Deck 49: The Child With Alterations in Hematologic Function

Question 1

Which parental statement indicates correct understanding of information presented regarding the treatment for infant anemia?
1) "We will add green leafy vegetables to our child's low-iron formula."
2) "We will discontinue the use of vitamin C supplements by 6 months of age."
3) "We will begin an iron-fortified infant cereal at 4 to 6 months of age."
4) "We will introduce cow's milk by 6 months of age."

Answer 1

3

Question 2

Which teaching topic should the nurse include in the discharge instructions for the family of child diagnoses with sickle-cell disease to prevent crisis?
1) Respiratory infection and dehydration
2) Mid-range altitudes
3) Weight loss without dehydration
4) Overhydration

Answer 2

1

Question 3

During a natural disaster, a child diagnosed with hemophilia is injured and bleeding internally. Which blood product should the nurse plan to administer if the appropriate factor is not available?
1) Platelets
2) Whole blood
3) Packed cells
4) Fresh or fresh frozen plasma

Answer 3

4

Question 4

Which parental statements regarding precipitating factors for sickle-cell disease indicate correct understanding of the discharge information presented by the nurse? Select all that apply.
1) "My child should avoid regular exercise."
2) "We should provide acetaminophen or ibuprofen to treat fever."
3) "Our child needs to drink lots of fluid to avoid dehydration when playing sports."
4) "High altitudes can cause exacerbation and should be avoided."
5) "Fluid restriction is necessary to avoid exacerbations from occurring."

Question 5

Which nursing action is appropriate when treating a school-age child, diagnosed with hemophilia, for a superficial wound above the knee?
1) Applying pressure to the area
2) Applying a warm, moist pack to the area
3) Performing some passive range-of-motion to the affected leg
4) Keeping the affected extremity in a dependent position

Question 6

Which symptoms should the nurse include in the teaching plan for the family of a recently child diagnosed with aplastic anemia?
1) Fatigue and fever
2) Runny nose and cough
3) Nausea and vomiting
4) Cyanosis and bradycardia

Question 7

Which is the priority teaching point for the nurse to include in the discharge instructions for the parents of a child who was admitted in a sickle-cell crisis?
1) Rapid weaning of pain medications
2) A diet high in protein
3) Adequate hydration
4) Restriction of activities

Question 8

Which rationale should the nurse include in the teaching session, related to infant iron deficiency anemia, when a parent asks why it is inappropriate to switch from formula to cow's milk prior to 1 year of age? Select all that apply.
1) Cow's milk is a poor source of iron.
2) The child may be exposed to an antibiotic in processed milk.
3) Cow's milk has a high fat content.
4) In young children, cow's milk can lead to bleeding from the gastrointestinal tract.
5) Cow's milk contains no vitamin C, which is necessary for iron absorption.

Question 9

Which is the priority nursing intervention when providing care to a pediatric client who is experiencing disseminated intravascular coagulation (DIC)?
1) Preparing the child for radiographic procedures
2) Implementing the prescribed fluid restriction for the child
3) Encouraging the child to frequently ambulate
4) Monitoring the child's oxygen saturation and vital signs

Question 10

A school-age child diagnosed with classic hemophilia is admitted to the hospital for hemorrhage into the knee joint. Which nursing diagnosis should the nurse use to plan care for this child?
1) Risk for Impaired Physical Mobility related to joint stiffness and contractures
2) Risk for Impaired Tissue Perfusion (cerebral) related to blood loss.
3) Activity Intolerance related to bleeding
4) Disturbed Body Image related to swollen knee

Question 11

The parents of an infant diagnosed with sickle-cell disease ask, "How did our child get this disease? Neither one of us has it." Which should the nurse consider when responding to the parents?
1) The father is not the biologic father of the infant.
2) The mother of the child has the trait, but the father does not.
3) The father of the child has the trait, but the mother does not.
4) The mother and the father of the child have the sickle-cell trait.

Question 12

Which is the priority nursing diagnosis for the child diagnosed with idiopathic thrombocytopenic purpura (ITP)?
1) Ineffective Breathing Pattern
2) Nausea
3) Fluid Volume Deficit
4) Risk for Injury

Question 13

The nurse is administering packed red blood cells to a child with sickle-cell disease (SCD). When should the nurse monitor the child closely due to the risk of reaction?
1) Six hours after the transfusion is given.
2) At the end of the administration of the transfusion.
3) The first 20 mL of blood administered.
4) Never; children with SCD do not have reactions.

Question 14

Which risks should the nurse closely assess a pediatric client for during the posttransplant phase of hematopoietic stem cell transplantation (HSCT)?
1) Hemorrhage
2) Thrombosis
3) Pancytopenia
4) Infection
5) Fluid volume overload

Question 15

A child who has beta-thalassemia is receiving numerous blood transfusions and deferoxamine (Desferal) therapy. The parents ask how the deferoxamine will help their child. Which response by the nurse is accurate?
1) "It stimulates red blood cell production."
2) "It prevents iron overload."
3) "It provides vitamin supplementation."
4) "It decreases the risk of transfusion reactions."

Question 16

A child diagnosed with hemophilia presents to the emergency department (ED) with multiple injuries following a motor vehicle crash. Which injury is the priority when conducting the nursing assessment?
1) Occipital hematoma
2) Radial fracture
3) Dislocated shoulder
4) Abdominal abrasions

Question 17

Which concepts should the nurse include in the discharge instructions for a child who has undergone a hematopoietic stem cell transplantation (HSCT)? Select all that apply.
1) Keeping the child on a high-calcium diet
2) Practicing good hand washing
3) Avoiding live plants and fresh vegetables
4) Avoiding influenza vaccinations
5) Returning the child to school within 6 weeks

Question 18

The nurse prepares to administer a vitamin K injection during the admission assessment for a newborn. The father asks, "Why does my baby need a shot?" Which rationale for administering this injection should the nurse include in the response?
1) Activates clotting factors
2) Dissolves blood clots
3) Promotes gas exchange
4) Promotes the production of hemoglobin

Question 19

The nurse is providing care to a child diagnosed with hemophilia who states, "I am going to join a bike club at school." Which recommendation should the nurse give to the child?
1) Wear knee pads, elbow pads, and a helmet while bicycling.
2) Consider a swim club instead of the bicycling club.
3) Do not join the club.
4) Participate only in the social activities of the club.

Question 20

A child diagnosed with aplastic anemia is admitted to the hospital. The parents ask the nurse what aplastic anemia is. Which response by the nurse is accurate?
1) "Aplastic anemia causes a proliferation of white blood cells."
2) "Aplastic anemia is characterized by abnormally shaped red blood cells."
3) "Aplastic anemia is caused the bone marrow producing inadequate cells."
4) "Aplastic anemia is a disorder that occurs after a viral illness."

Question 21

A child is diagnosed with lymphocytopenia. Which parental statements indicate understanding of this diagnosis? Select all that apply.
1) "My child may be prone to allergic reactions."
2) "My child may have trouble initiating an inflammatory response."
3) "My child may require iron supplements to treat this disorder."
4) "My child may require further testing for leukemia."
5) "My child may have been exposed to tuberculosis."

Question 22

The healthcare provider orders laboratory tests following the initiation of treatment for a child diagnosed with iron deficiency anemia. Which laboratory result should the nurse share with the child's family as an indication of improvement?
1) Low hemoglobin
2) Normal platelet count
3) High reticulocyte count
4) Low hematocrit

Question 23

The heatlthcare provider prescribes a unit of packed red blood cells for a pediatric client. Which intravenous fluid should the nurse hang during the blood transfusion?
1) D₅W
2) D₅LR
3) D₅ 1/4NS
4) NS

Question 24

Which functions of white blood cells (WBCs) should the nurse include in a teaching session for the family of a pediatric client who is diagnosed with human immunodeficiency virus (HIV)? Select all that apply.
1) Carry oxygen from the lungs to the tissues
2) Return carbon dioxide from the tissues to the lungs
3) Assist the body to fight infection
4) Assist the body to fight allergens
5) Form hemostatic plugs to stop bleeding

Question 25

Which functions of red blood cells (RBCs) should the nurse include in a teaching session for the family of a pediatric client who is diagnosed with anemia? Select all that apply.
1) Carry oxygen from the lungs to the tissues
2) Return carbon dioxide from the tissues to the lungs
3) Assist the body to fight infection
4) Assist the body to fight allergens
5) Form hemostatic plugs to stop bleeding

Question 26

Which topic should the nurse include in the discharge instructions for the family of a child who has undergone hematopoietic stem cell transplantation (HSCT)?
1) Avoiding influenza vaccination
2) Returning to school within 6 weeks
3) Maintaining a low-calcium diet
4) Practicing diligent hand hygiene

Question 27

The nurse is providing care to a pediatric client who is diagnosed with leukopenia. Which disorders should the nurse suspect based on this information? Select all that apply.
1) Cardiovascular
2) Immune
3) Bone marrow
4) Respiratory
5) Neurologic

Question 28

A school-age child is admitted to the hospital in a sickle-cell crisis. Which actions should the nurse include in the plan of care to address the child's pain?
1) Administering opioid analgesics, per order
2) Administering nonsteroidal anti-inflammatory drugs (NSAIDs), per order
3) Applying cold packs to affected joints, prn
4) Encouraging oral fluid intake
5) Maintaining bed rest

Question 29

Which injury prevention topics should the nurse include in the plan of care for a pediatric client who has received hematopoietic stem cell transplantation (HSCT)? Select all that apply.
1) Medication storage strategies
2) Needle and syringe disposal
3) Immunization schedule
4) Yearly influenza vaccination
5) Routine dental appointments

Question 30

The nurse is preparing to administer a blood transfusion to a child with a severe anemia. Which type of transfusion reaction can be avoided by the nurse's assessment?
1) Allergic
2) Hemolytic
3) Febrile
4) Septic