ATI RN
The Hematologic System ATI Questions
Question 1 of 5
The nurse is assisting with the collection of data from a patient with a hematologic disorder. On which body system should the nurse expect to focus when collecting this data?
Correct Answer: D
Rationale: The correct answer is D because hematologic disorders affect all body systems due to their impact on blood production, clotting, and oxygen transport. The nurse needs to assess respiratory system for oxygenation, genitourinary system for kidney function, cardiovascular system for circulation, and other systems for secondary effects. Choices A, B, and C are incorrect as they focus on specific systems, while hematologic disorders can impact multiple systems. It is important to consider the interconnectedness of the body and assess all systems comprehensively.
Question 2 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 3 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 4 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.
Question 5 of 5
You are consulted on a 4-year-old girl who is newly diagnosed with standard-risk pre-B acute lymphoblastic leukemia. After reviewing her previous complete blood examinations, you note she has had a platelet count ranging from 80,000 to 100,000 cells/mcL over the past 2 years. Her father mentions that he has also been told he has mild thrombocytopenia. You suspect the child may have a cancer predisposition syndrome. Which sample should you send for analysis, and which gene is most likely implicated?
Correct Answer: B
Rationale: The correct answer is B: Skin fibroblasts to evaluate the ETV6 gene. In individuals with familial thrombocytopenia and a history of malignancy, ETV6 gene mutations are often implicated. Sending skin fibroblasts for analysis allows for genetic testing to identify any ETV6 gene mutations that may be present. Skin fibroblasts are commonly used for genetic testing as they provide a stable and reliable source of DNA. Choice A (Skin fibroblasts to evaluate the RUNXI gene) is incorrect because RUNXI gene mutations are not typically associated with familial thrombocytopenia and cancer predisposition syndromes. Choice C (Buccal swab to evaluate the RUNXI gene) is also incorrect for the same reason. Choice D (Buccal swab to evaluate the ETV6 gene) is incorrect because buccal swabs may not provide enough genetic material for comprehensive testing of the ETV6 gene, which is