ATI Hematologic System Quizlet

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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: Step-by-step rationale for why the correct answer is D, Nephroblastoma:
1. The child has a cancer predisposition syndrome, likely Beckwith-Wiedemann syndrome (BWS).
2. BWS is associated with an increased risk of developing Wilms tumor (nephroblastoma).
3. The large tongue, omphalocele, and overgrowth placing the child at the 95th percentile for height and weight are all characteristic features of BWS.
4. Therefore, the patient is most at risk of developing nephroblastoma.

Summary of why the other choices are incorrect:
A: Pleuropulmonary blastoma - Not typically associated with BWS or the described clinical features.
B: Hepatocellular carcinoma - Not commonly linked to BWS or the clinical presentation provided.
C: Cystic nephroma - Not a typical tumor associated with BWS or the clinical findings described in the patient.

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A female infant is diagnosed with hemophagocytic lymphohistiocytosis (HLH) not associated with an Epstein-Barr virus (EBV) infection. In taking the family history, you learn that another female infant died of HLH 2 years ago. Also, a newborn female child died of an unknown disease 4 years prior and was said have been bleeding profusely, jaundiced, and had a distended abdomen. When counseling the family about the genetics of HLH, how will you explain it?

  • A. It is an X-linked syndrome
  • B. It is an autosomal recessive syndrome
  • C. It is a dominant inheritance syndrome
  • D. It is an autosomal recessive syndrome with incomplete penetrance
Correct Answer: B

Rationale: The correct answer is B: It is an autosomal recessive syndrome. HLH is typically inherited in an autosomal recessive manner, meaning that two copies of the affected gene are needed to manifest the disease. In this case, the family history indicates that multiple female infants were affected, suggesting a recessive pattern. Choice A is incorrect as HLH is not an X-linked syndrome, indicated by the affected female infants. Choice C is incorrect since dominant inheritance would not result in multiple affected female infants. Choice D is also incorrect as autosomal recessive syndromes do not typically exhibit incomplete penetrance.

A patient who is undergoing consolidation therapy for the treatment of leukemia has been experiencing debilitating fatigue. How can the nurse best meet this patient's needs for physical activity?

  • A. Teach the patient about the risks of immobility and the benefits of exercise.
  • B. Assist the patient to a chair during awake times, as tolerated.
  • C. Collaborate with the physical therapist to arrange for stair exercises.
  • D. Teach the patient to perform deep breathing and coughing exercises.
Correct Answer: B

Rationale: The correct answer is B because assisting the patient to a chair during awake times allows for gradual physical activity, promoting mobility without overwhelming the patient. This option supports the patient's need for movement while considering their current level of fatigue.

A is incorrect because educating the patient about the benefits of exercise may not be feasible or appropriate given the patient's current fatigue levels.

C is incorrect as stair exercises may be too strenuous for a patient experiencing debilitating fatigue, potentially leading to further exhaustion and risk of injury.

D is incorrect because deep breathing and coughing exercises primarily focus on respiratory health and may not directly address the patient's need for physical activity to combat fatigue.

A patient with a diagnosis of acute myeloid leukemia (AML) is being treated with induction therapy on the oncology unit. What nursing action should be prioritized in the patient's care plan?

  • A. Protective isolation and vigilant use of standard precautions
  • B. Provision of a high-calorie, low-texture diet and appropriate oral hygiene
  • C. Including the family in planning the patient's activities of daily living
  • D. Monitoring and treating the patient's pain
Correct Answer: A

Rationale: The correct answer is A: Protective isolation and vigilant use of standard precautions. This is the priority because patients with AML are at high risk for infections due to compromised immune systems. Isolation and strict infection control measures help prevent exposure to pathogens. B is incorrect as the main priority is infection prevention, not diet. C is incorrect as involving the family is important but not the priority. D is incorrect as pain monitoring is important but not the priority in this case.

Which of the following is associated with normocytic normochromic anaemia?

  • A. Iron deficiency
  • B. Primaquine
  • C. Pregnancy
  • D. Sickle cell disease
Correct Answer: C

Rationale: Normocytic normochromic anemia is characterized by normal-sized red blood cells with normal hemoglobin content. Pregnancy is associated with this type of anemia due to increased blood volume and iron demands. Iron deficiency anemia (choice A) is typically microcytic hypochromic. Primaquine (choice B) is not known to cause normocytic normochromic anemia. Sickle cell disease (choice D) results in hemolytic anemia with abnormal red blood cell morphology. Thus, the correct answer is C as it aligns with the characteristics of normocytic normochromic anemia.

A 17-year-old female presents with cervical adenopathy and a history of daily fevers and drenching night sweats. A biopsy is performed and reveals classic Hodgkin lymphoma. Which of the following is least appropriate as part of the staging workup?

  • A. Chest x-ray
  • B. CT scan of chest, abdomen, and pelvis
  • C. Functional imaging (PET scan)
  • D. Lumbar puncture and cerebrospinal fluid (CSF) analysis
Correct Answer: D

Rationale: The correct answer is D: Lumbar puncture and cerebrospinal fluid (CSF) analysis. In Hodgkin lymphoma staging, CNS involvement is rare at initial presentation. Therefore, routine CSF analysis is not recommended unless there are specific neurological symptoms suggestive of CNS disease. A lumbar puncture carries risks of complications and should not be performed routinely. Choices A, B, and C are appropriate for staging in Hodgkin lymphoma to evaluate for distant metastases and characterize disease extent.

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