ATI RN
The Hematologic System ATI Questions
Question 1 of 5
A patient is prescribed a transfusion of washed packed red blood cells. What should the nurse realize as being the rationale for the using this type of blood?
Correct Answer: C
Rationale: The correct answer is C because washing packed red blood cells reduces the risk of a febrile reaction by removing white blood cells, plasma proteins, and other substances that could lead to an immune response. Choice A is incorrect as hypothermia is not a primary concern with washed packed red blood cells. Choice B is incorrect as the process does not cleanse blood cells of impurities. Choice D is incorrect as the main purpose of washing blood cells is to reduce the risk of adverse reactions, not to remove harmful particles.
Question 2 of 5
A patient's complete blood count (CBC) shows a hemoglobin of 19 g/dL and a hematocrit of 54%. Which question should the nurse ask to determine possible causes of this finding?
Correct Answer: B
Rationale: The correct answer is B: Do you have any history of lung disease? A high hemoglobin and hematocrit can be indicative of chronic hypoxia, often seen in lung diseases like COPD. The nurse should ask about lung disease to explore the possibility of chronic hypoxia as the underlying cause. Choices A, C, and D are incorrect as they do not directly relate to the potential cause of elevated hemoglobin and hematocrit levels in this scenario.
Question 3 of 5
The health care provider tells the nurse that a client is to be started on a platelet inhibitor. About what drug does the nurse plan to teach the client?
Correct Answer: A
Rationale: The correct answer is A: Clopidogrel (Plavix). Platelet inhibitors like Clopidogrel work by preventing blood clots by inhibiting platelet aggregation. Clopidogrel is commonly used to reduce the risk of heart attack and stroke. Enoxaparin (Lovenox) is a low molecular weight heparin used to prevent blood clots. Reteplase (Retavase) is a thrombolytic agent used to dissolve blood clots. Warfarin (Coumadin) is an anticoagulant that works by inhibiting clotting factors in the liver, but it does not directly target platelets like Clopidogrel.
Question 4 of 5
A 9-year-old boy presents to the emergency department with emesis and headache of 3 weeks' duration. MRI reveals a large heterogeneous mass in the cerebellum. He undergoes a resection, and the pathology is most consistent with a classic medulloblastoma. Which of the following findings would classify the patient as a high-risk medulloblastoma?
Correct Answer: C
Rationale: The correct answer is C. A presurgical spine MRI revealing bulky tumor in the spine classifies the patient as high-risk medulloblastoma due to metastasis. This finding indicates dissemination of the tumor beyond the primary site in the cerebellum, which is associated with poorer prognosis and necessitates more aggressive treatment. Choice A is incorrect because elevated serum and CSF tumor markers are not specific indicators of high-risk medulloblastoma. Choice B (WNT subgrouping) is associated with favorable prognosis, so it does not classify the patient as high-risk. Choice D (postoperative brain MRI showing no residual tumor) is a positive outcome but does not address the presence of metastasis, which is crucial in determining high-risk status.
Question 5 of 5
An 8-year-old girl presents with National Cancer Institute (NCI) Standard Risk acute pre-B-cell acute lymphoblastic leukemia. Her family history is significant for her mother having been diagnosed with breast cancer at age 34 years and a maternal uncle who developed osteosarcoma as a teenager. What cytogenetic abnormality is most likely to be detected in this patient?
Correct Answer: D
Rationale: The correct answer is D: Hypodiploidy with a modal chromosome number of 34. In pediatric pre-B-cell acute lymphoblastic leukemia, hypodiploidy (fewer than 44 chromosomes) is associated with poor prognosis. A modal chromosome number of 34 is specifically linked to high-risk disease. A: t(1;19) is characteristic of pre-B-cell acute lymphoblastic leukemia but is associated with intermediate prognosis, not standard risk. B: CRLF2 rearrangement with a JAK2 mutation is seen in a subset of high-risk acute lymphoblastic leukemia cases, not standard risk. C: KMT24 rearrangement is not a known cytogenetic abnormality in acute lymphoblastic leukemia.