ATI LPN
ATI LPN Med Surg Haematology Questions
Extract:
Question 1 of 5
The nurse is caring for a patient with stage IV Hodgkin disease. Where should the nurse expect to find enlarged lymph nodes during the assessment?
Correct Answer: D
Rationale: Stage IV Hodgkin disease involves widespread lymph node and organ involvement, leading to generalized lymphadenopathy. Earlier stages (I-III) have more localized lymph node involvement.
Question 2 of 5
A nurse is collecting data from a client who has leukemia. Which of the following findings has the highest priority?
Correct Answer: D
Rationale: A low platelet count (125,000/mm³) increases bleeding risk, making it the highest priority in leukemia patients. Low hematocrit, bone pain, and weight loss are concerning but less immediately life-threatening.
Question 3 of 5
A nurse is assisting with the care of a client who is receiving a blood transfusion. The nurse should monitor for which of the following findings as an indication the client is having an acute hemolytic reaction?
Correct Answer: D
Rationale: Low back pain is a hallmark of acute hemolytic reaction due to the breakdown of red blood cells and hemoglobin release, which can stress the kidneys. Pulmonary congestion is linked to fluid overload, urticaria to allergic reactions, and vomiting is less specific to hemolytic reactions.
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 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.