ATI RN
ATI Hematologic System Questions
Question 1 of 5
An older adult patient is receiving a transfusion of packed red blood cells after being injured in a car accident. On assessment, the nurse notes a new finding of bounding pulse, crackles, and increasing dyspnea. What should the nurse do first, after stopping the transfusion?
Correct Answer: B
Rationale: The correct answer is B: Raise the head of the bed. After stopping the transfusion due to signs of fluid overload, the priority is to alleviate symptoms and improve respiratory function. Elevating the head of the bed helps reduce venous return, decreasing preload and cardiac workload, which can help manage symptoms like dyspnea and crackles. This action promotes better oxygenation and reduces the risk of complications like pulmonary edema. Assessing vital signs (Choice A) is important but not the immediate priority. Encouraging deep breathing and coughing (Choice C) may exacerbate respiratory distress in this situation. Administering diphenhydramine (Choice D) is not indicated for fluid overload.
Question 2 of 5
A patient with pancytopenia has a bone marrow aspiration from the left posterior iliac crest. Which action would be important for the nurse to take after the procedure?
Correct Answer: D
Rationale: The correct answer is D: Have the patient lie on the left side for 1 hour. This position helps prevent bleeding by applying pressure to the site. Elevating the head of the bed (A) is not necessary for this procedure. Applying a 2-inch gauze dressing (B) may disrupt the site and increase the risk of bleeding. Using half-inch sterile gauze to pack the wound (C) is not recommended for bone marrow aspiration sites as it can lead to infection.
Question 3 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 4 of 5
A nurse is caring for four clients. After reviewing today's laboratory results, which client should the nurse see first?
Correct Answer: C
Rationale: The correct answer is C. The nurse should see the client with a prothrombin time (PT) of 28 seconds first because PT measures the time it takes for blood to clot. A PT of 28 seconds is prolonged, indicating potential bleeding risk. This requires immediate attention to prevent complications. Choice A: A client with an international normalized ratio of 2.8 may indicate anticoagulant therapy but is not as urgent as a prolonged PT. Choice B: A platelet count of 128,000/mm³ is low but doesn't necessarily require immediate intervention compared to a prolonged PT. Choice D: A red blood cell count of 5.1 million/L is within normal range and does not indicate an urgent issue related to clotting or bleeding.
Question 5 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.