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 patients with severe factor XI deficiency, like this 16-year-old female, fresh frozen plasma can provide factor XI replacement and improve hemostasis. The dose of 20 mL/kg is appropriate to achieve a factor XI level of around 20%, which is sufficient for hemostasis during surgery. Now, let's analyze the other choices: A: Cryoprecipitate (five units), which will likely raise her factor XI level to 20% - Cryoprecipitate contains factor VIII and fibrinogen, but the amount of factor XI in cryoprecipitate is minimal and may not significantly raise factor XI levels to the required 20%. B: Factor XI concentrate (20 units/kg), which will raise her factor XI level to 20% - While factor XI concentrate is
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: The correct answer is B because starting chemotherapy before resection at week 12 can help shrink the tumor, making it more manageable for surgery. A is incorrect because preoperative chemotherapy can improve outcomes. C is incorrect because radiotherapy may not be necessary if the tumor is completely resected. D is incorrect because radiotherapy may still be necessary even if the tumor is resected before chemotherapy.
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. Pallor is difficult to detect in dark-skinned individuals due to the lack of contrast. The conjunctiva of the eye provides a reliable area to assess for pallor as it is mucous membrane with blood vessels that can show changes in color. It is not accurate to assess for pallor by having the patient open the hand widely (B) as skin color on hands may vary. Looking at the roof of the mouth (C) may not accurately reflect pallor. Palpating for areas of mild swelling (D) does not assess for pallor, but rather for edema.
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, cooperation, and reducing anxiety. This empowers the client to participate actively in their care. Assessing for shellfish allergies (A) is irrelevant unless a specific contrast agent is used. Placing the client on radiation precautions (B) is unnecessary for radioisotopic imaging. Sedating the client (C) may not be indicated and should be avoided if possible. Teaching the client about the procedure (D) addresses the immediate need and supports client safety and understanding.
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 the most likely causative agent of acute viral hemorrhagic fever following a tick bite due to its association with tick transmission. Crimean Congo virus is a tick-borne virus that causes severe hemorrhagic fever in humans. The other options, Hantavirus, Rift Valley virus, and Marburg virus, are not typically transmitted by ticks. Hantavirus is spread through rodent feces, Rift Valley virus is transmitted by mosquitoes, and Marburg virus is transmitted through direct contact with infected animals or their bodily fluids. Therefore, based on the history of tick bite, Crimean Congo virus is the most probable causative agent.