Question 1

Where are blood cells produced during fetal development?

Accepted Answer

During fetal development, blood cells are primarily produced in the liver and spleen, before this function is taken over by the bone marrow after birth.

Question 2

What features of red blood cells (RBCs) allow them to reach all the tissues of the body?

Accepted Answer

Red blood cells have a unique shape, size, and structure, including being biconcave and flexible, which allows them to travel through the smallest blood vessels to reach all tissues.

Question 3

The primary function of white blood cells (WBCs) is to guard against microorganisms and to do which of the following?

Accepted Answer

White blood cells (WBCs) are primarily involved in the immune response by protecting the body against both infectious disease and foreign invaders. One of their roles includes removing debris, such as dead or dying cells, and fighting off pathogens.

Question 4

What is the main function of platelets?

Accepted Answer

The main function of platelets is to facilitate blood coagulation to control bleeding. They are crucial for the clotting process, which helps stop bleeding when a blood vessel is injured.

Question 5

The pediatric nurse doing assessments on infants and young children is aware that the most common blood disorder in children is:

Accepted Answer

Anemia is the most common blood disorder in children, often due to iron deficiency, which can result from inadequate dietary intake, rapid growth periods, or blood loss.

Question 6

Which of the following types of anemia would the nurse most expect to find in infants and toddlers?

Accepted Answer

Iron deficiency anemia is the most common type of anemia found in infants and toddlers, often due to inadequate dietary intake of iron.

Question 7

Parents ask the nurse why their adolescent daughter and several of her friends tend to be anemic. Which of the following is the nurse's best response?

Accepted Answer

Teenage girls often make poor dietary choices, which can lead to iron deficiency anemia, especially during a period of rapid growth and increased iron needs.

Question 8

When a child progresses to moderate iron-deficiency anemia, the caregivers or the nurse will notice which of the following signs?

Accepted Answer

General irritability, weakness, and lack of interest in play are common signs of moderate iron-deficiency anemia in children. These symptoms result from the body's reduced capacity to carry oxygen due to lower hemoglobin levels, affecting energy levels and mood.

Question 9

As iron-deficiency anemia progresses beyond the moderate stage, the nurse assessing the child will most likely find which of the following signs?

Accepted Answer

As iron-deficiency anemia progresses, the body shows signs of inadequate oxygen delivery and iron supply to tissues, leading to symptoms such as systolic murmurs (due to the heart working harder to pump oxygen-deficient blood), hair loss, brittle nails (due to poor oxygen and nutrient supply), and an enlarged spleen (as part of the body's response to increased hemolysis or breakdown of red blood cells).

Question 10

The nurse is assessing a child who has anemia. The child has a yellowish skin color. This skin color is most likely indicative of which of the following conditions associated with severe anemia?

Accepted Answer

The yellowish skin color in a child with anemia is most likely indicative of increased destruction of red blood cells (RBCs), a condition known as hemolytic anemia. This can lead to jaundice, which is characterized by a yellowish skin color due to the buildup of bilirubin, a byproduct of the breakdown of red blood cells.

Question 11

Why are premature infants more at risk for iron-deficiency anemia than full-term infants?

Accepted Answer

Premature infants have lower iron stores at birth and use up their stores of hemosiderin more quickly than full-term infants, leading to a higher risk of iron-deficiency anemia.

Question 12

The nurse is working with a mother who is breastfeeding her 2-month-old infant with blood-loss anemia. The blood loss has been stopped, and efforts are made to increase the infant's supply of iron. The nurse will advise the mother to:

Accepted Answer

Breast milk is the best source of nutrition for infants, even those with blood-loss anemia, as long as the blood loss has been stopped. The mother's milk can be supplemented with additional iron if needed, under the guidance of a healthcare provider, rather than switching to formula or introducing solid foods like iron-fortified cereal, which is not recommended for infants under 4 to 6 months of age.

Question 13

The school nurse is working with a pregnant adolescent. The nurse will advise the young woman to eat foods high in iron and also high in which of the following vitamins to increase the absorption of iron?

Accepted Answer

Vitamin C enhances the absorption of iron from the gastrointestinal tract, especially when the iron is consumed in plant-based, non-heme form. This is particularly important for pregnant women who need increased iron for both their own health and the development of the fetus.

Question 14

A parent calls the nurse and frantically reports that a child has gotten into the mother's ferrous sulfate pills and ingested a number of these pills. The child is vomiting, has bloody diarrhea, and is complaining of abdominal pain. The nurse will tell the mother to:

Accepted Answer

The symptoms described are indicative of iron poisoning, which can be life-threatening. Immediate medical attention is necessary, so calling EMS and getting the child to the emergency room is the appropriate action.

Question 15

What is the primary focus of nursing intervention when the child has iron-deficiency anemia?

Accepted Answer

The primary focus of nursing intervention when a child has iron-deficiency anemia is caregiver education. This involves teaching caregivers about the importance of an iron-rich diet, the administration of iron supplements if prescribed, and the recognition of symptoms indicating a need for further medical evaluation. Educating caregivers is crucial for the prevention and management of iron-deficiency anemia in children.

Question 16

The nurse is doing discharge teaching with caregivers who will be giving their toddler a liquid iron supplement. The nurse will teach the parents to administer the liquid iron supplement in which of the following ways?

Accepted Answer

Administering liquid iron supplements through a straw, a medicine dropper, or a syringe in the back part of the mouth helps to avoid staining the teeth and ensures that the supplement is swallowed properly. Mixing iron with certain foods or antacids can interfere with its absorption.

Question 17

The nurse is talking to the working parents of a child with sickle cell anemia. The nurse explores the feelings of the parents and finds that both parents are admitting to feeling guilty a lot of the time. Which of the following causes will the nurse most likely find as the greatest contributor or cause of this guilt?

Accepted Answer

The greatest contributor to the parents' guilt is likely the fact that both are carriers of the sickle cell gene, which is a hereditary condition. This genetic contribution directly leads to the child's condition, which can cause significant guilt in parents understanding their role in their child's illness.

Question 18

In talking with parents about the life expectancy of children who have the sickle cell trait, the nurse will share with the parents whose children with the sickle cell trait:

Accepted Answer

Individuals with the sickle cell trait (carriers of one sickle cell gene and one normal hemoglobin gene) do not typically have a decreased life expectancy. They can live normal lives, as the trait usually does not manifest the severe symptoms associated with sickle cell disease.

Question 19

When sickle cells are not able to pass through the microcirculation, which of the following signs or symptoms will the nurse find on assessment of a child with sickle cell anemia?

Accepted Answer

Pain is a common symptom in sickle cell anemia due to vaso-occlusive crises, where the sickled cells obstruct blood flow in the microcirculation, leading to ischemia and pain.

Question 20

The nurse is working with a child who has vaso-occlusive crisis. The nurse is aware that if this vaso-occlusive crisis is not resolved, the most likely result will be:

Accepted Answer

Vaso-occlusive crisis, often seen in conditions like sickle cell disease, leads to reduced blood flow and oxygen delivery to tissues. If not resolved, this can result in tissue death or infarction of the distal tissues due to prolonged ischemia.

Quiz 26: Hematological Alterations