ATI RN
Hematology NCLEX Questions Questions
Question 1 of 5
A 45-year-old woman is admitted to the surgical service with severe arterial insufficiency of the right second toe. She has no prior medical history and takes no medications. Physical examination findings are normal except for mild splenomegaly and signs of early gangrene in the right second toe. All pulses are full and equal throughout. Diagnostic testing results are shown in Table 9.Q2. Which of the following is the most likely diagnosis?
Correct Answer: A
Rationale: Extreme thrombocytosis (platelet count 1,300 × 10^9/L), mild splenomegaly, and atypical megakaryocyte clusters in bone marrow suggest essential thrombocythemia, a myeloproliferative neoplasm causing thrombosis (toe gangrene). Vasculitis (B) lacks hematologic findings. CML (C) typically shows Philadelphia chromosome, absent here. PMF (D) would show reticulin fibrosis, not seen.
Question 2 of 5
A 22-year-old woman is brought to the emergency department after having 1 witnessed tonic-clonic seizure. She had appeared confused for the preceding few hours. On examination, she is febrile and appears slightly confused; otherwise, neurologic and physical examination findings are normal. Laboratory testing results are shown in Table 9.Q12, and the peripheral blood smear is shown in Figure 9.Q12. What is the most appropriate next step in management?
Correct Answer: D
Rationale: Fever, confusion, seizure, anemia (hemoglobin 8 g/dL), thrombocytopenia (platelets 50 × 10^9/L), and renal dysfunction (creatinine 2.5 mg/dL) suggest thrombotic thrombocytopenic purpura (TTP). Plasma exchange is the treatment of choice. Transfusions (A, B) don’t address pathogenesis; platelets (B) may worsen TTP. Gamma globulin (C) is ineffective.
Question 3 of 5
A 75-year-old African American man was seen last week by his primary care physician for mild dyspnea. He has also noted intermittent peripheral edema. During the evaluation, an electrocardiogram showed low-voltage QRS complexes in the limb leads. The troponin T level was elevated (0.07 ng/mL). This finding suggested the need for a coronary angiogram, which showed no significant coronary artery disease. An echocardiogram showed diffuse left ventricular thickening with a granular texture to the myocardium and a septal thickness of 2.5 cm (normal <1.1 cm). The complete blood cell count results were normal. Serum and urine protein electrophoresis and immunofixation were unremarkable. Serum free light chain levels were not increased. What is the most likely diagnosis?
Correct Answer: D
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
Question 4 of 5
The most likely diagnosis for the condition described in Question 1 is
Correct Answer: D
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
Question 5 of 5
Matching: Hemolytic anemia - Dactylitis
Correct Answer: D
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.