ATI LPN
ATI LPN Med Surg Haematology Questions
Extract:
Nurses Notes
0830:
Child was brought in by parents for unexplained bruising and red spots on the child's shoulders, thighs, and back. Parents report child has had a cold for more than 2 months and over-the-counter medications have not helped relieve the cold symptoms. Lung sounds clear. Child moves all extremities well with some swelling noted in knees and elbows. Abdomen soft with active bowel sounds.
1000:
Parents report child had small nosebleed "a few minutes ago" and child states. "My arms and legs hurt all over." Child's nosebleed has been resolved with only small amount of blood noted on tissues.
Vital Signs
0830:
Temperature 38° C (100.4° F)
Heart rate 100/min
Respiratory rate 20/min
Blood pressure 102/64 mm Hg
Oxygen saturation 98% on room air
1000:
Temperature 38.3° C (101° F) Heart rate 112/min Respiratory rate 24/min
Blood pressure 104/62 mm Hg
Oxygen saturation 97% on room air
Diagnostic Results
WBC count 15.000/mm3 (5,000 to 10,000/mm3)
Hgb 8 g/dL (10 to 15.5 g/dL)
Hct 32% (32% to 44%)
Question 1 of 5
The nurse is reviewing the data collection findings and diagnostic results. For each data collection finding, click to specify if the finding is consistent with leukemia, sickle cell anemia, or hemophilia. Each finding may support more than 1 disease process.
| Options | Leukemia | Sickle Cell Anemia | Hemophilia |
|---|---|---|---|
| A. Reported pain: Leukemia, Sickle Cell Anemia | |||
| B. Bleeding: Leukemia, Hemophilia | |||
| C. Temperature: Leukemia, Sickle Cell Anemia | |||
| D. Bruising: Leukemia, Hemophilia | |||
| E. WBC count: Leukemia |
Correct Answer: A,B,C,D,E
Rationale: Reported pain is consistent with leukemia (bone pain) and sickle cell anemia (vaso-occlusive crises). Bleeding and bruising align with leukemia (thrombocytopenia) and hemophilia (clotting factor deficiency). Elevated temperature suggests infection in leukemia or sickle cell anemia. High WBC count is typical in leukemia due to abnormal white cells.
Extract:
Question 2 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 3 of 5
The home care nurse is providing teaching to the family of a patient with multiple myeloma. Which nursing diagnosis should guide the nurse for this teaching?
Correct Answer: C
Rationale: Multiple myeloma weakens bones through osteolytic lesions, increasing fracture risk. Teaching about injury prevention is critical. Airway clearance, perfusion, and bleeding are less relevant.
Question 4 of 5
The nurse is caring for a patient with a platelet count of <20,000/mm3 (150,000-400000). Which of the following precautions should the nurse take in providing care for this patient?
Correct Answer: B
Rationale: With a low platelet count, the patient is at high risk for bleeding. Using a soft toothbrush minimizes the risk of gum injury and bleeding, which is a critical safety measure for thrombocytopenic patients. Reporting fever, while important, does not address bleeding risk directly. Hot liquids and straight razors increase the risk of burns or cuts, which could lead to uncontrollable bleeding.
Question 5 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.