ATI RN
The Hematologic System ATI Questions
Question 1 of 5
A 16-year-old female patient with severe factor XI deficiency presents with acute appendicitis and requires urgent surgery. You are called by the surgeon, who wants to know what, if any, blood products or treatments are required to reduce the risk of perioperative bleeding. The patient weighs 62 kg. What should you tell him to administer?
Correct Answer: C
Rationale: The correct answer is C: Fresh frozen plasma (20 mL/kg), which will raise her factor XI level to 20%. Fresh frozen plasma contains various clotting factors, including factor XI. In a patient with severe factor XI deficiency, administering fresh frozen plasma can increase factor XI levels and help reduce the risk of perioperative bleeding. The dose of 20 mL/kg is appropriate for this patient's weight of 62 kg. Cryoprecipitate (choice A) may contain factor XI but is not the optimal choice for raising factor XI levels specifically. Factor XI concentrate (choice B) would be ideal but is not commonly available, making fresh frozen plasma a more practical option. Prothrombin complex concentrate (choice D) primarily contains factors II, VII, IX, and X, but not factor XI, so it would not effectively raise factor XI levels in this patient.
Question 2 of 5
You are caring for a patient with a large localized Ewing sarcoma of the soft tissues of the arm. The surgeon believes that the tumor can be resected without amputation but asks whether you can give some chemotherapy to shrink the tumor before surgery. Which of the following would you tell the surgeon?
Correct Answer: B
Rationale: Step 1: Agreeing to wait until week 12 of therapy before resection allows chemotherapy to shrink the tumor, making surgery easier and potentially less extensive. Step 2: Waiting until week 12 also helps assess the tumor's response to chemotherapy, guiding further treatment decisions. Step 3: Choosing not to delay the resection until week 12 may risk more extensive surgery or complications due to the tumor's size. Step 4: Opting for radiotherapy regardless of tumor resection status at week 12 is not advisable as unnecessary radiation exposure should be avoided unless absolutely necessary.
Question 3 of 5
A nurse is assessing a dark-skinned client for pallor. What nursing assessment is best to assess for pallor in this client?
Correct Answer: A
Rationale: The correct answer is A: Assess the conjunctiva of the eye. The conjunctiva is a thin, transparent layer covering the white part of the eye. Pallor, which is paleness of the skin or mucous membranes, is more easily observed in the conjunctiva of the eye in dark-skinned individuals. This area provides a contrast to the skin tone, making it easier to detect subtle changes in color. Assessing the conjunctiva allows for a more accurate evaluation of pallor in dark-skinned clients compared to other areas like the palm, mouth, or palpation for swelling, which may not provide as clear of an indication of pallor.
Question 4 of 5
A client is having a radioisotopic imaging scan. What action by the nurse is most important?
Correct Answer: D
Rationale: The correct answer is D because educating the client about the procedure is crucial for informed consent, reducing anxiety, and promoting cooperation during the scan. This empowers the client to understand what to expect and how to prepare. Assessing for shellfish allergies (A) is not directly related to the scan. Placing the client on radiation precautions (B) is unnecessary as the exposure is minimal, and sedating the client (C) should only be considered if medically indicated, not as a routine practice.
Question 5 of 5
A patient who is suspected of having acute viral hemorrhagic fever reveals history of tick bite. Which of the following is the most possible causative agent?
Correct Answer: C
Rationale: The correct answer is C: Crimean Congo virus. This is because Crimean Congo virus is a tick-borne virus known to cause acute viral hemorrhagic fever. Tick bite history increases suspicion for this virus. A: Hantavirus is transmitted through rodent feces and urine. B: Rift Valley virus is transmitted through mosquito bites. D: Marburg virus is transmitted through contact with infected animals.