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Hematology in Practice 2nd Edition Test Bank

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    Chapter 1: Introduction to Hematology and Basic Laboratory Practice Multiple Choice Identify the choice that best completes the statement or answers the question. ____ 1. Tube length when referring to the microscope is the: a. Resolution power of the objective b. Distance from the eyepiece to the objective c. Numerical aperture d. Magnitude of the image on the stage ____ 2. What is the most useful corrective action for the microscope when fine details cannot be visualized in immature cells? a. Open up diaphragm for maximum light. b. Wipe off lenses with lens cleaner. c. Get a new slide. d. Move to a lower power. ____ 3. Which of the following behaviors is a violation of standard precautions? a. Handwashing after glove removal b. Use of impermeable laboratory gowns c. Use of goggles and face shields d. Placing laboratory notebooks on laboratory work area ____ 4. Standards and calibrators differ from control materials because: a. An exact amount of analyte is present in a standard or calibrator b. A variable amount of analyte is present depending on patient samples c. Standards only need to be within a target range d. Standards are run to the best estimate of the known value ____ 5. If the confidence interval for most laboratories is 95.5%, what is the acceptable range for hemoglobin if a hemoglobin control was run with a mean of 12.5 and a standard deviation of 1.0? a. 9.5 to 12.5 b. 10.5 to 14.5 c. 11.5 to 15.5 d. 10.0 to 13.5 ____ 6. Proper mixing of samples and timely delivery of samples to the laboratory are both examples of: a. Delta checks b. Postanalytic variables c. Preanalytic variables d. Reflex testing ____ 7. A delta check is a historical reference on samples run in the laboratories. Once a sample fails a delta check, the most obvious corrective action is to: a. Verify the identification of the patient sample b. Reestablish the parameters of the delta check c. Perform reflex testing

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    d. Perform a manual method ____ 8. Which of the following is the definition of a reference interval? a. A solution of a known amount of analyte b. Materials analyzed concurrently with unknown samples c. Values established for a particular analyte, given a method, instrument, or patient population d. Validation techniques on flagged samples ____ 9. Which of the following is not considered a postanalytic variable? a. Delta checks b. Proper anticoagulant used c. Specimen checked for clots d. Critical results called ____ 10. Error analysis, standard protocols, and turnaround time are all part of the: a. Quality assurance system b. Quality control program c. Reference standards d. Delta check protocol ____ 11. The average of a group of data points is defined as the: a. Mean b. Mode c. Median d. Modicum ____ 12. Safety training is part of new employee training in health care and includes: a. Biological hazards b. Chemical hazards c. Environmental hazards d. All of the above ____ 13. Control materials are: a. Analyzed concurrently with the unknown samples b. Substances with a known amount of analyte c. Used to calibrate the method d. All of the above ____ 14. Delta checks are used in the hematology laboratory to: a. Compare past patient results to the current result b. Verify control accuracy c. Establish a target range d. Establish reference ranges for a particular analyte ____ 15. When handwashing after a patient contact, the soap application process should last at least: a. 5 seconds b. 15 seconds c. 20 seconds

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    d. 30 seconds ____ 16. Which of the following represents an example of a safety violation in the laboratory? a. Application of cosmetics b. Mouth pipetting c. Consuming bottled water d. All the above True/False Indicate whether the statement is true or false. ____ 17. Standard deviation is a measurement of precision. ____ 18. Accuracy is a measurement of the true value of an analyte. ____ 19. A normal distribution curve will have 99.7% of the measured values fall within 2 SDs. Short Answer 20. Label the parts of the microscope.

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    Chapter 1: Introduction to Hematology and Basic Laboratory Practice Answer Section MULTIPLE CHOICE 1. ANS: B PTS: 1 2. ANS: A PTS: 1 3. ANS: D PTS: 1 4. ANS: A PTS: 1 5. ANS: B PTS: 1 6. ANS: C PTS: 1 7. ANS: A PTS: 1 8. ANS: C PTS: 1 9. ANS: B PTS: 1 10. ANS: A PTS: 1 11. ANS: A PTS: 1 12. ANS: D PTS: 1 13. ANS: A PTS: 1 14. ANS: A PTS: 1 15. ANS: B PTS: 1 16. ANS: D PTS: 1 TRUE/FALSE 17. ANS: T PTS: 1 18. ANS: T PTS: 1 19. ANS: F PTS: 1 SHORT ANSWER 20. ANS: 1. Objectives 2. Stage 3. Eye piece 4. Base 5. Light source 6. Iris diaphragm 7. Course adjustment knob 8. Fine adjustment knob 9. Stage adjustment knobs 10. Clips 11. Substage condenser

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    PTS: 1

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    Chapter 2: From Hematopoiesis to the Complete Blood Count Multiple Choice Identify the choice that best completes the statement or answers the question. ____ 1. Wh at is the average M:E ratio for normal adult bone marrow? a. 1:3 b. 4:1 c. 1:4 d. 6:1 ____ 2. The key organs involved in extramedullary hematopoiesis include the: a. Kidney and thymus b. Lymph nodes and heart c. Liver and spleen d. Kidney and liver ____ 3. Which of these assays is the best test to assess the bone marrow’s response to anemic stress? a. Hemoglobin value b. MCV value c. Reticulocyte count d. Hematocrit ____ 4. Antibody - coated red cells that have their antibodies stripped away in the spleen usually reappear in the circulation as: a. Spherocytes b. Microcytes c. Acanthocytes d. Burr cells ____ 5. A peripheral blood smear indicator of ineffective bone marrow response is: a. The presence of basophilic stippling b. A lack of polychromasia c. Higher numbers of nucleated red cells d. An increased number of red cells ____ 6. A patient with the following values — RBC = 4.01  10 12 /L, Hgb = 12.5 g/dL, and Hct = 37.2% — will most likely have which of the following RBC indices? a. MCV = 92.8 fL, MCH = 31.2 pg, MCHC = 33.6% b. MCV = 92.8 fL, MCH = 33.6 pg, MCHC = 31.2% c. MCV = 107.8 fL, MCH = 32.1 pg, MCHC = 33.6% d. MCV = 132.2 fL, MCH = 32.1 pg, MCHC = 33.5% ____ 7. The hormone responsible for red blood cell development in the bone marrow is: a. Thyroxin b. Insulin c. Leukopoietin d. Erythropoietin

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    ____ 8. Which of the following sites is the most preferable site for bone marrow aspiration and biopsy in adults? a. Sternum b. Iliac crest c. Fibula d. Vertebra ____ 9. A patient’ s hemoglobin is 12.3 g/dL. On the peripheral smear, the red cells appear normochromic, normocytic. The hematocrit value that correlates with these data is: a. 34% b. 37% c. 40% d. 43% ____ 10. A Wright - stained smear of a patient with an elevated reticulocyte count should show: a. Polychromasia b. Agglutination c. Rouleaux d. Microcytosis ____ 11. Erythropoietin is produced by the: a. Kidneys b. Liver c. Spleen d. Thymus gland ____ 12. Bone marrow aspiration is usually required in conditions of: a. Anemia b. Hypoxia c. Leukemia d. Hepatosplenomegaly ____ 13. Opsonizing antibodies produced by the spleen serve to: a. Strip the capsule from bacterial pathogens b. Recycle erythrocyte byproducts c. Aid in extramedullary hematopoiesis d. Fight viral infection ____ 14. The spleen harbors _____ of the circulatory platelet mass. a. one - quarter b. one - third c. one - half d. three - quarters ____ 15. Mature red blood cells leave the bone marrow and enter the circulation via the: a. Reticuloendothelial system b. Osteoclasts c. Spleen

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    d. Bone marrow sinuses ____ 16. Correlation checks between the red blood cell count, the hemoglobin, and the hematocrit are significant parts of QA (quality assurance) in the hematology lab. These correlations are known as: a. Delta checks b. The rules of three c. Quality control d. Analytical variables ____ 17. The ______ is one of the most stable parameters in a CBC. a. MCV b. Hct c. MCHC d. MCH ____ 18. The CBC parameter that gives insight as to the amount of anisocytosis present in a specimen is: a. RDW b. MCHC c. MCV d. Hgb True/False Indicate whether the statement is true or false. ____ 19. T cells are responsible for humoral immunity. ____ 20. Patients with moderate anemias (7 to 10 g/dL) may be asymptomatic.

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    Chapter 2: From Hematopoiesis to the Complete Blood Count Answer Section MULTIPLE CHOICE 1. ANS: B PTS: 1 2. ANS: C PTS: 1 3. ANS: C PTS: 1 4. ANS: A PTS: 1 5. ANS: B PTS: 1 6. ANS: A PTS: 1 7. ANS: D PTS: 1 8. ANS: B PTS: 1 9. ANS: B PTS: 1 10. ANS: A PTS: 1 11. ANS: A PTS: 1 12. ANS: C PTS: 1 13. ANS: A PTS: 1 14. ANS: B PTS: 1 15. ANS: D PTS: 1 16. ANS: B PTS: 1 17. ANS: A PTS: 1 18. ANS: A PTS: 1 TRUE/FALSE 19. ANS: F PTS: 1 20. ANS: T PTS: 1

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    Chapter 3: Red Blood Cell Production, Function, and Relevant Red Blood Cell Morphology Multiple Choice Identify the choice that best completes the statement or answers the question. ____ 1. The erythrocyte stage that marks the beginning of hemoglobinization is called: a. Basophilic normoblast b. Polychromatophilic normoblast c. Orthochromic normoblast d. Pronormoblast ____ 2. One of the key morphological features of the nucleated red cell stages is: a. Basophilic cytoplasm through every stage of maturation b. Granules in the cytoplasm c. A round nucleus d. An increase in size as the cell matures ____ 3. The red cell protein that is responsible for deformability and flexibility of the red cell is: a. Spectrin b. Glycophorin c. Glycine d. EPO ____ 4. Increased plasma cholesterol may lead to the development of which of these abnormal red cell morphologies? a. Spherocytes b. Target cells c. Microcytes d. Helmet cells ____ 5. Which of the following RBC pathways is responsible for providing 90% of the cellular ATP for red cell metabolism? a. Embden - Meyerhof pathway b. Methemoglobin reductase pathway c. Rapoport - Luebering pathway d. Hexose monophosphate shunt ____ 6. The hemoglobin molecule consists of: a. One heme molecule, one globin chain b. One heme molecule, four globin chains c. Two heme molecules, two globin chains d. Four heme molecules, four globin chains ____ 7. The basic pathophysiology of the thalassemic conditions is a/an: a. Decreased or absent globin chain synthesis b. Absence of iron absorption c. Failure to incorporate iron into the pronormoblast d. Side effect of iron overload

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    ____ 8. Asynchrony in the bone marrow is defined as the: a. Presence of nucleoli throughout each maturation phase b. Presence of extremely basophilic cytoplasm in all precursors c. Lack of nuclear development in precursor cells d. Nuclear development and hemoglobin development that is unbalanced ____ 9. Polychromatophilic macrocytes in the peripheral smear are most likely: a. Siderocytes b. Reticulocytes c. Spherocytes d. Pappenheimer bodies ____ 10. The red cell inclusion derived from denatured hemoglobin are: a. Howell - Jolly bodies b. Pappenheimer bodies c. Heinz bodies d. Siderotic granules ____ 11. The degree of effective erythropoietic activity in any hematological disorder is most readily assessed by a/an: a. Red cell count b. Reticulocyte count c. M:E ratio d. Hemoglobin determination ____ 12. When hemolysis is produced by the intravascular fragmentation of red cells, which red cell morphology will be produced? a. Spherocytes b. Macrocytes c. Acanthocytes d. Schistocytes ____ 13. Most hypochromic cells will have an MCHC that is: a. Greater than 36% b. Less than 30% c. Greater than 27% d. Less than 27% ____ 14. Reversible sickled cells are described as having a: a. Crescent shape with one pointed projection b. Crescent shape with two pointed projections c. Half - moon shape with rounded ends d. Half - moon shape with pointed projection ____ 15. The last nucleated stage of erythrocytic maturation is the: a. Pronormoblast b. Orthochromic normoblast c. Polychromatophilic normoblast

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    d. Basophilic normoblast ____ 16. Red cell inclusions that are remnants of DNA are termed: a. Cabot rings b. Howell Jolly bodies c. Heinz bodies d. Pappenheimer bodies ____ 17. From each pronormoblast precursor cell, _____ mature red blood cells are produced. a. 4 b. 8 c. 12 d. 16 ____ 18. Pappenheimer bodies are composed of: a. Iron b. Denatured hemoglobin c. DNA d. RNA ____ 19. Describe the hemoglobin content of the cell at the end of the pointer. a. Normochromic b. Hypochromic c. Polychromatophilic d. Hyperchromic

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    ____ 20. Identify the cell at the end of the pointer. a. Spherocyte b. Schistocyte c. Acanthocyte d. Normocyte ____ 21. Identify the cell at the end of the pointers. a. Reticulocyte b. Spherocyte c. Sickle cell d. Target cell

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    ____ 22. The term used to describe the inclusions seen in the cell at the end of the pointer is (Wright’s stain): a. Pappenheimer bodies b. Basophilic stippling c. Howell Jolly bodies d. Siderotic granules True/False Indicate whether the statement is true or false. ____ 23. The higher the N:C ratio, the more mature the cell. ____ 24. The anucleate mature red blood cell has no ability to produce protein.

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    Chapter 3: Red Blood Cell Production, Function, and Relevant Red Blood Cell Morphology Answer Section MULTIPLE CHOICE 1. ANS: B PTS: 1 2. ANS: C PTS: 1 3. ANS: A PTS: 1 4. ANS: B PTS: 1 5. ANS: A PTS: 1 6. ANS: D PTS: 1 7. ANS: A PTS: 1 8. ANS: D PTS: 1 9. ANS: B PTS: 1 10. ANS: C PTS: 1 11. ANS: B PTS: 1 12. ANS: D PTS: 1 13. ANS: B PTS: 1 14. ANS: C PTS: 1 15. ANS: B PTS: 1 16. ANS: B PTS: 1 17. ANS: D PTS: 1 18. ANS: A PTS: 1 19. ANS: C PTS: 1 20. ANS: A PTS: 1 21. ANS: D PTS: 1 22. ANS: B PTS: 1 TRUE/FALSE 23. ANS: F PTS: 1 24. ANS: T PTS: 1

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