ATI Hematologic System Test

ATI Hematologic System Test Related

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A laboratory study is conducted to determine the optimal usage of platelets for transfusion. The blood bank inventory along with the transfusion records and medical records of subjects who were recipients of platelet transfusion are reviewed. Which of the following conclusions is most likely to be made from this study?

  • A. Frozen storage of platelets helps increase the units available.
  • B. Platelet transfusions are rarely successful in patients with autoimmune thrombocytopenia.
  • C. Platelet units carry no risk for transmission of hepatitis C infection.
  • D. Pooled donor platelets are preferred over single-donor platelets.
Correct Answer: B

Rationale: The correct answer is B. Platelet transfusions are rarely successful in patients with autoimmune thrombocytopenia.

Rationale:
1. Patients with autoimmune thrombocytopenia have low platelet levels due to immune destruction.
2. Platelet transfusions may not be effective as the underlying autoimmune process continues to destroy transfused platelets.
3. Reviewing transfusion records of these patients would likely show low success rates of platelet transfusions.

Summary of Incorrect Choices:
A: Frozen storage of platelets increasing units available is not directly related to the success of platelet transfusions in autoimmune thrombocytopenia.
C: Platelet units do carry a risk of transmitting hepatitis C infection, so this conclusion is incorrect.
D: Preference for pooled donor platelets over single-donor platelets does not address the success of platelet transfusions in autoimmune thrombocytopenia.

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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 risk factor for poorer outcomes in acute myeloid leukemia (AML) due to factors such as frailty, comorbidities, and reduced tolerance to aggressive treatments. Older adults are less likely to tolerate intensive chemotherapy and have lower overall survival rates compared to younger patients.

Choice A is incorrect because early diagnosis alone does not guarantee good outcomes in AML, especially in older adults. Choice B is incorrect because the five-year survival rate for older adults with AML is much lower than 50%. Choice D is incorrect because while pre-illness health may influence survival rates, age is a more significant factor in predicting outcomes in older patients with AML.

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 is a medication used to stimulate red blood cell production in patients with renal failure. One of the potential adverse effects of epoetin therapy is an increase in blood pressure due to the rapid rise in red blood cell count. This can lead to hypertension. Monitoring for hypertension is crucial to prevent any complications. The other choices, muscle pain, edema, and dry mouth, are not directly associated with epoetin therapy in renal failure patients. Muscle pain could be a general issue but not specific to this medication. Edema is more commonly associated with fluid retention in renal failure, and dry mouth is not a typical adverse effect of epoetin therapy.

An older client asks the nurse why 'people my age' have weaker immune systems than younger people. What responses by the nurse are best? (Select all that apply.)

  • A. Bone marrow produces more blood cells as you age.'
  • B. You may have decreased levels of circulating platelets.'
  • C. You have lower levels of plasma proteins in the blood.'
  • D. Lymphocytes become more reactive to antigens.'
Correct Answer: C

Rationale: Rationale:
- As we age, there is a decrease in the production of plasma proteins, which are essential for immune function.
- Lower levels of plasma proteins can lead to a weaker immune response.
- This decline in plasma proteins can make older individuals more susceptible to infections.
- Choices A, B, and D are incorrect as they do not directly address the impact of aging on immune system function.

Bone marrow responds to iron therapy by increasing erythropoietic activity. Which of the following in bone marrow would most likely indicate erythropoiesis?

  • A. Myelocytes
  • B. Reticulocytes
  • C. Ring sideroblasts
  • D. Target cells
Correct Answer: B

Rationale: The correct answer is B: Reticulocytes. Reticulocytes are immature red blood cells released by the bone marrow into the bloodstream in response to increased erythropoietic activity. They indicate ongoing erythropoiesis as they mature into fully functional red blood cells. Myelocytes (A) are immature granulocytic precursors, not involved in erythropoiesis. Ring sideroblasts (C) are seen in conditions like sideroblastic anemia and indicate abnormal iron metabolism. Target cells (D) are red blood cells with a central bull's eye appearance and are associated with conditions like liver disease and thalassemias, not specifically erythropoiesis.

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.

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