What is the average normal pH range of blood?

7.35-7.45

Which of the following is a regulatory function of blood?

maintenance of normal pH in body tissues

Which of the following is a protective function of blood?

prevention of blood loss

Blood is a ________.

suspension

The ______ is the fluid portion of the blood.

plasma

In a centrifuged sample of blood, what makes up the buffy coat?

white blood cells and platelets

Which of the following is NOT a function of blood?

distribution
HORMONE PRODUCTION
protection
regulation

The most abundant plasma protein is ________.

albumin

Which of these is not a normal plasma protein?

fibrinogen
THROMBOPLASTIN
gamma globulin
albumin

Which of the following is true about blood plasma?

It is about 90% water

The main protein in blood plasma is:

albumin

Which plasma constituent is the main contributor to osmotic pressure?

albumin

T OR F: The primary source of RBCs in the adult human being is the bone marrow in the shafts of the long bones.

false

T OR F: Leukemia refers to cancerous conditions of white blood cells.

true

T OR F: The RBC "graveyard" is the liver.

false

T OR F: Hemorrhagic anemias result from blood loss.

true

T OR F: White blood cells are produced through the action of colony-stimulating factors.

true

T OR F: Hemoglobin is made up of the protein heme and the red pigment globin.

false

T OR F: Each heme contains an atom of iron and can transport one molecule of oxygen.

true

T OR F: Each hemoglobin molecule can transport two molecules of oxygen.

false

T OR F: Diapedesis is the process by which red blood cells move into tissue spaces from the interior of blood capillaries.

false

T OR F: Positive chemotaxis is a feedback system that signals leukocyte migration into damaged areas.

true

T OR F: A condition of leukocytosis indicates over 11,000 white blood cells per cubic millimeter in the blood.

true

T OR F: Basophils increase in number when parasitic invasion occurs.

false

T OR F: Leukopenia is an abnormally low number of leukocytes.

true

T OR F: Leukocytes move through the circulatory system by amoeboid motion.

false

T OR F: Granulocytes called neutrophils are phagocytic and are the most numerous of all white blood cell types.

true

T OR F: All lymphocytes are leukocytes, but not all leukocytes are lymphocytes.

true

T OR F: Myelocytic leukemia involves a cancerous condition of lymphocytes.

false

Which of the choices below is the parent cell for all formed elements of blood?

pluripotent stem cell (hemocytoblast)

Which of the following might trigger erythropoiesis?

hypoxia of EPO-producing cells

As red blood cells age ________.

membranes "wear out" and the cells become damaged

James has a hemoglobin measurement of 16 g/100 ml blood. This is ________.

within the normal range

All of the following can be expected with polycythemia except ________.

LOW BLOOD VISCOSITY
high hematocrit
increased blood volume
high blood pressure

No visible cytoplasmic granules are present in ________.

monocytes

Place the following in correct developmental sequence:
1. reticulocyte
2. proerythroblast
3. normoblast
4. late erythroblast

2, 4, 3, 1

A lack of intrinsic factor, leading to a deficiency of vitamin B12 and large pale cells called macrocytes, is characteristic of ________.

pernicious anemia

Which of the following is characteristic of all leukocytes?

they are nucleated

Platelets ________.

stick to the damaged area of a blood vessel and help seal the break

Sickling of red blood cells can be produced in those with sickle-cell anemia by ________.

travel at high altitude and vigorous exercise

Complications of aplastic anemia generally do not include ________.

bleeding disorders
suppressed immunity
impaired formation of all formed elements
INCREASE OF LEUKOCYTES AS A RESULT OF ERYTHROCYTE LOSS

What organ in the body regulates erythrocyte production?

kidney

The formed element ________ can kill parasitic worms.

eosinophils

A(n) ________ is a committed granular leukocyte stem cell that produces neutrophils.

myeloblast

The rarest leukocyte is the ________.

basophil

When monocytes migrate into the interstitial spaces, they are called ________.

macrophages

Destruction of the hematopoietic components of red marrow leads to a condition called ________.

aplastic anemia

________ is the stage of development in the life of an erythrocyte during which the nucleus is ejected.

normoblast

Hemoglobin is composed of ________ polypeptide chains.

4

Which of the following is not a formed element of the blood?

Erythrocytes
Platelets
ANTIBODIES
Leukocytes

Choose the statement that is true concerning hemoglobin.

It is composed of four protein chains and four heme groups.

In adults, red blood cell production occurs in__________.

red bone marrow

Which of the following does not stimulate erythrocyte production?

Erythropoietin
A drop in normal blood oxygen levels
Testosterone
HYPERVENTILATING

Bilirubin is cleared from the body by:

the liver

Which of the following is correctly matched?

Pernicious anemia: results from a vitamin B12 deficiency

An abnormal excess of erythrocytes is called__________.

polycythemia

The most abundant leukocytes are:

neutrophils

You observe a large cell with a "U" shaped nucleus. This cell is most likely a(n):

monocyte

Platelet formation is regulated by:

thrombopoietin

Hemostasis leads to:

stoppage of bleeding

The first step in hemostasis is:

vascular spasm

Which of the formed elements contains hemoglobin and transports respiratory gases?

erythrocytes

Which of the following is NOT a functional characteristic of leukocytes?

diapedesis
LEUKOCYTOSIS
positive chemotaxis
amoeboid motion

Which leukocyte functions in phagocytizing bacteria?

neutrophil

A man of Mediterranean ancestry goes to his doctor with the following symptoms: he is very tired all of the time, and he has difficulty catching his breath after even mild exercise. His doctor orders the following tests: CBC, hematocrit, and differential WBC count. The tests show immature erythrocytes, fragile erythrocytes, and less than 2 million RBCs per cubic millimeter. What would be a tentative diagnosis and suggested treatment?

The diagnosis is thalassemia. The treatment is blood transfusion.

A 68-year-old male is admitted to the hospital for emphysema. He is hypoxic and his lab tests reveal low oxygen levels. His hematocrit is 65%. The physician has told him that he has a type of polycythemia in which he has an increased number of erythrocytes circulating in his bloodstream. The patient tells the nurse that he does not understand what that means. How would the nurse explain this in terms the patient could understand?

You have decreased oxygen levels in your blood, and your body has responded by producing more RBCs, causing a type of polycythemia, the term for excessive RBC production.

An elderly patient tells the nurse that she has been very tired lately and has difficulty walking to her mailbox without getting very short of breath. The nurse notes that her mucous membranes are pale. The patient states that since her husband died three months ago, she has not been eating well. How could you explain the patient's clinical manifestations?

They are attributed to the reduction in the amount of oxygen available to tissues.

A 17-year-old black male is admitted to the hospital in sickle-cell crisis. What is a top priority for patients in sickle-cell crisis?

Pain management. The sickled cells tend to pile up in capillaries and smaller blood vessels, making the blood more viscous. Normal circulation is impaired, causing swelling and severe pain.

A 52-year-old woman was diagnosed with leukemia, and has been receiving chemotherapy as an outpatient. She tells the RN that she hasn't been feeling well. The patient's skin is warm to the touch and she has a low-grade fever of 100.2°F. The neutrophil blood count is less than 1000/µl. Why is the nurse concerned about this patient?

Neutropenia is a concern because of the neutrophil's role in phagocytosis of bacteria. A low-grade fever suggests that the patient has an infection, and in someone who has neutropenia an infection is a major concern for survival.

T OR F: The immediate response to blood vessel injury is clotting.

false

T OR F: The process of fibrinolysis disposes of bacteria when healing has occurred.

false

Which of the following is a pivotal molecule associated with the external surfaces of aggregated platelets and is involved in the intrinsic and extrinsic mechanisms of blood clotting?

PF3

Which of the following is not a phase of hemostasis?

vascular spasm
platelet plug formation
FIBRINOLYSIS
coagulation

The slowest step in the clotting process is ________.

formation of prothrombin activator

Thromboembolic disorders ________.

include embolus formation, a clot moving within the circulatory system

Which of the following is not a cause of bleeding disorders?

excess secretion of platelet-derived growth factor (PDGF)

Which sequence is correct for the following events?
1. fibrinogen → fibrin
2. clot retraction
3. formation of thromboplastin
4. prothrombin → thrombin

3, 4, 1, 2

All of the following conditions impair coagulation except ________.

vitamin K deficiency
VASCULAR SPASM
severe hypocalcemia
liver disease

Which of the following represents a difference between extrinsic and intrinsic blood clotting cascades?

one is faster than the other

The enzyme ______ digests fibrin clots.

plasmin

Which of the following would not lead to a bleeding disorder?

EXCESS CALCIUM IN THE DIET
Impaired liver function
Vitamin K deficiency
Thrombocytopenia

A person who lacks agglutinogens A and B would have blood type:

O

Which of the following scenarios could result in HDN (hemolytic disease of the newborn)?

B- female pregnant with an AB+ baby.

Which of the following is NOT a part of hemostasis?

VASCULAR RELAXATION
vascular spasm
platelet plug formation
coagulation

What protein involved in coagulation provides the scaffolding for tissue repair?

fibrin

What is an embolus?

a blood clot that has broken loose and is floating freely in the blood stream

T OR F: A person with type B blood could receive blood from a person with either type B or type O blood.

true

Which blood type is called the universal donor?

O

Which of the statements below is an incorrect or false statement?

Transfusion of incompatible blood can be fatal.
Unique to the ABO blood group is the presence in the plasma of preformed antibodies.
BLOOD TYPING FOR THE KELL, LEWIS, AND DUFFY FACTORS IS ALWAYS DONE BEFORE A BLOOD TRANSFUSION.
When a transfusion reaction occurs, the oxygen-carrying capacity of the transfused blood cells is disrupted and the clumping of RBCs in small vessels hinders blood flow to tissues beyond those points.

An individual who is blood type AB negative can ________.

receive any blood type in moderate amounts except that with the Rh antigen

When neither anti-A sera nor anti-B sera clot on a blood plate with donor blood, the blood is type ________.

O

Blood volume restorers include all of the following except ________.

dextran
PACKED CELLS
albumin
saline solutions

Fred's blood was determined to be AB positive. What does this mean?

There are no antibodies to A, to B, or to Rh antigens in the plasma.

When can erythroblastosis fetalis not possibly happen in the child of an Rh negative mother?

IF THE FATHER IS Rh-
if the child is Rh+
if the father is Rh+
if the child is type O positive

The universal recipient blood type is ________.

AB

Choose the compatible transfusion.

Donate type O blood to a recipient with type AB blood.

Which of the following does not serve as a site for blood cell production in the developing fetus?

Fetal yolk sac
Liver
Spleen
INTESTINES
Red bone marrow

T OR F: Erythrocytes lack a nucleus.

true

T OR F: All leukocytes are also lymphocytes.

false

Which ABO blood type is considered to be the universal donor?

O

Why would there be cause for concern if a young pregnant mother is Rh-, her husband is Rh+, and this is their second child?

If the second child is Rh+ and the mother did not take RhoGAM, there is a chance that the child will develop erythroblastosis fetalis and die before birth.

A total WBC count and a differential WBC count have been ordered for Mrs. Johnson. What information is obtained from the differential count that the total count does not provide?

The differential count determines the relative proportion of individual leukocyte types. The total WBC count indicates an increase or decrease in number of WBCs.

What three blood tests might be ordered for a patient if anemia is suspected?

Hematocrit, complete blood count, and microscopic study of erythrocytes

A patient complains of no energy, a chronic sore throat, a low-grade fever, and is tired and achy. His doctor notes an enlarged spleen upon examination. What diagnosis would you expect, and what definitive test would you request?

The diagnosis is infectious mononucleosis. The test would be a differential white blood cell count to look for elevated numbers of monocytes and atypical lymphocytes.

The special type of hemoglobin present in fetal red blood cells is ________.

hemoglobin F

Select the correct statement regarding blood cell formation.

Red marrow is the main site of blood cell formation throughout adult life.

T OR F: A person's blood type is genetically determined.

true

Normally, the amount of plasma in whole blood is ________ than the amount of formed elements; plasma makes up approximately ________ percent of whole blood.

greater;55

This component of blood plasma includes molecules that are important for body defense, osmotic balance, and lipid transport.

plasma proteins

The most numerous blood cells are ________.

red blood cells

A normal red blood cell count is ________; of the sexes, ________ generally have greater numbers.

4 to 6 million/mm2 of blood; men

These are the most abundant leukocytes, constituting 40-70% of all white blood cells.

neutrophils

These white blood cells kill parasitic worms and play a complex role in allergic responses and asthma.

eosinophils

This formed element is essential for blood clotting.

platelets

The hematocrit measures ________.

the volume of RBC in a blood sample

From the choices listed here, the most accurate way to assess the oxygen-carrying capacity of the blood is probably to measure the ________.

hemoglobin content

What is true about blood typing?

Type AB blood contains antigens A and B.

The major function of the red blood cells (RBC) is to ________.

transport O2 and CO2

Which of the following white blood cells are granulocytes?

basophils and neutrophils

This cell is the largest white blood cell. It lacks cytoplasmic granules and has a kidney-shaped nucleus.

monocyte

Platelets ________.

are the smallest formed elements of blood

A person who has symptoms of paleness and chronic fatigue is suspected of having anemia. To investigate this suspicion further, it would be most helpful to measure ________.

hematocrit

Leukopenia ________.

may indicate a disease such as cirrhosis of the liver or tuberculosis

A blood test reveals a large increase in the number of RBCs. One possible explanation for this may be ________.

polycythemia

Which test measures hemoglobin concentration in the blood?

hemoglobinometer determination

A patient reports to the doctor that she bruises very easily, and when she cuts herself, she has a hard time stopping the bleeding. What test might a health care provider order to help diagnose this problem?

coagulation time

A person with type AB blood receives a transfusion of type O blood. Will there be a transfusion reaction? Why or why not?

no: the recipient has no antibodies to antigens A and B, and therefore can receive blood from a type O donor

Which of the following compromises a logical sequence of vessels as blood exits the heart?

Arteries, capillaries, veins

After centrifuging, of the listed blood components, which contains the components of immune function?

Buffy coat (white blood cells)

The major function of the most common plasma protein, albumin is _________.

maintenance of plasma osmotic pressure and buffering changes in plasma pH

Red blood cells are efficient oxygen transport cells. Of the following characteristics, which is the major contributer to the significan oxygen-carrying capacity of a red blood cell?

Red blood cells are biconcave discs

Each hemoglobin can transport ___ oxygen atoms.

4

Oxygen binds to the _____ portion of hemoglobin.

iron atom (in heme)

A patient with low iron levels would experience which of the following symptoms?

an increase in fatigue

A hematopoietic stem cell will give rise to _____.

erythrocytes, leukocytes, and platelets

Predict the outcome of an overdose of the hormone erythropoietin.

The blood viscosity increases to levels that may induce heart attacks or strokes.

What response would you expect after traveling to high altitude for two weeks?

THe kidneys would secrete elevated amounts of erythropoietin.

If a patient has pernicious anemia, the inability of the body to absorb vitamin B12, the patient ______.

would have a decreased number of red blood cells

which of the following statements is true regarding the mechanism controlling movement of white blood cells into damaged areas?

White blood cells exit the capillary and move through the tissue spaces with cytoplasmic extensions by following a trail of chemicals produced by other white blood cells.

An elevated neutrophil cound would be indicative of _____.

an acute bacterial infection

Antihistamines counter the actions of which white blood cells?

Basophils

A ____ is the progenitor of platelets.

megakaryocyte

Leukemia is the general descriptor for which of the following disorders?

Overproduction of abnormal leuocytes

An oral heparin medication might be prescribed for a patient who:

is at risk for embolism (clots that spontaneously form and wedge in blood vessels).

Why doesn't a clot fill the entire vasculature system once it has started forming?

Rapid blood flow washes away and dilutes activated clotting factors; Thrombin is inactivated by antithrombin 3 if it enters the general circulation.

Activation of the extrinsic pathway of coagulation requires exposure of the blood to _____.

tissue factor 3

WHy don't platelets form plugs in undamaged vessels?

Only contact of platelets with exposed collagen fibers and von Willebrand factor causes them to be sticky and form plugs.

WHy is it possible for a person whith type A negative blood to have a negative reaction when receiving a transfusion of whole type O negative blood?

The type O blood may have high enough levels of anti-A antibodies that could cross-react with the recipient's cells.

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