Nokea
A nurse is educating a patient about the role of B lymphocytes. The nurses description will include which of the following physiologic processes?
- A. Stem cell differentiation
- B. Cytokine production
- C. Phagocytosis
- D. Antibody production
Correct Answer: D
Rationale: B lymphocytes are capable of differentiating into plasma cells. Plasma cells, in turn, produce antibodies. Cytokines are produced by NK cells. Stem cell differentiation greatly precedes B lymphocyte production.
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A patient with a hematologic disorder asks the nurse how the body forms blood cells. The nurse should describe a process that takes place where?
- A. In the spleen
- B. In the kidneys
- C. In the bone marrow
- D. In the liver
Correct Answer: C
Rationale: Bone marrow is the primary site for hematopoiesis. The liver and spleen may be involved during embryonic development or when marrow is destroyed. The kidneys release erythropoietin, which stimulates the marrow to increase production of red blood cells (RBCs). However, blood cells are not primarily formed in the spleen, kidneys, or liver.
The nurses brief review of a patients electronic health record indicates that the patient regularly undergoes therapeutic phlebotomy. Which of the following rationales for this procedure is most plausible?
- A. The patient may chronically produce excess red blood cells.
- B. The patient may frequently experience a low relative plasma volume.
- C. The patient may have impaired stem cell function.
- D. The patient may previously have undergone bone marrow biopsy.
Correct Answer: A
Rationale: Persistently elevated hematocrit is an indication for therapeutic phlebotomy. It is not used to address excess or deficient plasma volume and is not related to stem cell function. Bone marrow biopsy is not an indication for therapeutic phlebotomy.
The nurse is describing normal RBC physiology to a patient who has a diagnosis of anemia. The nurse should explain that the RBCs consist primarily of which of the following?
- A. Plasminogen
- B. Hemoglobin
- C. Hematocrit
- D. Fibrin
Correct Answer: B
Rationale: Mature erythrocytes consist primarily of hemoglobin, which contains iron and makes up 95% of the cell mass. RBCs are not made of fibrin or plasminogen. Hematocrit is a measure of RBC volume in whole blood.
A patient is being treated in the ICU after a medical error resulted in an acute hemolytic transfusion reaction. What was the etiology of this patients adverse reaction?
- A. Antibodies to donor leukocytes remained in the blood.
- B. The donor blood was incompatible with that of the patient.
- C. The patient had a sensitivity reaction to a plasma protein in the blood.
- D. The blood was infused too quickly and overwhelmed the patients circulatory system.
Correct Answer: B
Rationale: An acute hemolytic reaction occurs when the donor blood is incompatible with that of the recipient. In the case of a febrile nonhemolytic reaction, antibodies to donor leukocytes remain in the unit of blood or blood component. An allergic reaction is a sensitivity reaction to a plasma protein within the blood component. Hypervolemia does not cause an acute hemolytic reaction.
A man suffers a leg wound which causes minor blood loss. As a result of bleeding, the process of primary hemostasis is activated. What occurs in primary hemostasis?
- A. Severed blood vessels constrict.
- B. Thromboplastin is released.
- C. Prothrombin is converted to thrombin.
- D. Fibrin is lysed.
Correct Answer: A
Rationale: Primary hemostasis involves the severed vessel constricting and platelets collecting at the injury site. Secondary hemostasis occurs when thromboplastin is released, prothrombin converts to thrombin, and fibrin is lysed.