ATI RN
ATI Hematologic System Quizlet Questions
Question 1 of 5
The nurse is reviewing laboratory results and notes an aPTT level of 28 seconds. The nurse should notify the health care provider in anticipation of adjusting which medication?
Correct Answer: B
Rationale: The correct answer is B: Heparin. An aPTT level of 28 seconds indicates a shorter clotting time than normal, suggesting that the patient may be at risk for bleeding due to excessive anticoagulation with heparin. The nurse should notify the healthcare provider to adjust the heparin dosage to prevent bleeding complications. A: Aspirin is an antiplatelet medication and does not affect aPTT levels. C: Warfarin is a vitamin K antagonist and primarily affects the PT/INR levels, not aPTT. D: Erythropoietin is a hormone that stimulates red blood cell production and does not affect clotting parameters such as aPTT.
Question 2 of 5
A 6-year-old boy is noted to have worsening visual acuity on serial eye exams. Recent MRI of his brain and orbits reveals an optic chiasm mass, most consistent with an optic pathway glioma. Upon further examination, the physician notes axillary freckling and numerous “spots†on the patient's skin. This patient most likely has a which of the following genetic disorders?
Correct Answer: A
Rationale: The correct answer is A: Neurofibromatosis type-1 (NF1). This is because the patient presents with optic pathway glioma, axillary freckling, and numerous skin spots, which are classic features of NF1. NF1 is associated with multiple neurocutaneous manifestations, including café-au-lait spots, neurofibromas, and optic pathway gliomas. Li Fraumeni syndrome (B) is a cancer predisposition syndrome characterized by a high risk of developing various cancers, not typically associated with optic pathway gliomas or skin manifestations. Tuberous sclerosis (C) presents with features like facial angiofibromas, cortical tubers, and cardiac rhabdomyomas, not axillary freckling or optic pathway gliomas. Cystic Fibrosis (D) is a genetic disorder affecting the lungs and digestive system, not associated with the symptoms described in the patient.
Question 3 of 5
A 4-year-old child with acute lymphoblastic leukemia is receiving high-dose methotrexate during interim maintenance. He receives ondansetron and арретitant during his stay, which control his nausea and vomiting well. These medications work by inhibiting signaling in which part of the brain?
Correct Answer: E
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
Question 4 of 5
You receive a phone call from a community pediatrician who is caring for a 2-year-old toddler with a cancer predisposition syndrome. The pediatrician describes a child at the 95th percentile for height and weight with a history of corrective oral surgery to reduce a large tongue and a history of an omphalocele in infancy. The pediatrician is currently performing ultrasound of the abdomen and laboratory evaluation for this patient every 3 months. Which tumor is this patient most at risk of developing?
Correct Answer: D
Rationale: Step-by-step rationale for why the correct answer is D, Nephroblastoma: 1. The child has a cancer predisposition syndrome, likely Beckwith-Wiedemann syndrome (BWS). 2. BWS is associated with an increased risk of developing Wilms tumor (nephroblastoma). 3. The large tongue, omphalocele, and overgrowth placing the child at the 95th percentile for height and weight are all characteristic features of BWS. 4. Therefore, the patient is most at risk of developing nephroblastoma. Summary of why the other choices are incorrect: A: Pleuropulmonary blastoma - Not typically associated with BWS or the described clinical features. B: Hepatocellular carcinoma - Not commonly linked to BWS or the clinical presentation provided. C: Cystic nephroma - Not a typical tumor associated with BWS or the clinical findings described in the patient.
Question 5 of 5
An 18-month-old boy, whose parents are first cousins, is referred to you because of a significant episode of epistaxis. The parents report that the child had bleeding after circumcision and large hematomas with immunizations. Platelet aggregation studies show the following: This child's platelets are unable to interact with which of the following?
Correct Answer: B
Rationale: The correct answer is B: Fibrinogen. In this case, the child is likely suffering from Glanzmann thrombasthenia, a rare inherited platelet disorder where platelets lack the ability to bind to fibrinogen. This results in impaired platelet aggregation and clot formation, leading to bleeding tendencies. The other options (A, C, D) are not affected in Glanzmann thrombasthenia. Platelets interact normally with ADP (A), von Willebrand factor (C), and Platelet factor 4 (D) in this disorder.