Question 1

A child with thalassemia major receives blood transfusions frequently. The nurse is aware that a complication of repeated blood transfusions is:

Accepted Answer

As a result of repeated blood transfusions, excessive deposits of iron (hemosiderosis) are stored in tissues.

Question 2

The nurse would ask the patient with hemophilia A to reconsider a vacation he has planned to:

Accepted Answer

Hemophiliacs are discouraged from exercising in high altitudes and exposure to cold as this depletes their already low oxygen concentration.

Question 3

The statement made by a parent indicating understanding of health maintenance of a child with sickle cell anemia is:

Accepted Answer

Prevention of dehydration, which can trigger the sickling process, is a priority goal in the care of a child with sickle cell disease.

Question 4

When dealing with a preschool-age child with a life-threatening illness, the nurse should remember that at this age the child's concept of death includes:

Accepted Answer

The preschooler views death as reversible and temporary.

Question 5

A child who is receiving a transfusion should be closely assessed for:

Accepted Answer

The child receiving a blood transfusion is observed for signs of a transfusion reaction including chills, itching, fever, rash, headache, and back pain.

Question 6

A child has just been diagnosed with acute lymphoblastic leukemia. The nurse is aware that the result of an overproduction of immature white blood cells in the bone marrow is:

Accepted Answer

An overproduction of immature white blood cells increases the child's susceptibility to infection.

Question 7

On admission, a child with leukemia has widespread purpura and a platelet count of 19,000/mm³. The priority nursing intervention is:

Accepted Answer

When platelets are low, the greatest danger is spontaneous intracranial bleeding. Neurological assessments are therefore a priority of care.

Question 8

A newly married couple is seeking genetic counseling because they are both carriers of the sickle cell trait. How can the nurse best explain their children's risk of inheriting this disease?

Accepted Answer

The sickle cell gene is inherited from both parents; therefore each offspring has a one-in-four chance of inheriting the disease.

Question 9

The nurse would teach the parents of a child with a low platelet count to avoid:

Accepted Answer

Aspirin interferes with platelet function and should be avoided to prevent the risk of prolonged bleeding.

Question 10

The nurse, caring for a child receiving chemotherapy, notes that the child's abdomen is firm and slightly distended. Also, there is no record of a bowel movement for the last 2 days. These assessment findings suggest the possibility of:

Accepted Answer

Peripheral neuropathy may be signaled by severe constipation resulting from decreased nerve sensations in the bowel.

Question 11

An adolescent is diagnosed with Hodgkin's disease. Lymph nodes on both sides of her diaphragm have been found to be involved, including cervical and inguinal nodes. The disease is in:

Accepted Answer

Lymph node regions on both sides of the diaphragm are consistent with a diagnosis of stage III Hodgkin's disease.

Question 12

The nurse would instruct the parent to give ferrous sulfate drops to the child:

Accepted Answer

Vitamin C aids in the absorption of iron, whereas food and milk interfere with the absorption of iron.

Question 13

The nurse would include in a teaching plan about mouth care of a child receiving chemotherapy to:

Accepted Answer

A soft toothbrush reduces capillary damage and mucous membrane breakdown, and prevents bleeding and infection. Commercial mouthwashes may kill oral flora that combat infection. Waterpiks are useful for toughening gums.

Question 14

A 2-year-old child has been diagnosed with hemophilia A. The information the nurse would include in a teaching plan about home care would be:

Accepted Answer

When bleeding occurs, the traditional approach is to follow RICE-rest, ice, compression, and elevation.

Question 15

A 3-year-old child with sickle cell disease is admitted to the hospital in sickle cell crisis for severe abdominal pain. The nurse recognizes that the type of crisis the child is most likely experiencing is:

Accepted Answer

Vaso-occlusive crises or painful crises are caused by obstruction of blood flow by sickle cells, infarctions, and some degrees of vasospasm.

Question 16

The nurse notes that a 4-year-old child's gums bleed easily and he has bruising and petechiae on his extremities. The lab value that would be consistent with these symptoms is:

Accepted Answer

The normal platelet count is 150,000 to 400,000/mm³. This finding is very low, indicating an increased bleeding potential.

Question 17

The statement by a mother that may indicate a cause for her 9-month-old having iron deficiency anemia is:

Accepted Answer

Because cow's milk contains very little iron, infants should drink iron-fortified formula for the first year of life.

Question 18

When the child receiving a transfusion complains of back pain and itching, the nurse's initial action would be to:

Accepted Answer

If a blood transfusion reaction occurs, the first action is to stop the blood infusion, keep the line open with normal saline, and notify the charge nurse.

Question 19

When teaching the mother of a young child about iron deficiency anemia, the nurse would tell her that a rich source of iron is:

Accepted Answer

Good nutritional sources of iron include boiled egg yolk, liver, green leafy vegetables, cream of wheat, dried fruits, beans, nuts, and whole-grain breads.

Question 20

A 6-year-old with leukemia asks, "Who will take care of me in heaven?" The best response for the nurse to make is:

Accepted Answer

This response gives the child an opportunity to verbalize his or her feelings and concerns, whereas the closed response in option 2 shuts off communication. The asking of a "why" question is not therapeutic as it calls for justification.

Quiz 26: The Child With a Condition of the Blood, Blood-Forming Organs, or Lymphatic System