Question 1

Iron dextran is ordered for a young child with severe iron-deficiency anemia. What nursing considerations should be included?

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

Question 2

A young child with human immunodeficiency virus (HIV) is receiving several antiretroviral drugs. What is the purpose of these drugs?

Accepted Answer

A)  Cure the disease 
B)  Delay disease progression 
C)  Prevent spread of disease 
D)  Treat Pneumocystis carinii pneumonia

Question 3

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

Question 4

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. Of what are these manifestations most suggestive?

Accepted Answer

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

Question 5

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.

Question 6

Which 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 
C)  Acquired immunodeficiency syndrome (AIDS) 
D)  Severe combined immunodeficiency disease

Question 7

Several complications can occur when a child receives a blood transfusion. Which is an immediate sign or symptom of an air embolus?

Accepted Answer

A)  Chills and shaking 
B)  Nausea and vomiting 
C)  Irregular heart rate 
D)  Sudden difficulty in breathing

Question 8

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.

Question 9

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.

Question 10

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.

Question 11

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.

Question 12

The nurse is teaching parents of an infant about the causes of iron-deficiency anemia. Which statement best describes iron-deficiency anemia in infants?

Accepted Answer

A)  It is caused by depression of the hematopoietic system. 
B)  It is easily diagnosed because of an infant's emaciated appearance. 
C)  Clinical manifestations are similar regardless of the cause of the anemia. 
D)  Clinical manifestations result from a decreased intake of milk and the preterm addition of solid foods.

Question 13

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.

Question 14

Chelation therapy is begun on a child with b-thalassemia major. What is the purpose of this therapy?

Accepted Answer

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

Exam 24: The Child with Hematologic or Immunologic Dysfunction