NURS 8022 – Exam 2 (2025/2026) – with
Complete Questions and Answers
1. A 70-year-old patient with chronic kidney disease (CKD) has worsening anemia.
Which physiologic process is most directly impaired?
a) Conversion of yellow marrow to red marrow
b) Differentiation of progenitor cells in the spleen
c) Fetal liver erythropoiesis
d) Mitosis of stem cells in the thymus
Answer: a) Conversion of yellow marrow to red marrow
Rationale: Erythropoietin (EPO), produced by the kidneys, stimulates conversion
of yellow marrow to red marrow. In CKD, EPO is deficient, reducing this
conversion and causing anemia.
2. Which site is NOT typically an active bone marrow site in a healthy adult?
a) Vertebrae
b) Distal femur
c) Sternum
d) Pelvic bones
Answer: b) Distal femur
Rationale: Active marrow in adults is found in axial skeleton (pelvis, vertebrae,
sternum, ribs, skull, proximal humerus/femur). Distal femur is usually yellow
marrow.
3. During fetal development, hematopoiesis occurs primarily in the:
a) Bone marrow and lymph nodes
b) Liver and spleen
c) Thymus and kidneys
d) Lungs and pancreas
Answer: b) Liver and spleen
Rationale: Fetal hematopoiesis occurs in liver/spleen before bone marrow takes
over after birth.
,4. A patient with severe hypoxia has a rapid increase in RBC production. Which of
the following mechanisms is the primary driver?
a) Increased differentiation of megakaryocytes
b) Faster proliferation of stem cells into progenitor cells
c) Decreased apoptosis of neutrophils
d) Conversion of red marrow to yellow marrow
Answer: b) Faster proliferation of stem cells into progenitor cells
Rationale: Hypoxia → EPO release → faster proliferation and differentiation of
stem cells, plus conversion of yellow to red marrow.
5. Which statement best distinguishes red marrow from yellow marrow?
a) Red marrow produces platelets; yellow marrow produces RBCs
b) Red marrow produces RBCs; yellow marrow does not
c) Yellow marrow is found only in children
d) Yellow marrow is the primary site of erythropoietin production
Answer: b) Red marrow produces RBCs; yellow marrow does not
Rationale: Red marrow is hematopoietic; yellow marrow is mostly fat and non-
hematopoietic.
6. A researcher is studying factors that increase hematopoiesis. Which of the
following would they observe?
a) Conversion of red marrow to yellow marrow
b) Slower differentiation of progenitor cells
c) Faster proliferation of stem cells into progenitor cells
d) Decreased EPO levels
Answer: c) Faster proliferation of stem cells into progenitor cells
Rationale: Increased hematopoiesis involves faster proliferation, faster
differentiation, and conversion of yellow → red marrow.
7. Which bone is a site of active red marrow in a healthy 30-year-old?
a) Distal radius
b) Cranium
c) Phalanges
d) Tibial shaft
Answer: b) Cranium
Rationale: Active sites include cranium, vertebrae, pelvis, sternum, ribs, proximal
humerus/femur.
, 8. A patient with anemia fails to convert yellow marrow to red marrow. Which
hormone is most likely deficient?
a) Thrombopoietin
b) Erythropoietin
c) Cortisol
d) Insulin-like growth factor
Answer: b) Erythropoietin
Rationale: EPO drives conversion of yellow to red marrow.
9. In a fetus at 24 weeks gestation, where are hematopoietic stem cells primarily
located?
a) Bone marrow
b) Liver
c) Thymus
d) Kidneys
Answer: b) Liver
Rationale: Fetal liver is a major hematopoietic site before marrow takes over.
10. Which of the following would NOT increase hematopoiesis?
a) Hypoxia
b) EPO administration
c) Bone marrow fibrosis
d) Conversion of yellow to red marrow
Answer: c) Bone marrow fibrosis
Rationale: Fibrosis replaces functional marrow, reducing hematopoiesis.
11. A patient has a fractured sternum. Which marrow type is most likely present at
that site?
a) Yellow marrow
b) Red marrow
c) Gelatinous marrow
d) White marrow
Answer: b) Red marrow
Rationale: Sternum is an active red marrow site in adults.
12. The two stages of hematopoiesis are:
a) Mitosis and meiosis
Complete Questions and Answers
1. A 70-year-old patient with chronic kidney disease (CKD) has worsening anemia.
Which physiologic process is most directly impaired?
a) Conversion of yellow marrow to red marrow
b) Differentiation of progenitor cells in the spleen
c) Fetal liver erythropoiesis
d) Mitosis of stem cells in the thymus
Answer: a) Conversion of yellow marrow to red marrow
Rationale: Erythropoietin (EPO), produced by the kidneys, stimulates conversion
of yellow marrow to red marrow. In CKD, EPO is deficient, reducing this
conversion and causing anemia.
2. Which site is NOT typically an active bone marrow site in a healthy adult?
a) Vertebrae
b) Distal femur
c) Sternum
d) Pelvic bones
Answer: b) Distal femur
Rationale: Active marrow in adults is found in axial skeleton (pelvis, vertebrae,
sternum, ribs, skull, proximal humerus/femur). Distal femur is usually yellow
marrow.
3. During fetal development, hematopoiesis occurs primarily in the:
a) Bone marrow and lymph nodes
b) Liver and spleen
c) Thymus and kidneys
d) Lungs and pancreas
Answer: b) Liver and spleen
Rationale: Fetal hematopoiesis occurs in liver/spleen before bone marrow takes
over after birth.
,4. A patient with severe hypoxia has a rapid increase in RBC production. Which of
the following mechanisms is the primary driver?
a) Increased differentiation of megakaryocytes
b) Faster proliferation of stem cells into progenitor cells
c) Decreased apoptosis of neutrophils
d) Conversion of red marrow to yellow marrow
Answer: b) Faster proliferation of stem cells into progenitor cells
Rationale: Hypoxia → EPO release → faster proliferation and differentiation of
stem cells, plus conversion of yellow to red marrow.
5. Which statement best distinguishes red marrow from yellow marrow?
a) Red marrow produces platelets; yellow marrow produces RBCs
b) Red marrow produces RBCs; yellow marrow does not
c) Yellow marrow is found only in children
d) Yellow marrow is the primary site of erythropoietin production
Answer: b) Red marrow produces RBCs; yellow marrow does not
Rationale: Red marrow is hematopoietic; yellow marrow is mostly fat and non-
hematopoietic.
6. A researcher is studying factors that increase hematopoiesis. Which of the
following would they observe?
a) Conversion of red marrow to yellow marrow
b) Slower differentiation of progenitor cells
c) Faster proliferation of stem cells into progenitor cells
d) Decreased EPO levels
Answer: c) Faster proliferation of stem cells into progenitor cells
Rationale: Increased hematopoiesis involves faster proliferation, faster
differentiation, and conversion of yellow → red marrow.
7. Which bone is a site of active red marrow in a healthy 30-year-old?
a) Distal radius
b) Cranium
c) Phalanges
d) Tibial shaft
Answer: b) Cranium
Rationale: Active sites include cranium, vertebrae, pelvis, sternum, ribs, proximal
humerus/femur.
, 8. A patient with anemia fails to convert yellow marrow to red marrow. Which
hormone is most likely deficient?
a) Thrombopoietin
b) Erythropoietin
c) Cortisol
d) Insulin-like growth factor
Answer: b) Erythropoietin
Rationale: EPO drives conversion of yellow to red marrow.
9. In a fetus at 24 weeks gestation, where are hematopoietic stem cells primarily
located?
a) Bone marrow
b) Liver
c) Thymus
d) Kidneys
Answer: b) Liver
Rationale: Fetal liver is a major hematopoietic site before marrow takes over.
10. Which of the following would NOT increase hematopoiesis?
a) Hypoxia
b) EPO administration
c) Bone marrow fibrosis
d) Conversion of yellow to red marrow
Answer: c) Bone marrow fibrosis
Rationale: Fibrosis replaces functional marrow, reducing hematopoiesis.
11. A patient has a fractured sternum. Which marrow type is most likely present at
that site?
a) Yellow marrow
b) Red marrow
c) Gelatinous marrow
d) White marrow
Answer: b) Red marrow
Rationale: Sternum is an active red marrow site in adults.
12. The two stages of hematopoiesis are:
a) Mitosis and meiosis
