NUR 2356 MDC 1 Final Exam 2026 Update |NUR2356 Multidimensional Care 1 Final Exam
Version A & B With Complete 300 Questions And Correct Detailed Answers|Agrade
Question 1
Which of the following physiological conditions is the primary stimulus for the production of red
blood cells (erythropoiesis)?
A) Severe tachycardia
B) Excessive tachypnea
C) Activation of the renin-angiotensin system
D) Tissue hypoxia
E) Elevated serum glucose levels
Correct Answer: D) Hypoxia
Rationale: Erythropoiesis is regulated by the hormone erythropoietin, which is released
primarily by the kidneys in response to low oxygen levels (hypoxia) in the blood. When
tissues do not receive enough oxygen, the body stimulates the bone marrow to produce
more RBCs to increase oxygen-carrying capacity.
Question 2
What are the four main components that constitute the composition of human blood?
A) RBC, WBC, plasma, and glucose
B) RBC, WBC, platelets, and plasma
C) Albumin, protein, RBC, and platelets
D) WBC, lymphocytes, platelets, and hormones
E) Hemoglobin, iron, plasma, and WBC
Correct Answer: B) RBC, WBC, platelets, and plasma
Rationale: Human blood consists of "formed elements" and a liquid matrix. The formed
elements are the erythrocytes (RBCs), leukocytes (WBCs), and thrombocytes (platelets).
The liquid portion is the plasma, which transports nutrients, hormones, and waste
products.
Question 3
Plasma is composed primarily of water. What is the standard percentage breakdown of water
versus solutes in human plasma?
A) 50% water, 50% solutes
B) 75% water, 25% solutes
C) 90% water, 10% solutes
D) 95% water, 5% solutes
E) 80% water, 20% solutes
Correct Answer: C) 90% H2O and 10% solutes
Rationale: Plasma is roughly 90% water. The remaining 10% consists of various solutes
including proteins (albumin, globulins, fibrinogen), glucose, electrolytes, hormones, and
metabolic waste products.
, 2
Question 4
A nurse is preparing an infant for a bone marrow aspiration. Which anatomical site should the
nurse expect the provider to use for this procedure?
A) Iliac crest (pelvis)
B) Scapula
C) Sternum
D) Tibia
E) Clavicle
Correct Answer: D) Tibia
Rationale: In infants, the tibia is the preferred site for bone marrow aspiration because it
contains a high concentration of active red marrow and is easily accessible and safe to
access in this age group.
Question 5
For toddlers and preschoolers, which two anatomical sites are most commonly utilized for bone
marrow aspiration?
A) Ribs and sternum
B) Pelvis and skull
C) Femur and tibia
D) Clavicle and scapula
E) Vertebra and pelvis
Correct Answer: C) femur and tibia
Rationale: As children grow from infancy into the toddler/preschool years, marrow
production is still active in the long bones. The femur and tibia remain the most accessible
and productive sites for diagnostic aspiration.
Question 6
Once a child reaches the age of 5, which site becomes the primary location for bone marrow
aspiration?
A) Tibia
B) Sternum
C) Iliac crest (pelvis)
D) Clavicle
E) Ribs
Correct Answer: C) pelvis (iliac crest)
Rationale: In children over age 5, the iliac crest (pelvis) becomes the standard site for
aspiration. This site provides a larger area of accessible marrow and is the standard site
used through adulthood.
Question 7
In young adults and adults, bone marrow production shifts away from the long bones of the
, 3
extremities. Which of the following is NOT a primary site of marrow production in an adult?
A) Ribs
B) Sternum
C) Distal tibia
D) Vertebra
E) Pelvis
Correct Answer: C) Distal tibia
Rationale: In adults, active red marrow is found primarily in the "axial skeleton" (ribs,
sternum, vertebrae, skull, and pelvis). The marrow in the distal extremities of the long
bones (like the tibia) is replaced by yellow, fatty marrow as an individual matures.
Question 8
How is "Anemia" clinically defined in a pediatric patient?
A) A condition where WBC levels are dangerously low
B) A condition where blood pressure is lower than normal
C) A condition in which levels of RBCs and hemoglobin are lower than normal
D) A condition where blood volume is decreased due to dehydration
E) An inherited disorder of the platelets
Correct Answer: C) a condition in which levels of red blood cells and hemoglobin are lower
than normal
Rationale: Anemia is not a disease itself but a clinical sign of an underlying disorder. It
results in a reduced oxygen-carrying capacity of the blood, which can lead to tissue hypoxia
and various systemic symptoms.
Question 9
Which of the following is NOT one of the four most common types of pediatric anemia
discussed in this course?
A) Iron deficiency anemia
B) Sickle cell anemia
C) Lead poisoning (Anemia of lead toxicity)
D) Beta-Thalassemia
E) Vitamin B12 Pernicious Anemia
Correct Answer: E) Vitamin B12 Pernicious Anemia
Rationale: While pernicious anemia exists, the four primary types emphasized in this
pediatric MDC course are iron deficiency, lead poisoning, sickle cell, and B-thalassemia.
Question 10
"Iron deficiency anemia" is specifically caused by which of the following mechanisms?
A) Excessive destruction of RBCs by the spleen
B) Reduction in iron stores causing inadequate production of hemoglobin
C) A genetic mutation of the hemoglobin molecule
, 4
D) Accumulation of lead in the bone marrow
E) Chronic overhydration diluting the blood
Correct Answer: B) reduction in the iron stores of the body causing an inadequate
production of hemoglobin
Rationale: Iron is the central component of the heme group in hemoglobin. Without
sufficient iron stores, the body cannot manufacture enough hemoglobin to fill RBCs,
resulting in small, pale cells.
Question 11
A child presents with pallor, tachycardia, lethargy, and irritability. Which condition should the
nurse suspect?
A) Polycythemia
B) Iron deficiency anemia
C) Hemophilia A
D) Hypercalcemia
E) Thrombocytopenia
Correct Answer: B) Iron deficiency anemia
Rationale: Pallor (paleness), tachycardia (increased heart rate to compensate for low O2),
tachypnea, lethargy, and irritability are classic clinical manifestations of iron deficiency
anemia.
Question 12
At what age do full-term infants typically begin to deplete the iron stores they received from
their mother in utero?
A) 2 months
B) 4 months
C) 6 months
D) 12 months
E) 18 months
Correct Answer: C) Full term infants have maternal iron stores until approximately 6
months of age
Rationale: During the third trimester, the fetus stores iron from the mother. This "bank" of
iron lasts about 6 months, after which the infant must begin receiving dietary iron (fortified
cereal or formula) to prevent anemia.
Question 13
Why are preterm neonates at a higher risk for iron deficiency anemia than full-term infants?
A) They have an allergic reaction to breast milk
B) They haven't had enough time in utero to store a sufficient iron supply
C) They produce Hemoglobin S instead of Hemoglobin A
D) Their kidneys do not produce erythropoietin
Version A & B With Complete 300 Questions And Correct Detailed Answers|Agrade
Question 1
Which of the following physiological conditions is the primary stimulus for the production of red
blood cells (erythropoiesis)?
A) Severe tachycardia
B) Excessive tachypnea
C) Activation of the renin-angiotensin system
D) Tissue hypoxia
E) Elevated serum glucose levels
Correct Answer: D) Hypoxia
Rationale: Erythropoiesis is regulated by the hormone erythropoietin, which is released
primarily by the kidneys in response to low oxygen levels (hypoxia) in the blood. When
tissues do not receive enough oxygen, the body stimulates the bone marrow to produce
more RBCs to increase oxygen-carrying capacity.
Question 2
What are the four main components that constitute the composition of human blood?
A) RBC, WBC, plasma, and glucose
B) RBC, WBC, platelets, and plasma
C) Albumin, protein, RBC, and platelets
D) WBC, lymphocytes, platelets, and hormones
E) Hemoglobin, iron, plasma, and WBC
Correct Answer: B) RBC, WBC, platelets, and plasma
Rationale: Human blood consists of "formed elements" and a liquid matrix. The formed
elements are the erythrocytes (RBCs), leukocytes (WBCs), and thrombocytes (platelets).
The liquid portion is the plasma, which transports nutrients, hormones, and waste
products.
Question 3
Plasma is composed primarily of water. What is the standard percentage breakdown of water
versus solutes in human plasma?
A) 50% water, 50% solutes
B) 75% water, 25% solutes
C) 90% water, 10% solutes
D) 95% water, 5% solutes
E) 80% water, 20% solutes
Correct Answer: C) 90% H2O and 10% solutes
Rationale: Plasma is roughly 90% water. The remaining 10% consists of various solutes
including proteins (albumin, globulins, fibrinogen), glucose, electrolytes, hormones, and
metabolic waste products.
, 2
Question 4
A nurse is preparing an infant for a bone marrow aspiration. Which anatomical site should the
nurse expect the provider to use for this procedure?
A) Iliac crest (pelvis)
B) Scapula
C) Sternum
D) Tibia
E) Clavicle
Correct Answer: D) Tibia
Rationale: In infants, the tibia is the preferred site for bone marrow aspiration because it
contains a high concentration of active red marrow and is easily accessible and safe to
access in this age group.
Question 5
For toddlers and preschoolers, which two anatomical sites are most commonly utilized for bone
marrow aspiration?
A) Ribs and sternum
B) Pelvis and skull
C) Femur and tibia
D) Clavicle and scapula
E) Vertebra and pelvis
Correct Answer: C) femur and tibia
Rationale: As children grow from infancy into the toddler/preschool years, marrow
production is still active in the long bones. The femur and tibia remain the most accessible
and productive sites for diagnostic aspiration.
Question 6
Once a child reaches the age of 5, which site becomes the primary location for bone marrow
aspiration?
A) Tibia
B) Sternum
C) Iliac crest (pelvis)
D) Clavicle
E) Ribs
Correct Answer: C) pelvis (iliac crest)
Rationale: In children over age 5, the iliac crest (pelvis) becomes the standard site for
aspiration. This site provides a larger area of accessible marrow and is the standard site
used through adulthood.
Question 7
In young adults and adults, bone marrow production shifts away from the long bones of the
, 3
extremities. Which of the following is NOT a primary site of marrow production in an adult?
A) Ribs
B) Sternum
C) Distal tibia
D) Vertebra
E) Pelvis
Correct Answer: C) Distal tibia
Rationale: In adults, active red marrow is found primarily in the "axial skeleton" (ribs,
sternum, vertebrae, skull, and pelvis). The marrow in the distal extremities of the long
bones (like the tibia) is replaced by yellow, fatty marrow as an individual matures.
Question 8
How is "Anemia" clinically defined in a pediatric patient?
A) A condition where WBC levels are dangerously low
B) A condition where blood pressure is lower than normal
C) A condition in which levels of RBCs and hemoglobin are lower than normal
D) A condition where blood volume is decreased due to dehydration
E) An inherited disorder of the platelets
Correct Answer: C) a condition in which levels of red blood cells and hemoglobin are lower
than normal
Rationale: Anemia is not a disease itself but a clinical sign of an underlying disorder. It
results in a reduced oxygen-carrying capacity of the blood, which can lead to tissue hypoxia
and various systemic symptoms.
Question 9
Which of the following is NOT one of the four most common types of pediatric anemia
discussed in this course?
A) Iron deficiency anemia
B) Sickle cell anemia
C) Lead poisoning (Anemia of lead toxicity)
D) Beta-Thalassemia
E) Vitamin B12 Pernicious Anemia
Correct Answer: E) Vitamin B12 Pernicious Anemia
Rationale: While pernicious anemia exists, the four primary types emphasized in this
pediatric MDC course are iron deficiency, lead poisoning, sickle cell, and B-thalassemia.
Question 10
"Iron deficiency anemia" is specifically caused by which of the following mechanisms?
A) Excessive destruction of RBCs by the spleen
B) Reduction in iron stores causing inadequate production of hemoglobin
C) A genetic mutation of the hemoglobin molecule
, 4
D) Accumulation of lead in the bone marrow
E) Chronic overhydration diluting the blood
Correct Answer: B) reduction in the iron stores of the body causing an inadequate
production of hemoglobin
Rationale: Iron is the central component of the heme group in hemoglobin. Without
sufficient iron stores, the body cannot manufacture enough hemoglobin to fill RBCs,
resulting in small, pale cells.
Question 11
A child presents with pallor, tachycardia, lethargy, and irritability. Which condition should the
nurse suspect?
A) Polycythemia
B) Iron deficiency anemia
C) Hemophilia A
D) Hypercalcemia
E) Thrombocytopenia
Correct Answer: B) Iron deficiency anemia
Rationale: Pallor (paleness), tachycardia (increased heart rate to compensate for low O2),
tachypnea, lethargy, and irritability are classic clinical manifestations of iron deficiency
anemia.
Question 12
At what age do full-term infants typically begin to deplete the iron stores they received from
their mother in utero?
A) 2 months
B) 4 months
C) 6 months
D) 12 months
E) 18 months
Correct Answer: C) Full term infants have maternal iron stores until approximately 6
months of age
Rationale: During the third trimester, the fetus stores iron from the mother. This "bank" of
iron lasts about 6 months, after which the infant must begin receiving dietary iron (fortified
cereal or formula) to prevent anemia.
Question 13
Why are preterm neonates at a higher risk for iron deficiency anemia than full-term infants?
A) They have an allergic reaction to breast milk
B) They haven't had enough time in utero to store a sufficient iron supply
C) They produce Hemoglobin S instead of Hemoglobin A
D) Their kidneys do not produce erythropoietin
