ATI Hematologic System Quizlet

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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 have inherent hypercoagulability due to immature coagulation factors and increased risk of endothelial injury from central lines or catheters. Necrotizing enterocolitis further increases the risk of venous stasis due to decreased gut perfusion.

Choice A: The 3-day-old full-term infant admitted for hyperbilirubinemia is less likely to have significant risk factors for thrombosis compared to a premature infant with necrotizing enterocolitis.

Choice B: The 6-month-old male admitted for respiratory syncytial virus is less likely to have prolonged immobilization or other significant risk factors compared to a premature infant in the NICU.

Choice D: The 7-year-old male with acute lymphoblastic leukemia has a higher risk of thromb

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A 72-year-old male with enlargement of superficial lymph nodes and mild hepatosplenomegaly is diagnosed as having chronic lymphatic leukemia (CLL). The most important criteria for diagnosis of this disease is the

  • A. Presence of hypogammaglobulinemia
  • B. Absolute lymphocytes
  • C. Male predominance
  • D. Presence of enlarged lymph nodes
Correct Answer: B

Rationale: The correct answer is B: Absolute lymphocytes. In CLL, the most important diagnostic criteria is an absolute lymphocyte count greater than 5,000/microliter. This is crucial for distinguishing CLL from other lymphoproliferative disorders. The presence of hypogammaglobulinemia (choice A) is not specific to CLL and can be seen in other conditions. Male predominance (choice C) is an epidemiological feature and not a diagnostic criterion. Enlarged lymph nodes (choice D) are a common clinical finding but do not solely confirm the diagnosis of CLL.

The nurse notes that a patient's gaping wound is developing a blood clot. Which body substance is responsible for this clot formation?

  • A. Plasma
  • B. Platelets
  • C. Red blood cells
  • D. White blood cells
Correct Answer: B

Rationale: Platelets are responsible for clot formation in the body. When a wound occurs, platelets are activated and adhere to the site, forming a plug to stop bleeding. They release chemicals to further enhance clot formation. Plasma is the liquid component of blood, red blood cells carry oxygen, and white blood cells are part of the immune system, none of which are directly involved in clot formation.

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.

Which of the following is the most suitable anti malarial drug for pregnant women?

  • A. Atovaquone and proguanil
  • B. Quinine and doxycycline
  • C. Quinine and clindamycin
  • D. Primaquine
Correct Answer: C

Rationale: The correct answer is C: Quinine and clindamycin. Quinine is considered safe for use in pregnancy to treat malaria, as it has been used for many years without significant adverse effects. Clindamycin is also safe for use in pregnancy and can be used in combination with quinine to treat malaria. Atovaquone and proguanil (choice A) are not recommended for use in pregnancy due to limited safety data. Quinine and doxycycline (choice B) is not suitable for pregnant women as doxycycline is contraindicated during pregnancy. Primaquine (choice D) is not recommended for use during pregnancy as it can cause harm to the fetus.

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: Helping the patient manage the opioid analgesic regimen. This is the priority intervention for severe bone pain in multiple myeloma because opioids are the most effective for managing severe pain. Opioids target the central nervous system to reduce pain perception, providing significant relief. Implementing distraction techniques (A) may offer temporary relief but will not address the underlying pain. Educating about hot and cold packs (B) may be helpful for mild pain but is not sufficient for severe bone pain. Teaching NSAIDs (C) is not recommended for multiple myeloma pain management due to potential kidney issues.

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