ATI RN
ATI Hematologic System Test Questions
Question 1 of 5
A 14-year-old boy presents with cough, shortness of breath, and difficulty lying down. His face and neck swell when his arms are raised. Chest x-ray reveals a large mediastinal mass. A tissue diagnosis is desired. A biopsy is performed with local anesthesia because the anesthesiologist thinks that the patient has a very high general anesthesia risk. Which of the following findings does not make general anesthesia unsafe?
Correct Answer: D
Rationale: The correct answer is D. A malignancy of hematopoietic origin does not inherently make general anesthesia unsafe. This is because anesthesia risk is typically influenced by factors such as airway patency, respiratory function, and cardiac status. Choices A, B, and C all indicate potential complications that could make general anesthesia unsafe, such as airway obstruction due to a large mediastinal mass (A), compromised tracheal cross-sectional area (B), and impaired respiratory function (C). These factors would necessitate careful consideration and potential modifications in the anesthesia plan to ensure patient safety.
Question 2 of 5
A 7-year-old boy presents with recent onset of vomiting and lethargy. Blood smear shows increased neutrophils with a left shift and 8% abnormal cells. Bone marrow contains 60% of the same cells. Flow cytometry shows that the cells are TdT–, CD10+, CD19+, CD20+, sIg+. What is the most likely diagnosis?
Correct Answer: A
Rationale: The correct answer is A: Burkitt leukemia/lymphoma. This diagnosis is supported by the presence of abnormal cells that are CD10+, CD19+, CD20+, sIg+, which are characteristic of Burkitt lymphoma. The absence of TdT– indicates that it is not T-cell ALL. B-cell ALL would typically show TdT positivity. Hematogones are immature B-cell precursors commonly seen in the bone marrow of healthy children and do not typically present with the described clinical picture. The high percentage of abnormal cells in both blood and bone marrow, along with the specific immunophenotype, point towards Burkitt leukemia/lymphoma.
Question 3 of 5
An infant is born with a firm mass over the chest with a central area of purpura and a 'halo' around it. An ultrasound reveals a high-flow lesion. What is the most likely diagnosis?
Correct Answer: C
Rationale: The most likely diagnosis in this case is congenital hemangioma (Choice C). This is because the description of a firm mass over the chest with central purpura and a 'halo' suggests a rapidly involuting congenital hemangioma. The high-flow lesion seen on ultrasound is characteristic of this type of hemangioma. Choice A (Fibrosarcoma) is incorrect as fibrosarcoma typically presents differently and does not typically have a central area of purpura. Choice B (Infantile hemangioma) is incorrect as infantile hemangiomas are not usually present at birth and do not typically have a 'halo' appearance. Choice D (Capillary malformation) is incorrect as capillary malformations do not usually present as a firm mass with central purpura and a 'halo'. In summary, the key features described in the question point towards a diagnosis of congenital hemangioma, making Choice C the most likely
Question 4 of 5
A study is designed to investigate the rates of central line–associated blood stream infections among pediatric hematology/oncology patients. Three common central line types (totally implanted catheter [port], peripherally inserted central catheter [PICC], and tunneled externalized catheter [TEC]) were included in the study. What data structure is central line type?
Correct Answer: C
Rationale: The correct answer is C: Nominal. Central line type is a nominal data structure because it represents categories without any inherent order or ranking. In this study, the central line types (port, PICC, TEC) are distinct categories with no numerical value or order. It's important to distinguish between the different types of central lines, but they cannot be ordered in a meaningful sequence, making them nominal. Incorrect answers: A: Continuous - Central line type does not have a continuous range of values, it is categorical. B: Dichotomous - Dichotomous data structure has only two categories, while central line type has more than two distinct categories. D: Ordinal - Ordinal data structure involves categories with a clear order or ranking, which is not applicable to central line types as they do not have a natural order.
Question 5 of 5
You receive a phone call from a community pediatrician who is caring for a 2-year-old toddler with a cancer predisposition syndrome. The pediatrician describes a child at the 95th percentile for height and weight with a history of corrective oral surgery to reduce a large tongue and a history of an omphalocele in infancy. The pediatrician is currently performing ultrasound of the abdomen and laboratory evaluation for this patient every 3 months. Which tumor is this patient most at risk of developing?
Correct Answer: D
Rationale: The correct answer is D: Nephroblastoma (Wilms tumor). This patient likely has Beckwith-Wiedemann syndrome given the features of overgrowth, macroglossia, and omphalocele. Beckwith-Wiedemann syndrome is associated with an increased risk of Wilms tumor. Wilms tumor is the most common renal malignancy in childhood. Monitoring for Wilms tumor with ultrasound and laboratory evaluations is appropriate due to the increased risk in this patient population. Choice A: Pleuropulmonary blastoma is a rare lung tumor more commonly seen in children under 2 years old. It is not typically associated with Beckwith-Wiedemann syndrome. Choice B: Hepatocellular carcinoma is a primary liver cancer more commonly seen in adults, not children with Beckwith-Wiedemann syndrome. Choice C: Cystic nephroma is a benign kidney tumor typically seen in young children, but it is not associated with Beckwith-Wiedemann syndrome nor is it malignant