ATI MedSurg Test Bank, Hematologic Disorders
Questions With 100% Correct Answers And
Elaborations 2022/2023|Already Graded A|
1. Of the four major blood components, plasma:
a. is made up of circulating ions.
b. comprises about 55% of blood volume.
c. is transported to the cells by serum proteins.
d. comprises about 45% of blood volume.
ANS: B
Blood has four major components: (1) a fluid component called plasma, (2) circulating solutes such as ions, (3)
serum proteins, and (4) cells. Plasma comprises about 55% of blood volume and is the transportation medium
for important serum proteins such as albumin, globulin, fibrinogen, prothrombin, and plasminogen. The
hematopoietic cells comprise the remaining 45% of blood volume.
DIF:Cognitive Level: ComprehensionREF:p. 460
OBJ: Explain the normal anatomy and physiology of the hematological and immune systems.
TOP: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity
1/41
,2. Erythrocytes (RBCs) are flexible biconcave disks without nuclei whose primary component is an oxygen-
carrying molecule called:
a. erythropoietin.
b. a reticulocyte.
c. hemoglobin.
d. 2,3-DPG
ANS: C
Erythrocytes (RBCs) are flexible biconcave disks without nuclei whose primary component is an oxygen-carrying
molecule called hemoglobin. RBCs are generated from precursor stem cells under the influence of a growth
factor called erythropoietin. Erythropoietin is secreted by the kidney in response to a perceived decrease in
perfusion or tissue hypoxia. Reticulocytes are immature RBCs that may be released when there is a demand for
RBCs that exceeds the number of available mature cells. The oxygen affinity for hemoglobin is modulated
primarily by the concentration of 2,3-diphosphoglycerate (2,3-DPG) and depends on the blood pH and body
temperature.
DIF:Cognitive Level: KnowledgeREF:p. 464
OBJ: Explain the normal anatomy and physiology of the hematological and immune systems.
TOP: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity
3. Erythrocytes (RBCs) are generated from precursor stem cells under the influence of a growth factor called:
a. reticulocytes.
b. hemoglobin.
c. 2,3-DPG.
d. erythropoietin.
2/41
,ANS: D
RBCs are generated from precursor stem cells under the influence of a growth factor called erythropoietin.
Erythropoietin is secreted by the kidney in response to a perceived decrease in perfusion or tissue hypoxia.
Reticulocytes are immature RBCs that may be released when there is a demand for RBCs that exceeds the
number of available mature cells. The RBC transports hemoglobin, whose function is the transport of oxygen
and carbon dioxide. Hemoglobin binds with oxygen in the lungs and transports it to the tissues. The oxygen
affinity for hemoglobin is modulated primarily by the concentration of 2,3-diphosphoglycerate (2,3-DPG) and
depends on the blood pH and body temperature.
DIF:Cognitive Level: KnowledgeREF:p. 464
OBJ: Explain the normal anatomy and physiology of the hematological and immune systems.
TOP: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity
4. The nurse is caring for a patient who has undergone a splenectomy, and notices that the patient’s platelet
count has increased. The nurse realizes that the increase is due to:
a. platelet response to infection.
b. stimulation secondary to erythropoietin.
c. the patient’s inability to store platelets.
d. the platelet’s 120-day life cycle.
ANS: C
Two thirds of the platelets circulate in the blood. The spleen stores the remaining third and may become
enlarged if excess or rapid platelet removal occurs. In patients who have had a splenectomy, 100% of the
platelets remain in circulation. Platelets are the first responders in the clotting response (not infection), and
they form a platelet plug that temporarily repairs an injured vessel. RBCs (not platelets) are generated from
precursor stem cells under the influence of a growth factor called erythropoietin. Platelets have a life span of 8
to 12 days, but they may be used more rapidly if there are many vascular injuries or clotting stimuli. Maturation
of RBCs takes 4 to 5 days, and their life span is about 120 days.
DIF:Cognitive Level: ComprehensionREF:p. 465
OBJ: Explain the normal anatomy and physiology of the hematological and immune systems.
3/41
, TOP: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity
5. The nurse examines the patient’s complete blood count with differential analysis and notices that the
patient’s neutrophils are elevated, but the lymphocytes are lower than normal. The drop in lymphocyte count in
the differential is most likely due to:
a. the increase in neutrophil count.
b. a new viral infection.
c. a decreased number of “bands.”
d. the lack of immature neutrophils.
ANS: A
The differential count measures the percentage of each type of white blood cell (WBC) present in the venous
blood sample, the total adding up to 100%. If the percentage of one type of WBC goes up (neutrophil count),
the percentage of the remaining WBCs must go down as a result of the mathematical function of the
differential. An elevation in the neutrophil count usually indicates a bacterial infection. “Bands” are immature
neutrophils. The phrase “a shift to the left” refers to an increased number of “bands,” or band neutrophils,
compared with mature neutrophils on a complete blood count (CBC) report. This finding generally indicates an
acute bacterial infectious process (not viral) that draws on the WBC reserves in the bone marrow and causes
less mature forms to be released.
DIF:Cognitive Level: ComprehensionREF:p. 466
OBJ:Describe pathophysiological changes that affect hematological and immunological structure and
function.TOP:Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity
6. The nurse is caring for a patient receiving chemotherapeutic agents, and notices that the patient’s
neutrophils count is low. The nurse realizes that:
a. the patient has a bacterial infection.
b. a shift to the left is occurring.
4/41
Questions With 100% Correct Answers And
Elaborations 2022/2023|Already Graded A|
1. Of the four major blood components, plasma:
a. is made up of circulating ions.
b. comprises about 55% of blood volume.
c. is transported to the cells by serum proteins.
d. comprises about 45% of blood volume.
ANS: B
Blood has four major components: (1) a fluid component called plasma, (2) circulating solutes such as ions, (3)
serum proteins, and (4) cells. Plasma comprises about 55% of blood volume and is the transportation medium
for important serum proteins such as albumin, globulin, fibrinogen, prothrombin, and plasminogen. The
hematopoietic cells comprise the remaining 45% of blood volume.
DIF:Cognitive Level: ComprehensionREF:p. 460
OBJ: Explain the normal anatomy and physiology of the hematological and immune systems.
TOP: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity
1/41
,2. Erythrocytes (RBCs) are flexible biconcave disks without nuclei whose primary component is an oxygen-
carrying molecule called:
a. erythropoietin.
b. a reticulocyte.
c. hemoglobin.
d. 2,3-DPG
ANS: C
Erythrocytes (RBCs) are flexible biconcave disks without nuclei whose primary component is an oxygen-carrying
molecule called hemoglobin. RBCs are generated from precursor stem cells under the influence of a growth
factor called erythropoietin. Erythropoietin is secreted by the kidney in response to a perceived decrease in
perfusion or tissue hypoxia. Reticulocytes are immature RBCs that may be released when there is a demand for
RBCs that exceeds the number of available mature cells. The oxygen affinity for hemoglobin is modulated
primarily by the concentration of 2,3-diphosphoglycerate (2,3-DPG) and depends on the blood pH and body
temperature.
DIF:Cognitive Level: KnowledgeREF:p. 464
OBJ: Explain the normal anatomy and physiology of the hematological and immune systems.
TOP: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity
3. Erythrocytes (RBCs) are generated from precursor stem cells under the influence of a growth factor called:
a. reticulocytes.
b. hemoglobin.
c. 2,3-DPG.
d. erythropoietin.
2/41
,ANS: D
RBCs are generated from precursor stem cells under the influence of a growth factor called erythropoietin.
Erythropoietin is secreted by the kidney in response to a perceived decrease in perfusion or tissue hypoxia.
Reticulocytes are immature RBCs that may be released when there is a demand for RBCs that exceeds the
number of available mature cells. The RBC transports hemoglobin, whose function is the transport of oxygen
and carbon dioxide. Hemoglobin binds with oxygen in the lungs and transports it to the tissues. The oxygen
affinity for hemoglobin is modulated primarily by the concentration of 2,3-diphosphoglycerate (2,3-DPG) and
depends on the blood pH and body temperature.
DIF:Cognitive Level: KnowledgeREF:p. 464
OBJ: Explain the normal anatomy and physiology of the hematological and immune systems.
TOP: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity
4. The nurse is caring for a patient who has undergone a splenectomy, and notices that the patient’s platelet
count has increased. The nurse realizes that the increase is due to:
a. platelet response to infection.
b. stimulation secondary to erythropoietin.
c. the patient’s inability to store platelets.
d. the platelet’s 120-day life cycle.
ANS: C
Two thirds of the platelets circulate in the blood. The spleen stores the remaining third and may become
enlarged if excess or rapid platelet removal occurs. In patients who have had a splenectomy, 100% of the
platelets remain in circulation. Platelets are the first responders in the clotting response (not infection), and
they form a platelet plug that temporarily repairs an injured vessel. RBCs (not platelets) are generated from
precursor stem cells under the influence of a growth factor called erythropoietin. Platelets have a life span of 8
to 12 days, but they may be used more rapidly if there are many vascular injuries or clotting stimuli. Maturation
of RBCs takes 4 to 5 days, and their life span is about 120 days.
DIF:Cognitive Level: ComprehensionREF:p. 465
OBJ: Explain the normal anatomy and physiology of the hematological and immune systems.
3/41
, TOP: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity
5. The nurse examines the patient’s complete blood count with differential analysis and notices that the
patient’s neutrophils are elevated, but the lymphocytes are lower than normal. The drop in lymphocyte count in
the differential is most likely due to:
a. the increase in neutrophil count.
b. a new viral infection.
c. a decreased number of “bands.”
d. the lack of immature neutrophils.
ANS: A
The differential count measures the percentage of each type of white blood cell (WBC) present in the venous
blood sample, the total adding up to 100%. If the percentage of one type of WBC goes up (neutrophil count),
the percentage of the remaining WBCs must go down as a result of the mathematical function of the
differential. An elevation in the neutrophil count usually indicates a bacterial infection. “Bands” are immature
neutrophils. The phrase “a shift to the left” refers to an increased number of “bands,” or band neutrophils,
compared with mature neutrophils on a complete blood count (CBC) report. This finding generally indicates an
acute bacterial infectious process (not viral) that draws on the WBC reserves in the bone marrow and causes
less mature forms to be released.
DIF:Cognitive Level: ComprehensionREF:p. 466
OBJ:Describe pathophysiological changes that affect hematological and immunological structure and
function.TOP:Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity
6. The nurse is caring for a patient receiving chemotherapeutic agents, and notices that the patient’s
neutrophils count is low. The nurse realizes that:
a. the patient has a bacterial infection.
b. a shift to the left is occurring.
4/41
