Test Bank for Wilkins Clinical Assessment in Respiratory Care, 8th Edition Heuer

Test Bank for Wilkins Clinical Assessment in

Respiratory Care, 8th Edition Heuer

To download the complete and accurate content document, go to:

https://testbankbell.com/download/test-bank-for-wilkins-clinical-assessment-in-respira
tory-care-8th-edition-heuer/

Visit TestBankBell.com to get complete for all chapters

Chapter 07: Clinical Laboratory Studies
Heuer: Wilkins’ Clinical Assessment in Respiratory Care, 8th Edition

MULTIPLE CHOICE

1. Which of the following terms is used for red blood cells?

a. Leukocytes
b. Hemocytes
c. Monocytes
d. Erythrocytes
ANS: D
Red blood cells are also known as erythrocytes.

REF: p. 128 OBJ: 2

2. Which of the following is a formed element found in circulating blood?

a. Sodium
b. Platelets
c. Potassium
d. Bicarbonate
ANS: B
Formed elements in the blood include white blood cells, red blood cells, and platelets.

REF: p. 128 OBJ: 2

3. Which of the following terms is used for white blood cells?

a. Erythrocytes
b. Thrombocytes
c. Leukocytes
d. Hemocytes
ANS: C
White blood cells are also called leukocytes.

REF: p. 128 OBJ: 2

4. Which of the following terms is used for blood platelets?

a. Erythrocytes
b. Thrombocytes
c. Leukocytes
d. Hemocytes
ANS: B
Blood platelets are also called thrombocytes.

REF: p. 128 OBJ: 2

5. Which of the following white blood cells are granulocytes?

1. Basophil
 2. Eosinophil
3. Neutrophil
4. Lymphocyte
a. 1 and 4
b. 2 and 3
c. 1, 2, and 3
d. 2, 3, and 4
ANS: C
Lymphocytes do not have granular matter in their cytoplasm.

REF: p. 129 OBJ: 2

6. What type of white blood cell typically is most prevalent in the circulating blood?
a. Monocyte
b. Eosinophil
c. Neutrophil
d. Lymphocyte
ANS: C
The neutrophil is produced by the bone marrow in large quantities.

REF: p. 129 OBJ: 2

7. What percentage of circulating white blood cells is made up of neutrophils?

a. 10% to 30%
b. 25% to 50%
c. 50% to 70%
d. 60% to 85%
ANS: C
Neutrophils make up 50% to 70% of circulating white blood cells.

REF: p. 130 OBJ: 2 | 7

8. Which of the following terms describes the immature neutrophil?

a. Band
b. Monocyte
c. Erythrocyte
d. Reticulocyte
ANS: A
Immature neutrophils are known as bands because of the shape of their nuclei.

REF: p. 130 OBJ: 4 | 7

9. What percentage of normal circulating white blood cells are immature and nonsegmented?
a. 0% to 5%
b. 5% to 10%
c. 10% to 15%
d. 15% to 22%
ANS: A
 Normally, a very small portion of circulating white blood cells is nonsegmented.

REF: p. 130 OBJ: 4

10. Which of the following types of white blood cells fights bacterial infection?
a. Basophil
b. Monocyte
c. Neutrophil
d. Lymphocyte
ANS: C
The neutrophil is best known for its ability to fight infection.

REF: p. 130 OBJ: 3 | 7

11. What is the normal life span of the neutrophil?

a. 10 days
b. 21 days
c. 60 days
d. 90 days
ANS: A
The normal neutrophil lives about 10 days.

REF: p. 130 OBJ: 2 | 7

12. Which of the following terms describes an increase in white blood cell count associated
with a shift of cells from the marginated pool to the circulating pool?
a. Pseudoneutrophilia
b. Pseudoneutropenia
c. Neutropenia
d. Lymphocytosis
ANS: A
When marginated neutrophils shift back into the circulating pool, this is known as
pseudoneutrophilia.

REF: p. 131 OBJ: 6 | 7

13. Which of the following types of white blood cells is useful against allergic reactions and
defends against parasitic infestations?
a. Monocyte
b. Neutrophil
c. Eosinophil
d. Lymphocyte
ANS: C
The eosinophil is known to react in situations caused by exposure to allergens.

REF: p. 130 OBJ: 6 | 7

14. Which of the following types of white blood cells exists as two types—the B cell and the T
cell?
a. Basophil
b. Monocyte
c. Neutrophil
d. Lymphocyte
ANS: D
Lymphocytes can be either T cells or B cells.

REF: p. 130 OBJ: 6 | 7

15. What is the normal percentage of lymphocytes in circulating white blood cells?
a. 5% to 10%
b. 15% to 25%
c. 20% to 45%
d. 50% to 70%
ANS: C
Normally, 20% to 45% of circulating white blood cells are lymphocytes.

REF: p. 130 OBJ: 6 | 7

16. Which of the following types of white blood cells is physically the largest?
a. Basophil
b. Monocyte
c. Neutrophil
d. Lymphocyte
ANS: B
As viewed through the microscope, the monocyte is physically the largest white blood cell.

REF: p. 130 OBJ: 7

17. Which of the following types of white blood cells is responsible for phagocytosis?
a. Basophil
b. Monocyte
c. Neutrophil
d. Lymphocyte
ANS: B
The monocyte has the ability to engulf bacteria and foreign dust particles and eliminate
them from the lung.

REF: p. 130 OBJ: 9

18. Which of the following terms describes an abnormal increase in the proportion of
circulating immature neutrophils?
a. Neutrophilia
b. Left shift
c. Leukopenia
d. Leukocytosis
 ANS: B
When the number of bands circulating in the blood is higher than normal, this is referred to
as a left shift.

REF: p. 130 OBJ: 7

19. Which of the following terms describes the change in white blood cell count that often
occurs in patients with tuberculosis?
a. Lymphocytosis
b. Monocytosis
c. Eosinophilia
d. Basophilia
ANS: B
Patients with tuberculosis usually develop monocytosis.

REF: p. 130 OBJ: 7 | 9

20. Which of the following terms describes an overall abnormal decrease in white blood cell
count?
a. Anemia
b. Leukopenia
c. Leukocytosis
d. Polycythemia
ANS: B
An abnormal drop in the number of circulating white blood cells is known as leukopenia.

REF: p. 130 OBJ: 8

21. Which of the following types of leukocytosis is typically seen in patients with viral
infection?
a. Basophilia
b. Neutrophilia
c. Monocytosis
d. Lymphocytosis
ANS: D
Viral infections often cause lymphocytosis.

REF: p. 130 OBJ: 7 | 10

22. What is believed to cause neutropenia in patients with viral infection?

a. Phagocytosis
b. Increased margination of neutrophils
c. Increased neutrophil lysis
d. Increased loss of neutrophils to gastrointestinal waste
ANS: B
Viral infections cause neutrophils to marginate in larger numbers, and marginated
neutrophils are not counted in the white blood cell count.
 REF: p. 130 OBJ: 7 | 9

23. What cells proliferate in patients with leukemia?

a. Reticulocytes
b. Segmented neutrophils
c. Monocytes
d. Blasts
ANS: D
Leukemia is a disease of the bone marrow. It causes the bone marrow to release very
immature cells such as blasts.

REF: p. 132 OBJ: 8

24. What is the typical life span of a red blood cell?

a. 30 days
b. 60 days
c. 120 days
d. 180 days
ANS: C
The typical red blood cell will live for 120 days.

REF: p. 132 OBJ: 7

25. What can be said about the nucleus of the mature circulating red blood cell?
a. It is round.
b. It is absent.
c. It is large and red.
d. It is very small.
ANS: B
The mature red blood cell has no nucleus.

REF: p. 132 OBJ: 9

26. What substance is responsible for carrying red blood cell oxygen on to the tissues?
a. Thrombin
b. Cytokines
c. Hemoglobin
d. Prothrombin
ANS: C
Hemoglobin is the major substance found in red blood cells. Its main function is to carry
oxygen.

REF: p. 132 OBJ: 10

27. What substance is a vital constituent of the heme portion of hemoglobin?

a. Iron
b. Protein
c. Sodium
 d. Calcium
ANS: A
Iron is vitally important to the function of hemoglobin.

REF: p. 132 OBJ: 10

28. Which of the following terms describes an abnormal decrease in red blood cell count?
a. Anemia
b. Cytothemia
c. Leukopenia
d. Polycythemia
ANS: A
A low red blood cell count is known as anemia.

REF: p. 133 OBJ: 8

29. Which of the following terms describes red blood cells that are larger than normal?
a. Macrocytic
b. Hypercytotic
c. Hyperchromic
d. Polycythemic
ANS: A
Red blood cells that are larger than normal are termed macrocytic.

REF: p. 133 OBJ: 8

30. The most common type of anemia worldwide is the result of:
a. hemorrhage.
b. gastrointestinal bleeding.
c. iron deficiency.
d. vitamin B12 deficiency.
ANS: C
Iron deficiency is a very common cause of anemia because it reduces the presence of
hemoglobin in the red blood cells.

REF: p. 133 OBJ: 8

31. Which of the following terms describes anemia due to low hemoglobin levels?
a. Microcytic
b. Leukopenic
c. Hypocytotic
d. Hypochromic
ANS: D
Chromic refers to color, and hemoglobin is known for giving the red blood cell its bright
red color. Hypochromic refers to red cells that lack hemoglobin.

REF: p. 133 OBJ: 8

32. In which of the following conditions would secondary polycythemia not be expected?
a. Pulmonary fibrosis
b. Pulmonary embolism
c. Living at high altitude
d. Congenital heart disease
ANS: B
Secondary polycythemia occurs with chronic hypoxemia. Pulmonary embolism may cause
acute hypoxemia.

REF: p. 134 OBJ: 9

33. Heavy smokers are prone to what change in the red blood cell count?
a. Secondary polycythemia
b. Microcytic anemia
c. Hypochromic anemia
d. Macrocytic anemia
ANS: A
Heavy smokers have significant carbon monoxide in their blood. This is perceived by the
bone marrow as hypoxia. Thus, the bone marrow increases its production of red blood
cells.

REF: p. 134 OBJ: 9

34. In which of the following conditions would spurious polycythemia most likely be seen?
a. Lung cancer
b. Dehydration
c. Fever
d. Hypertension
ANS: B
Dehydration causes an increase in the concentration of red blood cells in the blood and
causes false polycythemia.

REF: p. 134 OBJ: 9

35. A patient with a platelet count of about 80,000/mm3 is likely to have what condition?
a. Infection
b. Renal failure
c. Excessive bleeding
d. None of the above, because this is a normal value
ANS: C
A platelet count of 80,000/mm3 is too low. The patient will have problems with bleeding.

REF: p. 133 OBJ: 9 | 10

36. What problem is associated with an abnormal international normalized ratio (INR) value?
a. Kidney disease
b. Liver failure
c. Bleeding
 d. Pulmonary edema
ANS: C
An abnormal INR value suggests problems with blood clotting.

REF: p. 134 OBJ: 10

37. Which of the following is considered the major cation of the extracellular fluid?
a. Sodium
b. Calcium
c. Chloride
d. Potassium
ANS: A
Sodium is considered the major cation of the extracellular fluid.

REF: p. 136 OBJ: 12

38. Which of the following symptoms is commonly seen with hyponatremia?

a. Confusion
b. Headache
c. Chest pain
d. Shortness of breath
ANS: A
A low sodium concentration often causes acute confusion in the patient.

REF: p. 136 OBJ: 12

39. What electrolyte abnormality is associated with irregular pulse, muscle weakness, and
abdominal distention?
a. Hyperkalemia
b. Hypokalemia
c. Hyponatremia
d. Hypernatremia
ANS: B
Hypokalemia (reduced potassium concentration) causes an irregular pulse and muscle
weakness.

REF: p. 136 OBJ: 12

40. Which of the following terms is used to describe an abnormally low potassium level?
a. Hyponatremia
b. Hypokalemia
c. Hypochloremia
d. Hypocalcemia
ANS: B
A low potassium level is known as hypokalemia.

REF: p. 136 OBJ: 12

41. Elevation of blood urea nitrogen (BUN) and creatinine levels in the blood suggests what
type of problem?
a. Renal failure
b. Liver failure
c. Heart disease
d. Gallbladder disease
ANS: A
BUN and creatinine are waste products of metabolism that usually are excreted by the
kidneys. If they are found to be elevated in the blood, kidney failure is possible.

REF: p. 139 OBJ: 13

42. What disease is associated with elevations in sodium and chloride in sweat?
a. Pneumonia
b. Emphysema
c. Renal disease
d. Cystic fibrosis
ANS: D
Patients with cystic fibrosis have elevated sodium and chloride levels in their sweat.

REF: p. 137 OBJ: 12

43. During evaluation of the enzymes, what disorder is associated with elevation of the
CK-MB on electrophoresis?
a. Hepatitis
b. Renal failure
c. Metabolic acidosis
d. Myocardial infarction
ANS: D
Elevation of the creatine kinase MB (CK-MB) fraction indicates damage to the heart
muscle.

REF: p. 141 OBJ: 14 | 15

44. The highest levels of aspartate aminotransferase (AST) are seen in acute:
a. pulmonary infarction.
b. hepatitis.
c. myocardial infarction.
d. renal failure.
ANS: B
AST is an enzyme that is found primarily in the liver. Hepatitis causes damage to the liver
and an abnormal increase in AST.

REF: p. 140 OBJ: 13

45. Elevation of troponin is associated with what disorder?

a. Acute myocardial infarction
b. Hepatitis
 c. Pulmonary embolism
d. Trauma
ANS: A
Troponin is an enzyme that is elevated by damage to the myocardium.

REF: p. 141 OBJ: 14 | 15

46. Which of the following disorders is associated with hyperglycemia?

a. Hepatitis
b. Diabetes
c. Renal failure
d. Myocardial infarction
ANS: B
Hyperglycemia, which refers to an increase in blood glucose level, is associated most often
with diabetes.

REF: p. 138 OBJ: 13

47. Hypoalbuminemia may result in what pulmonary problem?

a. Asthma
b. Emphysema
c. Diaphragm paralysis
d. Pulmonary edema
ANS: D
Hypoalbuminemia refers to a low blood protein level. This causes the osmotic pressure of
the blood to decrease, which leads to increased water in the lung.

REF: p. 139 OBJ: 13

48. Which of the following terms is used to describe the microorganisms present in the saliva
of a healthy person?
a. Normal flora
b. Acid-fast bacteria
c. Gram-negative pathogens
d. Gram-positive pathogens
ANS: A
The normal flora refers to the microorganisms normally present in the saliva.

REF: p. 143 OBJ: 17

49. The purpose of performing the sensitivity test on sputum samples is to:
a. determine the best antibiotic to prescribe.
b. determine the viscosity of the sputum.
c. determine the quality of the sputum sample.
d. identify the general type of organism responsible for the infection.
ANS: A
The sensitivity determines what antibiotics will be most effective against a microorganism
that is causing an infection.
 REF: p. 143 OBJ: 18

50. Which of the following organisms is responsible for most cases of bacterial pneumonia?
a. Pseudomonas
b. Klebsiella pneumoniae
c. Staphylococcus aureus
d. Streptococcus pneumoniae
ANS: D
Most community-acquired pneumonias are caused by the Streptococcus organism.

REF: p. 142 OBJ: 17 | 18

51. What procedure is performed by a pulmonologist to obtain organisms that may be present
deep in the lung in patients with pneumonia?
a. Sputum induction with hypotonic nebulized solution
b. Bronchoalveolar lavage (BAL)
c. Tracheal intubation with lavage
d. Thoracentesis
ANS: B
BAL is done to flush out organisms deep in the lung that cannot be obtained for culture
through less invasive procedures.

REF: p. 144 OBJ: 19

52. The classic dividing line between transudates and exudates is a protein level of __ g/dL.
a. 3
b. 6
c. 9
d. 12
ANS: A
Pleural fluid that has a protein concentration of more than 3 g/dL is known as an exudate.
Pleural fluid with a lower concentration of proteins is known as a transudate.

REF: p. 144 OBJ: 24

53. Which of the following conditions are known to cause anergy?

1. Chronic hypertension
2. Sarcoidosis
3. Lung cancer
4. Aging
a. 1 and 4
b. 2 and 3
c. 1, 2, and 3
d. 2, 3, and 4
ANS: D
Chronic hypertension does not cause anergy.
 REF: p. 145 OBJ: 25

54. For which of the following disorders does a skin test use purified protein derivative
(PPD)?
a. Sarcoidosis
b. Tuberculosis
c. Coccidioidomycosis
d. Histoplasmosis
ANS: B
PPD is injected under the skin when testing for tuberculosis.

REF: p. 145 OBJ: 28

55. If an infection is being effectively treated by an antibiotic, which of the following would
be true?
a. The Gram-stained smear will no longer demonstrate the pathogen.
b. The patient’s white blood count will increase.
c. The patient’s platelet count will rapidly increase.
d. The patient will present with foul-smelling sputum.
ANS: A
After a patient has been on a regimen of antimicrobial therapy, the Gram stain and culture
results can change. If the antibiotic is effective against the pathogen causing the infection,
the Gram stain and culture will no longer demonstrate the pathogen, but instead will reveal
organisms consistent with normal flora.

REF: p. 143 OBJ: 18

56. A patient presents with a D-dimer of 210 ng/mL. Which of the following would be a
suspected disease process or condition?
1. Streptococcal pneumonia
2. Pleural effusion
3. Pulmonary embolism
4. Tuberculosis
a. 1 and 4
b. 2 and 3
c. 1, 2, and 4
d. 2, 3, and 4
ANS: C
The D-dimer test has high sensitivity; a level below the upper limit of the reference range
can help rule out both systemic thrombosis, such as disseminated intravascular
coagulation, and local thrombosis, such as pulmonary embolism and deep vein thrombosis.

REF: p. 136 OBJ: 11

57. A 62 year-old male patients is presenting with shortness of breath and has a BNP level of
590 pg/mL. What is his likely diagnosis?
a. Congestive heart failure
b. Exacerbation of asthma
Test Bank for Wilkins Clinical Assessment in Respiratory Care, 8th Edition Heuer

c. Pneumonia
d. Exacerbation of COPD
ANS: A
BNP is a cardiac neurohormone secreted from membrane granules in the cardiac ventricles
as a response to ventricular volume expansion and pressure overload. BNP levels lower
than 100 pg/mL have a 90% negative predictive value and are thus useful in ruling out
congestive heart failure (CHF). A comparable positive predictive value for ruling in the
diagnosis of CHF occurs with BNP levels greater than 500 pg/mL.

REF: p. XX OBJ: 29

Visit TestBankBell.com to get complete for all chapters