Question 1

Which of the following parental demonstrations indicates that the parents understand the nurse's teaching with regard to prevention of iron-deficiency anemia?
A)The parents feed their infant with a formula that is not iron-fortified.
B)The child's vitamin C consumption is limited after one year of age.
C)The parents start iron-fortified infant cereal at four to six months of age.
D)Cow's milk is introduced into the child's diet at six months of age.

Accepted Answer

Starting iron-fortified infant cereal at four to six months of age is a recommended way to prevent iron-deficiency anemia in infants. Iron-fortified formula can also be used if the infant is not breastfed. Limiting vitamin C consumption or introducing cow's milk at six months of age can actually interfere with iron absorption and increase the risk of anemia.

Question 2

A child is admitted to the hospital and diagnosed with aplastic anemia. The parents ask the nurse what aplastic anemia is. Which would be the best description of aplastic anemia?
A)Causes a proliferation of white blood cells
B)Is characterized by abnormally shaped red blood cells
C)Is characterized by failure of the bone marrow to produce adequate numbers of cells
D)Is a disorder that occurs following a viral illness

Accepted Answer

Aplastic anemia is a disorder that is characterized by the failure of the bone marrow to produce adequate numbers of blood cells, including red blood cells, white blood cells, and platelets. This can lead to fatigue, increased infection risk, and bleeding problems.

Question 3

A child who has undergone a hematopoietic stem cell transplantation (HSCT) is ready for discharge. Which concepts are important for the nurse to include in discharge education? Standard Text: Select all that apply.
A)Keeping the child on a high-calcium diet
B)Practicing good hand washing
C)Avoiding live plants and fresh vegetables
D)Avoiding influenza vaccinations
E)Returning the child to school within six weeks

Accepted Answer

A,B,C

Question 4

A school-age child with hemophilia falls on the playground and goes to the nurse's office with superficial bleeding above the knee. The nurse should:
A)Apply pressure to the area for at least 15 minutes.
B)Apply a warm, moist pack to the area.
C)Perform some passive range-of-motion to the affected leg.
D)Keep the affected extremity in a dependent position.

Accepted Answer

A child with hemophilia has a clotting disorder and can bleed excessively even from minor injuries. The nurse should apply pressure to the area for at least 15 minutes to promote clotting and stop bleeding. The other options such as warm, moist pack or passive range of motion can further aggravate the bleeding. Keeping the affected extremity in a dependent position can also cause bleeding to worsen as gravity can cause blood to pool at the injured site.

Question 5

During discharge teaching to parents of a child hospitalized with sickle-cell crisis, the nurse should emphasize which of the following as a priority home care intervention?
A)Rapid weaning of pain medications
B)Promotion of a diet high in protein
C)Encouraging adequate hydration
D)Restriction of activities

Accepted Answer

Encouraging adequate hydration is the priority intervention for a child with sickle-cell crisis as dehydration can exacerbate sickle cell anemia and increase the risk of a crisis. Rapid weaning of pain medications should be done under the supervision of a healthcare provider and should not be a priority intervention during discharge teaching. A diet high in protein and restriction of activities may be recommended, however, they are not the priority intervention in this situation.

Question 6

A child has been diagnosed with sickle-cell disease. Both parents deny having the disease themselves. The parents ask the nurse how their child got this disease. The nurse recognizes that the only possible explanation of the etiology is:
A)The father is not the biological father of the infant.
B)The mother of the child has the trait, but the father doesn't.
C)The father of the child has the trait, but the mother doesn't.
D)The mother and the father of the child have the sickle-cell trait.

Accepted Answer

Sickle-cell disease is an autosomal recessive genetic disorder, which means that an individual must inherit two copies of the abnormal gene (one from each parent) to develop the disease. If both parents have the sickle-cell trait (meaning they each carry one copy of the abnormal gene), there is a 25% chance with each pregnancy that the child will inherit two copies of the gene and therefore develop sickle-cell disease. Therefore, the most likely explanation in this case is that both parents have the sickle-cell trait and passed on this abnormal gene to their child.

Question 7

Immediately after delivery, the nurse prepares to give the newborn a vitamin K injection. The new father is watching and asks the nurse why the baby is receiving a "shot." The nurse would explain that vitamin K injections are given to newborn infants to:
A)Activate clotting factors.
B)Break up blood clots.
C)Promote red blood cell function and assist in gas exchange.
D)Promote the production of hemoglobin.

Accepted Answer

Vitamin K is necessary for the production of clotting factors, which help prevent excessive bleeding. Newborns have low levels of vitamin K and do not yet produce adequate amounts on their own, which is why an injection is given soon after birth to prevent bleeding disorders.

Question 8

A child with hemophilia plans on participating in a bicycling club. Which recommendation should the nurse give to the child?
A)Wear kneepads, elbow pads, and a helmet while bicycling.
B)Consider a swim club instead of the bicycling club.
C)Do not join the club.
D)Participate only in the social activities of the club.

Accepted Answer

Wearing protective gear such as kneepads, elbow pads, and a helmet while bicycling can help prevent injuries in case of falls or accidents. This recommendation will allow the child to participate in the club and enjoy the physical activity while reducing the risk of bleeding or injury.

Question 9

A child who has Beta-thalassemia is receiving numerous blood transfusions. The child is also receiving deferoxamine (Desferal) therapy. The parents ask how the deferoxamine will help their child. Which is an action of deferoxamine that the nurse should convey?
A)Stimulates red blood cell production
B)Prevents iron overload
C)Provides vitamin supplementation
D)Prevents blood transfusion reactions

Accepted Answer

Deferoxamine is a medication used to treat iron overload in conditions such as Beta-thalassemia, where frequent blood transfusions can lead to excessive iron accumulation in the body. Deferoxamine binds with iron and helps the body eliminate it through urine and feces, thereby preventing iron overload and its complications. It does not stimulate red blood cell production, provide vitamin supplementation, or prevent blood transfusion reactions.

Question 10

During a hurricane emergency, a child with hemophilia is injured and bleeding internally. The child is transported to the hospital. Due to the emergency, the appropriate factor is not available. What blood product would be the next best option to promote clotting?
A)Platelets
B)Whole blood
C)Packed cells
D)Fresh or fresh frozen plasma

Accepted Answer

Fresh or fresh frozen plasma contains clotting factors that are needed for hemostasis in patients with bleeding disorders such as hemophilia. While platelets, whole blood, and packed cells may be helpful in other types of bleeding, they do not contain the necessary clotting factors for hemophilia.

Question 11

A nurse is planning to provide education for a family who has a child with sickle-cell anemia. For the prevention of a sickle-cell crisis, the nurse teaches the family the importance of avoiding which condition?
A)Respiratory infection and dehydration
B)Midrange altitudes
C)Weight loss without dehydration
D)Overhydration

Accepted Answer

Respiratory infection and dehydration can trigger sickle-cell crises by reducing oxygen supply and causing red blood cells to sickle. Avoiding respiratory infections through vaccination and good hygiene practices and maintaining adequate hydration through regular fluid intake can help prevent sickle-cell crises. The other options do not directly relate to sickle-cell crisis prevention.

Question 12

The nurse is administering packed red blood cells to a child with sickle-cell disease (SCD). The nurse knows that a transfusion reaction will most likely occur:
A)Six hours after the transfusion is given.
B)At the end of the administration of the transfusion.
C)Within the first 20 minutes of administration of the transfusion.
D)Never; children with SCD do not have reactions.

Accepted Answer

Children with SCD are at higher risk for transfusion reactions, particularly acute hemolytic reactions, which can occur within the first 20 minutes of transfusion. It is important for the nurse to closely monitor the child for signs of a reaction during this time.

Question 13

Which of the following are major risks during the post-transplant phase of hematopoietic stem cell transplantation (HSCT)? Standard Text: Select all that apply.
A)Bleeding
B)Thrombosis
C)Pancytopenia
D)Infection
E)Fluid volume overload

Accepted Answer

The answer of Which of the following are major risks...

Question 14

The nurse is teaching parents of the child with sickle-cell disease how to avoid precipitating factors that can contribute to a sickle-cell crisis. Which are precipitating factors that could contribute to a sickle-cell crisis? Standard Text: Select all that apply.
A)Regular exercise
B)Fever
C)Dehydration
D)Altitude
E)Increased fluid intake

Accepted Answer

Fever, dehydration, and high altitude are known precipitating factors for a sickle-cell crisis. Fever and infections can increase the body's metabolic rate and oxygen demand, dehydration can increase blood viscosity and promote sickling, and high altitude can lead to hypoxia, all of which can trigger a sickle-cell crisis. Regular exercise, when not excessive, and increased fluid intake are generally recommended to maintain health and prevent crises by promoting good circulation and hydration.

Question 15

For which complication(s) should the nurse observe during administration of Factor VIII to a child with hemophilia?
A)Fever and chills
B)Fat emboli
C)Nausea and vomiting
D)Congestive heart failure

Accepted Answer

Fever and chills are a potential adverse effect of Factor VIII administration. Fat emboli, nausea and vomiting, and congestive heart failure are not typically associated with this medication.

Question 16

Which of the following is a priority nursing diagnosis for the child with idiopathic thrombocytopenic purpura (ITP)?
A)Ineffective breathing pattern
B)Nausea
C)Fluid-volume deficit
D)Risk for injury

Accepted Answer

The child with ITP is at risk for injury due to the risk of bleeding, as the condition causes a decrease in platelet count. This can lead to bruising, petechiae, and even spontaneous bleeding in severe cases. Therefore, the priority nursing diagnosis would be Risk for injury. While the other options may be assessed and treated as needed, they are not the priority in this situation.

Question 17

A child with hemophilia comes to the emergency department following an automobile accident. The child presents with multiple injuries. When prioritizing care for the child, the nurse would be most concerned with which injury?
A)Occipital hematoma
B)Radial fracture
C)Dislocated shoulder
D)Abdominal abrasions

Accepted Answer

The most concerning injury for a child with hemophilia would be an occipital hematoma, which could lead to increased intracranial pressure and possible brain damage. Bleeding in the brain is a medical emergency for all patients, but especially for those with impaired clotting factors such as hemophilia. The other injuries listed, while still important to address, would not have the same potential for immediate harm.

Question 18

A child with meningococcemia is being admitted to the pediatric intensive care unit. This child should be placed in which type of room?
A)Private room, in respiratory isolation
B)Private room, in protective isolation
C)Private room, but not in isolation
D)Semiprivate room

Accepted Answer

A child with meningococcemia should be placed in a private room in respiratory isolation to prevent the spread of the infection through respiratory droplets. Isolation precautions are necessary to protect other patients, visitors, and staff from the potentially life-threatening infection.

Question 19

The nurse is caring for a child with disseminated intravascular coagulation (DIC). Which would be a priority nursing intervention for this child?
A)Preparation for radiograph procedures
B)Monitoring of fluid restriction
C)Frequent ambulation
D)Monitoring of oxygen saturation and vital signs

Accepted Answer

Monitoring of oxygen saturation and vital signs is a priority intervention for a child with DIC, as this condition can lead to severe bleeding, clotting, and organ damage that can cause respiratory and cardiovascular distress. Close monitoring of the child's oxygen saturation and vital signs can help the nurse detect any signs of worsening symptoms and respond promptly. Preparation for radiograph procedures, monitoring of fluid restriction, and frequent ambulation may also be important interventions for the child with DIC, but they are not the priority interventions that are essential for maintaining the child's immediate health and safety.

Question 20

When caring for a child diagnosed with aplastic anemia, the nurse would educate the parents regarding which common symptoms?
A)Fatigue and fever
B)Runny nose and cough
C)Nausea and vomiting
D)Cyanosis and bradycardia

Accepted Answer

Fatigue and fever are common symptoms of aplastic anemia, as the bone marrow is unable to produce enough red blood cells and white blood cells to fight off infection, leading to fatigue and an increased risk of infection causing fever. Runny nose and cough, nausea and vomiting, cyanosis and bradycardia are not common symptoms associated with aplastic anemia.

Quiz 28: Alterations in Hematologic Function

Which of the following parental demonstrations indicates that the parents understand the nurse's teaching with regard to prevention of iron-deficiency anemia?

A child is admitted to the hospital and diagnosed with aplastic anemia. The parents ask the nurse what aplastic anemia is. Which would be the best description of aplastic anemia?

A child who has undergone a hematopoietic stem cell transplantation (HSCT) is ready for discharge. Which concepts are important for the nurse to include in discharge education? Standard Text: Select all that apply.

A school-age child with hemophilia falls on the playground and goes to the nurse's office with superficial bleeding above the knee. The nurse should:

During discharge teaching to parents of a child hospitalized with sickle-cell crisis, the nurse should emphasize which of the following as a priority home care intervention?

A child has been diagnosed with sickle-cell disease. Both parents deny having the disease themselves. The parents ask the nurse how their child got this disease. The nurse recognizes that the only possible explanation of the etiology is:

Immediately after delivery, the nurse prepares to give the newborn a vitamin K injection. The new father is watching and asks the nurse why the baby is receiving a "shot." The nurse would explain that vitamin K injections are given to newborn infants to:

A child with hemophilia plans on participating in a bicycling club. Which recommendation should the nurse give to the child?

A child who has Beta-thalassemia is receiving numerous blood transfusions. The child is also receiving deferoxamine (Desferal) therapy. The parents ask how the deferoxamine will help their child. Which is an action of deferoxamine that the nurse should convey?

During a hurricane emergency, a child with hemophilia is injured and bleeding internally. The child is transported to the hospital. Due to the emergency, the appropriate factor is not available. What blood product would be the next best option to promote clotting?

A nurse is planning to provide education for a family who has a child with sickle-cell anemia. For the prevention of a sickle-cell crisis, the nurse teaches the family the importance of avoiding which condition?

The nurse is administering packed red blood cells to a child with sickle-cell disease (SCD) . The nurse knows that a transfusion reaction will most likely occur:

Which of the following are major risks during the post-transplant phase of hematopoietic stem cell transplantation (HSCT) ? Standard Text: Select all that apply.

The nurse is teaching parents of the child with sickle-cell disease how to avoid precipitating factors that can contribute to a sickle-cell crisis. Which are precipitating factors that could contribute to a sickle-cell crisis? Standard Text: Select all that apply.

For which complication(s) should the nurse observe during administration of Factor VIII to a child with hemophilia?

Which of the following is a priority nursing diagnosis for the child with idiopathic thrombocytopenic purpura (ITP) ?

A child with hemophilia comes to the emergency department following an automobile accident. The child presents with multiple injuries. When prioritizing care for the child, the nurse would be most concerned with which injury?

A child with meningococcemia is being admitted to the pediatric intensive care unit. This child should be placed in which type of room?

The nurse is caring for a child with disseminated intravascular coagulation (DIC) . Which would be a priority nursing intervention for this child?

When caring for a child diagnosed with aplastic anemia, the nurse would educate the parents regarding which common symptoms?