Chapter 23 – The Hematologic and Lymphatic System
Test Generator Questions
Page 2 of 5
1. A nurse is caring for a client diagnosed with an allergy. Which of the following should the nurse monitor in the client as signs and symptoms of an allergic response?
A. Vasodilation, edema, and itching
B. Vascular spasm or vasoconstriction
C. Spontaneous platelet plug formation
D. Coagulation process for a fibrin clot
Answer: A
Rationale: Foreign substances cause an inflammatory or a hypersensitivity reaction in the body, resulting in vasodilation, edema, and itching. These signs and symptoms are the result of an allergic or inflammatory response. Vascular spasm or vasoconstriction, spontaneous platelet plug formation, and the coagulation process that forms a fibrin clot are hemostatic initial responses and are not the result of an allergic or inflammatory response.
Chapter: 23 Objective: 2 Cognitive Level: Application
Client Needs: B Integrated Process: Nursing process
2. A 30-year-old woman is being treated for polycythemia vera and she wants to know about the properties of blood. The nurse identifies which of the following as the properties of blood, which differentiate it from other connective tissues?
A. Cells are heavier and more viscous than water
B. Despite being a liquid, it possesses an adhesive quality
C. Cells are not fixed, but move freely in the liquid portion
D. Although the composition is the same, the protein content is lower
Answer: C
Rationale: Though considered a connective tissue, blood differs from other connective tissues in that its cells are not fixed, but move freely in the liquid portion of the blood. Cells being heavier, thicker, and more viscous than water are a generic property of blood. Possessing an adhesive quality despite being a liquid is related to its ability to form solid clots. The composition of lymph is the same but it is lower in protein content.
Chapter: 23 Objective: 1 Cognitive Level: Comprehension
Client Needs: B Integrated Process: Teaching/learning
3. A client has been diagnosed with a lymphatic system disorder. The client is eager to learn about the function of the specialized lymphatic capillaries. The nurse identifies which of the following as the function of the specialized lymphatic capillaries?
A. Help maintain blood pressure and circulating fluid volume
B. Control the chemical and acid–base balance of the blood
C. Provide thickness to the circulating blood volume
D. Absorb digested fats and fat-soluble vitamins in the small intestine
Answer: D
Rationale: Specialized lymphatic capillaries called lacteals absorb digested fats and fat-soluble vitamins in the small intestine. To help maintain blood pressure and circulating fluid volume, to control the chemical and acid–base balance of the blood, or to provide thickness to the circulating blood volume are not the functions of the specialized lymphatic capillaries. Albumin, the largest group of plasma proteins, helps maintain blood pressure and circulating fluid volume. The maintenance of the salts within the plasma controls the chemical and acid–base balance of the blood. The function of albumin is to provide thickness to the circulating blood volume, thus providing osmotic pressure.
Chapter: 23 Objective: 8 Cognitive Level: Knowledge
Client Needs: A Integrated Process: Nursing process
4. An 8-year-old client is scheduled to undergo a tonsillectomy for chronic tonsillitis. The nurse caring for this client should know that which of the following symptoms is specifically related to tonsillitis?
A. Difficulty swallowing
B. Headache
C. Swelling and pain behind the ear
D. Difficulty breathing unless sitting upright
Answer: A
Rationale: When chronic tonsillitis is present, the client experiences difficulty in swallowing. Tonsillectomy is generally advised for enlarged, bacteria-loaded tonsils. Headache, swelling and pain behind the ear, and difficulty in breathing unless sitting upright are not symptoms of tonsillitis.
Chapter: 23 Objective: 6 Cognitive Level: Comprehension
Client Needs: B Integrated Process: Caring
5. A client is admitted to a healthcare facility with minor lacerations on the leg. The nurse caring for this client observes swelling in the tissues surrounding the affected area. A blood clot is suspected. The nurse should know that which of the following is the first step when the formation of a blood clot begins?
A. Prothrombin activator starts to react with additional calcium ions
B. Platelets break down and cause the release of thromboplastin
C. Thrombin converts the plasma protein fibrinogen into threads
D. The threads of fibrin form a net to entrap RBCs and platelets
Answer: B
Rationale: When tissue is injured, first the platelets break down and cause the release of a chemical thromboplastin, which then interacts with certain protein factors and calcium ions to form prothrombin activator. This is the first step when the formation of a blood clot begins. Prothrombin activator reacting with additional calcium ions, thrombin converting the plasma protein fibrinogen into threads, or the threads of fibrin forming a net to entrap RBCs and platelets are the subsequent stages of blood clotting and not the first step.
Chapter: 23 Objective: 5 Cognitive Level: Comprehension
Client Needs: A-2 Integrated Process: Nursing process
6. A nurse is caring for an industrial accident victim who has suffered blood loss from a nicked blood vessel. The nurse notes that there are no signs of swelling seen at the site of injury. The nurse should know that which of the following factors may lead to inability of the blood to clot?
A. Low levels of globulin synthesized by the body
B. Decrease in the release of chemical mediators
C. Release of immature neutrophils by bone marrow
D. Deficiency in any of the major coagulant substances
Answer: D
Rationale: Inability of the blood to clot in extensive hemorrhage may be due to a variety of factors, and a deficiency in any of the major coagulant substances can be considered as a prime factor. Low levels of globulin synthesized by the body, decrease in the release of chemical mediators, or the release of immature neutrophils by bone marrow are not the factors related to the inability to clot. A decrease in the release of chemical mediators occurs due to the action of eosinophils during allergic reactions. The release of immature neutrophils by bone marrow is related to the demand for granulocytes becoming very high. Low levels of globulin synthesized by the body are associated with the response to antigens.
Chapter: 23 Objective: 5 Cognitive Level: Knowledge
Client Needs: B Integrated Process: Caring
7. A nurse is caring for a client with a low platelet count. The nurse understands that a low platelet count affects which of the following?
A. Immune response
B. Detoxification of foreign proteins
C. Clotting of blood
D. Release of histamine
Answer: C
Rationale: The nurse understands that a low platelet count affects clotting of blood. T lymphocytes or T cells are responsible for immune response. Eosinophils are involved in the detoxification of foreign particles. Basophils are involved in the release of histamines.
Chapter: 23 Objective: 5 Cognitive Level: Knowledge
Client Needs: B Integrated Process: Nursing process
8. A client undergoing a complete blood cell (CBC) count for the detection of anemia wants to know more about hemoglobin. Which of the following should the nurse explain to the client as being the main function of hemoglobin?
A. Gives its oxygen to cells of the body and picks up carbon dioxide
B. Defends the body against disease organisms, toxins, and irritants
C. Essential for blood clotting, plug formation and further hemostasis
D. Releases chemicals to assist the body in detoxifying foreign proteins
Answer: A
Rationale: The iron in hemoglobin picks up oxygen in a loose chemical combination. As blood circulates through the capillaries, the hemoglobin gives its oxygen to various cells of the body and picks up their carbon dioxide. Defending the body against disease organisms, toxins, and irritants, being essential for blood clotting, plug formation and further hemostasis, or releasing chemicals to assist the body in detoxifying foreign proteins, are not the main functions of hemoglobin. WBCs defend the body against disease organisms, toxins, and irritants. Platelets are essential for blood clotting, plug formation and hemostasis. Eosinophils release chemicals to assist the body in detoxifying foreign proteins.
Chapter: 23 Objective: 2 Cognitive Level: Comprehension
Client Needs: B Integrated Process: Nursing process
9. A volunteer wanting to donate blood for the first time wishes to know more about the various blood groups. The nurse educating the volunteer regarding the blood groups should mention which of the following as the determining factor that classifies blood into groups A, B, AB, and O?
A. Combinations of antigens and antibodies
B. Clumping of blood cells
C. Presence or absence of D antigen factor
D. Presence of B and T lymphocytes
Answer: A
Rationale: Blood falls into one of four groups (A, B, AB, and O), and these blood types are genetic combinations of antigens and antibodies found on the membranes of RBCs. Clumping of blood cells, presence or absence of D antigen factor, or presence of B and T lymphocytes do not determine the classification of blood into groups A, B, AB, and O. Crossmatching, a laboratory test of donor and recipient cells, determines clumping of cells. Presence or absence of the D antigen factor in the person’s blood determines whether the person is Rh positive or Rh negative. The presence of B lymphocytes and T lymphocytes determines the type of lymphocytes.
Chapter: 23 Objective: 6 Cognitive Level: Knowledge
Client Needs: B Integrated Process: Nursing process