Chapter 17 Blood Short answer Essay Exam
Fill-in-the-Blank/Short Answer Questions
1) The formed element ________ can kill parasitic worms
2) A ________ is a committed granular leukocyte stem cell which produces neutrophils.
3) The rarest leukocyte is the ________.
4) The potent platelet aggregate that attracts more platelets to the site of an injury is ________.
Answer: adenosine diphosphate (ADP
5) ________ is an antiprostaglandin drug that inhibits thromboxane A2 formation (platelet plug
6) The universal recipient blood type is ________.
7) When monocytes migrate into the interstitial spaces, they are called ________.
8) Destruction of the hematopoietic components of red marrow leads to a condition called
Answer: aplastic anemia
9) ________ is the stage of development in the life of an erythrocyte during which the nucleus is
10) Hemoglobin is composed of ________ polypeptide chains.
11) List the general factors that limit normal clot growth.
Answer: Rapid removal of coagulation factors and inhibition of activated clotting factors.
12) When are whole blood transfusions routinely given?
Answer: When there is rapid and substantial blood loss.
13) List the most common causes of bleeding disorders.
Answer: Platelet deficiency (thrombocytopenia); deficiency of procoagulants due to liver
disorders; or certain genetic conditions (hemophilias).
14) List one example for each of these three functions of blood: distribution, regulation, and
Answer: Distribution: deliver oxygen from lungs and nutrients from the digestive system to cells,
transport hormones, remove wastes. Regulation: maintain body temperature, pH, fluid
volume. Protection: prevent blood loss and infection.
15) List the granulocytes and describe their granules.
Answer: neutrophils/pale, indistinct; eosinophils/red; basophils/dark purple.
16) Why is iron not stored or transported in its free form? In what form(s) is it stored or
transported in blood?
Answer: Because free iron is toxic to body cells, iron is stored within cells as protein-iron
complexes such as ferritin and hemosiderin. It is transported loosely bound to a protein
17) Explain why blood is classified as a connective tissue.
Answer: It has both solid (cells) and liquid (extracellular) components. The formed elements
(cells) are suspended in a nonliving fluid matrix (plasma).
18) What determines whether blood is bright red or a dull, dark red?
Answer: In bright red blood, oxygen is bound to hemoglobin (oxygenated blood). In dull,
dark-red blood, oxygen has been released from the hemoglobin (deoxygenated blood).
19) Why is hemoglobin enclosed in erythrocytes rather than existing free in plasma?
Answer: Enclosed within erythrocytes, hemoglobin is prevented from breaking into fragments
that would leak out of the vascular system through porous capillaries. Additionally,
since itʹs enclosed, hemoglobin cannot contribute to blood viscosity and osmotic
20) What is the buffy coat found in centrifuged whole blood?
Answer: The buffy coat is a layer of centrifuged whole blood that contains leukocytes
21) Where and how is iron stored in the body?
Answer: Iron is mostly stored in hemoglobin of RBCs. Additional free ions are bound to
protein-iron molecules like ferritin, hemosiderin, and transferrin. Ferritin and
hemosiderin molecules are stored in the liver, spleen, and bone marrow. Transferrin
transports iron in the blood.
22) Name the granulocytes and state their percentage in whole blood.
Answer: Neutrophils 50-70%
1) Why would there be cause for concern if a young pregnant mother is Rh-, her husband is Rh+,
and this is their second child?
Answer: If the mother was given RhoGAM before or shortly after the birth of the first child, there
is little concern, because the RhoGAM prevented the mother from sensitizing herself
against her child. If she did not take RhoGAM, there is a chance the second child will
develop erythroblastosis fetalis and die before birth.
2) A total WBC count and a differential WBC count have been ordered for Mrs. Johnson. What
information is obtained from the differential count that the total count does not provide?
Answer: The differential count determines the relative proportion of individual leukocyte types
(a valuable diagnostic tool). The total WBC count indicates an increase or decrease in
number of WBCs.
3) List three blood tests that might be ordered if anemia is suspected.
Answer: The tests for anemia are hematocrit, complete blood count, and microscopic study of
4) A person complains of no energy, a chronic sore throat, a low-grade fever, and is tired and
achy. His doctor notes an enlarged spleen upon examination. What diagnosis would you
expect and what definitive test would you request?
Answer: The test would be a differential white blood cell count to look for elevated numbers of
monocytes and atypical lymphocytes. The diagnosis would be possible infectious
mononucleosis, pending test results.
5) A man of Mediterranean ancestry goes to his doctor with the following symptoms. He is very
tired all of the time. He has difficulty catching his breath after even mild exercise. His doctor
orders the following tests: CBC, hematocrit, differential WBC count. The tests show immature
erythrocytes, fragile erythrocytes, and less than 2 million RBCs per cubic millimeter. What
would be a tentative diagnosis and suggested treatment?
Answer: The diagnosis is thalassemia. The treatment is blood transfusion.
6) A 68-year-old male is admitted to the hospital for emphysema. He is hypoxic and his labs
reveal low oxygen levels. His hematocrit is 65%. The physician has told him that he has a
type of polycythemia in which he has an increased number of erythrocytes circulating in his
bloodstream. The client tells the nurse that he does not understand what that means. How
would the nurse explain this in terms the client would understand?
Answer: ʺBecause you have decreased oxygen levels in your blood, your body has responded by
producing more red blood cells, causing a type of polycythemia. The low oxygen level
stimulates erythropoietin production in the kidneys to stimulate more red blood cells.ʺ
7) An elderly client tells the nurse that she has been very tired lately and has difficulty walking to
her mailbox, without getting very short of breath. The nurse notes the mucous membranes are
pale. She states since her husband died three months ago, she has not been eating well. The
physician confirms that she has iron-deficiency anemia. How are the clientʹs clinical
manifestations and iron deficiency anemia related?
Answer: The clinical manifestations are directly attributed to the reduction in the amount of
oxygen available to tissues. Anemic individuals are fatigued, often pale, short of breath,
8) A 17-year-old black male is admitted to the hospital in sickle-cell crisis. Pain management is
a top priority for clients in sickle-cell crisis. Explain why.
Answer: Sickle cell anemia results from a defective hemoglobin S-producing gene which causes
red blood cells to roughen and become sickle-shaped. Such sickling can produce
hemolysis. The altered cells tend to pile up in capillaries and smaller blood vessels,
making the blood more viscous. Normal circulation is impaired, causing severe pain
9) A 52-year-old woman was diagnosed with leukemia and has been receiving chemotherapy as
an outpatient. She tells the RN that she hasnʹt been feeling well. The patientʹs skin is warm to
touch and she has a low-grade fever of 100.2 F. The neutrophil blood count is less than
1000/ul. The nurse is concerned about the possibility of infection because of the neutropenia
and low-grade fever. Explain why.
Answer: A low-grade fever in someone who has neutropenia is a major concern for survival.
Neutropenia is a concern because of the neutrophilʹs role in phagocytosis. This patient
has a decreased ability to fight off infection.
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