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NURS 8022 EXAM 2 QUESTIONS WITH CORRECT ANSWERS VERIFIED BY EXPERTS NEW GENERATION 2024

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NURS 8022 EXAM 2 QUESTIONS WITH CORRECT ANSWERS VERIFIED BY EXPERTS NEW GENERATION 2024 NURS 8022 EXAM 2 QUESTIONS WITH CORRECT ANSWERS VERIFIED BY EXPERTS NEW GENERATION 2024 NURS 8022 EXAM 2 QUESTIONS WITH CORRECT ANSWERS VERIFIED BY EXPERTS NEW GENERATION 2024 NURS 8022 EXAM 2 QUESTIONS WITH COR...

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  • September 29, 2024
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  • 2024/2025
  • Exam (elaborations)
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  • nurs 8022 exam 2 questions with correct answers
  • nurs 8022 exam 2 questions with
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NURS 8022 EXAM 2 QUESTIONS
WITH CORRECT ANSWERS
VERIFIED BY EXPERTS NEW
GENERATION 2024
Hematopoiesis - CORRECT ANSWER>>>>Process of blood cell production in adult
bone marrow or the liver and/or spleen of the fetus

Two stages
▪ Mitosis (proliferation)
▪ Maturation (differentiation)

Primary site of hematopoietic stem cells - CORRECT ANSWER>>>>Bone marrow
("myeloid tissue")

Difference between red and yellow bone marrow - CORRECT ANSWER>>>>Red
marrow produces RBCs, yellow marrow does not produce RBCs

Active bone marrow sites - CORRECT ANSWER>>>>pelvic bones
vertebrae
cranium
mandible
sternum
ribs
humerus
femur

Factors that increase hematopoiesis - CORRECT ANSWER>>>>(1) conversion of
yellow bone marrow, which does not produce blood cells, to hematopoietic red marrow
by the actions of erythropoietin (a hormone that stimulates erythrocyte production)
(2) faster differentiation of progenitor cells
(3) faster proliferation of stem cells into progenitor cells

Erythropoiesis - CORRECT ANSWER>>>>production of RBCs

Sequence of erythropoiesis - CORRECT ANSWER>>>>Pluripotent hematopoietic stem
cell --> committed Proerythroblast/Pronormoblast --> Erythroblast/Normoblast (Hgb
synthesis begins) --> Reticulocyte (nucleus is lost; 3 days spent in bone marrow, about
1 day in blood) --> Erythrocyte

** aprox. 1% of RBCs are reticulocytes **

In each step the quantity of hemoglobin increases and the nucleus decreases in size

,Erythropoietin - CORRECT ANSWER>>>>A hormone produced and released by the
kidney that stimulates the production of red blood cells by the bone marrow

Always present in plasma

Released in response to low renal oxygenation
- NOT the # of RBCs but rather oxygen delivery
- e RBC production increases within 24 hours; life span 4-12 hours; increased RBC # in
5 days
- Given to dialysis and chemo patients

Reticulocytes - CORRECT ANSWER>>>>▪ Last immature form of erythroblast

▪ Contains polyribosomes (globin synthesis) and mitochondria (heme synthesis)

▪ 24-48 hours after leaving bone marrow for circulation, matures into erythrocyte
- Loses polyribosomes and mitochondria
-Make up 1-2% of RBCs
- Last about 2 days in bone marrow and 1 day in blood continuing to mature
- During time of low HCT time in marrow decreased to as little as 1 day

▪ Reticulocyte count -- Indicates whether new RBCs are being produced; good indicator
of erythropoiesis

Renal oxygenation negative feedback loop - CORRECT ANSWER>>>>

Hemoglobin and its structure - CORRECT ANSWER>>>>Oxygen-carrying protein of
the erythrocyte --> may carry up to 300 hgb molecules

Reversible deformity to be abvle to squeeze through the tiniest of capillaries

Each Hgb molecule has 2 pairs of different globin chains and 4 complexes of iron +
heme
▪ Heme: large, flat, iron-protoporphyrin disk that is synthesized in the mitochondria and
can carry one molecule of oxygen
▪ Each Hgb can carry 4 molecules of oxygen

Heme vs Globin - CORRECT ANSWER>>>>Heme: Synthesized in mitochondria of
reticulocyte
- Carries Oxygen

Globin: Polyribosomes in reticulocytes
- 2 pairs of globin chains on each Hgb molecule
- Combo of pair determines type of globin chain

,▪ Most common hgb A: 2 alpha chains and 2 beta chains - hgb F (fetal): 2 alpha, 2
gamma

Red blood cell structure - CORRECT ANSWER>>>>Sac of Hgb, no nucleus or
mitochondria, only hemoglobin & enzymes surrounded by membrane

-Lack mitochondria, rely on glycolysis for energy --> "aerobic metabolism"

▪ Deficiencies of 2 enzymes result in anemia
• Pyruvate kinase - necessary for glycolysis - no glycolysis results in RBC damage and
death
• G6PD - involved in protecting the RBC against oxidative stress

Anisocytosis
Poikilocytosis - CORRECT ANSWER>>>>Variation in RBC size
Variation in RBC shape

Hereditary vs Acquired Hemolysis - CORRECT ANSWER>>>>Hereditary hemolysis:
sickle cell disease

Acquired hemolysis: immune mechanisms (transfusion reaction), infection (malaria),
drugs (penicillin), liver or kidney disease, toxins (chemicals, venoms)

Normal Labs (RBCs, Hgb, Hct, MCV, MCH) - CORRECT ANSWER>>>>RBCs 4.2-6.1
Hgb 12-18
Hct 35-50%

MCV: 78-100 (related to size)
MCH: 27-34 (related to hgb content)

Reticulocytes: new RBC formation - low suggest issues in production

Microcytic-Hypochromic Anemias - CORRECT ANSWER>>>>Characterized by red
cells that are abnormally small and contain reduced amounts of hemoglobin

Iron Deficiency Anemia (IDA)
Sideroblastic
Thalassemia

Iron Deficiency Anemia (IDA) - CORRECT ANSWER>>>>Type of Microcytic-
Hypochromic Anemia

- Most common type of anemia
- Highest risk: older adults, women, infants, poverty

- Associated with cognitive impairment in children

, - Causes: inadequate dietary intake; excessive blood loss (GI bleed most common
pathophysiologic cause); chronic parasite infestations; metabolic or functional iron
deficiency; menorrhagia (most common physiologic cause)

** Good sign of malignancy for postmenopausal women and men **

IDA Diagnostic Manifestations - CORRECT ANSWER>>>>▪ Low MCV, low MCH
▪ High RDW
▪ Low initial reticulocyte count - elevated once treatment and iron supplementation begin
▪ Ferritin low - #1 test for IDA
▪ Low serum iron; TIBC high - not enough iron to bind transferrin

IDA Clinical Manifestations - CORRECT ANSWER>>>>▪ Mild (hgb 10-12): likely no
symptoms

▪ Moderate (hgb 7-11): palpitations, dyspnea, exercise intolerance, angular stomatitis,
glossitis, pallor, koilonychia (pitting nails), pica (eating disorder in which a person eats
things not usually considered food)

▪ Severe (hgb <7): postural hypotension, dizziness, weakness, gastritis, paresthesias,
lethargy

▪ Elderly: lethargy and confusion

Sideroblastic Anemia - CORRECT ANSWER>>>>Type of Microcytic-Hypochromic
Anemia

Caused by a defect in mitochondrial heme synthesis
▪ Altered mitochondrial metabolism causes ineffective iron uptake and results in
dysfunctional hemoglobin synthesis --> intracellular iron accumulates
- Can be due to alcohol abuse, lead poisoning

Sideroblastic Anemia Diagnostic Manifestations - CORRECT ANSWER>>>>- Presence
of ringed sideroblasts in the bone marrow are diagnostic (erythroblasts contain iron
granules that have not been synthesized into hemoglobin)
- Hct 20-30%
- MCV usually normal
- Elevated serum iron ** iron overload** Enlarged spleen and liver
- High transferrin saturation = Low TIBC

Thalassemia - CORRECT ANSWER>>>>Type of Microcytic-Hypochromic Anemia

Characterized by abnormal formation of hemoglobin resulting from mutation that causes
loss of one or both alpha globin chains or one or both of beta globin chains

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