Question 1

Which statement best describes b-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.

Question 2

Which is most descriptive of the pathophysiology of leukemia?

Accepted Answer

A) Increased blood viscosity occurs. 
B) Thrombocytopenia (excessive destruction of platelets) occurs. 
C) Unrestricted proliferation of immature white blood cells (WBCs) occurs. 
D) First stage of coagulation process is abnormally stimulated. 
A) Increased blood viscosity occurs. 
B) Thrombocytopenia (excessive destruction of platelets) occurs. 
C) Unrestricted proliferation of immature white blood cells (WBCs) occurs. 
D) First stage of coagulation process is abnormally stimulated.

Question 3

The nurse is recommending how to prevent iron deficiency anemia in a healthy,term,breast-fed infant.Which should be suggested?

Accepted Answer

A) Iron (ferrous sulfate) drops after age 1 month 
B) Iron-fortified commercial formula by age 4 to 6 months 
C) Iron-fortified infant cereal by age 2 months 
D) Iron-fortified infant cereal by age 4 to 6 months 
A) Iron (ferrous sulfate) drops after age 1 month 
B) Iron-fortified commercial formula by age 4 to 6 months 
C) Iron-fortified infant cereal by age 2 months 
D) Iron-fortified infant cereal by age 4 to 6 months

Question 4

The nurse is teaching parents about the importance of iron in a toddler's diet.Which explains why iron deficiency anemia is common during toddlerhood?

Accepted Answer

A) Milk is a poor source of iron. 
B) Iron cannot be stored during fetal development. 
C) Fetal iron stores are depleted by age 1 month. 
D) Dietary iron cannot be started until age 12 months. 
A) Milk is a poor source of iron. 
B) Iron cannot be stored during fetal development. 
C) Fetal iron stores are depleted by age 1 month. 
D) Dietary iron cannot be started until age 12 months.

Question 5

The nurse has initiated a blood transfusion on a preschool child.The child begins to exhibit signs of a transfusion reaction.Place in order the interventions the nurse should implement sequencing from the highest priority to the lowest.Provide answer using lowercase letters separated by commas (e.g.,a,b,c,d).
a. Take the vital signs.
b. Stop the transfusion.
c. Notify the practitioner.
d. Maintain a patent IV line with normal saline.

Accepted Answer

b,a,d,c
If a blood transfusion reaction

Question 6

Which is the most effective pain-management approach for a child who is having a bone marrow aspiration?

Accepted Answer

A) Relaxation techniques 
B) Administration of an opioid 
C) EMLA cream applied over site 
D) Conscious or unconscious sedation 
A) Relaxation techniques 
B) Administration of an opioid 
C) EMLA cream applied over site 
D) Conscious or unconscious sedation

Question 7

The nurse is planning care for a school-age child admitted to the hospital with hemophilia.Which interventions should the nurse plan to implement for this child? (Select all that apply.)

Accepted Answer

A) Finger sticks for blood work instead of venipunctures 
B) Avoidance of IM injections 
C) Acetaminophen (Tylenol) for mild pain control 
D) Soft tooth brush for dental hygiene 
E) Administration of packed red blood cells 
A) Finger sticks for blood work instead of venipunctures 
B) Avoidance of IM injections 
C) Acetaminophen (Tylenol) for mild pain control 
D) Soft tooth brush for dental hygiene 
E) Administration of packed red blood cells

Question 8

Parents of a child with sickle cell anemia ask the nurse,"What happens to the hemoglobin in sickle cell anemia?" Which statement by the nurse explains the disease process?"

Accepted Answer

A) Normal adult hemoglobin is replaced by abnormal hemoglobin. 
B) There is a lack of cellular hemoglobin being produced. 
C) There is a deficiency in the production of globulin chains. 
D) The size and depth of the hemoglobin are affected. 
A) Normal adult hemoglobin is replaced by abnormal hemoglobin. 
B) There is a lack of cellular hemoglobin being produced. 
C) There is a deficiency in the production of globulin chains. 
D) The size and depth of the hemoglobin are affected.

Question 9

The nurse is conducting a staff in-service on inherited childhood blood disorders.Which statement describes severe combined immunodeficiency syndrome (SCIDS)?

Accepted Answer

A) There is a deficit in both the humoral and cellular immunity with this disease. 
B) Production of red blood cells is affected with this disease. 
C) Adult hemoglobin is replaced by abnormal hemoglobin in this disease. 
D) There is a deficiency of T and B lymphocyte production with this disease. 
A) There is a deficit in both the humoral and cellular immunity with this disease. 
B) Production of red blood cells is affected with this disease. 
C) Adult hemoglobin is replaced by abnormal hemoglobin in this disease. 
D) There is a deficiency of T and B lymphocyte production with this disease.

Question 10

An adolescent will receive a bone marrow transplant (BMT).The nurse should explain that the bone marrow will be administered by which route?

Accepted Answer

A) Bone grafting 
B) Bone marrow injection 
C) IV infusion 
D) Intra-abdominal infusion 
A) Bone grafting 
B) Bone marrow injection 
C) IV infusion 
D) Intra-abdominal infusion

Question 11

Meperidine (Demerol)is not recommended for children in sickle cell crisis because it:

Accepted Answer

A) may induce seizures. 
B) is easily addictive. 
C) is not adequate for pain relief. 
D) is given by intramuscular injection. 
A) may induce seizures. 
B) is easily addictive. 
C) is not adequate for pain relief. 
D) is given by intramuscular injection.

Question 12

A school-age child with leukemia experienced severe nausea and vomiting when receiving chemotherapy for the first time.Which is the most appropriate nursing action to prevent or minimize these reactions with subsequent treatments?

Accepted Answer

A) Encourage drinking large amounts of favorite fluids. 
B) Encourage child to take nothing by mouth (remain NPO) until nausea and vomiting subside. 
C) Administer an antiemetic before chemotherapy begins. 
D) Administer an antiemetic as soon as child has nausea. 
A) Encourage drinking large amounts of favorite fluids. 
B) Encourage child to take nothing by mouth (remain NPO) until nausea and vomiting subside. 
C) Administer an antiemetic before chemotherapy begins. 
D) Administer an antiemetic as soon as child has nausea.

Question 13

Myelosuppression,associated with chemotherapeutic agents or some malignancies such as leukemia,can cause bleeding tendencies because of a(n):

Accepted Answer

A) decrease in leukocytes. 
B) increase in lymphocytes. 
C) vitamin C deficiency. 
D) decrease in blood platelets. 
A) decrease in leukocytes. 
B) increase in lymphocytes. 
C) vitamin C deficiency. 
D) decrease in blood platelets.

Question 14

Iron dextran is ordered for a young child with severe iron deficiency anemia.Nursing considerations include to:

Accepted Answer

A) administer with meals. 
B) administer between meals. 
C) inject deeply into a large muscle. 
D) massage injection site for 5 minutes after administration of drug. 
A) administer with meals. 
B) administer between meals. 
C) inject deeply into a large muscle. 
D) massage injection site for 5 minutes after administration of drug.

Question 15

Parents of a hemophiliac child ask the nurse,"Can you describe hemophilia to us?" Which response by the nurse is descriptive of most cases of hemophilia?

Accepted Answer

A) Autosomal dominant disorder causing deficiency in 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 in 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 16

The parents of a child hospitalized with sickle cell anemia tell the nurse that they are concerned about narcotic analgesics causing addiction.Which is appropriate for the nurse to explain about narcotic analgesics?

Accepted Answer

A) Are often ordered but not usually needed 
B) Rarely cause addiction because they are medically indicated 
C) Are given as a last resort because of the threat of addiction 
D) Are used only if other measures, such as ice packs, are ineffective 
A) Are often ordered but not usually needed 
B) Rarely cause addiction because they are medically indicated 
C) Are given as a last resort because of the threat of addiction 
D) Are used only if other measures, such as ice packs, are ineffective

Question 17

The nurse is conducting a staff in-service on sickle cell anemia.Which 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 adhesion of sickle-shaped cells occurs. 
A) Sickle-shaped cells carry excess oxygen. 
B) Sickle-shaped cells decrease blood viscosity. 
C) Increased red blood cell destruction occurs. 
D) Decreased adhesion of sickle-shaped cells occurs.

Question 18

The school nurse is informed that a child with human immunodeficiency virus (HIV)will be attending school soon.Which is an important nursing intervention?

Accepted Answer

A) Carefully follow universal precautions. 
B) Determine how the child became infected. 
C) Inform the parents of the other children. 
D) Reassure other children that they will not become infected. 
A) Carefully follow universal precautions. 
B) Determine how the child became infected. 
C) Inform the parents of the other children. 
D) Reassure other children that they will not become infected.

Question 19

Which should the nurse teach about prevention of sickle cell crises to parents of a preschool child with sickle cell disease? (Select all that apply.)

Accepted Answer

A) Limit fluids at bedtime. 
B) Notify the health care provider if a fever of 38.5° C (101.3° F) or greater occurs. 
C) Give penicillin as prescribed. 
D) Use ice packs to decrease the discomfort of vasoocclusive pain in the legs. 
E) Notify the health care provider if your child begins to develop symptoms of a cold. 
A) Limit fluids at bedtime. 
B) Notify the health care provider if a fever of 38.5° C (101.3° F) or greater occurs. 
C) Give penicillin as prescribed. 
D) Use ice packs to decrease the discomfort of vasoocclusive pain in the legs. 
E) Notify the health care provider if your child begins to develop symptoms of a cold.

Question 20

The nurse is planning care for an adolescent with AIDS.Which is the priority nursing goal?

Accepted Answer

A) Preventing infection 
B) Preventing secondary cancers 
C) Restoring immunologic defenses 
D) Identifying source of infection 
A) Preventing infection 
B) Preventing secondary cancers 
C) Restoring immunologic defenses 
D) Identifying source of infection

Exam 26: The Child with Hematologic or Immunologic Dysfunction

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

Which is most descriptive of the pathophysiology of leukemia?

The nurse is recommending how to prevent iron deficiency anemia in a healthy,term,breast-fed infant.Which should be suggested?

The nurse is teaching parents about the importance of iron in a toddler's diet.Which explains why iron deficiency anemia is common during toddlerhood?

Which is the most effective pain-management approach for a child who is having a bone marrow aspiration?

The nurse is planning care for a school-age child admitted to the hospital with hemophilia.Which interventions should the nurse plan to implement for this child? (Select all that apply.)

Parents of a child with sickle cell anemia ask the nurse,"What happens to the hemoglobin in sickle cell anemia?" Which statement by the nurse explains the disease process?"

The nurse is conducting a staff in-service on inherited childhood blood disorders.Which statement describes severe combined immunodeficiency syndrome (SCIDS)?

An adolescent will receive a bone marrow transplant (BMT).The nurse should explain that the bone marrow will be administered by which route?

Meperidine (Demerol)is not recommended for children in sickle cell crisis because it:

A school-age child with leukemia experienced severe nausea and vomiting when receiving chemotherapy for the first time.Which is the most appropriate nursing action to prevent or minimize these reactions with subsequent treatments?

Myelosuppression,associated with chemotherapeutic agents or some malignancies such as leukemia,can cause bleeding tendencies because of a(n):

Iron dextran is ordered for a young child with severe iron deficiency anemia.Nursing considerations include to:

Parents of a hemophiliac child ask the nurse,"Can you describe hemophilia to us?" Which response by the nurse is descriptive of most cases of hemophilia?

The parents of a child hospitalized with sickle cell anemia tell the nurse that they are concerned about narcotic analgesics causing addiction.Which is appropriate for the nurse to explain about narcotic analgesics?

The nurse is conducting a staff in-service on sickle cell anemia.Which describes the pathologic changes of sickle cell anemia?

The school nurse is informed that a child with human immunodeficiency virus (HIV)will be attending school soon.Which is an important nursing intervention?

Which should the nurse teach about prevention of sickle cell crises to parents of a preschool child with sickle cell disease? (Select all that apply.)

The nurse is planning care for an adolescent with AIDS.Which is the priority nursing goal?

Perspectives of Pediatric Nursing

Community-Based Nursing Care of the Child and Family

Family Influences on Child Health Promotion

Social,Cultural,and Religious Influences on Child Health Promotion

Developmental and Genetic Influences on Child Health Promotion

Communication and Physical Assessment of the Child

Pain Assessment and Management in Children

Health Promotion of the Newborn and Family

Health Problems of Newborns

Health Promotion of the Infant and Family

Health Problems of Infants

Health Promotion of the Toddler and Family

Health Promotion of the Preschooler and Family

Health Problems of Toddlers and Preschoolers

Health Promotion of the School-Age Child and Family

Health Promotion of the Adolescent and Family

Health Problems of School-Age Children and Adolescents

Quality of Life for Children Living with Chronic or Complex Diseases

Impact of Cognitive or Sensory Impairment on the Child and Family

Family-Centered Home Care

Family-Centered Care of the Child During Illness and Hospitalization

Pediatric Variations of Nursing Interventions

The Child with Respiratory Dysfunction

The Child with Gastrointestinal Dysfunction

The Child with Cardiovascular Dysfunction

The Child with Genitourinary Dysfunction

The Child with Cerebral Dysfunction

The Child with Endocrine Dysfunction

The Child with Integumentary Dysfunction

The Child with Musculoskeletal or Articular Dysfunction

The Child with Neuromuscular or Muscular Dysfunction

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