ATI RN
Hematology Oncology Question Bank Questions
Question 1 of 4
Which of the following is true of clients with hemophilia A (classic hemophilia)?
Correct Answer: A
Rationale: In understanding why option A is the correct answer in this question about hemophilia A, it is crucial to grasp the pathophysiology of the condition. Hemophilia A is a genetic disorder characterized by a deficiency in clotting factor VIII, leading to impaired blood clotting. Due to this deficiency, bleeding in individuals with hemophilia A is often delayed after trauma because the clotting process is disrupted. This delayed bleeding is a hallmark feature of hemophilia A and distinguishes it from other bleeding disorders. Regarding why the other options are incorrect: - Option B: Hemarthrosis, or bleeding into joint spaces, is actually a common and significant complication in individuals with hemophilia A due to their impaired clotting mechanism. - Option C: In hemophilia A, coagulation and bleeding time are prolonged, not severely prolonged, due to the deficiency in factor VIII. - Option D: Client education plays a crucial role in managing hemophilia A by empowering individuals to recognize symptoms early, seek appropriate care, and prevent complications. Therefore, stating that client education is ineffective is inaccurate. Educational context: Understanding the key clinical manifestations and complications of hemophilia A is essential for healthcare professionals working in hematology and oncology. By grasping the nuances of this condition, clinicians can provide optimal care and support to individuals with hemophilia A, emphasizing the importance of early recognition, prompt treatment, and ongoing education to prevent complications and improve outcomes.
Question 2 of 4
In the process of admitting Mr. Johnson, the nurse observes multiple bruising, especially on the hands and forearms. These bruises are referred to as
Correct Answer: D
Rationale: In the scenario presented, the correct answer is D) ecchymoses. Ecchymoses are large, non-elevated bruises caused by the leakage of blood into the skin due to damaged blood vessels. This is a common manifestation in conditions such as thrombocytopenia or coagulopathies, where there is a decreased ability to clot blood, leading to easy bruising. Option A) erythropoiesis refers to the process of red blood cell production and is not directly related to bruising. Option B) leukoplakia is a condition affecting the mucous membranes, characterized by white patches, and is not associated with bruising. Option C) megakaryocytic hyperplasia is an increase in the production of platelet precursor cells, which would actually lead to increased platelet count and reduced bruising tendency. In an educational context, understanding the clinical significance of different types of bruising can help healthcare providers in diagnosing underlying conditions such as hematological disorders or coagulopathies. Recognizing ecchymoses can prompt further investigations to determine the cause and initiate appropriate management, highlighting the importance of keen observation and clinical assessment skills in patient care.
Question 3 of 4
A protocol of chlorambucil (Leukeran) and prednisone is prescribed for Mr. Johnson. The most serious delayed toxic symptom of antileukemic chemotherapy is
Correct Answer: A
Rationale: The correct answer is A) bone marrow depression. In the context of antileukemic chemotherapy like chlorambucil and prednisone, the most serious delayed toxic symptom is bone marrow depression. This is because these drugs target rapidly dividing cells, which include not only cancer cells but also normal cells in the bone marrow responsible for producing blood cells. Option B) loss of hair and libido is a common side effect of chemotherapy, but it is not the most serious delayed toxic symptom in this case. Option C) periorbital edema is not typically associated with chlorambucil and prednisone chemotherapy. Option D) orange urine may be a side effect of certain medications but is not the most serious delayed toxic symptom of antileukemic chemotherapy. In an educational context, understanding the potential toxicities and side effects of chemotherapy is crucial for healthcare professionals managing patients with hematologic malignancies. Recognizing the most serious toxicities can help in monitoring patients for potential complications and providing timely interventions to minimize risks and improve outcomes.
Question 4 of 4
Mr. D., who has suffered pelvic and crushing chest injuries, complains of a nose bleed and large bruises on his arms and legs. Laboratory data indicate prolonged prothrombin time, low platelet count, and incoagulable blood. A diagnosis of disseminated intravascular coagulation (DIC) is made and Mr. D. should be prepared for
Correct Answer: B
Rationale: In the case of Mr. D. presenting with DIC due to pelvic and chest injuries, the correct preparation is intravenous heparin administration. DIC is characterized by widespread activation of coagulation pathways, leading to both thrombosis and hemorrhage. Heparin, an anticoagulant, helps prevent further clot formation in DIC by inhibiting clotting factors. Option A, administration of furosemide, is incorrect as it is a diuretic that does not address the underlying coagulation abnormalities in DIC. Option C, thoracentesis, is a procedure to remove fluid from the pleural space and is not directly related to managing DIC. Option D, gastroscopy, is a procedure to visualize the upper gastrointestinal tract and is not the appropriate intervention for DIC. Educationally, understanding the pathophysiology of DIC and the role of heparin in managing this condition is crucial for healthcare professionals, especially those in hematology/oncology. This knowledge helps in timely and appropriate management of patients like Mr. D. to improve outcomes and prevent further complications associated with DIC.