ATI Hematologic System Test

ATI Hematologic System Test Related

Review ATI Hematologic System Test related questions and content

A 13-year-old Hispanic girl is found to have a WBC count of 6,500/mm3 with 40% Auer rod–containing granular blasts that, by flow cytometry, express very bright CD33 but are negative for human leukocyte antigen–DR isotype (HLA-DR). She is oozing blood around her peripheral IV site. Coagulation studies reveal an international normalized ratio (INR) of 3.4, a fibrinogen of 170, and a markedly elevated D-dimer. Marrow aspirate shows nearly 90% blasts with a similar morphology. You send the marrow to the fluorescence in situ hybridization (FISH) lab and request STAT testing for the most likely recurrent genetic abnormality based on the clinical presentation. How do you plan to initiate therapy?

  • A. Perform a lumbar puncture to determine leukemic involvement, then proceed with induction chemotherapy.
  • B. Begin therapy with all-trans retinoic acid (ATRA) immediately while aggressively managing coagulopathy with blood product support.
  • C. Start dexamethasone and hydroxyurea immediately while aggressively managing coagulopathy with blood product support.
  • D. Start induction chemotherapy, obtain HLA typing, and start a donor search because of the poor prognosis associated with this leukemic phenotype.
Correct Answer: B

Rationale: The correct answer is B: Begin therapy with all-trans retinoic acid (ATRA) immediately while aggressively managing coagulopathy with blood product support. The patient's presentation is consistent with acute promyelocytic leukemia (APL), indicated by the presence of Auer rod-containing blasts, very bright CD33 expression, and coagulopathy (elevated INR, low fibrinogen, elevated D-dimer). APL is associated with a specific genetic abnormality involving the PML-RARA fusion gene. ATRA is the mainstay of induction therapy for APL as it induces differentiation of leukemic promyelocytes. Aggressive management of coagulopathy is crucial to prevent life-threatening bleeding complications.

Incorrect answers:
A: Performing a lumbar puncture is not necessary at this stage as the patient's symptoms and laboratory findings point towards APL, not central nervous system involvement.
C: Dexamethasone and hydroxyurea are not

You may also like to solve these questions

C6PD reflect false normal report in:

  • A. iron def .an.
  • B. hypoplastic an.
  • C. hairy cell leuk.
  • D. shortly after haemolysis
Correct Answer: D

Rationale: The correct answer is D, shortly after hemolysis, because G6PD deficiency leads to a false-normal result due to the presence of reticulocytes in the blood following hemolysis. This is because reticulocytes have normal enzyme activity, masking the underlying deficiency. Iron deficiency anemia (A), hypoplastic anemia (B), and hairy cell leukemia (C) do not involve the same mechanism of false-normal reports in C6PD deficiency as seen in hemolysis.

A 40 year old patient is presented with unilateral palpebral edema and ipsilateral lymphadenopathy. He later develops megaesophagus and megacolon as complications. Which of the following vector is responsible for this parasitic infection?

  • A. Glossina morsitans
  • B. Ixodes scapularis
  • C. Rhodnius prolixus
  • D. Simulium damnosum
Correct Answer: C

Rationale: The correct answer is C: Rhodnius prolixus. This parasite is responsible for causing Chagas disease. The initial symptoms of unilateral palpebral edema and ipsilateral lymphadenopathy are characteristic of the acute phase of Chagas disease. The development of megaesophagus and megacolon are complications seen in the chronic phase. Rhodnius prolixus is a vector for Trypanosoma cruzi, the parasite that causes Chagas disease. Glossina morsitans is the vector for African trypanosomiasis (sleeping sickness), Ixodes scapularis is the vector for Lyme disease, and Simulium damnosum is the vector for onchocerciasis (river blindness), making them incorrect choices for this particular parasitic infection.

The nurse is caring for a patient who has a white blood cell (WBC) count of 8000/mm³. What concern should the nurse have about this finding?

  • A. The patient has an infection.
  • B. The patient is at risk for infection.
  • C. The patient has a hematological disorder.
  • D. There is no concern; this is a normal finding.
Correct Answer: D

Rationale: The correct answer is D because a WBC count of 8000/mm³ falls within the normal reference range of 4000-11000/mm³. Therefore, there is no immediate concern regarding infection or hematological disorder. Choice A is incorrect because a normal WBC count does not indicate infection. Choice B is incorrect as the count is within the normal range, not indicating increased infection risk. Choice C is incorrect as a normal WBC count does not suggest a hematological disorder.

A 77-year-old male is admitted to a unit with a suspected diagnosis of acute myeloid leukemia (AML). When planning this patient's care, the nurse should be aware of what epidemiologic fact?

  • A. Early diagnosis is associated with good outcomes.
  • B. Five-year survival for older adults is approximately 50%.
  • C. Five-year survival for patients over 75 years old is less than 2%.
  • D. Survival rates are wholly dependent on the patient's pre-illness level of health.
Correct Answer: C

Rationale: The correct answer is C: Five-year survival for patients over 75 years old is less than 2%. This is because older age is a significant negative prognostic factor in acute myeloid leukemia (AML). As individuals age, their overall health and ability to tolerate aggressive treatments decline, leading to poorer outcomes. The survival rate of less than 2% for patients over 75 years old reflects the challenges of treating AML in this age group.

Choice A is incorrect because early diagnosis does not necessarily guarantee good outcomes in AML, especially in older adults where other factors play a significant role. Choice B is incorrect as the five-year survival rate of 50% does not apply to older adults with AML. Choice D is incorrect as survival rates in AML are influenced by various factors beyond just the patient's pre-illness health status.

The nurse is staying with a patient who has been started on a blood transfusion. Which assessment should the nurse perform during a blood product infusion to detect a reaction?

  • A. Vital signs
  • B. Skin turgor
  • C. Bowel sounds
  • D. Pupil reactivity
Correct Answer: A

Rationale: Correct Answer: A (Vital signs)

Rationale: Monitoring vital signs during a blood transfusion is crucial to detect any adverse reactions promptly. Changes in blood pressure, pulse rate, temperature, and respiratory rate can indicate a potential reaction. By assessing vital signs, the nurse can intervene promptly if there is any sign of an adverse reaction, such as fever, hypotension, tachycardia, or shortness of breath.

Summary of Incorrect Choices:
B: Skin turgor is not directly related to detecting a reaction during a blood transfusion.
C: Bowel sounds are not indicative of a reaction during a blood transfusion.
D: Pupil reactivity is not relevant for monitoring during a blood transfusion.

Copyright © 2025 Nokea. All rights reserved.