ATI LPN
ATI LPN Med Surg Haematology Questions
Extract:
Nurses' Notes
0930:
Child is awake and alert, but not talkative. Child developed a fever last evening and has manifestations of an upper respiratory infection. Guardians brought child to the oncology outpatient clinic today. Guardians report child received their last dose of chemotherapy 3 weeks ago and child's sibling has a mild upper respiratory infection.
1000:
Breath sounds are equal with bilateral rhonchi in upper lobes. Mild subcostal retractions are noted. Large amount of clear nasal drainage is noted. Child's skin is pale, small bruises are noted on trunk and thighs. Child states, "I feel like I can't breathe." Bed raised to high-Fowler's, oxygen applied, and provider notified.
Vital Signs
0900:
Temperature 38° C (100° F)
Heart rate 90/min
Respiratory rate 22/min
Blood pressure 106/70 mm Hg
Oxygen saturation 97% on room air
1000:
Temperature 38.5° C (101.3° F)
Heart rate 108/min
Respiratory rate 30/min
Blood pressure 102/72 mm Hg
Oxygen saturation 90% on room air
Diagnostic Results
1000:
WBC count 5,000/mm3 (5.000 to 10,000/mm3)
RBC count 3.6 (4.0 to 5.5)
Hgb 10 g/dL (10 to 15.5 g/dL)
Hct 32% (32% to 44%)
Question 1 of 5
A pediatric nurse is assisting with the care of a school-age child who has leukemia. Which of the following data collection findings should the nurse report to the provider? Select the 5 findings that should be reported to the provider.
Correct Answer: B,C,D,F,G
Rationale: The findings to report include skin assessment (pallor and bruising indicate anemia/thrombocytopenia), breath sounds (rhonchi suggest infection), oxygen saturation (90% indicates hypoxia), retractions (sign of respiratory distress), and respiratory rate (increased to 30/min reflects distress). Blood pressure is normal, WBC count is low-normal, and hemoglobin, while low, is not immediately critical.
Extract:
Question 2 of 5
The nurse is reviewing laboratory values for a female patient and notes a hemoglobin level of 8.2 g/100 mL (12-16) and a hematocrit level of 21% (37% -47%). These levels are found in patients with which condition?
Correct Answer: B
Rationale: Low hemoglobin and hematocrit indicate anemia, which can result from blood loss, iron deficiency, or chronic disease. Thyroid disease, bronchitis, and hemochromatosis do not directly cause these findings.
Question 3 of 5
The nurse is triaging several patients in an urgent care center. One patient states that he has hemophilia and is bleeding, with no apparent signs of bleeding. Which priority action by the nurse is most appropriate at this time?
Correct Answer: B
Rationale: Hemophilia patients are at risk for internal bleeding, which may not be visible. Immediate placement in an exam room and physician notification ensure rapid assessment to prevent complications.
Question 4 of 5
A nurse is reinforcing teaching with a client has a new diagnosis of aplastic anemia. When discussing the pathology of this disease, which of the following instructions should the nurse include in the teaching?
Correct Answer: A
Rationale: Aplastic anemia is characterized by the failure of bone marrow to produce adequate red blood cells (RBCs), white blood cells, and platelets, leading to pancytopenia. It is not related to liver function, iron deficiency, or increased RBC destruction, which are characteristics of other conditions like hemolytic anemia.
Question 5 of 5
A nurse is collecting data on a client who is to receive a blood transfusion. Which of the following data is the nurse's priority before the transfusion begins?
Correct Answer: B
Rationale: Monitoring the baseline temperature is critical before a transfusion because a fever may indicate an infection or signal the onset of a transfusion reaction, such as a febrile non-hemolytic reaction. Skin color, hemoglobin level, and fluid intake are important but secondary to detecting immediate transfusion-related complications.