Deck 28: Alterations in Hematologic Function

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.

Answer 1

The parents start iron-fortified infant cereal at four to six months of age.

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

Answer 2

Is characterized by failure of the bone marrow to produce adequate numbers of cells

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

Answer 3

Keeping the child on a high-calcium diet
Practicing good hand washing
Avoiding live plants and fresh vegetables

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.

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

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.

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.

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.

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

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

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

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.

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

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

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

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

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

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

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

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

Question 21

A ten-year-old boy with classic hemophilia is admitted to the hospital for hemorrhage into the knee joint. Treatment is instituted on admission. What would be an appropriate nursing diagnosis for this child?

A)Risk for impaired physical mobility related to joint stiffness and contractures
B)Risk for impaired tissue perfusion (cerebral) related to blood loss.
C)Activity intolerance related to bleeding
D)Disturbed body image related to swollen knee

Question 22

A seven-year-old child is admitted in sickle-cell crisis. The nurse is concerned with reducing the child's pain. Recognizing that any activity that reduces the sickling will reduce the pain, nursing activities will include: Standard Text: Select all that apply.

A)Administration of narcotics.
B)Administration of NSAIDs.
C)Cold application.
D)Encouraging oral fluids.
E)Maintaining bed rest.

Question 23

The nurse is preparing to administer a blood transfusion to a child with a severe anemia. Which type of transfusion reaction may be within the nurse's realm of prevention?

A)Allergic
B)Hemolytic
C)Febrile
D)Septic

Question 24

Following treatment for iron deficiency anemia, the physician orders lab tests. Which lab value would indicate an improvement in the child's condition?

A)Low hemoglobin
B)Normal platelet count
C)High reticulocyte count
D)Low hematocrit

Question 25

The nurse recommends to the mother of a 10-month-old child that cow's milk not be introduced into the diet until after 12 months of age. The mother asks why she can't switch to cow's milk earlier. The nurse explains that cow's milk can lead to iron deficiency anemia because: Standard Text: Select all that apply.

A)Cow's milk is a poor source of iron.
B)The child may be exposed to an antibiotic in processed milk.
C)Cow's milk has a high fat content.
D)In young children, cow's milk can lead to bleeding from the gastrointestinal tract.
E)Cow's milk contains no vitamin C, which is necessary for iron absorption.

Question 26

The physician has ordered the child to receive a unit of packed red blood cells. In preparing to administer the blood, the nurse will initiate an intravenous line and hang what fluid?

A)D5W
B)D5LR
C)D5 1/4NS
D)NS