Child Health - Hematological.txt

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bamaguh1988
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Child Health - Hematological.txt
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2015-01-08 17:10:46
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  1. The nurse analyzes the laboratory results of a child with hemophilia. The nurse understands that which result will most likely be abnormal in this child?
    1. Platelet count 
    2. Hematocrit level 
    3. Hemoglobin level 
    4. Partial thromboplastin time
    4. Partial thromboplastin time
  2. The nurse is providing home care instructions to the parents of a 10-year-old child with hemophilia. Which sport activity should the nurse suggest for this child? 
    1. Soccer 
    2. Basketball 
    3. Swimming 
    4. Field hockey
    3. Swimming
  3. The nursing student is presenting a clinical conference and discusses the cause of b-thalassemia. The nursing student informs the group that a child at greatest risk of developing this disorder is which one? 
    1. A child of Mexican descent 
    2. A child of Mediterranean descent 
    3. A child whose intake of iron is extremely poor 
    4. A breast-fed child of a mother with chronic anemia
    2. A child of Mediterranean descent
  4. A child with b-thalassemia is receiving long-term blood transfusion therapy for the treatment of the disorder. Chelation therapy is prescribed as a result of too much iron from the transfusions. Which medication should the nurse anticipate to be prescribed? 
    1. Fragmin 
    2. Meropenem (Merrem) 
    3. Metoprolol (Toprol-XL) 
    4. Deferoxamine (Desferal)
    4. Deferoxamine (Desferal)
  5. The clinic nurse instructs parents of a child with sickle cell anemia about the precipitating factors related to sickle cell crisis. Which, if identified by the parents as a precipitating factor, indicates the need for further instructions? 
    1. Stress 
    2. Trauma 
    3. Infection
    4. Fluid overload
    4. Fluid overload
  6. A 10-year-old child with hemophilia A has slipped on the ice and bumped his knee. The nurse should prepare to administer which prescription? 
    1. Injection of factor X 
    2. Intravenous infusion of iron 
    3. Intravenous infusion of factor VIII 
    4. Intramuscular injection of iron using the Z-track method
    3. Intravenous infusion of factor VIII
  7. The nurse is instructing the parents of a child with iron deficiency anemia regarding the administration of a liquid oral iron supplement. Which instruction should the nurse tell the parents? 
    1. Administer the iron at mealtimes. 
    2. Administer the iron through a straw. 
    3. Mix the iron with cereal to administer. 
    4. Add the iron to formula for easy administration.
    2. Administer the iron through a straw.
  8. Laboratory studies are performed for a child suspected to have iron deficiency anemia. The nurse reviews the laboratory results, knowing that which result indicates this type of anemia? 
    1. Elevated hemoglobin level 
    2. Decreased reticulocyte count 
    3. Elevated red blood cell count 
    4. Red blood cells that are microcytic and hypochromic
    4. Red blood cells that are microcytic and hypochromic
  9. The nurse is reviewing a health care provider's prescriptions for a child with sickle cell anemia who was admitted to the hospital for the treatment of vaso-occlusive crisis. Which prescriptions documented in the child's record should the nurse question? Select all that apply. 
    1. Restrict fluid intake. 
    2. Position for comfort. 
    3. Avoid strain on painful joints. 
    4. Apply nasal oxygen at 2 L/minute. 
    5. Provide a high-calorie, high-protein diet. 
    6. Give meperidine (Demerol), 25 mg intravenously, every 4 hours for pain.
    • 1. Restrict fluid intake. 
    • 6. Give meperidine (Demerol), 25 mg intravenously, every 4 hours for pain.
  10. The nurse is conducting staff in-service training on von Willebrand's disease. Which should the nurse include as characteristics of von Willebrand's disease? Select all that apply. 
    1. Easy bruising occurs. 
    2. Gum bleeding occurs. 
    3.It is a hereditary bleeding disorder. 
    4. Treatment and care are similar to that for hemophilia. 
    5. It is characterized by extremely high creatinine levels. 
    6. The disorder causes platelets to adhere to damaged endothelium.
    • 1. Easy bruising occurs. 
    • 2. Gum bleeding occurs. 
    • 3. It is a hereditary bleeding disorder. 
    • 4. Treatment and care are similar to that for hemophilia. 
    • 6. The disorder causes platelets to adhere to damaged endothelium.
  11. Oral iron supplements are prescribed for a 6-year-old child with iron deficiency anemia (IDA). The nurse should instruct the mother to administer the iron with which food item? 
    1. Milk 
    2. Water 
    3. Apple juice 
    4. Orange juice
    4. Orange juice
  12. The pediatric nursing instructor asks a nursing student to describe the cause of the clinical manifestations that occur in sickle cell anemia. Which statement by the student is a correct response? 
    1. "Bone marrow depression occurs because of the development of sickled cells." 
    2. "Sickled cells increase blood flow through the body and cause a great deal of pain." 
    3. "Sickled cells mix with the unsickled cells and cause the immune system to become depressed." 
    4. "Sickled cells are unable to flow easily through the microvasculature, and their clumping obstructs blood flow."
    4. "Sickled cells are unable to flow easily through the microvasculature, and their clumping obstructs blood flow."
  13. The nurse is caring for a child with a diagnosis of hemophilia, and hemarthrosis is suspected because the child is complaining of pain in the joints. Which measure should the nurse expect to be prescribed for the child? 
    1. Range-of-motion exercises to the affected joint 
    2. Application of a heating pad to the affected joint 
    3. Application of a bivalved cast for joint immobilization 
    4. Nonsteroidal anti-inflammatory drugs (NSAIDs) for the pain
    3. Application of a bivalved cast for joint immobilization
  14. The home care nurse is providing safety instructions to the mother of a child with hemophilia. Which instruction should the nurse include to promote a safe environment for the child? 
    1. Eliminate any toys with sharp edges from the child's play area. 
    2. Allow the child to use play equipment only when a parent is present. 
    3. Place a helmet and elbow pads on the child every day as soon as the child awakens. 
    4. Allow the child to play indoors only, and avoid any outdoor play or playgrounds.
    1. Eliminate any toys with sharp edges from the child's play area.
  15. The nurse on the pediatric unit is caring for a child with hemophilia who has been in a motor vehicle crash. Which assessment finding, if noted in the child, indicates the need for follow-up? 
    1. The child maintains affected joints in an immobilized position and denies pain at this time. 
    2. The child's urine is noted to be clear and light yellow and is negative for red blood cells (RBCs). 
    3. The child maintains bruised joints in an elevated position; the bruises noted are beginning to turn yellow. 
    4. The child is drowsy and difficult to arouse; previously the child was able to respond to questions effectively.
    4. The child is drowsy and difficult to arouse; previously the child was able to respond to questions effectively.
  16. The nurse provides instructions regarding home care to the parents of a 3-year-old child hospitalized with hemophilia. Which statement, if made by the parent, indicates a need for further instructions? 
    1. "We will supervise our child closely." 
    2. "We will pad corners of the furniture." 
    3. "We will remove household items that can easily fall over." 
    4. "We will avoid having our child receive immunizations and cancel his scheduled dental appointments."
    4. "We will avoid having our child receive immunizations and cancel his scheduled dental appointments."
  17. A child is brought to the emergency department after being accidentally struck in the lower back region with a baseball bat. When gathering assessment data, the nurse discovers that the child has hemophilia. The nurse should immediately assess for which data? 
    1. The respiratory rate 
    2. The urine for hematuria 
    3. For signs of slurred speech 
    4. For complaints of headache
    2. The urine for hematuria
  18. A child in whom sickle cell anemia is suspected is seen in a clinic, and laboratory studies are performed. The nurse checks the laboratory results, knowing that which value would be increased in this disease? 
    1. Platelet count 
    2. Hematocrit level 
    3. Hemoglobin level 
    4. Reticulocyte count
    4. Reticulocyte count
  19. The pediatric nurse educator provides a teaching session to the nursing staff regarding hemophilia. Which statement regarding this disorder should the nurse plan to include in the discussion? 
    1. Males inherit hemophilia from their fathers. 
    2. Hemophilia is a Y-linked hereditary disorder. 
    3. Females inherit hemophilia from their mothers. 
    4. Hemophilia A results from deficiency of factor VIII.
    4. Hemophilia A results from deficiency of factor VIII.
  20. A 12-year-old child with newly diagnosed thalassemia is brought to the clinic exhibiting delayed sexual maturation, fatigue, anorexia, pallor, and complaints of headache. She seems listless and small for her age and has frontal bossing. What should the nurse expect to note on review of the results of the laboratory tests? 
    1. Macrocytosis and hyperchromia 
    2. Excessive red blood cell production 
    3. Excessive mature erythrocyte proliferation 
    4. Deficient production of functional hemoglobin
    4. Deficient production of functional hemoglobin
  21. The pediatric nurse educator is providing a teaching session to nursing staff. The topic is hemophilia, which is genetically passed through a sex-linked recessive gene. Which statement is a specific hemophilia-related concern? 
    1. Acetylsalicylic acid (aspirin) is given for pain control.
    2. Hemarthrosis is the result of synovial cavity aspiration. 
    3. Affected prepubescent girls should be counseled concerning menorrhagia, which may be life threatening. 
    4. Total joint rest along with ice pack application continues for 72 hours after factor VIII is administered.
    3. Affected prepubescent girls should be counseled concerning menorrhagia, which may be life threatening.
  22. An 11-year-old child is admitted to the hospital in vaso-occlusive sickle cell crisis. The nurse plans for which priority treatment in the care of the child? 
    1. Splenectomy, correction of acidosis 
    2. Adequate hydration, pain management 
    3. Frequent ambulation, oxygen administration 
    4. Passive range-of-motion exercises, adequate hydration
    2. Adequate hydration, pain management
  23. A 2-year-old boy with a diagnosis of hemophilia is admitted to the hospital with bleeding into the joint of the right knee. Which intervention should the nurse plan to implement with this child? 
    1. Measure the injured knee joint every shift. 
    2. Take the temperature by rectal method only. 
    3. Immobilize the joint and apply moist heat to the joint. 
    4. Administer acetylsalicylic acid (ASA) for pain control.
    1. Measure the injured knee joint every shift.
  24. A child with sickle cell anemia who is in vaso-occlusive crisis is admitted to the hospital. Which health care provider prescription would assist in reversing the vaso-occlusive crisis? 
    1. Monitor pulse oximetry. 
    2. Begin intravenous fluids. 
    3. Monitor vital signs and respiratory status. 
    4. Check the oxygen saturation level to be sure it is greater than 95%.
    2. Begin intravenous fluids.
  25. A child with a diagnosis of sickle cell anemia and vaso-occlusive crisis is complaining of severe pain, selecting number 8 on the 1 to 10 pain scale. Which medication would the nurse expect to be prescribed for pain control? 
    1. Morphine sulfate 
    2. Ibuprofen (Motrin IB) 
    3. Meperidine (Demerol) 
    4. Acetaminophen (Tylenol)
    1. Morphine sulfate
  26. A nurse is providing home care instructions to the mother of an infant who has just been found to have hemophilia. The nurse should tell the mother that care of the infant should include which appropriate measure? 
    1. Use aspirin for pain relief. 
    2. Pad crib rails and table corners. 
    3. Use a soft toothbrush for dental hygiene. 
    4. Use a generous amount of lubricant when taking a temperature rectally.
    2. Pad crib rails and table corners.
  27. The nurse is collecting data on a 12-month-old child with iron deficiency anemia. Which finding should the nurse expect to note in this child? 
    1. Cyanosis 
    2. Bradycardia 
    3. Tachycardia 
    4. Hyperactivity
    3. Tachycardia
  28. Oral iron is prescribed for a child with iron deficiency anemia. The nurse provides instructions to the mother regarding the administration of the iron. The nurse should instruct the mother to administer the medication in which way? 
    1. Between meals 
    2. Just before a meal 
    3. Just after the meal 
    4. With a fruit low in vitamin C
    1. Between meals
  29. The nurse provides instructions to the mother of a child with sickle cell disease. Which statement by the mother indicates a need for further teaching? 
    1. "I need to be sure that my child has adequate rest periods." 
    2. "I will take my child's temperature and watch for a fever." 
    3. "I need to encourage my child to drink large amounts of fluids." 
    4. "I know my child must spend as much time as possible in the sun."
    4. "I know my child must spend as much time as possible in the sun."
  30. The nurse is reviewing the laboratory results of a child with aplastic anemia and notes that the white blood cell (WBC) count is 2000 cells/mm3 and the platelet count is 150,000 cells/mm3. Which intervention should the nurse incorporate into the plan of care? 
    1. Avoid unnecessary injections. 
    2. Encourage quiet play activities. 
    3. Maintain strict neutropenic precautions. 
    4. Encourage the child to use a soft toothbrush.
    3. Maintain strict neutropenic precautions.
  31. The nursing student is assigned to care for a child with hemophilia. The nursing instructor reviews the plan of care with the student and asks the student to describe the characteristics of this disorder. Which statement by the student indicates a need for further research? 
    1. Males inherit hemophilia from their fathers. 
    2. Hemophilia A results from deficiency of factor VIII. 
    3. Females inherit the carrier status from their fathers and do not have bleeding tendencies. 
    4. Hemophilia is inherited in a recessive manner via a genetic defect on the X chromosome.
    1. Males inherit hemophilia from their fathers.
  32. The nurse is providing instructions to the mother of a 3-year-old child with hemophilia regarding care of the child. Which statement by the mother indicates a need for further teaching? 
    1. "I need to cancel all the dental appointments that I made for my child." 
    2. "If my child gets a cut, I should hold pressure on it until the bleeding stops." 
    3. "I should check the house and remove any household items that can easily fall over." 
    4. "I should move furniture with sharp corners out of the way and pad the corners of the furniture."
    1. "I need to cancel all the dental appointments that I made for my child."
  33. A child is brought to the emergency department after falling from a high swing and landing on the back. The nurse notes that the client also has hemophilia. Based on the client's history and the nature of the injury which should the nurse assess for first? 
    1. Blood in the urine 
    2. Oxygen saturation 
    3. Presence of headache 
    4. Presence of slurred speech
    1. Blood in the urine
  34. A child with a diagnosis of sickle cell disease (SCD) is being admitted for the treatment of vaso-occlusive crisis. The nurse prepares for the admission anticipating which prescription for the child? 
    1. NPO status 
    2. Intravenous (IV) fluids 
    3. Meperidine (Demerol) for pain 
    4. Intubation to administer oxygen
    2. Intravenous (IV) fluids
  35. A nursing student is assigned to care for a child with sickle cell disease (SCD). The nursing instructor asks the student to describe the causative factors related to this disease. Which statement by the student indicates a need for further research? 
    1. SCD is an autosomal recessive disease. 2. Children with the HbS (sickle cell hemoglobin) trait are not symptomatic. 
    3. If each parent carries the trait, the child will carry the trait and the probability of the child having the disease is 75%. 
    4. If one parent has the HbS trait and the other parent is normal, there is a 50% chance that each offspring will inherit the trait.
    3. If each parent carries the trait, the child will carry the trait and the probability of the child having the disease is 75%.
  36. The nurse is caring for a child with hemophilia and is reviewing the results that were sent from the laboratory. Which result should the nurse expect in this child? 
    1. Shortened prothrombin time (PT) 
    2. Prolonged prothrombin time (PT) 
    3. Shortened partial thromboplastin time (PTT) 
    4. Prolonged partial thromboplastin time (PTT)
    4. Prolonged partial thromboplastin time (PTT)
  37. A child is seen in the health care clinic for complaints of fever. On data collection, the nurse notes that the child is pale, tachycardic, and has petechiae. Aplastic anemia is suspected. The nurse understands that which diagnostic test will confirm the diagnosis of aplastic anemia? 
    1. Platelet count 
    2. Granulocyte count 
    3. Red blood cell count 
    4. Bone marrow biopsy
    4. Bone marrow biopsy
  38. The nurse is monitoring the laboratory values of a child with leukemia who is receiving chemotherapy. The nurse prepares to implement bleeding precautions if the child becomes thrombocytopenic and the platelet count is less than how many cells/mm3
    1. 200,000 
    2. 180,000 
    3. 160,000 
    4. 150,000
    4. 150,000

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