ATI RN
ATI Hematologic System Questions
Question 1 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 types in this study (port, PICC, TEC) are categorical and do not have a natural order or ranking. They are simply names or labels representing different types of central lines. This makes them fall under the nominal data structure category. Continuous data (choice A) would involve measurements with infinite possible values. Dichotomous data (choice B) would have only two categories. Ordinal data (choice D) would imply a natural ranking or order among the categories, which is not applicable in this context.
Question 2 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 (I) or a single extralymphatic site (IE) without systemic symptoms. In this case, the patient has a large mediastinal mass but no other sites of disease on metastatic workup. This corresponds to Stage I disease. Choice B: Stage II would indicate involvement of two or more lymph node regions on the same side of the diaphragm. Choice C: Stage III would indicate involvement of lymph node regions on both sides of the diaphragm. Choice D: Stage IV would indicate disseminated involvement of one or more extralymphatic organs or tissues. Therefore, based on the information provided, the correct stage for this patient is Stage I as per the Ann Arbor staging system.
Question 3 of 5
When reviewing the chemistry panel of a newly diagnosed patient with acute lymphoblastic leukemia who is lethargic, complaining of flank pain, and experiencing nausea and vomiting, which of the following would you expect to see?
Correct Answer: D
Rationale: Step-by-step rationale: 1. Lethargy, flank pain, nausea, vomiting in leukemia can suggest tumor lysis syndrome (TLS). 2. TLS can cause hyperkalemia, hyperphosphatemia, hyperuricemia, hypocalcemia, and elevated BUN. 3. Choice D has the highest potassium, phosphorus, uric acid, and BUN levels, and the lowest calcium level. 4. Therefore, choice D is the most consistent with the expected lab findings in tumor lysis syndrome. Summary: - Choice A has normal potassium, phosphorus, uric acid, calcium levels, and lower BUN. - Choice B has high potassium but normal phosphorus, uric acid, calcium, and slightly elevated BUN. - Choice C has low potassium, normal phosphorus, and elevated uric acid, calcium, and BUN. - Choice D aligns most closely with the expected lab findings in tumor lysis syndrome due to the pattern of
Question 4 of 5
A pediatric fellow is planning a project intended to decrease the incidence of acute chest syndrome among patients with sickle cell disease who are already admitted to the hospital for other reasons. The fellow discussed with her mentor whether the project proposal should be submitted for review by the Institutional Review Board (IRB). The mentor explains that, at their intuition, quality improvement activities do not require IRB review but research projects must be submitted to the IRB. Which of the following is NOT a relevant consideration in determining whether the project is research or quality improvement?
Correct Answer: C
Rationale: The correct answer is C because the intent to publish results in a peer-reviewed journal is not a relevant consideration in determining whether a project is research or quality improvement. Here's a step-by-step rationale: 1. Quality improvement aims to enhance processes within a specific institution, while research seeks to generate generalizable knowledge. 2. Methodology using Plan-Do-Study-Act cycles is common in both quality improvement and research projects. 3. Efforts to stabilize biases/confounders over time align with both quality improvement and research principles. 4. Intent to publish in a peer-reviewed journal does not define the project as research; it is possible to publish quality improvement initiatives as well.
Question 5 of 5
You are seeing a 2-year-old girl with new onset of fever and bronchitis. She has maculopapular rash and hepatosplenomegaly. Blood smear shows leukocytosis (100,000/mm3), anemia, and thrombocytopenia. Ancillary tests include fetal hemoglobin of 80% and normal blood karyotype. What is the most likely diagnosis?
Correct Answer: D
Rationale: The most likely diagnosis in this scenario is Juvenile myelomonocytic leukemia (JMML). This is supported by the presence of hepatosplenomegaly, maculopapular rash, leukocytosis, anemia, and thrombocytopenia in a young child. The elevated fetal hemoglobin level is characteristic of JMML. Additionally, a normal blood karyotype helps differentiate JMML from other leukemias. Choice A (Leukemoid Reaction) is incorrect because it is typically a reactive condition due to infections, not a primary hematological malignancy like JMML. Choice B (Acute lymphoblastic leukemia) is less likely due to the presence of hepatosplenomegaly and a high fetal hemoglobin level. Choice C (Chronic myeloid leukemia) is less likely in a young child with the given clinical presentation.