ATI LPN
ATI LPN Med Surg Haematology Questions
Extract:
Question 1 of 5
The nurse is caring for a patient who must undergo a splenectomy for treatment for idiopathic thrombocytopenic purpura (ITP). Which of the following statements best describes the rationale for the splenectomy?
Correct Answer: A
Rationale: In ITP, the spleen destroys platelets, leading to thrombocytopenia. Splenectomy reduces this destruction, increasing platelet counts. The spleen does not produce platelets or cause infections due to WBC loss in this context.
Question 2 of 5
A nurse is preparing to administer 1,000 mL of lactated Ringer's IV over 6 hr. The drop factor of the manual IV tubing is 10 gtt/mL. The nurse should set the manual IV infusion to deliver how many gtt/min? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)
Correct Answer: 28
Rationale: Flow rate = (
Total volume × Drop factor) ÷ Time in minutes = (1000 mL × 10 gtt/mL) ÷ 360 min = 27.78 ≈ 28 gtt/min. This calculation ensures the correct infusion rate for the IV fluid.
Question 3 of 5
A nurse is caring for a client who is receiving a unit of packed RBCs. About 15 min following the start of the transfusion, the nurse notes that the client is flushed and febrile, and reports chills. To help confirm that the client is having an acute hemolytic transfusion reaction, the nurse should observe for which of the following manifestations?
Correct Answer: D
Rationale: Hypotension is a key sign of an acute hemolytic transfusion reaction due to hemolysis causing shock. Jaw pain, urticaria, and distended neck veins are not typical of this reaction.
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 4 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 5 of 5
The nurse is preparing to assist the physician with a bone marrow biopsy. Which of the following interventions is most important for the nurse to carry out before the procedure?
Correct Answer: D
Rationale: Administering an analgesic before a bone marrow biopsy ensures patient comfort and reduces pain, which is a priority. Other actions, like explaining to family or draping, are secondary.