Question 1

Which clinical manifestation should the nurse expect when a child with sickle cell anemia experiences an acute vaso-occlusive crisis?

Accepted Answer

A)  Circulatory collapse 
B)  Cardiomegaly, systolic murmurs 
C)  Hepatomegaly, intrahepatic cholestasis 
D)  Painful swelling of hands and feet; painful joints 
A)  Circulatory collapse 
B)  Cardiomegaly, systolic murmurs 
C)  Hepatomegaly, intrahepatic cholestasis 
D)  Painful swelling of hands and feet; painful joints D

Question 2

What is the priority nursing intervention for a child hospitalized with hemarthrosis resulting from hemophilia?

Accepted Answer

A)  Immobilization and elevation of the affected joint 
B)  Administration of acetaminophen for pain relief 
C)  Assessment of the child's response to hospitalization 
D)  Assessment of the impact of hospitalization on the family system 
A)  Immobilization and elevation of the affected joint 
B)  Administration of acetaminophen for pain relief 
C)  Assessment of the child's response to hospitalization 
D)  Assessment of the impact of hospitalization on the family system A

Question 3

In teaching family members about their child's von Willebrand disease,what is the priority outcome for the child that the nurse should discuss?

Accepted Answer

A)  Prevention of injury 
B)  Maintaining adequate hydration 
C)  Compliance with chronic transfusion therapy 
D)  Prevention of respiratory infections 
A)  Prevention of injury 
B)  Maintaining adequate hydration 
C)  Compliance with chronic transfusion therapy 
D)  Prevention of respiratory infections A

Question 4

What is descriptive of most cases of hemophilia?

Accepted Answer

A)  Autosomal dominant disorder causing deficiency is a factor involved in the blood-clotting reaction 
B)  X-linked recessive inherited disorder causing deficiency of platelets and prolonged bleeding 
C)  X-linked recessive inherited disorder in which a blood-clotting factor is deficient 
D)  Y-linked recessive inherited disorder in which the red blood cells become moon shaped 
A)  Autosomal dominant disorder causing deficiency is a factor involved in the blood-clotting reaction 
B)  X-linked recessive inherited disorder causing deficiency of platelets and prolonged bleeding 
C)  X-linked recessive inherited disorder in which a blood-clotting factor is deficient 
D)  Y-linked recessive inherited disorder in which the red blood cells become moon shaped

Question 5

What action is not appropriate for a 14-month-old child with iron deficiency anemia?

Accepted Answer

A)  Decreasing the infant's daily milk intake to 24 oz or less 
B)  Giving oral iron supplements between meals with orange juice 
C)  Including apricots, dark-green leafy vegetables, and egg yolk in the infant's diet 
D)  Allowing the infant to drink the iron supplement from a small medicine cup 
A)  Decreasing the infant's daily milk intake to 24 oz or less 
B)  Giving oral iron supplements between meals with orange juice 
C)  Including apricots, dark-green leafy vegetables, and egg yolk in the infant's diet 
D)  Allowing the infant to drink the iron supplement from a small medicine cup

Question 6

What is a priority intervention in planning care for the child with disseminated intravascular coagulation (DIC)?

Accepted Answer

A)  Hospitalization at the first sign of bleeding 
B)  Teaching the child relaxation techniques for pain control 
C)  Management in the intensive care unit 
D)  Provision of adequate hydration to prevent complications 
A)  Hospitalization at the first sign of bleeding 
B)  Teaching the child relaxation techniques for pain control 
C)  Management in the intensive care unit 
D)  Provision of adequate hydration to prevent complications

Question 7

An assessment of a 7-month-old infant with a hemoglobin level of 6.5 mg/dL is likely to reveal an infant who is

Accepted Answer

A)  Lethargic, pale, and irritable 
B)  Thin, energetic, and sleeps little 
C)  Anorexic, vomiting, and has watery stools 
D)  Flushed, fussy, and tired 
A)  Lethargic, pale, and irritable 
B)  Thin, energetic, and sleeps little 
C)  Anorexic, vomiting, and has watery stools 
D)  Flushed, fussy, and tired

Question 8

A nurse is teaching home care instructions to parents of a child with sickle cell disease.Which instructions should the nurse include? Select all that apply.

Accepted Answer

A)  Limit fluid intake. 
B)  Administer aspirin for fever. 
C)  Administer penicillin as ordered. 
D)  Avoid cold and extreme heat. 
E)  Provide for adequate rest periods. 
A)  Limit fluid intake. 
B)  Administer aspirin for fever. 
C)  Administer penicillin as ordered. 
D)  Avoid cold and extreme heat. 
E)  Provide for adequate rest periods.

Question 9

How should the nurse respond when asked by the mother of a child with beta-thalassemia why the child is receiving deferoxamine?

Accepted Answer

A)  "To improve the anemia." 
B)  "To decrease liver and spleen swelling." 
C)  "To eliminate excessive iron being stored in the organs." 
D)  "To prepare your child for a bone marrow transplant." 
A)  "To improve the anemia." 
B)  "To decrease liver and spleen swelling." 
C)  "To eliminate excessive iron being stored in the organs." 
D)  "To prepare your child for a bone marrow transplant."

Question 10

What describes the pathologic changes of sickle cell anemia?

Accepted Answer

A)  Sickle-shaped cells carry excess oxygen. 
B)  Sickle-shaped cells decrease blood viscosity. 
C)  Increased red blood cell destruction occurs. 
D)  Decreased red blood cell destruction occurs. 
A)  Sickle-shaped cells carry excess oxygen. 
B)  Sickle-shaped cells decrease blood viscosity. 
C)  Increased red blood cell destruction occurs. 
D)  Decreased red blood cell destruction occurs.

Question 11

What should the discharge plan for a school-age child with sickle cell disease include?

Accepted Answer

A)  Restricting the child's participation in outside activities 
B)  Administering aspirin for pain or fever 
C)  Limiting the child's interaction with peers 
D)  Administering penicillin daily as ordered 
A)  Restricting the child's participation in outside activities 
B)  Administering aspirin for pain or fever 
C)  Limiting the child's interaction with peers 
D)  Administering penicillin daily as ordered

Question 12

A syndrome that leads to the deposition of platelets and fibrinogen plugs in the vasculature and the simultaneous depletion of platelets and clotting factor proteins is commonly known as DIC or _____________________.

Accepted Answer

disseminated intravascular coa

Question 13

What is the priority in the discharge plan for a child with immune thrombocytopenic purpura (ITP)?

Accepted Answer

A)  Teaching the parents to report excessive fatigue to the physician 
B)  Monitoring the child's hemoglobin level every 2 weeks 
C)  Providing a diet that contains iron-rich foods 
D)  Establishing a safe, age-appropriate home environment 
A)  Teaching the parents to report excessive fatigue to the physician 
B)  Monitoring the child's hemoglobin level every 2 weeks 
C)  Providing a diet that contains iron-rich foods 
D)  Establishing a safe, age-appropriate home environment

Question 14

What are the nursing priorities for a child with sickle cell disease in vaso-occlusive crisis?

Accepted Answer

A)  Administration of antibiotics and nebulizer treatments 
B)  Hydration and pain management 
C)  Blood transfusions and an increased calorie diet 
D)  School work and diversion 
A)  Administration of antibiotics and nebulizer treatments 
B)  Hydration and pain management 
C)  Blood transfusions and an increased calorie diet 
D)  School work and diversion

Question 15

What is true about the genetic transmission of sickle cell disease?

Accepted Answer

A)  Both parents must carry the sickle cell trait. 
B)  Both parents must have sickle cell disease. 
C)  One parent must have the sickle cell trait. 
D)  Sickle cell disease has no known pattern of inheritance. 
A)  Both parents must carry the sickle cell trait. 
B)  Both parents must have sickle cell disease. 
C)  One parent must have the sickle cell trait. 
D)  Sickle cell disease has no known pattern of inheritance.

Question 16

The nurse is caring for a child with iron-deficiency anemia.What should the nurse expect to find when reviewing the results of the complete blood count (CBC)? Select all that apply.

Accepted Answer

A)  Low hemoglobin levels 
B)  Elevated red blood cell (RB
C)  levels 
C)  Elevated mean cell volume (MCV) levels 
D)  Low reticulocyte count 
E)  Decreased MCV levels 
A)  Low hemoglobin levels 
B)  Elevated red blood cell (RB
C)  levels 
C)  Elevated mean cell volume (MCV) levels 
D)  Low reticulocyte count 
E)  Decreased MCV levels

Question 17

The mother of a child with hemophilia asks the nurse how long her child will need to be treated for hemophilia.What is the best response to this question?

Accepted Answer

A)  "Hemophilia is a lifelong blood disorder." 
B)  "There is a 25% chance that your child will have spontaneous remission and treatment will no longer be necessary." 
C)  "Treatment is indicated until after your child has progressed through the toddler years." 
D)  "It is unlikely that your child will need to be treated for his hemophilia because your first child does not have the disease." 
A)  "Hemophilia is a lifelong blood disorder." 
B)  "There is a 25% chance that your child will have spontaneous remission and treatment will no longer be necessary." 
C)  "Treatment is indicated until after your child has progressed through the toddler years." 
D)  "It is unlikely that your child will need to be treated for his hemophilia because your first child does not have the disease."

Question 18

The nurse is caring for a child with aplastic anemia.What nursing diagnoses are appropriate? Select all that apply.

Accepted Answer

A)  Acute Pain related to vaso-occlusion 
B)  Risk for Infection related to inadequate secondary defenses or immunosuppression 
C)  Ineffective Protection related to thrombocytopenia 
D)  Ineffective Tissue Perfusion related to anemia 
E)  Ineffective Protection related to abnormal clotting 
A)  Acute Pain related to vaso-occlusion 
B)  Risk for Infection related to inadequate secondary defenses or immunosuppression 
C)  Ineffective Protection related to thrombocytopenia 
D)  Ineffective Tissue Perfusion related to anemia 
E)  Ineffective Protection related to abnormal clotting

Question 19

The nurse is evaluating lab results to determine if her patient is experiencing a diagnosis of DIC.The nurse should anticipate the following results: increased red blood cell count,low platelet counts,and an increased fibrinogen level.Is this statement true or false?

Accepted Answer

A) True 
 B)False

Question 20

Which statement best describes beta-thalassemia major (Cooley anemia)?

Accepted Answer

A)  All formed elements of the blood are depressed. 
B)  Inadequate numbers of red blood cells are present. 
C)  Increased incidence occurs in families of Mediterranean extraction. 
D)  Increased incidence occurs in persons of West African descent. 
A)  All formed elements of the blood are depressed. 
B)  Inadequate numbers of red blood cells are present. 
C)  Increased incidence occurs in families of Mediterranean extraction. 
D)  Increased incidence occurs in persons of West African descent.

Exam 47: The Child With a Hematologic Alteration

Which clinical manifestation should the nurse expect when a child with sickle cell anemia experiences an acute vaso-occlusive crisis?

What is the priority nursing intervention for a child hospitalized with hemarthrosis resulting from hemophilia?

In teaching family members about their child's von Willebrand disease,what is the priority outcome for the child that the nurse should discuss?

What is descriptive of most cases of hemophilia?

What action is not appropriate for a 14-month-old child with iron deficiency anemia?

What is a priority intervention in planning care for the child with disseminated intravascular coagulation (DIC)?

An assessment of a 7-month-old infant with a hemoglobin level of 6.5 mg/dL is likely to reveal an infant who is

A nurse is teaching home care instructions to parents of a child with sickle cell disease.Which instructions should the nurse include? Select all that apply.

How should the nurse respond when asked by the mother of a child with beta-thalassemia why the child is receiving deferoxamine?

What describes the pathologic changes of sickle cell anemia?

What should the discharge plan for a school-age child with sickle cell disease include?

A syndrome that leads to the deposition of platelets and fibrinogen plugs in the vasculature and the simultaneous depletion of platelets and clotting factor proteins is commonly known as DIC or _____________________.

What is the priority in the discharge plan for a child with immune thrombocytopenic purpura (ITP)?

What are the nursing priorities for a child with sickle cell disease in vaso-occlusive crisis?

What is true about the genetic transmission of sickle cell disease?

The nurse is caring for a child with iron-deficiency anemia.What should the nurse expect to find when reviewing the results of the complete blood count (CBC)? Select all that apply.

The mother of a child with hemophilia asks the nurse how long her child will need to be treated for hemophilia.What is the best response to this question?

The nurse is caring for a child with aplastic anemia.What nursing diagnoses are appropriate? Select all that apply.

The nurse is evaluating lab results to determine if her patient is experiencing a diagnosis of DIC.The nurse should anticipate the following results: increased red blood cell count,low platelet counts,and an increased fibrinogen level.Is this statement true or false?

Which statement best describes beta-thalassemia major (Cooley anemia)?

Foundations of Maternity, Women’s Health, and Child Health Nursing

The Nurse’s Role in Maternity, Women’s Health, and Pediatric Nursing

The Childbearing and Child-Rearing Family

Communicating With Children and Families

Health Promotion for the Developing Child

Health Promotion for the Infant

Health Promotion during Early Childhood

Health Promotion for the School-Age Child

Health Promotion for the Adolescent

Hereditary and Environmental Influences on Development

Reproductive Anatomy and Physiology

Conception and Prenatal Development

Adaptations to Pregnancy

Nutrition for Childbearing

Prenatal Diagnostic Tests

Giving Birth

Intrapartum Fetal Surveillance

Pain Management for Childbirth

Nursing Care during Obstetric Procedures

Postpartum Adaptations

The Normal Newborn: Adaptation and Assessment

The Normal Newborn: Nursing Care

Newborn Feeding

The Childbearing Family With Special Needs

Pregnancy-Related Complications

Concurrent Disorders During Pregnancy

The Woman With an Intrapartum Complication

The Woman With a Postpartum Complication

The High-Risk Newborn: Problems Related to Gestational Age and Development

The High Risk Newborn: Acquired and Congenital Conditions

Management of Fertility and Infertility

Women’s Health Care

Physical Assessment of Children

Emergency Care of the Child

The Ill Child in the Hospital and Other Care Settings

The Child With a Chronic Condition or Terminal Illness

Principles and Procedures for Nursing Care of Children

Medication Administration and Safety for Infants and Children

Pain Management for Children

The Child With a Fluid and Electrolyte Alteration

The Child With an Infectious Disease

The Child With an Immunologic Alteration

The Child With a Gastrointestinal Alteration

The Child With a Genitourinary Alteration

The Child With a Respiratory Alteration

The Child With a Cardiovascular Alteration

The Child With Cancer

The Child With an Alteration in Tissue Integrity

The Child With a Musculoskeletal Alteration

The Child With an Endocrine or Metabolic Alteration

The Child With a Neurologic Alteration

Psychosocial Problems in Children and Families

The Child With a Developmental Disability

The Child With a Sensory Alteration

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