HESI The Hematologic System ATI

HESI LPN · HESI The Hematologic System ATI

Question 1 of 49

Several gene mutations have been associated with juvenile myelomonocytic leukemia (JMML), and they may or may not have prognostic implications. A gene expressionÃƒÂ¢Ã¢â€šÂ¬Ã¢â‚¬Å“based classification system has been found to be an independent predictor of clinical outcome in these patients. What is the disease signature that predicts a poor outcome?

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HESI LPN · HESI The Hematologic System ATI

Question 2 of 49

A client is having a radioisotopic imaging scan. What action by the nurse is most important?

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HESI LPN · HESI The Hematologic System ATI

Question 3 of 49

The nurse is concerned that a patient is demonstrating signs of red blood cell production. What laboratory value did the nurse most likely use to make this decision?

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HESI LPN · HESI The Hematologic System ATI

Question 4 of 49

An 18-year old male patient presents with bruising, fatigue, and diffuse extremity pain. He is noted to be tachypneic and hypoxic and has a diffuse interstitial infiltrate on chest x-ray. CBC reveals a WBC count of 285,000/mm3 (85% myeloblasts, with monocytic morphology), hemoglobin of 7.9 g/dL, and platelet count of 36,000/mm3. What is the most likely cause of the infiltrate and respiratory symptoms and the most appropriate initial treatment?

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HESI LPN · HESI The Hematologic System ATI

Question 5 of 49

Plat. Transfusion is not indicated in:

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Question 6 of 49

RBCs break into fragments, they are referred to as schistocytes. These type of cells are seen in

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HESI LPN · HESI The Hematologic System ATI

Question 7 of 49

Platelet aggregation is an important event in hemostasis. Which of the following statement is true for platelet aggregation in vascular injury?

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HESI LPN · HESI The Hematologic System ATI

Question 8 of 49

The International Normalized Ratio (INR) was developed for the purpose of

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Question 9 of 49

The nurse is assisting with the collection of data from a patient with a hematologic disorder. On which body system should the nurse expect to focus when collecting this data?

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HESI LPN · HESI The Hematologic System ATI

Question 10 of 49

A nurse is caring for a patient who is being treated for leukemia in the hospital. The patient was able to maintain her nutritional status for the first few weeks following her diagnosis but is now exhibiting early signs and symptoms of malnutrition. In collaboration with the dietitian, the nurse should implement what intervention?

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HESI LPN · HESI The Hematologic System ATI

Question 11 of 49

A nurse is administering epoetin intravenously to a client who has renal failure. Which of the following actions should the nurse take?

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HESI LPN · HESI The Hematologic System ATI

Question 12 of 49

Henoch Schonlein purpura is not associated with:

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Question 13 of 49

A nurse is caring for a client who is about to begin factor VIII therapy to treat hemophilia A. When administering factor VIII, which of the following actions should the nurse take?

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Question 14 of 49

A 19-year-old freshman in college presents with 'lumps' on the right side of his neck and in the right axilla. He had a fever to 39 Ãƒâ€šÃ‚Â°C 1 day in the past week. On physical exam, there are firm anterior cervical and axillary nodes, all greater than 2 cm in diameter. A chest x-ray shows a large mediastinal mass. A biopsy of the axillary node reveals classic Hodgkin lymphoma. Which of the following symptoms revealed during the history is a B symptom?

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HESI LPN · HESI The Hematologic System ATI

Question 15 of 49

A patient is prescribed a transfusion of washed packed red blood cells. What should the nurse realize as being the rationale for the using this type of blood?

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HESI LPN · HESI The Hematologic System ATI

Question 16 of 49

Peripheral bl. Picture is most useful in:

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HESI LPN · HESI The Hematologic System ATI

Question 17 of 49

You have been asked to see a 15-year-old girl who is being referred for evaluation of an ovarian mass. Her history is also significant for secondary amenorrhea, and physical examination shows signs of virilization. As you review her family history, what syndrome will you consider?

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Question 18 of 49

An emergency department nurse is triaging a 77-year-old man who presents with uncharacteristic fatigue as well as back and rib pain. The patient denies any recent injuries. The nurse should recognize the need for this patient to be assessed for what health problem?

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Question 19 of 49

A patient with advanced leukemia is responding poorly to treatment. The nurse finds the patient tearful and trying to express his feelings, but he is clearly having difficulty. What is the nurse's most appropriate action?

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Question 20 of 49

An 18-year old male patient with acute lymphoblastic leukemia recently started maintenance therapy and is complaining of increased hip pain. The pain increases during weight-bearing activity; however, it occasionally hurts at night as well. His CBCd is normal. Which of the following risk factors is most commonly associated with this process?

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HESI LPN · HESI The Hematologic System ATI

Question 21 of 49

Incorrect about pernicious an:

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Question 22 of 49

A 16-year-old female patient with severe factor XI deficiency presents with acute appendicitis and requires urgent surgery. You are called by the surgeon, who wants to know what, if any, blood products or treatments are required to reduce the risk of perioperative bleeding. The patient weighs 62 kg. What should you tell him to administer?

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Question 23 of 49

You are consulted on a 4-year-old girl who is newly diagnosed with standard-risk pre-B acute lymphoblastic leukemia. After reviewing her previous complete blood examinations, you note she has had a platelet count ranging from 80,000 to 100,000 cells/mcL over the past 2 years. Her father mentions that he has also been told he has mild thrombocytopenia. You suspect the child may have a cancer predisposition syndrome. Which sample should you send for analysis, and which gene is most likely implicated?

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Question 24 of 49

A nurse is caring for a client who is about to begin therapy with recombinant factor IX to treat hemophilia B. The client asks the nurse about the risk of disease transmission with recombinant factor IX as compared with plasma derived factor IX. The nurse should explain that the recombinant factor IX practically eliminates the risk for which of the following?

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HESI LPN · HESI The Hematologic System ATI

Question 25 of 49

Which of the following is not true in thrombasthenia:

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Question 26 of 49

You are seeing a 12-year-old female who presented to the emergency department with the sudden onset of severe abdominal pain. Imaging that was obtained to rule out appendicitis revealed a mass adjacent to the bladder. The mass was surgically resected, and pathology demonstrated a paraganglioma. Which of the studies below would be most useful to determine disease stage for this patient?

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HESI LPN · HESI The Hematologic System ATI

Question 27 of 49

Which of the following is a key feature of Factor XIII?

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Question 28 of 49

A nurse is assessing a dark-skinned client for pallor. What nursing assessment is best to assess for pallor in this client?

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Question 29 of 49

A patient's complete blood count (CBC) shows a hemoglobin of 19 g/dL and a hematocrit of 54%. Which question should the nurse ask to determine possible causes of this finding?

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Question 30 of 49

Dengue is a common vector-borne disease prevalent in tropical countries. Which of the following statement is true for dengue fever?

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Question 31 of 49

Which of the following is not the criteria in the international prognostic index for non Hodgkin's lymphoma?

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Question 32 of 49

An 8-year-old girl presents with National Cancer Institute (NCI) Standard Risk acute pre-B-cell acute lymphoblastic leukemia. Her family history is significant for her mother having been diagnosed with breast cancer at age 34 years and a maternal uncle who developed osteosarcoma as a teenager. What cytogenetic abnormality is most likely to be detected in this patient?

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Question 33 of 49

A nurse is caring for a client who has chronic stable angina. The nurse should identify that which of the following drugs inhibits the action of adenosine diphosphate receptors (ADP) on platelets and can be prescribed to reduce the client's risk for myocardial infarction?

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Question 34 of 49

A patient is suffered from vitamin K deficiency. Which of the coagulation factors will not be affected?

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Question 35 of 49

A patient who is infected with hookworms produces signs and symptoms of anemia. Which of the following can be seen in the peripheral blood smear of the patient?

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Question 36 of 49

A patient has an altered level of T and B cells. The nurse realizes that these cells are members of which cell type?

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Question 37 of 49

Diagnostic testing has resulted in a diagnosis of acute myeloid leukemia (AML) in an adult patient who is otherwise healthy. The patient and the care team have collaborated and the patient will soon begin induction therapy. The nurse should prepare the patient for which of the following?

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Question 38 of 49

A 16-year-old female presents to the emergency room with a new complaint of chest pain. When performing a review of systems and physical examination, which of the following would substantially decrease your suspicion for a diagnosis of pulmonary embolism?

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Question 39 of 49

Virchow's node receives lymphatics from all except:

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Question 40 of 49

A patient who is suspected of having acute viral hemorrhagic fever reveals history of tick bite. Which of the following is the most possible causative agent?

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Question 41 of 49

A 9-year-old boy presents to the emergency department with emesis and headache of 3 weeks' duration. MRI reveals a large heterogeneous mass in the cerebellum. He undergoes a resection, and the pathology is most consistent with a classic medulloblastoma. Which of the following findings would classify the patient as a high-risk medulloblastoma?

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Question 42 of 49

A 2-month-old girl is found to have a small, hard mass on her scalp. The mass increases in size over the next 4 weeks. A biopsy is performed that confirms a diagnosis of embryonal rhabdomyosarcoma. You initiate chemotherapy with vincristine, dactinomycin, and cyclophosphamide. The child presents to clinic for day 1 of cycle 3 of chemotherapy, and the mass on her scalp is smaller. She is afebrile, absolute neutrophil count is 1,405 cells/mcL, platelet count is 154,000/mcL, and total bilirubin is 0.8 mg/dL. Her mother reports she looks very tired because her eyelids have been 'very droopy,' and she thinks she has a sore throat because her cry is hoarse. Her last bowel movement was 2 days ago. What is the most appropriate chemotherapy plan?

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Question 43 of 49

A 50-year-old male who had frequent infections of his upper respiratory tract manifested with subcutaneous petechiae over his arms and legs. Investigations revealed low hemoglobin and a dry tap marrow. The most likely condition the patient is suffering from

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Question 44 of 49

According to the FAB classification, the L2 stage is characterized by:

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Question 45 of 49

You are caring for a patient with a large localized Ewing sarcoma of the soft tissues of the arm. The surgeon believes that the tumor can be resected without amputation but asks whether you can give some chemotherapy to shrink the tumor before surgery. Which of the following would you tell the surgeon?

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Question 46 of 49

You are consulting on a 10-year-old male with severe persistent neutropenia, a history of recurrent infections, and warts. The rest of the peripheral blood count is normal. His mother also has neutropenia. Bone marrow examination shows a hypercellular marrow and retained myeloid cells with vacuolated cytoplasm. There are no abnormalities in the red cells or platelet precursors. Cytogenetics are 46XY. You start granulocyte colony stimulating factor therapy and the neutrophil count increases. A mutation in which of the following genes is most likely to have caused this familial inherited bone marrow failure syndrome?

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Question 47 of 49

A patient has a bone marrow aspiration from the posterior iliac crest. Before the procedure, the patient's vital signs were: blood pressure 132/82 mm Hg and pulse 88 beats/min. One hour after the procedure, the blood pressure is 108/70 mm Hg and pulse is 96 beats/min. Which assessment is the least important for the patient at this time?

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Question 48 of 49

The health care provider tells the nurse that a client is to be started on a platelet inhibitor. About what drug does the nurse plan to teach the client?

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Question 49 of 49

A patient is being prepared to receive a prescribed blood transfusion. What is the best way that the LPN can assist the health team to prevent a transfusion reaction?

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