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ADVANCED PATHOPHYSIOLOGY PRACTICE QUESTIONS AND ANSWERS, Exams of Pathophysiology

London School of Hygiene & Tropical Medicine (LSHTM)Pathophysiology

ADVANCED PATHOPHYSIOLOGY PRACTICE QUESTIONS AND ANSWERS

Typology: Exams

2023/2024

Available from 08/02/2024

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Advanced Pathophysiology Practice Questions /
Immunity / Hematology
Which cells are known as granular lymphocytes?
1. Kupffer cells
2. Microglial cells
3. T cells
4. Natural killer cells -
4. Natural killer cells
1. Kupffer cells found in the liver are examples of macrophages. They are not known as granular
lymphocytes.
2. Microglial cells in the brain are examples of macrophages. They are not referred to as granular
lymphocytes.
3. T cells or T lymphocytes play a vital role in cell-mediated immunity. They are not known as granular
lymphocytes.
4. Natural killer cells act as a first-line of defense in the body and are a part of the innate immune
system. They contain cytoplasmic granules and are referred to as granular lymphocytes.
pg 202
Where does maturation of T lymphocytes occur?
1. Spleen
2. Bone marrow
3. Thymus gland
4. Lymph nodes -
3. Thymus gland
1. The maturation of B lymphocytes occurs in the spleen.
2. B lymphocytes mature in the bone marrow.
3. T lymphocytes mature in the thymus glands.
4. B cells, which are also known as B lymphocytes, mature in lymph nodes.
pg 203
Which is the predominant immunoglobulin produced after a host's re-exposure to an antigen?
1. Immunoglobulin G (IgG)
2. Immunoglobulin A (IgA)
3. Immunoglobulin E (IgE)
4. Immunoglobulin D (IgD) -
1. Immunoglobulin G (IgG)
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Advanced Pathophysiology Practice Questions /

Immunity / Hematology

Which cells are known as granular lymphocytes?

  1. Kupffer cells
  2. Microglial cells
  3. T cells
  4. Natural killer cells -
    1. Natural killer cells
  5. Kupffer cells found in the liver are examples of macrophages. They are not known as granular lymphocytes.
  6. Microglial cells in the brain are examples of macrophages. They are not referred to as granular lymphocytes.
  7. T cells or T lymphocytes play a vital role in cell-mediated immunity. They are not known as granular lymphocytes.
  8. Natural killer cells act as a first-line of defense in the body and are a part of the innate immune system. They contain cytoplasmic granules and are referred to as granular lymphocytes. pg 202 Where does maturation of T lymphocytes occur?
  9. Spleen
  10. Bone marrow
  11. Thymus gland
  12. Lymph nodes -
    1. Thymus gland
  13. The maturation of B lymphocytes occurs in the spleen.
  14. B lymphocytes mature in the bone marrow.
  15. T lymphocytes mature in the thymus glands.
  16. B cells, which are also known as B lymphocytes, mature in lymph nodes. pg 203 Which is the predominant immunoglobulin produced after a host's re-exposure to an antigen?
  17. Immunoglobulin G (IgG)
  18. Immunoglobulin A (IgA)
  19. Immunoglobulin E (IgE)
  20. Immunoglobulin D (IgD) -
    1. Immunoglobulin G (IgG)
  1. Immunoglobulin G is the predominant immunoglobulin produced after a host's re-exposure to an antigen. IgG comprises 75% to 80% of the total serum immunoglobulins.
  2. Immunoglobulin A comprises 7% to 15% of the total serum immunoglobulins. IgA is mainly found in saliva and nasal secretions.
  3. Immunoglobulin E is generally present in a low concentration in the blood, but it increases during allergic reactions.
  4. Immunoglobulin D comprises only 1% of total serum immunoglobulins. pg 204 A 27-year-old client is pregnant. The blood group of the client and the fetus are incompatible. Which antibodies produced by the mother against the fetus's blood cells do not affect the fetus?
  5. IgM
  6. IgG
  7. IgD
  8. none of the above -
    1. IgM
  9. During pregnancy, if the mother and fetus have incompatible blood types, IgM antibodies will be developed by the mother against the fetus's blood cells. However, because of the large size of IgM antibodies, they cannot cross the placenta, and the fetus is protected.
  10. During pregnancy, if the mother and fetus have incompatible blood types, IgM antibodies will be developed by the mother against the fetus's blood cells. The mother will not produce IgG antibodies in the given situation.
  11. During pregnancy, if the mother and fetus have incompatible blood types, IgM antibodies will be developed by the mother against the fetus's blood cells. The mother will not produce IgD antibodies in the given situation.
  12. The option "none of the above" is incorrect because IgM antibodies are developed by the mother against the fetus's blood cells in the given condition. pg 204 Which immunity is developed by an individual after experiencing illness?
  13. Innate immunity
  14. Active acquired adaptive immunity
  15. Passive acquired adaptive immunity
  16. None of the above -
    1. Active acquired adaptive immunity
  17. Innate immunity is the natural mechanism of the body that wards off foreign bodies as a first line of defense. Mucous producing cells are part of the body's innate immunity mechanism.
  18. Active acquired adaptive immunity is obtained through exposure to an antigen. It is developed after an individual experiences an illness.
  19. Passive acquired adaptive immunity is obtained by an individual after he or she is given pre-made, fully formed antibodies, such as vaccines, against an antigen.
  20. The option 'none of the above" is incorrect because the immunity developed by an individual after he or she experiences an illness is active acquired adaptive immunity.
  1. Passive acquired adaptive immunity can be acquired immediately after administration of a vaccine or immunoglobulin.
  2. Passive acquired adaptive immunity is a short-term immunity compared to active acquired adaptive immunity, which is a long-lasting immunity.
  3. In active acquired adaptive immunity, the body recognizes the antigens and remembers the antigen, whereas in passive acquired adaptive immunity, the body does not remember the antigen. It is not associated with immunologic memory.
  4. The answer option "all of the above" is correct because all the answer options are characteristics of passive acquired adaptive immunity. pg 204 A woman who is planning to get pregnant is ordered to obtain an antibody screening test. The test shows negative IgM. What does the test result indicate about the client?
  5. She has been exposed to rubella.
  6. She has developed rubella infection.
  7. She needs to be given the rubella vaccine.
  8. She is immune to rubella. -
    1. She needs to be given the rubella vaccine.
  9. The test result does not indicate that the client has been exposed to rubella. A positive IgM indicates that the client has been exposed to rubella recently.
  10. The test result does not indicate the client has developed rubella infection. A positive IgG indicates that the client has been exposed to rubella in the past and is immune to rubella.
  11. The test result indicates that the client needs to be given the rubella vaccine because the client has never developed immunity to rubella.
  12. The test result does not indicate the client is immune to rubella. pg 206 A client develops an erythematosus rash on the hands two days after working in the garden. What type of hypersensitivity reaction has the client developed?
  13. Type I immediate
  14. Type II cytotoxic
  15. Type III immune complex-mediated
  16. Type IV delayed -
    1. Type IV delayed
  17. Type I immediate hypersensitivity is an allergic reaction that develops on re-exposure to an antigen. The development of allergic rhinitis when an individual is exposed to mold I is an example of type I immediate hypersensitivity.
  18. In type II cytotoxic hypersensitivity, the immunoglobulins target the cells coated with antigens. Phagocytosis and antibody-mediated cell destruction occur in type II hypersensitivity reactions.
  19. Type III immune complex-mediated hypersensitivity occurs when antigen combines with the immunoglobulins in the bloodstream and is deposited in the tissues, resulting in organ dysfunction.

4 .Type IV delayed hypersensitivity is a cell-mediated immune response that takes at least two days to develop after an exposure to an antigen. A delayed hypersensitivity reaction occurs with exposure to poison ivy. The client has developed delayed hypersensitivity. pg 208 A registered nurse is teaching a student nurse about assessing the results of a Mantoux test done on a 15 - year-old client. The results indicate 5 mm tissue induration. Which statement made by the student nurse indicates effective learning?

  1. "The client is has an active case of tuberculosis (TB)."
  2. "The client has had an exposure to TB."
  3. "The client has not had an exposure to TB."
  4. "The client should be given TB vaccine immediately." -
    1. "The client has had an exposure to TB."
  5. If the Mantoux test result indicates an induration reaction of 10 mm or greater, the client might have active TB.
  6. If the Mantoux test result exhibits an induration reaction of 5 mm or fewer, then the client has probably had an exposure to TB in the past.
  7. If the Mantoux test result does not exhibit any swelling or induration reaction, the client has not had TB infection or exposure.
  8. If the Mantoux test result exhibits an induration reaction of 5 mm or fewer, then the client has probably had an exposure to TB in the past. So there is no need for administering TB vaccine to the client. pg 209 A nurse is assessing four clients who are suspected to have systemic lupus erythematosus. Which client has developed the disease? Client 1: Fever, butterfly rash on face, and joint inflammation Client 2: Fever, swollen joints, and general malaise Client 3: Erythema nodosum, weight loss, and fever Client 4: Hypothermia, elevated red blood cell count, and weight gain
  9. Client 1
  10. Client 2
  11. Client 3
  12. Client 4 -
    1. Client 1
  13. Client 1 has developed systemic lupus erythematosus because fever, a butterfly rash on the face, and joint inflammation are signs and symptoms of the disease.
  14. Client 2 has not developed systemic lupus erythematosus. Though fever and swollen joints are symptoms of systemic lupus erythematosus, the presence of a skin rash on the face is also a typical symptom of the disease. The client is at a higher risk of developing osteoporosis, as the symptoms exhibited are typical to that condition.
  1. Methotrexate therapy is an immunosuppressive therapy used in the treatment of rheumatoid arthritis, which is an autoimmune disorder. A white blood cell count below 4,500 cells per microliter indicates immunosuppression. This is a common side effect of the therapy.
  2. Methotrexate therapy is an immunosuppressive therapy. Weight gain might be associated with the therapy. However, weight gain is not a common side effect of the therapy.
  3. A urine specific gravity of 1.030 indicates the normal range. Methotrexate therapy does not alter the urine specific gravity; so any change in urine specific gravity is not a side effect of the therapy.
  4. Methotrexate therapy is an immunosuppressive therapy used to treat autoimmune diseases. Therefore, a low white blood cell count is a side effect of the therapy. Hence, the answer option "all of the above" is incorrect. pg 212 A client with scleroderma complains of painful ulcers on the knees. Which condition has the client?
  5. Telangiectasis
  6. Calcinosis
  7. Sclerodactyly
  8. Raynaud's phenomenon -
    1. Calcinosis
  9. Telangiectasia is a condition characterized by the dilatation of the capillaries. It causes the capillaries to appear as small red clusters, often spidery in appearance on the skin.
  10. Calcinosis is a condition in which an abnormal amount of calcium is found in the soft tissues. Calcinosis develops in the skin and in bony areas. This might cause skin breakdown.
  11. Sclerodactyly is localized thickening and tightening of the skin of the fingers or toes.
  12. Raynaud's phenomenon is reduced blood flow to the fingers and toes, which results in their discoloration. pg 216 A registered nurse is teaching a nursing student about the diagnostic test done for chronic mucocutaneous candidiasis. What statement made by the student nurse indicates effective teaching?
  13. "Potassium hydroxide wet mount is used to diagnose candida infection."
  14. "An antinuclear antibodies test is used to diagnose candida infection."
  15. "A C-reactive protein test is used to diagnose candida infection."
  16. "Urinalysis is used to diagnose candida infection." -
    1. "Potassium hydroxide wet mount is used to diagnose candida infection."
  17. Potassium hydroxide preparation is used to diagnose candida infection. Scrapings from the infected site are suspended in potassium hydroxide and examined microscopically to confirm the diagnosis.
  18. An antinuclear antibodies test is not a diagnostic test for candida infection. An antinuclear antibodies test is used to diagnose autoimmune disorders such as systemic lupus erythematosus.
  19. A C-reactive protein test is not done for confirming candida infection diagnosis. The test is used to detect inflammation in the body.
  20. Urinalysis is not ordered to diagnose candida infection. The test is used to detect a wide range of disorders, such as renal disorders and many other conditions.

pg 218 A nurse is reviewing the prescriptions of four clients. Assess the effects of the medication prescribed and identify the client who is most likely being treated for chronic mucocutaneous candidiasis. Client 1: Ketoconazole Client 2: Codeine Client 3: Amoxicillin Client 4: Acyclovir

  1. Client 1
  2. Client 2
  3. Client 3
  4. Client 4 - Client 1: Ketoconazole
  5. Ketoconazole is an anti-fungal medication used in the treatment of chronic mucocutaneous candidiasis.
  6. Codeine is an opioid analgesic used to relieve mild to moderate pain. It is not used to treat chronic mucocutaneous candidiasis.
  7. Amoxicillin in an antibiotic. It is not used to treat fungal infections.
  8. Acyclovir is an anti-viral medication. It is not used to treat fungal infections. pg 218 A nurse is reviewing the prescriptions of four clients who are being treated for chronic mucocutaneous candidiasis. Compare the effects of the medications and choose the medication that is least effective in treating chronic mucocutaneous candidiasis (CMC). Client 1: Itraconazole Client 2: Amorolfine Client 3: Fluconazole Client 4: Amphotericin B
  9. Client 1
  10. Client 2
  11. Client 3
  12. Client 4 - Client 2: Amorolfine
  13. Client 1 is receiving systemic anti-fungal treatment. Systemic antifungal therapy is the mainstay of CMC therapy. Itraconazole is prescribed for systemic fungal infections.
  14. Client 2 is prescribed a topical anti-fungal agent. The use of topical anti-fungal agents alone is generally ineffective in treating chronic mucocutaneous candidiasis.
  15. Client 3 is receiving systemic antifungal therapy. Systemic antifungal therapy is the mainstay of CMC therapy. Fluconazole is preferred when systemic antifungal treatment is required.
  16. Client 4 is prescribed systemic antifungal therapy. Systemic antifungal therapy is effective in treating chronic mucocutaneous candidiasis. Amphotericin B is used for systemic antifungal infections.
  1. Rheumatoid arthritis
  2. Osteoarthritis is not an autoimmune disease. It occurs because of wear and tear or overuse of joints.
  3. Rheumatoid arthritis is an autoimmune disease. It might occur because of genetic factors, hormonal imbalance, and immunological factors.
  4. Type II diabetes is not an autoimmune disease; type I diabetes is an autoimmune disease.
  5. Osteoarthritis and type II diabetes are not autoimmune diseases. Hence, the answer option "all of the above" is incorrect. pg 214 Which part of the body produces white blood cells?
  6. Tonsils
  7. Adenoids
  8. Thymus gland
  9. Bone marrow -
  10. Bone marrow
  11. White blood cells mature in the tonsils.
  12. White blood cells mature in the adenoids.
  13. White blood cells mature in the thymus gland.
  14. White blood cells are produced in the bone marrow. pg 231 The complete blood count report of a client, the enlarged lymph nodes, and epistaxis indicate that the client has developed acute lymphocytis leukemia. What could be the reason for the occurrence of epistaxis in the client?
  15. Crowding of platelets by blast cells
  16. Invasion of blast cells into the central nervous system
  17. Proliferation of blast cells in the center of the bones
  18. None of the above -
  19. Crowding of platelets by blast cells
  20. The reason for the occurrence of epistaxis is the crowding of platelets by blast cells. This leads to bleeding disorders in the client.
  21. Invasion of blast cells into the central nervous system causes headache.
  22. Proliferation of blast cells in the center of the bones causes bone pain mainly in the sternum, tibia, and femur bones.
  23. The reason for the occurrence of epistaxis is the crowding of platelets by blast cells. pg 240 Which white blood cells are the first responders in defense against antigens?
  24. Basophils
  25. Macrophages
  1. B lymphocytes
  2. T lymphocytes -
    1. Macrophages
  3. Basophils are a type of granulocyte cells which contribute less than 1% of circulating white blood cells.
  4. The first responders in defense against antigens are the macrophages. They function within the innate immune system.
  5. B lymphocytes are a type of lymphoid cells. They are produced in the bone marrow.
  6. T lymphocytes are a type of lymphoid cells. They are produced in the bone marrow. pg 231 On reviewing the blood reports of a client who presents with a fever, the nurse finds that the white blood cell count is 13,000/microliter. What term should the nurse use when documenting this finding?
  7. Leukocytosis
  8. Leukopenia
  9. Neutrophilia
  10. None of the above -
    1. Leukocytosis
  11. Leukocytosis occurs when the number of white blood cells is greater than 11,000/ microliter. Therefore, the client has developed leukocytosis.
  12. Leukopenia occurs when the number of white blood cells decreases below 4,000/ microliter.
  13. Neutrophilia occurs when the number of neutrophils increases above 7,700/microliter and the number of white blood cells is lesser than 11,000/microliter.
  14. The client has developed leukocytosis as the number of white blood cells is above 11,000/ microliter. pg 234 A nurse is reviewing the complete blood count of a client who presents with an infection. It shows that the white blood cell count is 9,000/microliter, neutrophil count is 8,500, leukocyte count is 4,000, eosinophil count is 600/microliter, and basophil is 1%. What should the nurse use when documenting this finding?
  15. Eosinophilia
  16. Neutrophilia
  17. Leukocytosis
  18. None of the above -
    1. Neutrophilia
  19. Eosinophilia is a condition where the number of eosinophils is greater than 600/ microliter in blood.
  20. Neutrophilia occurs when the number of neutrophils increases above 7,700/microliter and the number of white blood cells is fewer than 11,000/microliter. Therefore, the nurse should document that the client has developed neutrophilia.
  21. Leukocytosis is a condition where the number of leukocytes increases above 4,000/microliter.
  22. The client has developed neutrophilia, as the number of neutrophilia is above 7,700/microliter.
  1. A lymphocyte count less than 3,000/ microliter in children is lymphocytopenia.
  2. A lymphocyte count greater than 7,000/ microliter in children is lymphocytosis.
  3. A lymphocyte count less than 3,000/ microliter in children is lymphocytopenia. pg 235 The registered nurse is teaching the student nurse about hematological cancer. Which statement made by the student nurse indicates effective learning?
  4. "Exposure to intense radiation causes cancer."
  5. "Contact with benzene causes cancer."
  6. "Damaged deoxyribonucleic acid causes cancer."
  7. All of the above. -
    1. All of the above.
  8. Exposure to intense radiation causes hematological cancers.
  9. Contact with benzene causes hematological cancers.
  10. Damaged deoxyribonucleic acid causes hematological cancers.
  11. Exposure to intense radiation, contact with benzene, and damaged deoxyribonucleic acid causes hematological cancers. pg 236 Which blood component is developed from megakaryocytes?
  12. Platelets
  13. Red blood cells
  14. White blood cells
  15. None of the above -
    1. Platelets
  16. Megakaryocytes develop into blood platelets.
  17. Erythroblasts develop into red blood cells.
  18. Myeloblasts and monoblasts develop into different types of white blood cells.
  19. Megakaryocytes develop into blood platelets. pg 232 A client comes to the hospital with petechiae. The complete blood count report shows a decrease in the platelet count. What should the nurse include in the plan of care based on the information?
  20. Avoid invasive procedures.
  21. Discourage the use of stool softeners.
  22. Assess the temperature every 6 hours.
  23. Encourage the use of a hard bristle toothbrush. -
    1. Avoid invasive procedures.
  1. Petechiae is the development of small red or purple spots on the skin. Petechiae happen when there is a decrease in the platelet count. The nurse should avoid invasive procedures because a low platelet count increases susceptibility to bleeding.
  2. The nurse should encourage the client to use stool softeners to avoid bleeding while passing stool.
  3. Temperature is not the most important vital sign to monitor in this client.
  4. The nurse should encourage the client to use a soft bristle toothbrush because a low platelet count would cause gingival bleeding. pg 238 A nurse is formulating a nursing diagnosis for a client with chronic lymphoid leukemia. Which nursing measure should be included in the process?
  5. Placing the client in protective isolation
  6. Limiting visitors with cold and infections
  7. Ensuring that all visitors wash their hands before coming in contact with the client
  8. All of the above -
    1. All of the above
  9. Clients with serious blood conditions such as chronic lymphoid leukemia are prone to frequent infections. Therefore, the nurse should place the client in protective isolation to protect him or her from infection.
  10. Clients with serious blood conditions such as chronic lymphoid leukemia are prone to frequent infections. They readily catch cold and infection when they come in contact with persons with cold and infection. Therefore, the nurse should limit visitors with cold and infections.
  11. The nurse should ensure that all visitors meticulously wash their hands before they come in contact with the client with chronic lymphoid leukemia.
  12. The nurse should place the client in protective isolation, limit visitors with cold and infections, and ensure that all visitors wash their hands before coming in contact with the client. pg 238 A nurse is analyzing the report of a 5-year-old client with leukemia, who is receiving chemotherapy. The platelet count is 20,000/microliter. What would be the best intervention for the nurse to include in the client's plan of care?
  13. Monitor the client's vital signs.
  14. Check the temperature every six hours.
  15. Initiate protective isolation precautions.
  16. Use a soft toothbrush for oral care. -
    1. Use a soft toothbrush for oral care.
  17. The nurse should monitor the client's vital signs in order to assess for signs of infection. However, the client has low platelets and this is not the best intervention.
  18. The nurse should check the temperature every 6 hours in order to prevent infection. The client's condition does not indicate any risk of infection.
  19. The nurse should initiate protective isolation precautions in order to prevent infection. The client's condition does not indicate any risk of infection.

A client comes to the hospital with symptoms of an allergic reaction from an antibiotic. Which blood cells would show an increase in the complete blood count report?

  1. Neutrophils
  2. Eosinophils
  3. Basophils
  4. None of the above -
    1. Eosinophils
  5. Neutrophils are the first responders to an infection, stressful event, or inflammatory reactions. Epinephrine and corticosteroids stimulate the generation of neutrophils in the bloodstream.
  6. Eosinophils are generated by the bone marrow and are released during an allergic reaction or a parasitic infection. They include granules that contain enzymes such as histamine, eosinophil peroxidase, ribonuclease, deoxyribonuclease, lipase, and plasminogen.
  7. Basophils make up less than 1% of the WBCs in the bloodstream, but they rise in response to infection.
  8. Eosinophils are generated by the bone marrow and are released during allergic reactions. pg 234 The nurse is reviewing the complete blood count of a client who presents with a fever. It shows that the white blood cell count is 3,000/microliter. What should the nurse use when documenting this finding?
  9. Leukocytosis
  10. Leukopenia
  11. Neutrophilia
  12. None of the above -
    1. Leukopenia
  13. Leukocytosis occurs when the number of white blood cells is greater than 50,000/ microliter.
  14. Leukopenia occurs when the number of white blood cells decreases below 4,000/ microliter. Therefore, the client has developed leukopenia.
  15. Neutrophilia occurs when the number of neutrophils increases above 7,700/microliter and the number of white blood cells is fewer than 11,000/microliter.
  16. The client has developed leucopenia, as the number of white blood cells is below 4,000/microliter. pg 234 An 85-year-old client comes to the hospital and reports severe back pain. The client's blood report shows IgA concentration of 2 grams/deciliter and plasma cells of 8% in the bone marrow. The client does not show symptoms of anemia or hypercalcemia. Based on these findings, what should the nurse suspect?
  17. Multiple myeloma
  18. Monoclonalgammopathy of undetermined significance
  19. Both A and B
  20. None of the above -
    1. Monoclonalgammopathy of undetermined significance
  1. In multiple myeloma, the concentration of monoclonal proteins such as IgA would be greater than 3 gram/deciliter and the plasma cells would be greater than 10% in the bone marrow.
  2. The client has developed monoclonalgammopathy of undetermined significance (MGUS). The monoclonal protein, IgA level less than 3 grams/deciliter and plasma cells less than 10% in the bone marrow are indications of MGUS. Severe back pain is a symptom of MGUS.
  3. The symptoms and given values indicate that the client has developed MGUS.
  4. The client has developed MGUS. pg 246 Which clinical sign signifies leukocytosis?
  5. A white blood count of 3,000/microliter
  6. A white blood count of 52,000/microliter
  7. A decrease in signs and symptoms of infection
  8. Wounds that show no evidence of healing -
    1. A white blood count of 52,000/microliter
  9. A decrease in white blood cell count below 4,000/ microliter is leukopenia.
  10. An increase in white blood cell count in excess of 50,000/microliter is leukocytosis.
  11. Leukopenia decreases the signs of infection and increases the risk of infection.
  12. Leukopenia would decrease the client's healing ability. pg 234 What causes lymphomas?
  13. They develop in the precursor cells of the bone marrow.
  14. They appear like blast cells.
  15. They do not differentiate into mature cells.
  16. They arise from abnormal proliferation of T lymphocytes. -
    1. They arise from abnormal proliferation of T lymphocytes.
  17. Leukemia develops in the precursor cells of the bone marrow.
  18. Leukemia appears like the immature forms of these cells which are called blast cells.
  19. The blasts cells of leukemia continue to proliferate but do not differentiate into mature cells.
  20. Lymphoma cells specifically arise from proliferation of B or T lymphocytes. The tumor mainly begins in the lymph nodes. pg 236 What is the other name for white blood cells?
  21. Leukocytes
  22. Erythrocytes
  23. Thrombocytes
  24. None of the above -
    1. Leukocytes

pg 245 A 50-year-old client worked in the radiation department of a hospital for 6 years. He reports weakness and fatigue. The complete blood report of the client is documented. White blood cells: 25,600 cells/μL Red blood cells: 3.11million cells/μL Hemoglobin: 8.9 grams/dL Platelet: 130,000/μL White blood cell count: 150,000 /μL Blasts: 75% Lymphocytes: 20% Segs: 2% Based on these findings, what condition should the nurse suspect?

  1. Acute lymphocytic leukemia
  2. Chronic lymphocytic leukemia
  3. Acute myelogenous leukemia
  4. Chronic myelogenous leukemia -
    1. Chronic myelogenous leukemia
  5. In acute lymphocytic leukemia, the stem cell precursors for T or B lymphocytes in the bone marrow do not function and do not mature beyond the lymphoblast stage.
  6. In chronic lymphocytic leukemia, the B cells have failed to differentiate from precursor B cells in the bone marrow.
  7. In acute myelogenous leukemia, the number of blood cells produced by the bone marrow decreases. This leads to anemia, bleeding disorders, and development of infections.
  8. The client has developed chronic myelogenous leukemia. Weakness and fatigue are symptoms of this condition. The elevated numbers of white blood cells and blast cells are indications of chronic myelogenous leukemia. pg 249 The complete blood count report of a client with a high fever as a result of infection is documented. Red blood cells: 4.50 million cells/μL White blood cells: 10,000 cells/ μL Neutrophils: 2,500 cells/μL Basophils: 50 cells/μL Eosinophils: 150 cells/μL Platelets: 350,000/ μL Based on these findings, what condition should the nurse suspect?
  9. Neutrophilia
  10. Neutropenia
  11. Leukocytosis
  12. Eosinophilia -
  1. Neutrophilia
  2. The client has developed neutrophilia. The decrease in the number of neutrophils below 7,700/μL and white blood cells less than 11,000/μL is indicative of neutrophilia.
  3. Neutropenia is a condition where the number of neutrophils decreases below 1,500 cells/μL.
  4. Leukocytosis is a condition where there is an increase in the number of blast cells in the bone marrow.
  5. Eosinophilia is a condition where there is abnormal increase in the number of eosinophils. pg 234 A client presents to the hospital with complaints of chest pain. The complete blood count report of the client shows the following. Red blood cells: 3.0 cells x 106 Hemoglobin: 10 g/dL Hematocrit: 35% Mean corpuscular value: 70 Mean corpuscular hemoglobin: 25 Which condition has the client developed?
  6. Folate-deficiency anemia
  7. Vitamin B12 deficiency anemia
  8. Iron-deficiency anemia
  9. None of the above -
  10. Iron-deficiency anemia
  11. Folate-deficiency anemia causes macrocytic or megaloblastic anemia. The complete blood count results show presence of microcytic anemia.
  12. Vitamin B12 deficiency anemia causes macrocytic or megaloblastic anemia. The complete blood count results show presence of microcytic anemia.
  13. The client has developed iron-deficiency anemia. The low mean corpuscular level and mean corpuscular hemoglobin are indications of microcytic anemia. Microcytic anemia occurs due to iron deficiency. Low circulating hemoglobin results in low circulating oxygen and poor tissue perfusion, which in turn would lead to the development of chest pain.
  14. "None of the above" is incorrect; the client has developed iron-deficiency anemia. pg 259 The complete blood count with differential of a client who complains of weakness shows the following. Red blood cells: 3.2 cells x 106 Hemoglobin: 9 g/dL Hematocrit: 35% Mean corpuscular value: 75 Hemoglobin A: 0% Hemoglobin F: 80% Hemoglobin A2: 10%