ATI Hematologic System Test

ATI Hematologic System Test Related

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A nurse is caring for a patient with Hodgkin lymphoma at the oncology clinic. The nurse should be aware of what main goal of care?

  • A. Cure of the disease
  • B. Enhancing quality of life
  • C. Controlling symptoms
  • D. Palliation
Correct Answer: A

Rationale: The correct answer is A: Cure of the disease. The main goal of care for a patient with Hodgkin lymphoma is to achieve a cure whenever possible. This is because Hodgkin lymphoma is a potentially curable cancer with appropriate treatment. Achieving a cure means eradicating the cancer cells completely and preventing its recurrence in the future. This is the most desirable outcome for the patient's long-term health and well-being.

Incorrect choices:
B: Enhancing quality of life - While improving the patient's quality of life is important, the primary goal in treating Hodgkin lymphoma is to cure the disease.
C: Controlling symptoms - Symptom management is important in providing comfort to the patient, but the main goal is to cure the disease.
D: Palliation - Palliative care focuses on relieving symptoms and improving quality of life in patients with advanced or incurable diseases. For Hodgkin lymphoma, the main goal is to aim for a cure rather than palliation.

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You receive a phone call from a community pediatrician who is caring for a 2-year-old toddler with a cancer predisposition syndrome. The pediatrician describes a child at the 95th percentile for height and weight with a history of corrective oral surgery to reduce a large tongue and a history of an omphalocele in infancy. The pediatrician is currently performing ultrasound of the abdomen and laboratory evaluation for this patient every 3 months. Which tumor is this patient most at risk of developing?

  • A. Pleuropulmonary blastoma
  • B. Hepatocellular carcinoma
  • C. Cystic nephroma
  • D. Nephroblastoma
Correct Answer: D

Rationale: The correct answer is D: Nephroblastoma. This patient most likely has Beckwith-Wiedemann Syndrome (BWS) due to the large tongue (macroglossia) and omphalocele. BWS is associated with an increased risk of nephroblastoma (Wilms tumor). The 95th percentile for height and weight is also a characteristic feature of BWS. Ultrasound and laboratory evaluation are appropriate monitoring tools for nephroblastoma in this patient due to the increased risk associated with BWS.

A: Pleuropulmonary blastoma is more commonly associated with DICER1 syndrome, not BWS.
B: Hepatocellular carcinoma is not commonly associated with BWS.
C: Cystic nephroma is not typically associated with BWS, and nephroblastoma is a more common tumor in this context.

A nurse is caring for a client who is about to begin taking epoetin. An increase in which of the following laboratory values should indicate to the nurse that the therapy is effective?

  • A. PT
  • B. WBC
  • C. Hgb
  • D. Platelets
Correct Answer: C

Rationale: The correct answer is C: Hgb (hemoglobin). Epoetin is a medication used to stimulate red blood cell production, which should increase hemoglobin levels. Higher hemoglobin levels indicate improved oxygen-carrying capacity and overall effectiveness of the therapy. PT (A), WBC (B), and Platelets (D) are not directly affected by epoetin therapy, so an increase in these values would not be indicative of the medication's effectiveness.

A nurse is preparing to assist with a bone marrow biopsy. Which anatomical site should the nurse anticipate will be used to obtain the specimen?

  • A. Ribs
  • B. Humerus
  • C. Posterior iliac crest
  • D. Long bones in the legs
Correct Answer: C

Rationale: The correct answer is C: Posterior iliac crest. A bone marrow biopsy is commonly performed at the posterior iliac crest because it provides easy access to the bone marrow. This site has a high concentration of red bone marrow, making it an ideal location for obtaining a bone marrow specimen. The iliac crest is also a flat and easily accessible surface, which allows for safe and efficient insertion of the biopsy needle. Ribs (A) are not typically used due to the risk of puncturing the lungs. The humerus (B) is not a common site for bone marrow biopsy. Long bones in the legs (D) are not typically used due to the difficulty in accessing the bone marrow at those sites.

When assessing a newly admitted patient, the nurse notes pallor of the skin and nail beds. The nurse should ensure that which laboratory test has been ordered?

  • A. Platelet count
  • B. Neutrophil count
  • C. White blood cell count
  • D. Hemoglobin (Hgb) level
Correct Answer: D

Rationale: The correct answer is D: Hemoglobin (Hgb) level. Pallor of the skin and nail beds indicates possible anemia, which is a decrease in red blood cells or hemoglobin. Checking the hemoglobin level will confirm if the patient is anemic. Platelet count (A) assesses for clotting ability, not anemia. Neutrophil count (B) and White blood cell count (C) are indicators of infection or inflammation, not anemia. Therefore, ensuring the hemoglobin level has been ordered is crucial for assessing the patient's pallor.

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.

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