Question 1

The parents of a child hospitalized with sickle cell anemia tell the nurse that they are concerned about narcotic analgesics causing addiction.The nurse should provide what explanation in response to the parent's concern?

Accepted Answer

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

Question 2

MATCHING
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.

-Second priority

Accepted Answer

A) Take the vital signs 
B) Stop the transfusion 
C) Notify the practitioner 
D) Maintain a patent intravenous (IV) line with normal saline

Question 3

The parents of a child diagnosed with aplastic anemia tell the nurse that a bone marrow transplant (BMT)may be necessary.What should the nurse recognize as important when discussing this with the family?

Accepted Answer

A)  BMT should be done at time of diagnosis. 
B)  Parents and siblings of child have a 25% chance of being a suitable donor. 
C)  Finding a suitable donor involves matching antigens from the human leukocyte antigen (HL
A)  system. 
D)  If BMT fails, chemotherapy or radiotherapy must be continued.

Question 4

What is the primary result of anemia?

Accepted Answer

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

Question 5

What name is given to identify an acquired hemorrhagic disorder that is characterized by excessive destruction of platelets?

Accepted Answer

A)  Aplastic anemia 
B)  Thalassemia major 
C)  Disseminated intravascular coagulation 
D)  Immune thrombocytopenia

Question 6

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

Question 7

The nurse is planning activity for a 4-year-old child with anemia.Which activity should the nurse plan for this child?

Accepted Answer

A)  Game of "hide and seek" in the children's outdoor play area 
B)  Participation in dance activities in the playroom 
C)  Puppet play in the child's room 
D)  A walk down to the hospital lobby

Question 8

Which condition 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 9

MATCHING
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.

-First priority

Accepted Answer

A) Take the vital signs 
B) Stop the transfusion 
C) Notify the practitioner 
D) Maintain a patent intravenous (IV) line with normal saline

Question 10

Which statement most accurately 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

Question 11

Which statement best 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.

Question 12

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.The nurse should explain that:

Accepted Answer

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

Question 13

Iron dextran is ordered for a young child with severe iron deficiency anemia.What nursing consideration should be considered?

Accepted Answer

A)  Administering with meals 
B)  Administering between meals 
C)  Injecting deeply into a large muscle 
D)  Massaging injection site for 5 minutes after administration of drug

Exam 43: The Child With Hematologic or Immunologic Dysfunction

The parents of a child hospitalized with sickle cell anemia tell the nurse that they are concerned about narcotic analgesics causing addiction.The nurse should provide what explanation in response to the parent's concern?

MATCHING 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. -Second priority

The parents of a child diagnosed with aplastic anemia tell the nurse that a bone marrow transplant (BMT) may be necessary.What should the nurse recognize as important when discussing this with the family?