ATI RN · Anatomy of Hematologic System
Question 1 of 52
Cooley's anemia is:
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ATI RN · Anatomy of Hematologic System
Question 2 of 52
A 14-year-old male patient is diagnosed with very high risk acute lymphoblastic leukemia and is likely going to require an allogeneic hematopoietic stem cell transplant to cure his leukemia. Prior to going to transplant, he is likely to require multiple blood transfusions. Which of the following products or component modifications is the best way to prevent him from developing alloimmunization due to anti-HLA antibodies prior to transplant?
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ATI RN · Anatomy of Hematologic System
Question 3 of 52
A 13-year-old boy presents to the emergency department with complaints of headache and visual changes. History reveals progressive dyspnea on exertion, generalized fatigue, and increased bruising. His labs are significant for a WBC of 350,000/mcL, of which 80% are reported to be blasts and appear to be myeloblasts without the presence of Auer rods. His hemoglobin is 7.2 g/dL, and his platelets are 18,000/mcL. A CT scan of the head shows a small intracerebral hemorrhage. His coags are normal. Which of the following is the most appropriate therapy?
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ATI RN · Anatomy of Hematologic System
Question 4 of 52
A patient shows prolonged prothrombin time and activated partial thromboplastin time. Blood test otherwise is normal. Which of the following is the most probably diagnosis for this patient's condition?
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ATI RN · Anatomy of Hematologic System
Question 5 of 52
You have a new patient consult in clinic this morning. The referral packet includes the newborn screen report, which is flagged abnormal hemoglobinopathy screen, F, A, Bart's, refer to hematology, and a complete blood count done at 4 years of age with a hemoglobin of 10 g/dL and an MCV of 68. The pediatrician has informed the parents the child has some form of alpha thalassemia. The older brother had the same newborn screen results but had a normal complete blood count when checked. The mother wants to know why her second child has an abnormal complete blood count when she and her husband do not have any blood problems. How would you respond to the child's mother?
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ATI RN · Anatomy of Hematologic System
Question 6 of 52
A 60-year-old patient with chronic myeloid leukemia will be treated in the home setting and the nurse is preparing appropriate health education. What topic should the nurse emphasize?
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ATI RN · Anatomy of Hematologic System
Question 7 of 52
The nurse is assessing a client experiencing anemia. Which laboratory findings will the nurse expect for this client? (Select all that apply.)
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ATI RN · Anatomy of Hematologic System
Question 8 of 52
A 35-year-old male is admitted to the hospital complaining of severe headaches, vomiting, and testicular pain. His blood work shows reduced numbers of platelets, leukocytes, and erythrocytes, with a high proportion of immature cells. The nurse caring for this patient suspects a diagnosis of what?
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ATI RN · Anatomy of Hematologic System
Question 9 of 52
A nurse is teaching a client about taking ferrous sulfate to treat iron deficiency anemia. Which of the following instructions should the nurse include? (Select All)
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ATI RN · Anatomy of Hematologic System
Question 10 of 52
When should autologous hematopoietic stem cell transplantation be used, and what are the common cancers it is used for?
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ATI RN · Anatomy of Hematologic System
Question 11 of 52
The nurse is assisting with the preparation of a blood transfusion for a patient. Which type of fluid should the nurse select to transfuse with the blood?
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ATI RN · Anatomy of Hematologic System
Question 12 of 52
Graft versus host disease is a complication of transfusion in patients of bone marrow transplantation. This can be best avoided by
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ATI RN · Anatomy of Hematologic System
Question 13 of 52
Increase Fe & normal TIBC are found in:
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Question 14 of 52
Hepato-splenomegaly with lymphadenopathy occur in all except:
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ATI RN · Anatomy of Hematologic System
Question 15 of 52
You are seeing a 13-year-old boy with fatigue, weight loss, night sweats, and splenomegaly. Peripheral blood shows anemia, thrombocytosis, and leukocytosis (300,000/mm3). What is this patient's most likely diagnosis?
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ATI RN · Anatomy of Hematologic System
Question 16 of 52
Which statement is correct regarding lymphocyte counts in infants versus adults?
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ATI RN · Anatomy of Hematologic System
Question 17 of 52
A 17-year-old patient is referred to you for a platelet count of 1,200,000/mm3. On history, she notes that she often has numbness and tingling in her hands and feet and has frequent epistaxis. She is otherwise well-appearing and has no recent infections. On her exam, you note splenomegaly. What do you expect to see on further evaluation?
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ATI RN · Anatomy of Hematologic System
Question 18 of 52
After receiving a diagnosis of acute lymphocytic leukemia, a patient is visibly distraught, stating, 'I have no idea where to go from here.' How should the nurse prepare to meet this patient's psychosocial needs?
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ATI RN · Anatomy of Hematologic System
Question 19 of 52
A 20-month-old otherwise healthy male presents late for his 18-month well child check. During his first year of life, he took iron-fortified formula and had a point-of-care hemoglobin (Hgb) of 12 g/dL at his 1-year well child check. His mother reports that he is a picky eater but loves milk and has recently become obsessive about chewing the corners of his cardboard books. Physical examination is normal except for a flow murmur. Which combination of laboratory test results listed below would most likely characterize this patient?
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ATI RN · Anatomy of Hematologic System
Question 20 of 52
A patient with non-Hodgkin's lymphoma is receiving information from the oncology nurse. The patient asks the nurse why she should stop drinking and smoking and stay out of the sun. What would be the nurse's best response?
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ATI RN · Anatomy of Hematologic System
Question 21 of 52
The nurse examines the lymph nodes of a patient during a physical assessment. Which assessment finding would be of most concern to the nurse?
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ATI RN · Anatomy of Hematologic System
Question 22 of 52
An infant is born with a 7 cm × 6 cm lesion over the upper extremity from the elbow to the shoulder. The lesion is indurated and purpuric, with some petechiae around the edges. No other areas of petechiae are noted on the skin. The infant is doing well without other systemic problems. i were 9 and 9. You are called by the pediatric nurse practitioner to the NICU. What is the most appropriate next step?
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ATI RN · Anatomy of Hematologic System
Question 23 of 52
A nurse is caring for a patient who has a diagnosis of acute leukemia. What assessment most directly addresses the most common cause of death among patients with leukemia?
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ATI RN · Anatomy of Hematologic System
Question 24 of 52
Half life of plat. Is:
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ATI RN · Anatomy of Hematologic System
Question 25 of 52
The nurse is monitoring a patient receiving a blood product and is concerned that the blood is going to deteriorate before it is complete infused. What is the maximum time that blood can hang during infusion before it begins to deteriorate?
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ATI RN · Anatomy of Hematologic System
Question 26 of 52
The mean cell volume of the patient is 90 fl and the reticulocyte production index is low. Which of the following is the most possible cause of anemia in this patient?
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ATI RN · Anatomy of Hematologic System
Question 27 of 52
Which of the following is false regarding Burkitt's lymphoma?
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ATI RN · Anatomy of Hematologic System
Question 28 of 52
The nurse is reviewing the results of a patient's arterial blood gas analysis. What should the nurse recognize as being a normal blood pH?
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ATI RN · Anatomy of Hematologic System
Question 29 of 52
A nurse is reviewing the medication record of a client who is receiving alteplase following an acute myocardial infarction (MI). Which of the following medications should the nurse expect the client to be taking in addition to the alteplase?
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ATI RN · Anatomy of Hematologic System
Question 30 of 52
A nurse reviews the laboratory data for an older patient. The nurse would be most concerned about which finding?
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ATI RN · Anatomy of Hematologic System
Question 31 of 52
A 2-year-old girl has a diagnosis of overall stage IV favorable histology Wilms' tumor with pulmonary metastases and local stage III disease due to finding positive lymph nodes. After she completes 6 weeks of vincristine/dactinomycin/doxorubicin (DD4A) chemotherapy, restaging shows complete resolution of some but not all lung nodules. Tumor genetic testing reveals combined loss of heterozygosity for 1p and 16q. Which of the following would be the most appropriate treatment plan?
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ATI RN · Anatomy of Hematologic System
Question 32 of 52
A young child with consanguineous parents has developmental delay and a history of multiple recurrent bacterial infections and short stature. He presents to the emergency department following trauma and requires a blood transfusion. Blood work identifies leukocytosis, neutrophilia, and the Bombay blood group (absent H antigen as well as absent A and B antigens). What is this patient's diagnosis?
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ATI RN · Anatomy of Hematologic System
Question 33 of 52
The nurse is reviewing the parts of the complete blood count and differential with a patient. Where should the nurse state that neutrophils, eosinophils, and basophils are produced?
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ATI RN · Anatomy of Hematologic System
Question 34 of 52
A nurse is caring for a client who is experiencing an acute ischemic cerebrovascular event due to a thrombus in a cerebral vessel. Which of the following drugs should the nurse expect to administer?
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ATI RN · Anatomy of Hematologic System
Question 35 of 52
What is the nurse's priority when caring for a client who just completed a bone marrow aspiration and biopsy?
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ATI RN · Anatomy of Hematologic System
Question 36 of 52
A 12-year-old patient has been referred to you following complete resection with clean margins of a high-grade malignant peripheral nerve sheath tumor of the shoulder region. The tumor measured approximately 4 cm in greatest dimension. A CT scan of the chest and a bone scan were within normal limits. The patient does not have evidence of neurofibromatosis type 1 (NF1). Which of the following treatment approaches would you recommend?
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ATI RN · Anatomy of Hematologic System
Question 37 of 52
Artemisinin and its derivatives are used in the treatment of severe forms of chloroquine-resistant falciparum because they have:
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ATI RN · Anatomy of Hematologic System
Question 38 of 52
A nurse is monitoring a client following ferrous sulfate administration. The nurse should monitor the client for which of the following adverse effects?
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ATI RN · Anatomy of Hematologic System
Question 39 of 52
A 13-year-old girl presents with acute myeloid leukemia (AML) and a WBC count of 120,000/mm3. Cytogenetics reveals a normal karyotype, and fluorescence in situ hybridization (FISH) tests for inv(16), t(8;21), t(15;17); 11q23 abnormalities; monosomy 7; and 5q deletion are negative. Molecular testing is negative for mutations in FLT3, NPM1, and CEBPA. She is treated with 10 days of daunorubicin, AraC, and gemtuzumab for induction therapy. On day 30, she recovers counts, and a bone marrow aspiration shows 2.2% leukemic blasts by flow cytometry. She receives a second course of treatment with daunorubicin and AraC, and her marrow is now in morphologic remission and is MRD-negative by flow cytometry. She has no HLA-matched siblings, but an unrelated donor search reveals a large number of potential matches. Which course of treatment is most likely to result in the best outcome?
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ATI RN · Anatomy of Hematologic System
Question 40 of 52
Plummer Vinson syndrome is not associated with:
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ATI RN · Anatomy of Hematologic System
Question 41 of 52
A study is designed to investigate the rates of central line–associated blood stream infections (CLABSI) among pediatric hematology/oncology patients. Investigators wish to compare the length of stay (LOS) between subjects receiving three common central line types (totally implanted catheter [port], peripherally inserted central catheter [PICC], and tunneled externalized catheter [TEC]). It is discovered that LOS is not normally distributed. What is the appropriate test for comparing the LOS between patients receiving the three central line types?
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ATI RN · Anatomy of Hematologic System
Question 42 of 52
A 4-year-old girl with a history of recurrent epistaxis and easy bruising is referred to you for evaluation. She is found to have a prolonged PTT and a factor VIII level that is less than 1%. Both parents have a history of excessive bleeding. She is admitted with a severe episode of epistaxis, and your colleague orders 40 IU/kg of recombinant factor VIII. Her epistaxis resolves initially but within an hour starts again at the same severity as before. What is the best next step?
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ATI RN · Anatomy of Hematologic System
Question 43 of 52
Waldeyer's ring does not include:
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ATI RN · Anatomy of Hematologic System
Question 44 of 52
A 10-year-old girl is a long-term survivor of type II pleuropulmonary blastoma (PPB). You suspect she has a cancer predisposition syndrome and perform genetic testing, which confirms she has DICER1 syndrome. Which other cancer is she predisposed to?
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ATI RN · Anatomy of Hematologic System
Question 45 of 52
During haemostasis, prostacyclin
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ATI RN · Anatomy of Hematologic System
Question 46 of 52
Koilonychias is a specific feature of
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Question 47 of 52
The nurse is documenting findings after completing data collection with a patient. What term should the nurse use to document a large area of discoloration from hemorrhage under the skin?
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ATI RN · Anatomy of Hematologic System
Question 48 of 52
A 5-year-old boy presents with a 3-week history of his right eye “not moving to the right side.†The remainder of his neurologic exam is normal with the exception of a weak gag. MRI of the brain reveals a diffusely infiltrative mass in the pons. If this patient were to undergo a stereotactic biopsy, what would be the most likely molecular finding?
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ATI RN · Anatomy of Hematologic System
Question 49 of 52
A peripheral blood smear showing increase in numbers of neutrophils, band cells, basophils, eosinophils, and platelets is most suggestive
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ATI RN · Anatomy of Hematologic System
Question 50 of 52
A laboratory finding of granulocytosis
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ATI RN · Anatomy of Hematologic System
Question 51 of 52
What are the six dimensions of quality care according to the Institute of Medicine?
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ATI RN · Anatomy of Hematologic System
Question 52 of 52
A client is having a bone marrow biopsy today. What action by the nurse takes priority?
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