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The nurse is caring for three clients who have the following blood count values: Client A has 24,500/mm?³ white blood cells (WBCs), client B has 13.4 g/dL hemoglobin, and client C has a 250,000/mm?³ platelet count. Which statement correctly describes the condition of each client?
- A. Client A has a normal WBC count, client B has a higher hemoglobin count than normal, and client C has a normal platelet count.
- B. Client A has a higher WBC count than normal, client B has a normal hemoglobin count, and client C has a normal platelet count.
- C. Client A has a higher WBC count than normal, client B has a normal hemoglobin count, and client C has a higher platelet count than normal.
- D. Client A has a lower WBC count than normal, client B has a normal hemoglobin count, and client C has a normal platelet count.
Correct Answer: B
Rationale: The normal leukocyte count is between 5000 and 10,000/mm?³. Client A has an increased number of leukocytes greater than 10,000/mm?³ and hence has leukocytosis. In adults, the normal amount of hemoglobin is 12.0 to 17.4 g/dL; therefore, client B has a normal hemoglobin count. A normal circulating platelet count is 150,000 to 350,000/mm?³ platelets; therefore, client C has a normal platelet count.
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A client is in the hospital with a bleeding gastric ulcer and requires a blood transfusion. He has been typed and crossmatched for 2 units of packed red blood cells and found to have type O blood. What type of blood will the nurse administer to this client?
- A. Type A
- B. Type B
- C. Type AB
- D. Type O
Correct Answer: D
Rationale: Those with type O blood can only receive type O blood. Clients with all other blood types can receive type O blood provided the Rh factor is compatible.
A client is being treated for anemia and has a hemoglobin level of 9.6 g/dL. What does the nurse understand is the basic nutritional component of heme in hemoglobin that the client may be deficient in?
- A. Folic acid
- B. Copper
- C. Protein
- D. Iron
Correct Answer: D
Rationale: Iron is the basic nutritional component of heme in hemoglobin. Folic acid is essential for the maturation of red blood cells. Copper (minute amount) is involved in the transfer of iron from storage to plasma.
A nurse is providing care to a cancer client. Which protein in plasma functions primarily as immunologic agents?
- A. Gamma globulins
- B. Albumin
- C. Fibrinogen
- D. Beta globulins
Correct Answer: A
Rationale: Globulins are divided into three groups: alpha, beta, and gamma. The gamma globulins are also called immunoglobulins. Globulins function primarily as immunologic agents; they prevent or modify some types of infectious diseases. The other options are incorrect.
Albumin is a protein in the plasma portion of the blood. Under normal conditions, albumin cannot pass through the wall of a capillary. What significance is this for the vascular compartment?
- A. Helps push oxygen into the tissues of the body
- B. Retains leukocytes in the vascular compartment
- C. Helps retain fluid in the vascular compartment
- D. Absorbs carbon dioxide from the tissues for transport to the lungs
Correct Answer: C
Rationale: Under normal conditions, albumin cannot pass through a capillary wall. Consequently, albumin helps maintain the osmotic pressure that retains fluid in the vascular compartment. Albumin does not push oxygen into the tissues of the body or absorb carbon dioxide for transport to the lungs. Albumin also does not retain leukocytes in the vascular compartment.
A client is admitted to the emergency department with significant blood loss. The physician prescribes 2 units of packed red blood cells to be transfused immediately. Which blood groups would be compatible with his O Rh-positive blood group?
- A. O Rh-positive or O Rh-negative
- B. Only O Rh-positive
- C. Only O Rh-negative
- D. AB Rh-positive or Rh-negative
Correct Answer: A
Rationale: People with Rh-positive blood can receive Rh-positive or Rh-negative blood because a negative Rh indicates a missing Rh factor. Antibodies, immunoglobulins in plasma that inactivate any substance that is non-self, react with incompatible red blood cell antigens. Therefore, people with type O blood are universal donors because they do not have antigens on the red cell membrane. Therefore, the client can be transfused with either O Rh-positive or O Rh-negative blood.