Question 1

Which statement accurately describes 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 C

Question 2

Which statement best describes the pathological 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. C

Question 3

Which sentence is a good explanation for teaching children about white blood cells?

Accepted Answer

A)   They carry the oxygen you breathe from your lungs to parts of your body.
B)   They help keep germs from causing infections.
C)   They are small parts of cells that make bleeding stop.
D)   They are the liquid portion of your blood. B

Question 4

What is the most appropriate nursing diagnosis for a child with anemia?

Accepted Answer

A)   Activity intolerance related to generalized weakness
B)   Decreased cardiac output related to abnormal hemoglobin
C)   Risk for injury related to depressed sensorium
D)   Risk for injury related to dehydration and abnormal hemoglobin

Question 5

Several blood tests are ordered for a preschool child with severe anemia.She is crying and upset because she remembers the venipuncture done at the clinic 2 days ago.What should the nurse explain to the child?

Accepted Answer

A)   Venipuncture discomfort is very brief.
B)   Only one venipuncture will be needed.
C)   Topical application of local anaesthetic can eliminate venipuncture pain.
D)   Most blood tests on children require only a finger puncture because a small amount of blood is needed.

Question 6

The nurse is planning care for an adolescent with acquired immunodeficiency syndrome.What is the priority nursing goal?

Accepted Answer

A)   Prevent infection.
B)   Prevent secondary cancers.
C)   Restore immunological defences.
D)   Identify the source of infection.

Question 7

Which should the nurse recommend when teaching parents how to prevent iron-deficiency anemia in a healthy term breastfed infant?

Accepted Answer

A)   Iron (ferrous sulphate) drops after age 1 month.
B)   Iron-fortified commercial formula can be used by age 4 to 6 months.
C)   Iron-fortified infant cereal can be used by age 2 months.
D)   Iron-fortified infant cereal can be used at approximately 6 months of age.

Question 8

What information should the nurse include when teaching the mother of a 9-month-old infant about administering liquid iron preparations?

Accepted Answer

A)   They should be given with meals.
B)   They should be stopped immediately if nausea and vomiting occur.
C)   Adequate dosage will turn the stools a tarry green colour.
D)   The preparation should be allowed to mix with saliva and bathe the teeth before swallowing.

Question 9

An 8-year-old girl is receiving a blood transfusion when the nurse notes that she has developed precordial pain,dyspnea,distended neck veins,slight cyanosis,and a dry cough.What are these manifestations most suggestive of?

Accepted Answer

A)   Air emboli
B)   Allergic reaction
C)   Hemolytic reaction
D)   Circulatory overload

Question 10

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

Accepted Answer

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

Question 11

Why is iron-deficiency anemia 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.

Question 12

Which age group is most at risk for iron-deficiency anemia?

Accepted Answer

A)   Term infant
B)   School-aged children
C)   Adolescent
D)   Young adult

Question 13

Which immunization should be given with caution to children infected with human immunodeficiency virus?

Accepted Answer

A)   Influenza
B)   Varicella
C)   Pneumococcal
D)   Inactivated poliovirus

Question 14

Which sentence 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)   The first stage of the coagulation process is abnormally stimulated.

Question 15

What is the purpose of initiating chelation therapy on a child with beta-thalassemia major?

Accepted Answer

A)   Treat the disease.
B)   Eliminate excess iron.
C)   Decrease the risk of hypoxia.
D)   Manage nausea and vomiting.

Question 16

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

Accepted Answer

A)   Encourage the child to drink large amounts of his favourite fluids.
B)   Encourage the 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 17

What is caused by a virus that primarily infects a specific subset of T lymphocytes,the CD4+ T cells?

Accepted Answer

A)   Wiskott-Aldrich syndrome
B)   Idiopathic thrombocytopenic purpura (ITP) 
C)   Acquired immunodeficiency syndrome (AIDS) 
D)   Severe combined immunodeficiency disease

Question 18

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

Question 19

Which statement accurately describes anemia?

Accepted Answer

A)   Increased blood viscosity
B)   Depressed hematopoietic system
C)   Presence of abnormal hemoglobin
D)   Decreased oxygen-carrying capacity of blood

Question 20

A young boy will receive a bone marrow transplant (BMT),which is possible because one of his older siblings is a histocompatible donor.What is the term for this type of BMT?

Accepted Answer

A)   Syngeneic
B)   Allogeneic
C)   Monoclonal
D)   Autologous

Exam 48: Hematological or Immunological Dysfunction