ATI RN
ATI Hematologic System Quizlet Questions
Question 1 of 5
A 12-year-old patient with localized osteosarcoma is being treated with cisplatin, doxorubicin, and high-dose methotrexate. The pain at his primary site rapidly resolves after initiation of chemotherapy. After tumor resection, pathology reveals the tumor was greater than 95% necrotic. You want to continue cisplatin, doxorubicin, and high-dose methotrexate. Which of the following is the best answer regarding the evaluations that should be performed to monitor for toxicity in patients receiving cisplatin, doxorubicin, and high-dose methotrexate?
Correct Answer: C
Rationale: The correct answer is C because it includes essential evaluations to monitor for toxicity associated with cisplatin, doxorubicin, and high-dose methotrexate. 1. Complete blood count: To monitor for potential bone marrow suppression caused by chemotherapy drugs. 2. Creatinine: To assess renal function, as cisplatin can cause nephrotoxicity. 3. Serum magnesium: Monitoring for hypomagnesemia, a common side effect of cisplatin. 4. Audiogram: To screen for hearing loss, a known side effect of cisplatin. 5. Echocardiogram: To evaluate for cardiotoxicity, especially with doxorubicin known to cause cardiomyopathy. Other choices are incorrect: A: Does not include serum magnesium, audiogram, and echocardiogram, which are important for monitoring toxicity. B: While electrolytes and EKG are relevant, it lacks creatinine, serum magnesium, and other crucial tests. D:
Question 2 of 5
A 10-year-old patient with aplastic anemia, who is blood type B negative, is receiving a red blood cell transfusion. About 10 minutes after the transfusion starts, the patient develops anxiety and lower back pain. The transfusion continues for another 5 minutes until it is stopped when he develops a temperature of 40 °C with chills and rigors. A transfusion reaction work-up is most likely to reveal what findings?
Correct Answer: D
Rationale: The correct answer is D because in this scenario, the patient is experiencing symptoms of a transfusion reaction, likely a hemolytic transfusion reaction due to ABO incompatibility. The presence of a positive Direct Antiglobulin Test (DAT) for C3 indicates complement activation, supporting the diagnosis. Choice A (Spherocytes on peripheral blood smear) is incorrect as spherocytes are seen in autoimmune hemolytic anemia, not typically in transfusion reactions. Choice B (Gram-negative Bacillus on gram stain of remaining RBC unit) is unlikely as the symptoms are more indicative of a hemolytic reaction rather than an infection. Choice C (Chest x-ray with bilateral pulmonary infiltrates) is suggestive of transfusion-related acute lung injury (TRALI), but the symptoms described in the question (fever, chills, rigors) are more indicative of a hemolytic reaction rather than TRALI.
Question 3 of 5
The pathophysiology of venous thrombosis is often explained by Virchow's triad, which includes hypercoagulability, endothelial injury, and venous stasis. Based on Virchow's triad and your knowledge of risk factors for thrombosis, which of the following pediatric patients has the greatest risk of hospital-acquired venous thromboembolism?
Correct Answer: C
Rationale: The correct answer is C because the ex-28 week premature infant requiring NICU-level care for necrotizing enterocolitis has the greatest risk of hospital-acquired venous thromboembolism. Premature infants are at higher risk due to their immature coagulation system and prolonged immobility. Necrotizing enterocolitis further increases the risk due to inflammation and endothelial injury. Hypercoagulability is common in premature infants. Choices A, B, and D have lower risk as they do not have the same combination of risk factors as the premature infant in choice C.
Question 4 of 5
You are treating a patient with localized osteosarcoma of the distal femur with methotrexate, doxorubicin, and cisplatin (MAP) chemotherapy. At week 10 of treatment, the patient undergoes complete resection of the tumor. Pathology demonstrates 40% necrosis. Which of the following represents the most appropriate further therapy?
Correct Answer: D
Rationale: Rationale: The correct answer is D, continuing with MAP chemotherapy. The 40% necrosis rate indicates a good response to the current regimen. Continuing MAP ensures completion of the planned therapy and maximizes the benefit of the initial treatment's response. Choice A (Ifosfamide and etoposide) and B (MAPIE) are not indicated as the response to MAP was favorable. Choice C (Gemcitabine docetaxel) is not the standard of care for osteosarcoma. Continuing with MAP is the most appropriate option for this patient.
Question 5 of 5
A hospitalized client has a platelet count of 58,000/mm3 (58 × 109/L). What action by the nurse is most appropriate?
Correct Answer: D
Rationale: The correct answer is D: Place the client on safety precautions. With a platelet count of 58,000/mm3, the client is at risk for bleeding due to thrombocytopenia. Placing the client on safety precautions will help prevent injuries and minimize bleeding risks. This includes using a soft-bristled toothbrush, avoiding IM injections, and using caution with activities that may cause trauma. A: Encouraging high-protein foods is not directly related to managing the client's thrombocytopenia. B: Neutropenic precautions are for clients with low white blood cell counts, not low platelet counts. C: Limiting visitors to healthy adults is important for clients with compromised immune systems, not specifically for thrombocytopenia.