ATI RN
ATI Hematologic System Test Questions
Question 1 of 5
A leukemia investigator plans to obtain bone marrow under general anesthesia to measure minimal residual disease (MRD) and to see if this time point can predict early relapse. The specimen will be obtained at a time point when otherwise no bone marrow would be sampled. The results are not shared with the treating oncologist, and no therapeutic interventions are decided or based on the results. Which of the following statements is most accurate about this intervention?
Correct Answer: C
Rationale: Step 1: General anesthesia carries inherent risks, making the procedure more than minimal-risk. Step 2: The absence of therapeutic interventions based on results does not make the procedure low-risk. Step 3: Performing an additional procedure does not automatically make it minimal-risk. Step 4: Not sharing results with the treating oncologist may raise ethical concerns. Summary: Choice C is correct because the use of general anesthesia increases the risk level of the procedure, making it greater than minimal-risk. Choices A, B, and D are incorrect as they do not adequately address the specific risk associated with the use of general anesthesia in this scenario.
Question 2 of 5
An infant is born with a firm mass over the chest with a central area of purpura and a 'halo' around it. An ultrasound reveals a high-flow lesion. What is the most likely diagnosis?
Correct Answer: C
Rationale: The correct answer is C: Congenital hemangioma. A congenital hemangioma presents as a firm mass with purpura and a 'halo' due to rapid growth of blood vessels. The central area of purpura indicates thrombosis. The high-flow lesion on ultrasound suggests an increased blood flow. Fibrosarcoma (A) is a malignant tumor of fibrous tissue and does not present with these characteristic features. Infantile hemangioma (B) typically appears after birth and has a different clinical presentation. Capillary malformation (D) is a vascular malformation that does not typically show the same features as described in the question.
Question 3 of 5
A study is designed to investigate the rates of central line–associated blood stream infections among pediatric hematology/oncology patients. Three common central line types (totally implanted catheter [port], peripherally inserted central catheter [PICC], and tunneled externalized catheter [TEC]) were included in the study. What data structure is central line type?
Correct Answer: C
Rationale: The correct answer is C: Nominal. The central line type is a categorical variable with no inherent order or ranking. Each type is distinct and cannot be quantitatively ordered or measured. It is not continuous (A), as it is not on a scale. It is not dichotomous (B) as there are more than two categories. It is not ordinal (D) because the types do not have a clear order or ranking. Therefore, central line type is best represented by a nominal data structure.
Question 4 of 5
You receive a phone call from a community pediatrician who is caring for a 2-year-old toddler with a cancer predisposition syndrome. The pediatrician describes a child at the 95th percentile for height and weight with a history of corrective oral surgery to reduce a large tongue and a history of an omphalocele in infancy. The pediatrician is currently performing ultrasound of the abdomen and laboratory evaluation for this patient every 3 months. Which tumor is this patient most at risk of developing?
Correct Answer: D
Rationale: The correct answer is D: Nephroblastoma. This patient most likely has Beckwith-Wiedemann Syndrome (BWS) due to the large tongue (macroglossia) and omphalocele. BWS is associated with an increased risk of nephroblastoma (Wilms tumor). The 95th percentile for height and weight is also a characteristic feature of BWS. Ultrasound and laboratory evaluation are appropriate monitoring tools for nephroblastoma in this patient due to the increased risk associated with BWS. A: Pleuropulmonary blastoma is more commonly associated with DICER1 syndrome, not BWS. B: Hepatocellular carcinoma is not commonly associated with BWS. C: Cystic nephroma is not typically associated with BWS, and nephroblastoma is a more common tumor in this context.
Question 5 of 5
A 2-month-old infant is brought to your clinic with an extensive scaly rash on the scalp, which has been biopsied and shown to be Langerhans cell histiocytosis (LCH). You want to determine whether this patient has skin-only LCH or involvement of any of the 'high-risk' organs. The child has a normal CBC; normal liver enzymes and bilirubin; and a normal skeletal survey, skull films, and chest X ray. What other screening test will be important for finding involvement of a high-risk organ?
Correct Answer: D
Rationale: The correct answer is D: Serum albumin and total protein. In LCH, high-risk organ involvement includes the liver and spleen. Serum albumin and total protein levels can help assess liver function, as low levels may indicate liver involvement. A normal CBC, liver enzymes, and bilirubin do not rule out organ involvement, as LCH can affect organs without causing significant abnormalities in these tests. Reticulocyte count (A) is not relevant for assessing high-risk organ involvement in LCH. Erythrocyte sedimentation rate (B) is a nonspecific marker of inflammation and not specific for organ involvement. Alkaline phosphatase (C) is more indicative of bone or liver disease rather than specifically assessing high-risk organ involvement in LCH.