Question 1

Which of the following clusters of symptoms would lead you to suspect a child has idiopathic thrombocytopenic purpura (ITP)?

Accepted Answer

A)  Multiple infections; bruising; abnormal bone marrow aspiration 
B)  Lower extremity that is warm to touch, edematous, and painful 
C)  Spontaneous nosebleeds; bruising; petechiae 
D)  Increased platelet count; recent-onset venous thrombosis 
A)  Multiple infections; bruising; abnormal bone marrow aspiration 
B)  Lower extremity that is warm to touch, edematous, and painful 
C)  Spontaneous nosebleeds; bruising; petechiae 
D)  Increased platelet count; recent-onset venous thrombosis C

Question 2

Maternal-fetal blood incompatibility may exist in which of the following conditions?

Accepted Answer

A)  Mother is Rh-positive, and fetus is Rh-negative. 
B)  Mother is Rh-negative, and fetus is Rh-positive. 
C)  Mother has type A blood, and fetus has type O blood. 
D)  Mother has type AB, blood and fetus has type B blood. 
A)  Mother is Rh-positive, and fetus is Rh-negative. 
B)  Mother is Rh-negative, and fetus is Rh-positive. 
C)  Mother has type A blood, and fetus has type O blood. 
D)  Mother has type AB, blood and fetus has type B blood. B

Question 3

Iron deficiency anemia:

Accepted Answer

A)  is most common between the ages of 2 and 4 years. 
B)  is related to gender and race. 
C)  may be related to socioeconomic factors. 
D)  is rare among teenagers. 
A)  is most common between the ages of 2 and 4 years. 
B)  is related to gender and race. 
C)  may be related to socioeconomic factors. 
D)  is rare among teenagers. C

Question 4

Which condition increases the risk of developing malignant lymphoma?

Accepted Answer

A)  Sickle cell disease 
B)  Sickle cell trait 
C)  Renal failure 
D)  AIDS 
A)  Sickle cell disease 
B)  Sickle cell trait 
C)  Renal failure 
D)  AIDS

Question 5

A major symptom of vaso-occlusive crisis in sickle cell anemia is:

Accepted Answer

A)  peripheral edema. 
B)  pain. 
C)  petechiae. 
D)  an enlarged spleen. 
A)  peripheral edema. 
B)  pain. 
C)  petechiae. 
D)  an enlarged spleen.

Question 6

A 5-year-old female dies from sickle cell disease. The most likely cause of death is:

Accepted Answer

A)  decreased hemoglobin. 
B)  infection. 
C)  an obstructive crisis. 
D)  a hyperhemolytic crisis. 
A)  decreased hemoglobin. 
B)  infection. 
C)  an obstructive crisis. 
D)  a hyperhemolytic crisis.

Question 7

The alpha and beta thalassemias are inherited in an _____ fashion.

Accepted Answer

A)  autosomal recessive 
B)  autosomal dominant 
C)  X-linked recessive 
D)  X-linked dominant 
A)  autosomal recessive 
B)  autosomal dominant 
C)  X-linked recessive 
D)  X-linked dominant

Question 8

A 16-month-old female presents with tachycardia, pallor, anorexia, and systolic murmur. Hemoglobin determination indicates a content below _____ g/dl.

Accepted Answer

A)  2 
B)  5 
C)  10 
D)  14 
A)  2 
B)  5 
C)  10 
D)  14

Question 9

A 12-month-old toddler weighing 18 pounds is brought to the clinic because of weakness, slow physical growth, and developmental delays. His mother reports that the only food he will consume is cow's milk. Considering this information, the nurse decides that the child probably has:

Accepted Answer

A)  pernicious anemia. 
B)  iron deficiency anemia. 
C)  aplastic anemia. 
D)  hemolytic anemia. 
A)  pernicious anemia. 
B)  iron deficiency anemia. 
C)  aplastic anemia. 
D)  hemolytic anemia.

Question 10

A 22-year-old female gives birth at 20 weeks' gestation to a stillborn fetus. Physical exam reveals gross edema of the entire body and anemia. This condition is referred to as:

Accepted Answer

A)  hyperbilirubinemia. 
B)  hydrops fetalis. 
C)  erythroblastosis fetalis. 
D)  ascites. 
A)  hyperbilirubinemia. 
B)  hydrops fetalis. 
C)  erythroblastosis fetalis. 
D)  ascites.

Question 11

A 2-year-old male presented with growth and maturation retardation and splenomegaly. He died shortly after arriving at the ER. Autopsy revealed thalassemia secondary to defective:

Accepted Answer

A)  erythrocyte membranes. 
B)  iron metabolism. 
C)  stem cell formation. 
D)  hemoglobin synthesis. 
A)  erythrocyte membranes. 
B)  iron metabolism. 
C)  stem cell formation. 
D)  hemoglobin synthesis.

Question 12

A 3-year-old child presents with bruising on the legs and trunk and a petechial rash. The mother also reports frequent nosebleeds. Lab tests reveal a decreased platelet count. The most likely diagnosis is:

Accepted Answer

A)  idiopathic thrombocytopenic purpura. 
B)  leukemia. 
C)  thalassemia. 
D)  hemophilia. 
A)  idiopathic thrombocytopenic purpura. 
B)  leukemia. 
C)  thalassemia. 
D)  hemophilia.

Question 13

In the United States, sickle cell disease most commonly occurs in:

Accepted Answer

A)  Asians. 
B)  African Americans. 
C)  Hispanics. 
D)  Caucasians. 
A)  Asians. 
B)  African Americans. 
C)  Hispanics. 
D)  Caucasians.

Question 14

Hydrops fetalis may result from which type of thalassemia?

Accepted Answer

A)  Beta minor 
B)  Beta major 
C)  Alpha minor 
D)  Alpha major 
A)  Beta minor 
B)  Beta major 
C)  Alpha minor 
D)  Alpha major

Question 15

A 38-year-old female gives birth to a stillborn fetus. Autopsy reveals cardiomegaly, hepatomegaly, edema, and ascites. The most likely cause is:

Accepted Answer

A)  alpha-thalassemia minor. 
B)  alpha-thalassemia major. 
C)  hemoglobin H disease. 
D)  alpha-trait. 
A)  alpha-thalassemia minor. 
B)  alpha-thalassemia major. 
C)  hemoglobin H disease. 
D)  alpha-trait.

Question 16

The erythrocytes of a person with sickle cell anemia may become sickled if:

Accepted Answer

A)  oxygen tension is low. 
B)  pH is increased. 
C)  plasma osmolality is decreased. 
D)  fever develops. 
A)  oxygen tension is low. 
B)  pH is increased. 
C)  plasma osmolality is decreased. 
D)  fever develops.

Question 17

A 1-year-old is diagnosed with idiopathic thrombocytopenic purpura (ITP). The most serious concern is development of:

Accepted Answer

A)  respiratory infection. 
B)  asymmetric bruising. 
C)  intracranial bleeding. 
D)  immunosuppression. 
A)  respiratory infection. 
B)  asymmetric bruising. 
C)  intracranial bleeding. 
D)  immunosuppression.

Question 18

A 6-year-old male presents with fatigue, jaundice, and irritability. A blood smear shows the presence of sickled cells. Erythropoiesis is compromised in this child, resulting in a(n):

Accepted Answer

A)  vaso-occlusive crisis. 
B)  sequestration crisis. 
C)  aplastic crisis. 
D)  hyperhemolytic crisis. 
A)  vaso-occlusive crisis. 
B)  sequestration crisis. 
C)  aplastic crisis. 
D)  hyperhemolytic crisis.

Question 19

The type of sickle cell crisis seen only in young children is:

Accepted Answer

A)  hyperhemolytic. 
B)  vaso-occlusive. 
C)  aplastic. 
D)  sequestration. 
A)  hyperhemolytic. 
B)  vaso-occlusive. 
C)  aplastic. 
D)  sequestration.

Question 20

A 5-year-old male is diagnosed with leukemia. Which of the following symptoms would be expected?

Accepted Answer

A)  Fatigue 
B)  Jaundice 
C)  Irritability 
D)  Bradycardia 
A)  Fatigue 
B)  Jaundice 
C)  Irritability 
D)  Bradycardia

Exam 21: Alterations of Hematologic Function in Children

Which of the following clusters of symptoms would lead you to suspect a child has idiopathic thrombocytopenic purpura (ITP)?

Maternal-fetal blood incompatibility may exist in which of the following conditions?

Iron deficiency anemia:

Which condition increases the risk of developing malignant lymphoma?

A major symptom of vaso-occlusive crisis in sickle cell anemia is:

A 5-year-old female dies from sickle cell disease. The most likely cause of death is:

The alpha and beta thalassemias are inherited in an _____ fashion.

A 16-month-old female presents with tachycardia, pallor, anorexia, and systolic murmur. Hemoglobin determination indicates a content below _____ g/dl.

A 12-month-old toddler weighing 18 pounds is brought to the clinic because of weakness, slow physical growth, and developmental delays. His mother reports that the only food he will consume is cow's milk. Considering this information, the nurse decides that the child probably has:

A 22-year-old female gives birth at 20 weeks' gestation to a stillborn fetus. Physical exam reveals gross edema of the entire body and anemia. This condition is referred to as:

A 2-year-old male presented with growth and maturation retardation and splenomegaly. He died shortly after arriving at the ER. Autopsy revealed thalassemia secondary to defective:

A 3-year-old child presents with bruising on the legs and trunk and a petechial rash. The mother also reports frequent nosebleeds. Lab tests reveal a decreased platelet count. The most likely diagnosis is:

In the United States, sickle cell disease most commonly occurs in:

Hydrops fetalis may result from which type of thalassemia?

A 38-year-old female gives birth to a stillborn fetus. Autopsy reveals cardiomegaly, hepatomegaly, edema, and ascites. The most likely cause is:

The erythrocytes of a person with sickle cell anemia may become sickled if:

A 1-year-old is diagnosed with idiopathic thrombocytopenic purpura (ITP). The most serious concern is development of:

A 6-year-old male presents with fatigue, jaundice, and irritability. A blood smear shows the presence of sickled cells. Erythropoiesis is compromised in this child, resulting in a(n):

The type of sickle cell crisis seen only in young children is:

A 5-year-old male is diagnosed with leukemia. Which of the following symptoms would be expected?

Cellular Biology

Genes and Genetic Diseases

Altered Cellular and Tissue Biology

Fluids and Electrolytes, Acids and Bases

Innate Defenses: Inflammation

Adaptive Immunity

Hypersensitivities, Infection, and Immune Deficiencies

Stress and Disease

Biology of Cancer and Tumor Spread

Cancer Epidemiology, Manifestations, and Treatment

Cancer in Children

Structure and Function of the Neurologic System

Pain, Temperature, Sleep, and Sensory Function

Concepts of Neurologic Dysfunction

Alterations of Neurologic Function

Alterations of Neurologic Function in Children

Mechanisms of Hormonal Regulation

Alterations of Hormonal Regulation

Structure and Function of the Hematologic System

Alterations of Hematologic Function

Structure and Function of the Cardiovascular and Lymphatic Systems

Alterations of Cardiovascular Function

Alterations of Cardiovascular Function in Children

Structure and Function of the Pulmonary System

Alterations of Pulmonary Function

Alterations of Pulmonary Function in Children

Structure and Function of the Renal and Urologic Systems

Alterations of Renal and Urinary Tract Function

Alterations of Renal and Urinary Tract Function in Children

Structure and Function of the Reproductive Systems

Alterations of the Reproductive Systems, Including Sexually Transmitted Infections

Structure and Function of the Digestive System

Alterations of Digestive Function

Alterations of Digestive Function in Children

Structure and Function of the Musculoskeletal System

Alterations of Musculoskeletal Function

Alterations of Musculoskeletal Function in Children

Structure, Function, and Disorders of the Integument

Alterations of the Integument in Children

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