Question 1

A 2-year-old child has been diagnosed with hemophilia A. The information the nurse would include in a teaching plan about home care would be:

Accepted Answer

A)   if bleeding occurs, apply pressure, ice, elevate, and rest the extremity.
B)   children's aspirin in lowered doses may be given for joint discomfort.
C)   a firm, dry toothbrush should be used to clean teeth at least twice a day.
D)   do not permit interactive play with other children. A

Question 2

The nurse notes that a 4-year-old child's gums bleed easily and he has bruising and petechiae on his extremities. The lab value that would be consistent with these symptoms is:

Accepted Answer

A)   platelet count of 25,000/mm³.
B)   hemoglobin level of 8 g/dL.
C)   hematocrit level of 36%.
D)   leukocyte count of 14,000/mm³. A

Question 3

When the child receiving a transfusion complains of back pain and itching, the nurse's initial action would be to:

Accepted Answer

A)   notify the charge nurse.
B)   disconnect intravenous lines immediately.
C)   give diphenhydramine (Benadryl) .
D)   clamp off blood and keep line open with normal saline. D

Question 4

The most recent blood count for a child who received chemotherapy last week shows neutropenia. The priority nursing diagnosis for this child is:

Accepted Answer

A)   risk for infection.
B)   risk for hemorrhage.
C)   altered skin integrity.
D)   disturbance in body image.

Question 5

The nurse would teach the parents of a child with a low platelet count to avoid:

Accepted Answer

A)   ibuprofen.
B)   aspirin.
C)   caffeine.
D)   prednisone.

Question 6

A child with thalassemia major receives blood transfusions frequently. The nurse is aware that a complication of repeated blood transfusions is:

Accepted Answer

A)   hemarthrosis.
B)   hematuria.
C)   hemoptysis.
D)   hemosiderosis.

Question 7

The nurse takes into consideration an important focus of nursing care for the dying child and the family, which is that:

Accepted Answer

A)   nursing care should be organized to minimize contact with the child.
B)   adequate oral intake is crucial to the dying child.
C)   families should be made aware that hearing is the last sense to stop functioning before death.
D)   it is best for the family if the nursing staff provides all of the child's care.

Question 8

What are the classic symptoms of thalassemia major (Cooley's anemia)? Select all that apply.

Accepted Answer

A)   Hepatomegaly
B)   Jaundice
C)   Protruding teeth
D)   Pathological fractures
E)   Cardiac failureF)  None of the above

Question 9

The nurse would include in a teaching plan about mouth care of a child receiving chemotherapy to:

Accepted Answer

A)   use commercial mouthwash.
B)   clean teeth with a soft toothbrush.
C)   avoid use of a Water-Pik.
D)   inspect the mouth weekly for ulcerations.

Question 10

A child has just been diagnosed with acute lymphoblastic leukemia. The nurse is aware that the result of an overproduction of immature white blood cells in the bone marrow is:

Accepted Answer

A)   decreased T-cell production.
B)   decreased hemoglobin.
C)   increased blood clotting.
D)   increased susceptibility to infection.

Question 11

The nurse shows slides of red blood cells from a child with sickle cell disease, noting that in addition to their sickle shape, the cells contain the abnormal element of ______________ _____.

Accepted Answer

The answer of The nurse shows slides of red blood...

Question 12

What should be included in the nursing care of a 12-year-old child receiving radiation therapy for Hodgkin's disease? Select all that apply.

Accepted Answer

A)   Application of sunblock
B)   Appetite stimulation
C)   Conservation of energy
D)   Provision for expressions of anger
E)   Preparation for premature sexual development

Question 13

To prevent ________________ ________________ the nurse warms the blood that is to be given as a transfusion through a central line.

Accepted Answer

The answer of To prevent ________________ ________________ the nurse warms...

Question 14

A newly married couple is seeking genetic counseling because they are both carriers of the sickle cell trait. How can the nurse best explain the children's risk of inheriting this disease?

Accepted Answer

A)   Every fourth child will have the disease; two others will be carriers.
B)   All of their children will be carriers, just as they are.
C)   Each child has a one in four chance of having the disease and a two in four chance of being a carrier.
D)   The risk levels of their children cannot be determined by this information.

Question 15

An adolescent is diagnosed with Hodgkin's disease. Lymph nodes on both sides of her diaphragm have been found to be involved, including cervical and inguinal nodes. The disease is in stage:

Accepted Answer

A)   I.
B)   II.
C)   III.
D)   IV.

Question 16

A 3-year-old child with sickle cell disease is admitted to the hospital in sickle cell crisis with severe abdominal pain. The nurse recognizes that the type of crisis the child is most likely experiencing is:

Accepted Answer

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

Question 17

The nurse takes into consideration that hemophilia A is a congenital disorder that is:

Accepted Answer

A)   seen in males and females equally.
B)   transmitted by symptom-free females.
C)   a sex-linked dominant trait.
D)   a defective gene located on the Y chromosome.

Question 18

The nurse confirms that sickle cell trait can be distinguished from sickle cell disease by a lab test called ________________.

Accepted Answer

The answer of The nurse confirms that sickle cell trait...

Question 19

A child who is receiving a transfusion should be closely assessed for:

Accepted Answer

A)   fever.
B)   lethargy.
C)   jaundice.
D)   bradycardia.

Question 20

Why would the nurse urge the family of a dying 12-year-old boy to include his 8-year-old sister in care? Select all that apply.

Accepted Answer

A)   She will feel less neglected by the parents.
B)   She can make amends for past hostilities to her brother.
C)   She will feel less helpless.
D)   She can express her feelings through care.
E)   She can experience being supportive of her parents and brother.F)  None of the above

Exam 27: The Child with a Condition of the Blood, Blood-Forming Organs, or