Deck 51: The Child With Alterations in Hematologic Function

Question 1

A child who has undergone hematopoietic stem cell transplantation (HSCT)is ready for discharge.It is important that the nurse teach the family to:

A)Keep the child on a low-calcium diet.
B)Return the child to school within 6 weeks.
C)Practice good handwashing.
D)Avoid obtaining influenza vaccinations.

Answer 1

Practice good handwashing.

Question 2

A child recently has been diagnosed with aplastic anemia.Support for the family should include:

A)Referrals to support groups and Social Services.
B)Short-term support.
C)Genetic counseling.
D)Nutrition counseling.

Answer 2

Referrals to support groups and Social Services.

Question 3

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 a warm,moist pack to the area.
B)Perform some passive range-of-motion to the affected leg.
C)Apply pressure to the area for at least 15 minutes.
D)Keep the affected extremity in a dependent position.

Answer 3

Apply pressure to the area for at least 15 minutes.

Question 4

A child with meningococcemia is being admitted to the pediatric intensive care unit.This child should be placed in a:

A)Semi-private room.
B)Private room,but not in isolation.
C)Private room,in protective isolation.
D)Private room,in respiratory isolation.

Question 5

Which of these drugs would the nurse expect to administer for a sickle cell pain crisis?

A)Morphine sulfate (Duramorph)
B)Meperidine (Demerol)
C)Acetaminophen (Tylenol)
D)Ibuprofen (Advil)

Question 6

The nurse is administering packed red blood cells to a child with sickle cell disease.The nurse knows that a transfusion reaction is most likely to occur:

A)6 hours after the transfusion is given.
B)Within the first 20 minutes of administration of the transfusion.
C)At the end of the administration of the transfusion.
D)Never.Blood reactions to transfusions do not occur.

Question 7

A child with sickle cell disease,in splenic sequestration crisis,is being admitted.The nurse should assign this patient to a:

A)Semi-private room.
B)Reverse isolation room.
C)Contact isolation room.
D)Private room.

Question 8

The nurse is caring for a child with disseminated intravascular coagulation (DIC).A priority nursing intervention for this child is:

A)Frequent ambulation.
B)Maintenance of skin integrity.
C)Monitoring of fluid restriction.
D)Preparation for x-ray procedures.

Question 9

A child who has ß-thalassemia is receiving numerous blood transfusions.The child also is receiving deferoxamine (Desferal)therapy.The parents ask how the deferoxamine will help their child.The nurse explains that the deferoxamine (Desferal)is given to:

A)Prevent blood transfusion reactions.
B)Stimulate red blood cell production.
C)Provide vitamin supplement.
D)Prevent iron overload.

Question 10

Parents demonstrate that they understand the nurse's teaching with regard to prevention of iron-deficiency anemia if they:

A)Feed their infant with a formula that is not iron-fortified.
B)Start iron-fortified infant cereal at 4-6 months of age.
C)Introduce cow's milk when the child is 6 months old.
D)Limit vitamin C consumption after 1 year of age.

Question 11

A mother of a premature infant asks the nurse about the baby's need for supplemental iron.What is the nurse's best response?

A)"Since iron stores are developed during the third trimester of pregnancy,premature infants require supplemental iron."
B)"All infants require iron supplements."
C)"The small body size of the preterm infant calls for supplemental iron to promote growth."
D)"Preterm infants have decreased ability to synthesize iron."

Question 12

A child has been diagnosed with sickle cell disease.The parents are unsure how their child contracted the disease.The nurse should explain that the:

A)Mother and the father of the child have the sickle cell trait.
B)Mother of the child has the trait but the father doesn't.
C)Father of the child has the trait but the mother doesn't.
D)Mother of the child has sickle cell disease,but the father doesn't have the disease or the trait.

Question 13

A priority nursing diagnosis for the child with idiopathic thrombocytopenic purpura (ITP)is:

A)Risk for injury (bleeding).
B)Ineffective breathing pattern.
C)Nausea.
D)Fluid volume deficit.

Question 14

The nurse is evaluating the activity tolerance of a 9-month-old with iron-deficiency anemia.The finding that indicates the child is tolerating activity is:

A)Tachycardia.
B)Decreased alertness.
C)Respiratory rate less than 50 with activity.
D)Muscle weakness.

Question 15

A child with hemophilia plans on participating in a bicycling club.The nurse should recommend that the child:

A)Consider a swim club instead of the bicycling club.
B)Wear kneepads,elbow pads,and a helmet while bicycling.
C)Participate only in the social activities of the club.
D)Not join the club.