ATI Hematologic System Test

ATI Hematologic System Test Related

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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.

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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 range of 4000-11000/mm³. The normal WBC count indicates the body's ability to fight infections and maintain immunity. The other choices are incorrect because:
A: The patient does not necessarily have an infection based solely on the WBC count.
B: The patient is not necessarily at risk for infection with a normal WBC count.
C: There is no indication of a hematological disorder based on the WBC count within the normal range.

In iron deficiency anemia there is characteristically

  • A. An atrophic gastritis
  • B. A low mean corpuscular volume
  • C. A reduced total iron binding capacity
  • D. Megaloblastic changes in the bone marrow
Correct Answer: B

Rationale: The correct answer is B: A low mean corpuscular volume. In iron deficiency anemia, there is a decreased amount of iron available for hemoglobin synthesis, leading to smaller and paler red blood cells. This results in a low mean corpuscular volume (MCV). Atrophic gastritis (choice A) is associated with vitamin B12 deficiency anemia, not iron deficiency anemia. Choice C (reduced total iron binding capacity) is incorrect because in iron deficiency anemia, there is an increased total iron binding capacity due to the body's attempt to capture more iron. Megaloblastic changes in the bone marrow (choice D) are seen in megaloblastic anemia, not iron deficiency anemia.

You are seeing a 12-year-old boy in the survivorship program who presented at 2 years old with a desmoplastic nodular medulloblastoma. You note the child recently underwent germline genetic testing and was found to have nevoid basal cell carcinoma syndrome. In which gene is the child most likely to have a pathogenic variant?

  • A. PTEN
  • B. CDKN2A
  • C. SUFU
  • D. SMARCB1
Correct Answer: C

Rationale: Rationale: The correct answer is C: SUFU. Nevoid basal cell carcinoma syndrome, also known as Gorlin syndrome, is associated with pathogenic variants in the SUFU gene. SUFU is a tumor suppressor gene involved in the sonic hedgehog signaling pathway, which plays a role in medulloblastoma and basal cell carcinoma development. PTEN (A) is associated with Cowden syndrome, CDKN2A (B) with familial atypical multiple mole melanoma syndrome, and SMARCB1 (D) with rhabdoid tumor predisposition syndrome, but not specifically linked to nevoid basal cell carcinoma syndrome.

A nurse is caring for a patient who has been diagnosed with leukemia. The nurse's most recent assessment reveals the presence of ecchymoses on the patient's sacral area and petechiae in her forearms. In addition to informing the patient's primary care provider, the nurse should perform what action?

  • A. Initiate measures to prevent venous thromboembolism (VTE).
  • B. Check the patient's most recent platelet level.
  • C. Place the patient on protective isolation.
  • D. Ambulate the patient to promote circulatory function.
Correct Answer: B

Rationale: Step-by-step rationale for why answer B is correct:
1. Petechiae and ecchymoses indicate potential thrombocytopenia in a leukemia patient.
2. Checking the patient's platelet level will confirm thrombocytopenia and guide treatment.
3. Low platelet levels can lead to bleeding complications, hence the importance of monitoring.
4. Prompt intervention based on platelet level results can prevent worsening complications.

Summary of why other choices are incorrect:
A: Initiating measures to prevent VTE is not directly related to the patient's current presentation of ecchymoses and petechiae.
C: Placing the patient on protective isolation is not indicated for thrombocytopenia.
D: Ambulating the patient may be beneficial for circulation but does not address the underlying issue of potential thrombocytopenia.

A nurse is caring for a client who has renal failure and is receiving epoetin. The nurse should monitor the client for which of the following adverse effects?

  • A. Hypertension
  • B. Muscle pain
  • C. Edema
  • D. Dry mouth
Correct Answer: A

Rationale: The correct answer is A: Hypertension. Epoetin stimulates red blood cell production, increasing blood volume and potentially leading to hypertension. This adverse effect is known as hypertensive crisis. Muscle pain (B), edema (C), and dry mouth (D) are not typically associated with epoetin therapy for renal failure. Thus, they are incorrect choices.

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