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UT Arlington NURS 5315 - Chapter 29 Exam

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Copyright © 2019, Elsevier Inc. All Rights Reserved. 1Chapter 29: Alterations of Erythrocytes, Platelets, and Hemostatic FunctionMcCance/Huether: Pathophysiology: The Biologic Basis of Disease in Adults and Children, 8th EditionMULTIPLE CHOICE 1. What term is used to describe the capacity of some erythrocytes to vary in size, especially in relationship to some anemias?a. Poikilocytosisb. Isocytosisc. Anisocytosisd. MicrocytosisANS: CAnisocytosis means assuming various sizes and is a term used to describe erythrocytes in some anemias. Poikilocytosis is used to describe erythrocytes that can assume various shapes. Isocytosis and microcytosis are not terms that are associated with this condition.PTS: 1 DIF: Cognitive Level: Remembering 2. What is the fundamental physiologic manifestation of anemia?a. Hypotensionb. Hyperesthesiac. Hypoxiad. IschemiaANS: CThe fundamental physiologic manifestation of anemia is a reduced oxygen-carrying capacity of the blood, resulting in tissue hypoxia. Hypotension may result when the initial compensatory mechanism, vasoconstriction, fails to provide adequate perfusion to tissues. Ischemia may result if the oxygen deficit in tissues and organs is severe or prolonged. Hyperesthesia is not a finding.PTS: 1 DIF: Cognitive Level: Remembering 3. The paresthesia that occurs in vitamin B12 deficiency anemia is a result of which of these?a. Reduction in acetylcholine receptors in the postsynaptic nervesb. Myelin degeneration in the spinal cordc. Destruction of myelin in peripheral nervesd. Altered function of neurons in the parietal lobeANS: BEffects on the nervous system can occur if a vitamin B12 deficiency causes anemia. Myelin degeneration may occur with the resultant loss of fibers in the spinal cord, producing paresthesia (numbness), gait disturbances, extreme weakness, spasticity, and reflex abnormalities. The paresthesia is not caused by reduction in acetylcholine receptors, destruction of myelin in peripheral nerves, or altered neuronal function in the parietal lobe.PTS: 1 DIF: Cognitive Level: Remembering 4. Which of these describes how the body compensates for anemia?a. Increasing rate and depth of breathingb. Decreasing capillary vasoconstrictionc. Hemoglobin holding more firmly onto oxygend. Kidneys releasing more erythropoietinANS: ATissue hypoxia from anemia creates additional demands and compensatory actions on the pulmonary and hematologic systems. The rate and depth of breathing increase in an attempt to increase the availability of oxygen. The body does not compensate by decreasing vasoconstriction, tightening the hemoglobin bonds with oxygen, or releasing more erythropoietin.PTS: 1 DIF: Cognitive Level: Remembering 5. Which of these classified as a megaloblastic anemia?a. Iron deficiencyb. Perniciousc. Sideroblasticd. HemolyticANS: BMegaloblastic anemia is characterized by a low red blood cell count and larger-than-normal red blood cells. Pernicious anemia is the most common type of megaloblastic anemia. Iron deficiency is a hypochromic, microcytic anemia meaning the red blood cells are pale and small. The red blood cells in sideroblastic anemia are not abnormally large; they have an abnormal ring of iron around the nucleus of the RBC. Hemolytic anemia is normochromic, normocytic anemia caused by blood loss.PTS: 1 DIF: Cognitive Level: RememberingCopyright © 2019, Elsevier Inc. All Rights Reserved. 2 6. The students learn that deficiencies in folate and vitamin B12 alter the synthesis of which of these?a. RNAb. Cell membranec. DNAd. MitochondriaANS: CDeficiencies in folate and vitamin B12 result in defective erythrocyte precursor DNA synthesis. These deficiencies are not associated with alterations of RNA, cell membranes, or mitochondria.PTS: 1 DIF: Cognitive Level: Remembering 7. A patient has defective secretion of the intrinsic factor leading to anemia. What treatment option does the healthcare professional discuss with the patient?a. Increasing iron sources in the diet such as red meat.b. Vitamin B12 injections initially given once a week.c. Having relatives tested for bone marrow donation.d. Better control of the patient’s underlying disorder.ANS: BIntrinsic factor (IF) is responsible for B12 uptake from the gut. A lack of IF leads to pernicious anemia, which is treated with vitamin B12 injections for the rest of the person’s life. The injections are weekly at first the monthly. Increasing dietary iron would help with iron-deficiency anemia. A bone marrow transplant might be used to treat aplastic anemia. Better control of an underlying medical condition would be important in anemia of chronic disease.PTS: 1 DIF: Cognitive Level: Applying 8. After a person has a subtotal gastrectomy for chronic gastritis, which type of anemia will result?a. Iron deficiencyb. Aplasticc. Folic acidd. PerniciousANS: DA gastrectomy will lead to deficient intrinsic factor which is related to pernicious anemia. The gastrectomy would not lead to iron deficiency, aplastic, or folic acid anemia.PTS: 1 DIF: Cognitive Level: Remembering 9. Which condition resulting from untreated pernicious anemia (PA) is fatal?a. Brain hypoxiab. Liver hypoxiac. Heart failured. Renal failureANS: CUntreated PA is fatal, usually because of heart failure.PTS: 1 DIF: Cognitive Level: Remembering 10. How is the effectiveness of vitamin B12 therapy measured?a. Reticulocyte countb. Serum transferringc. Hemoglobind. Serum vitamin B12ANS: AThe effectiveness of cobalamin replacement therapy is determined by a rising reticulocyte count. The other options are not used as indicators of the effectiveness of vitamin B12 therapyPTS: 1 DIF: Cognitive Level: Remembering 11. A healthcare professional has educated a student on folic acid. Which statement by the student indicates that more teaching is needed?a. Folic acid absorption is dependent on the enzyme folacin.b. Folic acid is stored in the liver.c. Folic acid is essential for RNA and DNA synthesis within erythrocytes.d. Folic acid is absorbed in the upper small intestine.ANS: AFolic acid absorption is not dependent on the enzyme folacin. The professional would need to provide more teaching if the student made this statement. The other options are true statements regarding folic acid.PTS: 1 DIF: Cognitive Level: EvaluatingCopyright © 2019, Elsevier Inc. All Rights Reserved. 3 12. Which anemia produces small, pale erythrocytes?a. Folic acidb. Hemolyticc. Iron deficiencyd. PerniciousANS: CThe


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