ATI RN
ATI Hematologic System Quizlet Questions
Question 1 of 5
A 16-year-old patient with a left-side pelvic osteosarcoma is taking extended release oxycodone twice daily as well as immediate release oxycodone for breakthrough pain approximately 2 or 3 times per day. She describes her pain as burning, tingling, and shooting in her left leg. Her pain worsens with hot showers. Her most recent EKG has a QTc of 495. What would be the best strategy to manage her pain?
Correct Answer: D
Rationale: The correct answer is D: Add gabapentin three times daily. Gabapentin is a first-line option for neuropathic pain, which is likely the cause of the patient's burning, tingling, and shooting leg pain. The worsening of pain with hot showers is also characteristic of neuropathic pain. Gabapentin's mechanism of action in reducing neuropathic pain makes it a suitable choice for this patient. Switching to methadone (A) may not directly address the neuropathic pain component. Recommending more frequent use of immediate release oxycodone (B) may lead to increased risk of opioid-related adverse effects. While amitriptyline (C) is also used for neuropathic pain, starting with gabapentin is more appropriate given the patient's current opioid regimen and EKG findings.
Question 2 of 5
A 19-year old male patient with a history of acute lymphoblastic leukemia, currently 13 years from completion of therapy, presents for a fertility consultation. He is interested in his risk for infertility. Which of the following statements is true?
Correct Answer: A
Rationale: Step 1: Semen analysis is the gold standard for assessing male fertility. Step 2: The patient's history of ALL and completion of therapy make semen analysis relevant. Step 3: Long-term survivors of ALL are at risk for infertility due to treatment effects. Step 4: Semen analysis can provide valuable information on sperm count, motility, and morphology. Summary: - Option A is correct as semen analysis is crucial for assessing male fertility. - Option B is incorrect as alkylator dosages affect both males and females. - Option C is incorrect as sperm cryopreservation should ideally be offered at diagnosis. - Option D is incorrect as infertility risk may be higher than testosterone deficiency in this case.
Question 3 of 5
In a study to investigate the rates of central line–acquired bacterial infections, it is discovered that patient length of stay (LOS) is not normally distributed but is highly right-skewed. What is the correct relationship between the mean, median, and mode of LOS?
Correct Answer: C
Rationale: The correct relationship between mean, median, and mode in a highly right-skewed distribution is that the mean is greater than the median and mode. In a right-skewed distribution, the mean is pulled towards the longer tail, making it greater than the median, which is the middle value when the data is arranged in order. The mode is the most frequent value, but in a right-skewed distribution, it will be the smallest value, making the mean greater than both the median and mode. Therefore, choice C is correct. Choices A, B, and D are incorrect because they do not reflect the specific relationship between mean, median, and mode in a highly right-skewed distribution.
Question 4 of 5
You are consulted on a 4-year-old girl who is newly diagnosed with standard-risk pre-B acute lymphoblastic leukemia. After reviewing her previous complete blood examinations, you note she has had a platelet count ranging from 80,000 to 100,000 cells/mcL over the past 2 years. Her father mentions that he has also been told he has mild thrombocytopenia. You suspect the child may have a cancer predisposition syndrome. Which sample should you send for analysis, and which gene is most likely implicated?
Correct Answer: B
Rationale: The correct answer is B: Skin fibroblasts to evaluate the ETV6 gene. In this scenario, the presence of mild thrombocytopenia in both the father and the child raises suspicion of a genetic predisposition. ETV6 gene mutations are commonly associated with inherited thrombocytopenia and predisposition to leukemia. Skin fibroblasts are ideal for genetic testing due to their stable genetic material. Choice A is incorrect as RUNX1 gene mutations are linked to familial platelet disorder with predisposition to acute myeloid leukemia, not pre-B acute lymphoblastic leukemia. Choices C and D are incorrect as buccal swabs may not provide sufficient genetic material for comprehensive analysis.
Question 5 of 5
A female infant is diagnosed with hemophagocytic lymphohistiocytosis (HLH) not associated with an Epstein-Barr virus (EBV) infection. In taking the family history, you learn that another female infant died of HLH 2 years ago. Also, a newborn female child died of an unknown disease 4 years prior and was said have been bleeding profusely, jaundiced, and had a distended abdomen. When counseling the family about the genetics of HLH, how will you explain it?
Correct Answer: B
Rationale: The correct answer is B: It is an autosomal recessive syndrome. HLH is typically inherited in an autosomal recessive manner, meaning that two copies of the affected gene are needed to manifest the disease. In this case, the family history indicates that multiple female infants were affected, suggesting a recessive pattern. Choice A is incorrect as HLH is not an X-linked syndrome, indicated by the affected female infants. Choice C is incorrect since dominant inheritance would not result in multiple affected female infants. Choice D is also incorrect as autosomal recessive syndromes do not typically exhibit incomplete penetrance.