wayground logo

Free Printable Worksheets

Font size

S
M
L
XL
Worksheets

Exam 4 (Medsurg): Hematology

Total questions: 130

Worksheet time: 1hrs 6mins

Name
Class
Date
1.

What is the definition of hematopoiesis?

a)

production of blood cells

b)

destruction of blood cells

c)

utilization of blood cells

d)

storage of blood cells

2.

Which organs and systems are considered blood-forming tissues?

a)

Bone marrow, spleen, lymph system

b)

Heart, lungs, kidneys, liver

c)

Muscles, pancreas, bone marrow

d)

Stomach, intestines, pancreas, spleen, lymph nodes

3.

Where does hematopoiesis PRIMARILY occur?

a)

Within the bone marrow

b)

Within the liver

c)

Within the spleen

d)

Within the lymphatic system

4.

Bone marrow produces which of the following?

a)

RBCs, WBCs, and platelets

b)

Plasma and lymph

c)

Hormones and enzymes

d)

Nerves and muscles

5.

How many types of blood cells develop from nondifferentiated immature blood cells (stem cells)?

a)

1

b)

2

c)

3

d)

4

6.

What is the soft material that fills the central core of bones called?

a)

Marrow

b)

Cartilage

c)

Vasculature

d)

Epiphysial Plate

7.

What is the function of yellow bone marrow?

a)

Adipose storage

b)

Blood cell production

c)

Calcium storage

d)

Inflammatory mediator storage

8.

Red bone marrow is _______.

a)

Hematopoietic

b)

Osteogenic

c)

Adipose

d)

Cartilaginous

9.

SATA: In adults, red marrow is found in flat and irregular bones, such as?

a)

the ends of long bones

b)

the heads of long bones

c)

vertebrae

d)

ribs

e)

scapulae

10.

Blood is what percentage of total body weight?

a)

2%

b)

5%

c)

8%

d)

10%

11.

Whole blood is made up of 55% ______ and 45% formed elements.

a)

Plasma

b)

Water

c)

Hemoglobin

d)

Red blood cells

12.

PLASMA contains 7% proteins, 91% water, and other solutes. Which of the following is NOT a protein found in PLASMA?

a)

A) Albumin

b)

B) Globulin

c)

C) Fibrinogen

d)

D) Hemoglobin

13.

What is the normal range of platelets in blood?

a)

150k-400k/uL

b)

50k-100k/uL

c)

400k-600k/uL

d)

10k-50k/uL

14.

What is the normal range of erythrocytes (RBCs) in blood?

a)

4-6 x 10^6/uL

b)

1-2 x 10^6/uL

c)

7-9 x 10^6/uL

d)

10-12 x 10^6/uL

15.

What is the normal range of leukocytes (WBCs) in blood?

a)

4-11 x 10^3/uL

b)

11-20 x 10^3/uL

c)

1-4 x 10^3/uL

d)

20-30 x 10^3/uL

16.

Which type of leukocyte makes up 50-70% of WBCs?

a)

Neutrophils

b)

Lymphocytes

c)

Monocytes

d)

Eosinophils

17.

Which type of leukocyte makes up 20-40% of WBCs?

a)

Lymphocytes

b)

Neutrophils

c)

Monocytes

d)

Eosinophils

18.

Which type of leukocyte makes up 4-8% of WBCs?

a)

Monocytes

b)

Neutrophils

c)

Eosinophils

d)

Basophils

19.

Which type of leukocyte makes up 2-4% of WBCs?

a)

Eosinophils

b)

Neutrophils

c)

Basophils

d)

Lymphocytes

20.

Which type of leukocyte makes up 0-2% of WBCs?

a)

Basophils

b)

Neutrophils

c)

Lymphocytes

d)

Monocytes

21.

What percentage of blood is plasma?

a)

55%

b)

30%

c)

70%

d)

40%

e)

45%

22.

What percentage of blood is made up of true blood cells?

a)

45%

b)

25%

c)

60%

d)

80%

e)

55%

23.

Which blood cells are responsible for oxygen transport?

a)

RBCs (Red Blood Cells)

b)

WBCs (White Blood Cells)

c)

Platelets

d)

Plasma cells

24.

Which blood cells are responsible for protection from infection?

a)

WBCs (White Blood Cells)

b)

RBCs (Red Blood Cells)

c)

Platelets

d)

Plasma cells

25.

Which blood cells promote coagulation?

a)

Thrombocytes/platelets

b)

Erythrocytes/red blood cells

c)

Leukocytes/white blood cells

d)

Lymphocytes

26.

What is hemoglobin composed of?

a)

Iron + protein

b)

Calcium + fat

c)

Sodium + carbohydrate

d)

Potassium + vitamin

27.

Oxyhemoglobin is formed from which two components?

a)

O2 + iron

b)

CO2 + hemoglobin

c)

O2 + plasma

d)

CO2 + plasma

28.

Erythropoiesis is PRIMARILY stimulated by which bodily condition?

a)

Hypoxia

b)

Hyperglycemia

c)

Alkalosis

d)

Hypercalcemia

e)

Acidosis

29.

Erythropoiesis is controlled by erythropoietin, which is created by the _______?

a)

kidneys

b)

liver

c)

bone marrow

d)

lymph nodes

e)

heart

30.

Reticulocytes mature into ______ and are a good indication of production rates.

a)

RBCs

b)

WBCs

c)

Platelets

d)

Plasma cells

31.

Hemolysis removes abnormal, defective, damaged, and old ______ from circulation.

a)

RBCs

b)

WBCs

c)

Platelets

d)

Plasma

32.

What is the most common form of leukocyte, making up 50-70% of all leukocytes?

a)

Eosinophils

b)

Neutrophils

c)

Basophils

d)

Lymphocytes

33.

The primary function of neutrophils is ______.

a)

Phagocytosis

b)

Antibody production

c)

Mediator signaling

d)

Oxygen transport

e)

Histamine inhibition

34.

Mature neutrophil is segmented, called 'segs', with multiple segments in its ______.

a)

nucleus

b)

cytoplasm

c)

membrane

d)

cell wall

35.

Immature neutrophils are called ______ due to their non-segmented appearance.

a)

bands

b)

blasts

c)

reticulocytes

d)

monocytes

36.

An increase in percentage of bands is called a 'shift to the LEFT', meaning the bone marrow is releasing less-mature cells into circulation in response to a site of injury. SHIFTS TO THE LEFT OCCUR WITH:

a)

Chronic infection

b)

Acute infection

c)

Massive hemorrhage

d)

Autoimmune disease

37.

Eosinophils make up what percentage of all leukocytes?

a)

1-2%

b)

2-4%

c)

5-10%

d)

10-20%

38.

Granules in eosinophils contain ______.

a)

HISTAMINE

b)

HEPARIN

c)

SEROTONIN

d)

DOPAMINE

e)

HEMOGLOBIN

39.

These cells engulf antigen-antibody complexes formed during an ALLERGIC response.

a)

Neutrophils

b)

Eosinophils

c)

Basophils

d)

Monocytes

40.

Which type of cell defends against parasites?

a)

Eosinophils

b)

Neutrophils

c)

Basophils

d)

Lymphocytes

41.

Where are eosinophils found in large numbers?

a)

In the lungs and GI tract

b)

In the brain and spinal cord

c)

In the heart and kidneys

d)

In the skin and muscles

42.

Basophils make up less than what percentage of all leukocytes?

a)

2%

b)

10%

c)

5%

d)

20%

43.

Basophils have cytoplasmic granules that contain which substances?

a)

Heparin, serotonin, and histamine

b)

Insulin, glucagon, and somatostatin

c)

Dopamine, norepinephrine, and epinephrine

d)

Collagen, elastin, and keratin

44.

What happens when basophils are stimulated by an antigen?

a)

Basophils release their granules

b)

Basophils produce antibodies

c)

Basophils engulf bacteria

d)

Basophils differentiate into macrophages

45.

Lymphocytes make up what percentage of all leukocytes?

a)

20% to 40%

b)

5% to 10%

c)

50% to 60%

d)

70% to 80%

46.

Which type of leukocyte forms the basis of cellular and humoral immune responses?

a)

Lymphocytes

b)

Erythrocytes

c)

Platelets

d)

Neutrophils

e)

Basophils

47.

What are the two subtypes of lymphocytes?

a)

B cells and T cells

b)

Neutrophils and Eosinophils

c)

Macrophages and Monocytes

d)

Basophils and Dendritic cells

48.

Monocytes account for what percentage of all leukocytes?

a)

4-8%

b)

1-3%

c)

10-15%

d)

20-25%

49.

Which type of cell is the second to arrive at a site of injury or infection?

a)

Monocytes

b)

Neutrophils

c)

Lymphocytes

d)

Basophils

50.

When monocytes migrate into tissue, what do they become?

a)

Macrophages

b)

Neutrophils

c)

Eosinophils

d)

Basophils

51.

Where are resident macrophages stored?

a)

Spleen, lymph nodes, tonsils, and liver

b)

Bone marrow, pancreas, and kidneys

c)

Heart, lungs, and brain

d)

Skin, muscles, and intestines

52.

SATA: What are some functions of thrombocytes in the clotting process?

a)

initiates clotting process

b)

plugs openings in the capillary wall

c)

are factors in clot shrinkage and retraction

d)

regulated by thrombopoietin

e)

release granules when stimulated by an antigen

53.

What product of stem cells fragments into platelets?

a)

Megakaryocyte

b)

Megaerythrocyte

c)

Leukocyte

d)

Monocyte

e)

Megaleukocyte

54.

Hemostasis is defined as the ________ of bleeding.

a)

arrest

b)

increase

c)

initiation

d)

promotion

55.

What is the immediate hemostatic response of injured blood vessels called?

a)

Vasoconstrictive response

b)

Inflammatory response

c)

Platelet aggregation

d)

Fibrinolytic response

e)

Vasodilatory respone

56.

Vasoconstriction reduces leakage of blood from the injured vessel by ________ the size of the vessel.

a)

reducing

b)

increasing

c)

maintaining

d)

expanding

57.

Platelet plug formation is activated by exposure to ________ from the injured blood vessel.

a)

interstitial collagen

b)

elastin fibers

c)

smooth muscle cells

d)

endothelial cells

58.

Platelet 'stickiness' is called ________.

a)

adhesiveness

b)

aggregation

c)

coagulation

d)

fibrinolysis

59.

Formation of clumps is called ________ OR agglutination.

a)

aggregation

b)

diffusion

c)

precipitation

d)

sedimentation

60.

Clotting factors form a ________ fibrin clot on the platelet plug.

a)

visible

b)

invisible

c)

loose

d)

microscopic

61.

Clotting factors are labeled with both ________ and ________.

a)

names; Roman numerals

b)

letters; Arabic numbers

c)

colors; Egyptian symbols

d)

types; Navajo codes

62.

Which enzyme is the most powerful in the coagulation process and converts fibrinogen to fibrin?

a)

Thrombin

b)

Pepsin

c)

Amylase

d)

Lipase

63.

Anticoagulation occurs by two means: one of them is ________, which interferes with thrombin.

a)

antithrombins

b)

platelets

c)

fibrinogens

d)

erythrocytes

64.

Fibrinolytic System: Plasminogen, with the help of plasminogen activators, becomes _______.

a)

plasmin

b)

fibrin

c)

thrombin

d)

prothrombin

65.

Fibrinolytic System: Plasmin, with the help of RBCs and platelets, forms the fibrin clot via _______.

a)

fibrinolysis

b)

coagulation

c)

aggregation

d)

thrombosis

66.

Fibrinolytic System: Once the fibrin clot is formed, excess fibrin degradation products are released from the site of injury and back into the _______.

a)

bloodstream

b)

lymphatic system

c)

digestive tract

d)

alveoli

67.

Spleen: The spleen is located in the _______ (next to kidney).

a)

ULQ (Upper Left Quadrant)

b)

URQ (Upper Right Quadrant)

c)

LLQ (Lower Left Quadrant)

d)

LRQ (Lower Right Quadrant)

68.

Spleen Function: The spleen is able to produce _______ during fetal development.

a)

RBCs

b)

Folic Acid

c)

Insulin

d)

Bile

69.

Spleen Function: Filtration in the spleen removes old and damaged _______ from circulation.

a)

RBCs

b)

Platelets

c)

WBCs

d)

Plasma cells

70.

Spleen Function: The spleen removes hemoglobin from RBCs and returns iron component to the _______ for reuse.

a)

bone marrow

b)

spleen

c)

lymph nodes

d)

pancreas

71.

Spleen Function: Filters out bacteria, especially _______ organisms.

a)

ENCAPSULATED

b)

GRAM-POSITIVE

c)

AEROBIC

d)

ANAEROBIC

e)

GRAM-NEGATIVE

72.

Spleen Function: Contains a rich supply of lymphocytes, monocytes, and stored _______.

a)

immune globulins

b)

red blood cells

c)

enzymes

d)

megakaryocytes

73.

Spleen Function: Storage: stores RBCs and approximately _______ of total mass of platelets.

a)

30%

b)

10%

c)

50%

d)

70%

74.

For the body to acquire iron, it must first be:

a)

ingested

b)

created by the spleen

c)

created by the bone marrow

d)

recycled from dead white blood cells

75.

Iron Metabolism: _______ and hemosiderin assist in iron storage.

a)

Ferritin

b)

Transformerin

c)

Albumin

d)

Hemoglobin

76.

SATA: The lymphatic system consists of:

a)

lymph fluid

b)

lymphatic capillaries

c)

lymphatic ducts

d)

lymph nodes

e)

lymphatic arteries

77.

The lymph system ensures protein and fat from the GI tract and certain hormones are returned to the _______ system.

a)

circulatory

b)

digestive

c)

respiratory

d)

nervous

e)

bone marrow

78.

Fill in the blank: The lymph system returns excess interstitial fluid to the blood to prevent or reduce _______.

a)

edema

b)

anemia

c)

hypertension

d)

osteoporosis

79.

Which of the following describes lymph fluid?

a)

Clear fluid that circulates in the veins and arteries

b)

Pale yellow interstitial fluid that has diffused through capillary walls

c)

Red fluid found in arteries, arterioles, and veins

d)

Blue fluid in the lymph nodes and in the thyroid glands

80.

Lymph fluid circulates through special vasculature.

a)

True

b)

False

81.

Fill in the blank: Too much interstitial fluid or reduced absorption leads to _______.

a)

lymphedema

b)

anemia

c)

hypertension

d)

thrombocytopenia

82.

Fill in the blank: Lymphatic capillaries unite to form lymphatic vessels that carry all lymph fluid to the RIGHT lymphatic duct or the _______ duct.

a)

THORACIC

b)

BRONCHIAL

c)

AORTIC

d)

CAROTID

83.

Fill in the blank: Lymphatic capillaries drain into _______ veins in the neck.

a)

subclavian

b)

jugular

c)

carotid

d)

brachial

84.

Where is the largest concentration of lymph nodes found?

a)

In the brain surrounding the hypothalamus

b)

In the abdomen surrounding the GI tract

c)

In the legs surrounding the femoral artery

d)

In the arms surrounding the brachial artery

85.

Fill in the blank: The primary function of lymph nodes is filtration of _______ and foreign particles carried by lymph fluid.

a)

pathogens

b)

hormones

c)

enzymes

d)

nutrients

86.

The liver functions as a filter.

a)

True

b)

False

87.

Fill in the blank: The liver produces all _______ essential to hemostasis and blood coagulation.

a)

procoagulants

b)

autoantibodies

c)

hormones

d)

anticoagulants

e)

inflammatory mediators

88.

Fill in the blank: The liver stores excess _______.

a)

iron

b)

bone marrow

c)

platelets

d)

neutrophils

e)

basophils

89.

What are the components involved in normal hemostasis?

a)

Vascular endothelium, platelets, and coagulation factors

b)

Red blood cells, plasma, and antibodies

c)

Bone marrow, lymph nodes, and spleen

d)

White blood cells, plasma, and platelets

90.

Fill in the blank: Disruption of ANY of these components (vascular endothelium, platelets, and coagulation factors) may result in ______ or thrombotic disorders.

a)

bleeding

b)

infection

c)

inflammation

d)

allergy

91.

Which of the following is a result of thrombocytopenia?

a)

Increase in platelets

b)

Reduction of platelets

c)

Increase in red blood cells

d)

Decrease in white blood cells

92.

Thrombocytopenia results in abnormal hemostasis: prolonged or spontaneous ______.

a)

bleeding

b)

clotting

c)

inflammation

d)

hematapoeisis

93.

Which of the following is primarily an acquired disorder commonly from ingestion of certain herbs or drugs (i.e. St. John's Wort)?

a)

Thrombocytopenia

b)

Leukopenia

c)

Anemia

d)

Polycythemia

94.

During hemostasis, ______ gives time for a platelet response TO BEGIN and for the triggering of plasma clotting factors.

a)

vasodilation

b)

vasoconstriction

c)

hematopoeisis

d)

agglutination

e)

aggregation

95.

Clotting factors are ______ present in circulation in inactive forms until stimulated to initiate clotting through one of two pathways, which are the intrinsic and extrinsic pathways.

a)

never

b)

sometimes

c)

rarely

d)

always

96.

How is the intrinsic clotting pathway activated?

a)

massive hemorrhage

b)

collagen exposure

c)

phagocytosis

d)

antigen recognition

97.

How is the extrinsic clotting pathway initiated?

a)

exposure to collagen

b)

release of tissue factor or tissue thromboplastin from injured tissue

c)

release of histamine and bradykinin from mediators

d)

release of heparin, serotonin, and histamine from granules

98.

Anticoagulation occurs by two means: one of which is ________, which results in the direct dissolution of the fibrin clot.

a)

antithrombins

b)

fibrinolysis

c)

plasminogen

d)

agglutination

e)

fibrinogen

99.

SATA: Geriatric patients have a diminished ability to recover from acute illnesses, as well as compensate for chronic diseases due to what factors of normal aging?

a)

bone marrow alterations

b)

decreased hemoglobin levels

c)

decreased vascular integrity

d)

reduced blood cell responsiveness

100.

Thrombocytopenia can either be ______ or ______.

a)

environmental, autoimmune

b)

bacterial, viral

c)

inherited, acquired

d)

interstitial, extracellular

101.

Which of the following is the MOST COMMON form of thrombocytopenia?

a)

Thrombotic thrombocytopenia purpura (TTP)

b)

Heparin-induced thrombocytopenia (HIT)

c)

Warfarin-induced thrombocytopenia (WIT)

d)

Immune thrombocytopenia purpura (ITP)

102.

Immune thrombocytopenia purpura (ITP) is primarily a ______ disease and is defined as a syndrome of abnormal ______ of circulating platelets.

a)

viral, genesis

b)

congenital, destruction

c)

autoimmune, destruction

d)

congenital, genesis

e)

bacterial, destruction

103.

Thrombotic Thrombocytopenic Purpura (TTP) is a rare disorder that is associated with _______ aggregation of platelets that form into ________.

a)

enhanced, microthrombi

b)

diminished, microthrombi

c)

enhanced, megakaryocytes

d)

diminished, megakaryocytes

104.

Thrombotic Thrombocytopenic Purpura (TTP) is caused by a deficiency of _______ enzymes.

a)

RBC

b)

WBC

c)

Platelet

d)

Plasma

105.

Thrombotic Thrombocytopenic Purpura (TTP) is considered a MEDICAL EMERGENCY, AS BLEEDING AND CLOTTING CAN OCCUR SIMULTANEOUSLY (SIMILAR TO DIC).

a)

True

b)

False

106.

Heparin-Induced Thrombocytopenia is associated with increased use of heparin. This type of thrombocytopenia creates a ____ feedback loop which can result in _____.

a)

positive, bleeds

b)

negative, bleeds

c)

positive, clots

d)

negative, clots

107.

Heparin-Induced Thrombocytopenia is considered:

a)

a moderate to severe disorder, requires hospitalization

b)

a mild disorder which can be treated outpatient

c)

a death sentence, go get the body bag ready

d)

life threatening, requires prompt hospitalization and possible intensive care

108.

Heparin-Induced Thrombocytopenia develops _______ days after heparin therapy is started.

a)

2-3

b)

3-5

c)

5-10

d)

7-14

109.

One hallmark indicator of Heparin-Induced Thrombocytopenia is a platelet ______ of _____ from baseline.

a)

spike, 50%

b)

spike, 150%

c)

drop, 50%

d)

drop, 150%

110.

SATA: What are some major complications of Heparin-Induced Thrombocytopenia?

a)

Venous thrombosis

b)

Arterial thrombosis

c)

DVT

d)

Pulmonary embolism

e)

Massive hemorrhage

111.

Patients with thrombocytopenia always exhibit signs and symptoms of the disorder.

a)

True

b)

False

112.

What is the MOST COMMON symptom of thrombocytopenia?

a)

DVT/PE

b)

Microthrombi

c)

Endothelial Injury

d)

Mucosal/Cutaneous Bleeding

113.

Ecchymoses is:

a)

large lesions secondary to hemorrage

b)

microhemorrages

c)

small bruise formed from numerous petechiae

d)

hangnail

114.

What is THE hallmark diagnostic indicator of thrombocytopenia?

a)

Decreased RBC count

b)

Decreased WBC count

c)

Decreased platelet count

d)

Decreased serum plasma

115.

A patient with thrombocytopenia suffering from prolonged bleeding will typically have a platelet count less than:

a)

100,000

b)

75,000

c)

50,000

d)

20,000

116.

A patient with thrombocytopenia suffering from massive hemorrhage will typically have a platelet count less than:

a)

100,000

b)

75,000

c)

50,000

d)

20,000

117.

Which medication should the RN AVOID giving to a patient with thrombocytopenia?

a)

Ibuprofen

b)

Naloxone

c)

Labetalol

d)

Aspirin

e)

Prednisone

118.

When treating Immune Thrombocytopenic Purpura (ITP), ________ are given to suppress phagocytic response of splenic macrophages, which results in an increased life span of platelets.

a)

NSAIDs

b)

Corticosteroids

c)

TNF inhibitors

d)

Anticoagulants

119.

An enlarged spleen sequesters and ______ platelets, resulting in _____ available clotting ability in the circulation.

a)

destroys, more

b)

destroys, less

c)

creates, more

d)

creates, less

120.

Platelet transfusions are used to increase platelet counts in life-threatening hemorrhages.

a)

True

b)

False

121.

Platelet transfusions are _____ used prophylactically, due to antibody formation.

a)

always

b)

never

c)

sometimes

d)

rarely

122.

Platelet transfusions are indicated for a platelet count less than ______/uL.

a)

50,000

b)

75,000

c)

20,000

d)

10,000

123.

Untreated Thrombotic Thrombocytopenia Purpura (TTP) usually results in IRREVERSIBLE _____ FAILURE AND DEATH.

a)

HEPATIC

b)

RENAL

c)

CARDIAC

d)

RESPIRATORY

124.

_________ can be used to aggressively reverse platelet consumption.

a)

Tranexamic Acid

b)

Vitamin K

c)

Plasmapharesis

d)

ECMO

125.

A patient is diagnosed with Heparin-Induced Thrombocytopenia (HIT). How long should the RN and other providers stop the heparin therapy for?

a)

at least 2 hours

b)

at least 12 hours

c)

at least 24 hours

d)

at least 72 hours

e)

permanently and forever

126.

Patients recovering from Heparin-Induced Thrombocytopenia (HIT) can be started on Coumadin once their platelet count reaches 150,000/uL. What type of medication should the patient be switched to in the meantime for anticoagulation therapy?

a)

direct thrombin inhibitor

b)

tPA

c)

warfarin

d)

alteplase

e)

tranexamic acid

127.

Chemotherapeutic drugs can cause thrombocytopenia and bone marrow suppression.

a)

True

b)

False

128.

In regards to a patient with thrombocytopenia, the RN should AVOID:

a)

encouraging patients to seek prompt treatment for any and all bleeding

b)

teaching self care measures to reduce bleeding risk

c)

administering IM or SQ medications unless absolutely necessary

d)

administering platelet transfusions

129.

Blood component therapy is frequently used to manage hematologic diseases. This type of therapy is considered a _______ measure.

a)

permanent

b)

curative

c)

non-effective

d)

temporary

130.

Blood component therapy can be done frequently for patients with hematologic diseases, as they are very safe and have negligible adverse effects.

a)

True

b)

False