Question 1

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

Accepted Answer

Classic hemophilia causes bleeding episodes into the joints, which can result in stiffness and contractures that impair physical mobility. This is the most appropriate nursing diagnosis for this child. While the other three options may be relevant to the child's overall care, they are not the most appropriate nursing diagnosis for the specific problem of hemorrhage into the knee joint.

Question 2

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.

Accepted Answer

Administration of narcotics (A) and NSAIDs (B) can help manage the pain associated with sickle cell crisis. Encouraging oral fluids (D) helps to hydrate the body, reducing blood viscosity and thus sickling. Maintaining bed rest (E) reduces oxygen demand on the body, which can also help minimize sickling. Cold application (C) is not recommended as it can cause vasoconstriction, potentially worsening sickling and pain.

Question 3

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

Accepted Answer

Hemolytic reactions occur when the donor blood is not compatible with the recipient's blood type, leading to destruction of the red blood cells and potentially life-threatening complications. This can be prevented by properly verifying blood types and compatibility prior to transfusion. Allergic, febrile, and septic reactions are not necessarily preventable by the nurse and may occur despite proper precautions.

Question 4

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

Accepted Answer

A high reticulocyte count indicates an increase in the production of red blood cells, which is a sign of improved condition following treatment for iron deficiency anemia. Low hemoglobin and low hematocrit would indicate ongoing anemia, while a normal platelet count is unrelated to iron deficiency anemia.

Question 5

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.

Accepted Answer

Cow's milk is a poor source of iron, and in young children, it can lead to bleeding from the gastrointestinal tract, which can contribute to iron deficiency anemia.

Question 6

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

Accepted Answer

Normal saline (NS) is the best choice for hanging fluid because it is a compatible solution with packed red blood cells. D5W, D5LR, and D5 1/4NS all contain glucose, which can cause hemolysis (breakdown of red blood cells) if administered with packed red blood cells. Therefore, NS is the only appropriate option.

Quiz 28: Alterations in Hematologic Function

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 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.

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?

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

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?