ATI RN
ATI Hematologic System Questions
Question 1 of 5
The nurse is assessing a patient with chronic lung disease. Which finding indicates long-term hypoxia?
Correct Answer: C
Rationale: The correct answer is C: Clubbed fingertips. Clubbing is a sign of prolonged hypoxia due to chronic lung disease. It is characterized by enlargement and rounding of the fingertips. This occurs as a result of chronic hypoxia causing tissue changes in the fingers. Pallor (A) is a pale skin color often indicating decreased blood flow. Dyspnea (B) is difficulty breathing and can be an acute symptom of hypoxia. Pulmonary crackles (D) are abnormal lung sounds indicating fluid accumulation and are not specific to long-term hypoxia.
Question 2 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. This action is crucial in managing the potential complication of fluid overload in the patient receiving a blood transfusion. Elevating the head of the bed helps reduce venous return to the heart, decreasing preload and cardiac workload. This can alleviate symptoms like dyspnea and crackles associated with fluid overload. Assessing vital signs (choice A) is important but should follow positioning the patient appropriately. Encouraging deep breathing and coughing (choice C) may exacerbate the patient's respiratory distress. Administering diphenhydramine (choice D) is not indicated for the symptoms described.
Question 3 of 5
A female patient's hematocrit level is 50% and oxygen saturation is 98% on room air. What should the nurse suspect as being the cause for this patient's hematocrit level?
Correct Answer: A
Rationale: The correct answer is A: Dehydration. When a patient is dehydrated, their blood volume decreases, leading to a relative increase in the concentration of red blood cells and hematocrit level. In this case, the patient's high hematocrit level of 50% indicates hemoconcentration due to dehydration. Oxygen saturation being normal suggests that the body is compensating for the decreased blood volume by maintaining adequate oxygen delivery. Summary of incorrect choices: B: Chronic renal failure would likely result in anemia due to decreased erythropoietin production. C: Bone marrow suppression would lead to a decrease in red blood cell production, causing anemia. D: Bleeding esophageal varices would result in acute blood loss and a decreased hematocrit level.
Question 4 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. Having the patient lie on the left side for 1 hour after a bone marrow aspiration helps to prevent bleeding by applying pressure to the site. This position helps to promote clotting and reduces the risk of hematoma formation. Elevating the head of the bed (choice A) is not necessary for this procedure. Applying a sterile 2-inch gauze dressing (choice B) is important but does not address the immediate post-procedure care. Using a half-inch sterile gauze to pack the wound (choice C) is not recommended as it may disrupt the clotting process.
Question 5 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. In chronic obstructive pulmonary disease (COPD), the lungs are unable to efficiently exchange oxygen and carbon dioxide, leading to tissue hypoxia. The body compensates for this by producing more red blood cells (polycythemia) to increase oxygen-carrying capacity. This helps deliver more oxygen to tissues. Choice A is incorrect because medications for bronchodilation do not directly cause polycythemia. Choice B is incorrect because overactive bone marrow is not the primary reason for polycythemia in COPD. Choice C is incorrect because polycythemia in COPD is not a response to combat anemia but rather to address tissue hypoxia.