ATI Hematologic System Test

ATI Hematologic System Test Related

Review ATI Hematologic System Test related questions and content

A 9-month-old boy has been referred to you for the evaluation of an enlarged abdomen. Imaging studies show a large liver mass (PRETEXT III). Alfa-fetoprotein is 98 ng/mL, and a CT scan of the lungs show bilateral lung metastases. A needle biopsy is performed, and you are planning to review the specimen with the pathologist. Which of the following diagnoses are you suspecting?

  • A. Pure fetal histology hepatoblastoma
  • B. Embryonal sarcoma of the liver
  • C. Fibrolamellar hepatocellular carcinoma
  • D. Small cell undifferentiated hepatoblastoma
Correct Answer: D

Rationale: The correct answer is D: Small cell undifferentiated hepatoblastoma. In hepatoblastoma, the presence of lung metastases indicates a high-risk tumor. The small cell undifferentiated subtype is more aggressive with a poorer prognosis compared to other subtypes. The AFP level is lower than typically seen in hepatoblastoma, but still within the range for this diagnosis. Pure fetal histology hepatoblastoma (choice A) is less common and usually associated with a better prognosis. Embryonal sarcoma of the liver (choice B) is a distinct entity with different histological features. Fibrolamellar hepatocellular carcinoma (choice C) typically occurs in older children and has a different imaging appearance.

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Which of the following requires IL-2 and IL-4 in the conversion of unilineage progenitor cell into mature circulating cell?

  • A. Neutrophil
  • B. Eosinophil
  • C. Basophil
  • D. B lymphocyte
Correct Answer: D

Rationale: The correct answer is D: B lymphocyte. IL-2 and IL-4 are crucial for the differentiation of B lymphocytes from unilineage progenitor cells. IL-2 supports proliferation and survival of B cells, while IL-4 promotes their differentiation into mature circulating cells. Neutrophils, eosinophils, and basophils develop independently of IL-2 and IL-4. Neutrophils mainly require granulocyte colony-stimulating factor (G-CSF), eosinophils require IL-5, and basophils are influenced by IL-3 and IL-5. Therefore, the correct answer is D as B lymphocytes specifically rely on IL-2 and IL-4 for their maturation.

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.

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: The correct answer is A: Vital signs. During a blood transfusion, the nurse should monitor the patient's vital signs regularly to detect any signs of a transfusion reaction, such as fever, chills, rash, or hypotension. Vital signs provide crucial information about the patient's overall condition and can help the nurse identify and respond promptly to any adverse reactions. Skin turgor (B), bowel sounds (C), and pupil reactivity (D) are not directly related to monitoring for transfusion reactions and are not sensitive indicators of an adverse reaction during a blood transfusion. Monitoring vital signs is essential for patient safety and early detection of any complications during the transfusion process.

The nurse assesses a patient who has numerous petechiae on both arms. Which question should the nurse ask the patient?

  • A. Do you take salicylates?
  • B. Are you taking any oral contraceptives?
  • C. Have you been prescribed antiseizure drugs?
  • D. How long have you taken antihypertensive drugs?
Correct Answer: A

Rationale: Correct Answer: A: Do you take salicylates?

Rationale:
1. Petechiae are tiny red or purple spots caused by bleeding under the skin.
2. Salicylates (like aspirin) can cause bleeding issues leading to petechiae.
3. Asking about salicylate use helps identify a potential cause for the petechiae.

Summary of Incorrect Choices:
B: Oral contraceptives are not typically associated with petechiae.
C: Antiseizure drugs do not commonly cause petechiae.
D: Antihypertensive drugs are not known to be a common cause of petechiae.

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: Step-by-step rationale:
1. Iron deficiency leads to decreased hemoglobin synthesis, resulting in smaller red blood cells.
2. Mean corpuscular volume (MCV) measures the average size of red blood cells.
3. In iron deficiency anemia, MCV is low due to the smaller red blood cells.
4. Therefore, choice B is correct as it reflects the characteristic feature of iron deficiency anemia.

Summary:
A: Atrophic gastritis is seen in pernicious anemia, not iron deficiency anemia.
C: Total iron binding capacity is increased, not reduced, in iron deficiency anemia.
D: Megaloblastic changes in the bone marrow are seen in megaloblastic anemias, not iron deficiency anemia.

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