ATI RN
ATI Hematologic System Questions
Question 1 of 5
A nursing student wants to know why clients with chronic obstructive pulmonary disease tend to be polycythemic. What response by the nurse instructor is best?
Correct Answer: D
Rationale: The correct answer is D because in chronic obstructive pulmonary disease (COPD), the lungs are unable to efficiently oxygenate the blood, leading to tissue hypoxia. Polycythemia is the body's compensatory mechanism to increase red blood cell production in an attempt to improve oxygen-carrying capacity to tissues. Choices A, B, and C are incorrect as polycythemia in COPD is primarily a response to tissue hypoxia rather than medication side effects, overactive bone marrow, or combating anemia related to increased metabolic rate.
Question 2 of 5
Blinatumomab, a bispecific T-cell engaging molecule, is active against which CD antigen that is expressed on B-lymphoblasts?
Correct Answer: C
Rationale: Step-by-step rationale: 1. Blinatumomab is a bispecific molecule designed to engage T-cells to target B-lymphoblasts. 2. It targets CD19, a B-cell-specific antigen expressed on B-lymphoblasts. 3. Engagement of T-cells via CD19 leads to targeted killing of B-lymphoblasts. 4. CD10, CD15, and CD20 are not specific to B-cells, making them incorrect choices. Summary: The correct answer is C (CD19) because blinatumomab's mechanism of action specifically targets B-lymphoblasts via CD19. Choices A, B, and D are incorrect as they do not have the same specificity for B-cells as CD19 does.
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. Central line type is a nominal data structure because it represents categories without any inherent order or ranking. In this study, the central line types (port, PICC, TEC) are distinct categories with no numerical significance or order. They are simply different types of central lines used for medical purposes. Continuous (A) data involves numerical values with infinite possibilities, which is not the case here. Dichotomous (B) data consists of only two categories, while in this study there are three central line types. Ordinal (D) data involves categories with a specific order or ranking, which is not applicable to central line types as they do not have a natural order.
Question 4 of 5
A newborn infant develops jaundice on day of life 2. Labs are drawn, and she has a hemoglobin of 7.4 g/dL with a reticulocyte count of 8%. Upon peripheral blood smear review, she is found to have bizarre red cell forms with significant polkilocytosis. Although her parents have normal blood counts, on review of their peripheral blood smears, they both have a moderate number of ovalocytes. Which of the following is the most likely cause of the infant's red cell findings?
Correct Answer: C
Rationale: The correct answer is C because the infant likely has hereditary elliptocytosis, an autosomal dominant disorder caused by mutations in the alpha-spectrin gene. Ovalocytes and polkilocytosis are characteristic of this condition. Since both parents have ovalocytes, it is likely that the infant inherited mutations from each parent, resulting in a more severe presentation. Anemia in hereditary elliptocytosis can improve over time due to compensatory mechanisms. Choices A, B, and D are incorrect as they describe different genetic disorders (hereditary spherocytosis, hereditary stomatocytosis, and pyruvate kinase deficiency, respectively) and do not match the clinical and family history provided.
Question 5 of 5
A 15-year-old female presents with 1 month of fatigue and 3 days of chest pain and shortness of breath. Her physical exam is unremarkable. A chest x-ray shows a large mediastinal mass that is greater than 33% of the diameter of her chest cavity. A biopsy shows nodular sclerosing, classic Hodgkin lymphoma (cHL). Metastatic workup at diagnosis, including CT scan of neck, chest, abdomen, and pelvis and PET scan, shows no other site of disease. According to the Ann Arbor staging system, the patient has which stage of cHL?
Correct Answer: A
Rationale: The correct answer is A: Stage I. In the Ann Arbor staging system for Hodgkin lymphoma, Stage I indicates involvement of a single lymph node region or a single extralymphatic organ or site. In this case, the patient's disease is limited to the mediastinum without involvement of other lymph nodes or organs. The large mediastinal mass is considered as a single site of disease. The absence of disease involvement in other areas based on the metastatic workup supports the classification as Stage I. The other choices (B, C, D) are incorrect because they represent more extensive disease involving multiple lymph node regions or extralymphatic organs, which is not the case in this patient.