A 22-year-old man is admitted to the hospital for an elective cholecystectomy. You are asked to see him because he had anemia on preoperative testing. He tells you that he has always been told by his physicians that he has mild anemia; his medical history is otherwise unremarkable. His vital signs are normal. His conjunctivae are mildly icteric, and the spleen is palpable in the left upper quadrant. Findings on the remainder of the physical examination are normal. Diagnostic testing results are shown in Table 9.Q3. Which of the following tests would most likely help confirm the diagnosis?

Questions 60

ATI RN

ATI RN Test Bank

ASCP Hematology Questions Questions

Question 1 of 5

A 22-year-old man is admitted to the hospital for an elective cholecystectomy. You are asked to see him because he had anemia on preoperative testing. He tells you that he has always been told by his physicians that he has mild anemia; his medical history is otherwise unremarkable. His vital signs are normal. His conjunctivae are mildly icteric, and the spleen is palpable in the left upper quadrant. Findings on the remainder of the physical examination are normal. Diagnostic testing results are shown in Table 9.Q3. Which of the following tests would most likely help confirm the diagnosis?

Correct Answer: B

Rationale: Lifelong mild anemia, icterus, splenomegaly, microspherocytes, and elevated reticulocytes (4%) suggest hereditary spherocytosis, confirmed by osmotic fragility test showing membrane defect. Hemoglobin electrophoresis (A) diagnoses hemoglobinopathies, not spherocytosis. Coombs tests (C) identify autoimmune hemolysis, unlikely given chronicity. Bone marrow biopsy (D) is unnecessary with adequate reticulocyte response.

Question 2 of 5

A 72-year-old man with chronic atrial fibrillation has been receiving dabigatran 75 mg twice daily for the past 6 months. He has not had any thrombotic or hemorrhagic complications. He has a history of colon polyps, for which he needs to undergo a colonoscopy with possible polypectomy. Apart from an irregular pulse, his physical examination findings are normal. Results were normal for a complete blood cell count and tests of renal and liver function. The calculated creatinine clearance is 28 mL/min. For how long should dabigatran use be discontinued before the colonoscopy?

Correct Answer: D

Rationale: Dabigatran’s prolonged half-life with creatinine clearance <30 mL/min requires discontinuation 3 days before procedures with bleeding risk (e.g., polypectomy), balancing thrombosis and hemorrhage risks. Shorter times (B, C) or none (A) risk bleeding; 7 days (E) is excessive.

Question 3 of 5

A 55-year-old man presented to his primary care physician for evaluation of fatigue. He was previously healthy with the exception of chronic musculoskeletal low back pain, for which he occasionally takes nonsteroidal anti-inflammatory drugs. On examination, he is pale. Complete blood cell count results are as follows: hemoglobin 8.3 g/dL, mean corpuscular volume 73 fL, leukocyte count 6.9 × 10^9/L, and platelet count 398 × 10^9/L. Results of the fecal occult blood test are positive. During upper and lower endoscopy, a 1.2 × 2.5-cm ulcerative lesion is noted in the lesser curvature of the stomach. The lesion is biopsied and identified as a MALT lymphoma. Which of the following is characteristic of MALT lymphoma?

Correct Answer: D

Rationale: Gastric MALT lymphoma is often Helicobacter pylori-related, with 70% cured by antibiotics (amoxicillin, omeprazole, clarithromycin). Anthracyclines (A) and radiotherapy (C) are for advanced cases. Chlamydophila psittaci (B) links to ocular MALT, not gastric. Transformation (D) is less common.

Question 4 of 5

A 10-month-old white male presents with a 1-day history of persistent bleeding after cutting his lip slightly. The family history is unremarkable, and the patient is receiving no medications. Laboratory data reveal a hemoglobin value of 11 g/dL, platelets of 350,000, a prothrombin time of 11.8 seconds, and a partial thromboplastin time (PTT) of 100 seconds, which is corrected by mixing of normal plasma. The most likely diagnosis is

Correct Answer: B

Rationale: Hemophilia A (B) causes prolonged PTT (factor VIII deficiency) corrected by mixing, with normal PT and platelets, fitting this bleeding profile.

Question 5 of 5

Matching: Hemolytic anemia - Decay-accelerating factor deficiency

Correct Answer: B

Rationale: Decay-accelerating factor deficiency relates to paroxysmal nocturnal hemoglobinuria, but in this context, autoimmune hemolytic anemia (B) fits best as an acquired condition.

Access More Questions!

ATI RN Basic


$89/ 30 days

ATI RN Premium


$150/ 90 days

Similar Questions