ATI Hematologic System Quizlet

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A 19-year old male patient with a history of acute lymphoblastic leukemia, currently 13 years from completion of therapy, presents for a fertility consultation. He is interested in his risk for infertility. Which of the following statements is true?

  • A. A semen analysis at this point would provide accurate information about future fertility.
  • B. Males can maintain gonadal function at higher cumulative alkylator dosages compared with females.
  • C. He should have been offered sperm cryopreservation at diagnosis.
  • D. His risk for testosterone deficiency is greater than his risk for infertility.
Correct Answer: A

Rationale: The correct answer is A. A semen analysis at this point would provide accurate information about future fertility because it assesses sperm count, motility, and morphology, which are crucial indicators of fertility potential. This is important for the patient to understand his current fertility status and make informed decisions about future fertility preservation options.

Choice B is incorrect because males are also susceptible to gonadal toxicity from alkylating agents, and there is no evidence to suggest that they can maintain gonadal function at higher dosages compared to females.

Choice C is incorrect because sperm cryopreservation should ideally have been offered at the time of leukemia diagnosis, but it is not too late to assess current fertility status with a semen analysis.

Choice D is incorrect as the patient's primary concern is infertility, not testosterone deficiency, which is a different issue altogether.

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A home health nurse is caring for a patient with multiple myeloma. Which of the following interventions should the nurse prioritize when addressing the patient's severe bone pain?

  • A. Implementing distraction techniques
  • B. Educating the patient about the effective use of hot and cold packs
  • C. Teaching the patient to use NSAIDs effectively
  • D. Helping the patient manage the opioid analgesic regimen
Correct Answer: D

Rationale: The correct answer is D because severe bone pain in multiple myeloma often requires strong analgesics like opioids for effective pain management. Distraction techniques (A) may provide temporary relief but may not address the underlying pain. Hot and cold packs (B) are more suited for musculoskeletal injuries, not severe bone pain. NSAIDs (C) are usually not sufficient for managing severe bone pain in multiple myeloma. Therefore, helping the patient manage the opioid analgesic regimen (D) is the priority for effective pain control.

A female infant is diagnosed with hemophagocytic lymphohistiocytosis (HLH) not associated with an Epstein-Barr virus (EBV) infection. In taking the family history, you learn that another female infant died of HLH 2 years ago. Also, a newborn female child died of an unknown disease 4 years prior and was said have been bleeding profusely, jaundiced, and had a distended abdomen. When counseling the family about the genetics of HLH, how will you explain it?

  • A. It is an X-linked syndrome
  • B. It is an autosomal recessive syndrome
  • C. It is a dominant inheritance syndrome
  • D. It is an autosomal recessive syndrome with incomplete penetrance
Correct Answer: B

Rationale: The correct answer is B: It is an autosomal recessive syndrome. HLH is typically inherited in an autosomal recessive pattern, meaning both parents must pass on a copy of the mutated gene for the child to develop the condition. In this case, the family history suggests a pattern of multiple affected female infants, which is more indicative of an autosomal recessive inheritance. Choice A (X-linked syndrome) is incorrect because the pattern of inheritance in this family does not align with X-linked inheritance. Choice C (dominant inheritance syndrome) is incorrect because a dominant inheritance pattern would not typically result in multiple affected offspring. Choice D (autosomal recessive syndrome with incomplete penetrance) is incorrect because incomplete penetrance would not explain the consistent occurrence of HLH in this family.

The pathophysiology of venous thrombosis is often explained by Virchow's triad, which includes hypercoagulability, endothelial injury, and venous stasis. Based on Virchow's triad and your knowledge of risk factors for thrombosis, which of the following pediatric patients has the greatest risk of hospital-acquired venous thromboembolism?

  • A. 3-day-old full-term infant admitted to hospital pediatrics for hyperbilirubinemia
  • B. 6-month-old male admitted to the infectious disease unit for respiratory syncytial virus
  • C. Ex-28 week premature infant, requiring NICU-level care for necrotizing enterocolitis
  • D. 7-year-old male with acute lymphoblastic leukemia receiving maintenance chemotherapy admitted to hematology/oncology unit for fever and neutropenia
Correct Answer: C

Rationale: The correct answer is C because the ex-28 week premature infant requiring NICU-level care for necrotizing enterocolitis has the greatest risk of hospital-acquired venous thromboembolism. Premature infants are at higher risk due to their immature coagulation system and prolonged immobility. Necrotizing enterocolitis further increases the risk due to inflammation and endothelial injury. Hypercoagulability is common in premature infants. Choices A, B, and D have lower risk as they do not have the same combination of risk factors as the premature infant in choice C.

In microcytic hypochromic anaemia

  • A. Red cells are larger with normal staining
  • B. Red blood cell count is increased
  • C. Haemtocrit and mean corpuscular haemoglobin are normal
  • D. Red cells are smaller with a pale large central pallor
Correct Answer: D

Rationale: In microcytic hypochromic anemia, red cells are smaller with decreased hemoglobin content, leading to pale appearance. Choice D is correct as it describes the typical characteristics of microcytic hypochromic anemia. Choice A is incorrect as red cells are smaller, not larger. Choice B is incorrect as red blood cell count is usually decreased. Choice C is incorrect as both hematocrit and mean corpuscular hemoglobin are decreased in microcytic hypochromic anemia.

All produce microcytic anemia except:

  • A. sideroblastic an.
  • B. thalassemia
  • C. pernicious anemia
  • D. lead poisoning
Correct Answer: C

Rationale: The correct answer is C: pernicious anemia. Pernicious anemia is a macrocytic anemia caused by vitamin B12 deficiency, leading to large red blood cells. Sideroblastic anemia (A) is a type of microcytic anemia due to ineffective iron utilization. Thalassemia (B) causes microcytic anemia due to decreased production of hemoglobin. Lead poisoning (D) can also lead to microcytic anemia by disrupting heme synthesis. Therefore, pernicious anemia is the only choice that does not produce microcytic anemia.

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