into the tissues and decreased blood volume. Low plasma albumin does not affect clotting factors, immunoglobulins, or iron.PTS: 1 DIF: Cognitive Level: Remembering 3. What is the life span of an erythrocyte (in days)?a. 20 to 30b. 60 to 90c. 100 to 120d. 200 to 240ANS: CBecause it cannot undergo mitotic division, the erythrocyte has a limited life span of up to approximately 120 days.PTS: 1 DIF: Cognitive Level: Remembering 4. What does the student learn about erythrocytes?a. Erythrocytes contain a nucleus, mitochondria, and ribosomes.b. Erythrocytes synthesize proteins.c. Erythrocytes have the ability to change shape to squeeze through microcirculation.d. Erythrocytes are more abundant in women than men.ANS: CReversible deformity enables the erythrocyte to assume a more compact torpedo-like shape, squeeze through the microcirculation, and return to normal. The mature erythrocyte lacks a nucleus and cytoplasmic organelles so it cannot synthesize protein or carry out oxidative reactions. Men have more erythrocytes than women (48% to 42% respectively).PTS: 1 DIF: Cognitive Level: Remembering 5. What are granulocytes that contain granules of vasoactive amines, such as histamine, called?a. Neutrophilsb. Eosinophilsc. Monocytesd. BasophilsANS: DBasophils contain cytoplasmic granules that hold an abundant mixture of biochemical mediators, including histamine, chemotactic factors, proteolytic enzymes, and an anticoagulant (heparin). These substances are not found in neutrophils, monocytes, or eosinophils.PTS: 1 DIF: Cognitive Level: Remembering 6. Which of these are formed elements of the blood that are not cells but are disk-shaped cytoplasmic fragments essential for blood clotting?a. Monocytesb. Plateletsc. Macrophagesd. ErythrocytesANS: BPlatelets (thrombocytes) are not true cells but are disk-shaped cytoplasmic fragments that are essential for blood coagulation and control of bleeding. Monocytes, macrophages, and erythrocytes are cells.PTS: 1 DIF: Cognitive Level: RememberingCopyright © 2019, Elsevier Inc. All Rights Reserved. 2 7. What are blood cells that differentiate into macrophages known as?a. Monocytesb. Neutrophilsc. Eosinophilsd. BasophilsANS: AMonocytes migrate into a variety of tissues and fully mature into tissue macrophages and myeloid dendritic cells. Neutrophils, eosinophils, and basophils do not undergo this transformation.PTS: 1 DIF: Cognitive Level: Remembering 8. Without prior exposure to an antigen, which cells are able to destroy some types of tumor cells and some virus-infected cells?a. Lymphocytesb. Plasma cellsc. Megakaryocytesd. Natural killer (NK) cellsANS: DNK cells, which resemble large granular lymphocytes, kill some types of tumor cells (in vitro) and some virus-infected cells without being induced by previous exposure to these antigens. This capability is not true of lymphocytes, plasma cells, or megakaryocytes.PTS: 1 DIF: Cognitive Level: Remembering 9. What is the life span of platelets (in days)?a. 10b. 30c. 90d. 120ANS: AA platelet circulates for approximately 8 to 11 days and ages. Macrophages of the mononuclear phagocyte system, mostly in the spleen, remove platelets.PTS: 1 DIF: Cognitive Level: Remembering 10. Fetal hematopoiesis occurs primarily in which structure?a. Gutb. Spleenc. Bone marrowd. ThymusANS: BThe spleen is the largest of the secondary lymphoid organs and the primary site of fetal hematopoiesis. The bone marrow and thymus are other primary lymphoid organs. Peyer patches in the small intestine are considered secondary lymphoid organs.PTS: 1 DIF: Cognitive Level: Remembering 11. What is the consequence of a splenectomy?a. The level of iron in circulation increases.b. Antibody production increases to improve immune function.c. The number of defective cells in circulation increases.d. The number of clotting factors increases.ANS: CSplenic absence from any cause (e.g., atrophy, traumatic injury, removal because of disease) has several secondary effects on the body, among them an increase in morphologically defective blood cells in the circulation, confirming the spleen’s role in removing old or damaged cells. Loss of the spleen does not increase iron blood levels, increase antibody production, or increase the number of clotting factors.PTS: 1 DIF: Cognitive Level: Remembering 12. A professor explains to a class that the reason lymph nodes enlarge and become tender during infection is because of what reason?a. B lymphocytes proliferate.b. The nodes are inflamed.c. The nodes fill with purulent exudate.d. The nodes are not properly functioning.ANS: AThe B lymphocyte proliferation in response to significant antigen (e.g., during infection) may result in lymph node enlargement and tenderness (reactive lymph node). The nodes are not specifically inflamed or filled with purulent exudate.PTS: 1 DIF: Cognitive Level: UnderstandingCopyright © 2019, Elsevier Inc. All Rights Reserved. 3 13. Which hemoglobin is made from oxidized ferric iron (Fe3+) and lacks the ability to bind oxygen?a. Deoxyhemoglobinb. Oxyhemoglobinc. Methemoglobind. Glycosylated hemoglobinANS: CWithout reactivation by methemoglobin reductase, the Fe3+-containing hemoglobin (methemoglobin) cannot bind oxygen. Deoxyhemoglobin is hemoglobin available for oxygen binding. Oxyhemoglobin is bound with oxygen.


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