Deck 22: Alterations of Hematological Function in Children

Question 1

What organ is responsible for removing sickled cells from circulation?

A) The liver
B) The pancreas
C) The kidney
D) The spleen

Answer 1

The spleen

Question 2

A 1-year-old female is diagnosed with anemia secondary to insufficient erythropoiesis. What is the most likely cause?

A) Genetic factors
B) An iron deficiency
C) A hemoglobin abnormality
D) An erythrocyte structural abnormality

Answer 2

An iron deficiency

Question 3

By what other name is the clotting factor IX disorder, hemophilia B, known as?

A) Classic hemophilia
B) Christmas disease
C) Thalassemia
D) von Willebrand disease

Answer 3

Christmas disease

Question 4

What type of genetic disorders are the alpha and beta thalassemias?

A) Autosomal recessive
B) Autosomal dominant
C) X-linked recessive
D) X-linked dominant

Question 5

If an infant has hydrops fetalis, which type of thalassemia does the nurse know this to be?

A) Beta minor
B) Beta major
C) Alpha minor
D) Alpha major

Question 6

Which mother-fetus combination is at most risk for a maternal-fetal blood incompatibility?

A) Mother is Rh positive, and fetus is Rh negative.
B) Mother is Rh negative, and fetus is Rh positive.
C) Mother has type A blood, and fetus has type O blood.
D) Mother has type AB blood, and fetus has type B blood.

Question 7

A mother has a child that is diagnosed with sickle cell anemia. While the mother does not have the disease, which characteristic of her genetic makeup is responsible for the child's disease?

A) Hb S and Hb S
B) Hb S and Hb A
C) Hb S and Hb C
D) Hb A and Hb C

Question 8

A 6-year-old male presents with marked fatigue, jaundice, and irritability. A blood smear shows the presence of sickled cells. Erythropoiesis is compromised in this child. Which crisis should the nurse monitor the patient for?

A) Vaso-occlusive crisis
B) Sequestration crisis
C) Aplastic crisis
D) Hyperhemolytic crisis

Question 9

Testing reveals that a child has hemophilia A. This bleeding disorder results from a deficiency in factor:

A) IX.
B) XII.
C) XIII.
D) VIII.

Question 10

A 2-year-old male presented with growth and maturation retardation and splenomegaly. He died shortly after arriving at the ER. Autopsy revealed thalassemia, a condition involving what feature?

A) Defective erythrocyte membranes
B) Poor iron metabolism
C) Inappropriate stem cell formation
D) Defective hemoglobin synthesis

Question 11

Which major symptom indicates to the nurse that patient diagnosed with sickle cell anemia is experiencing a vaso-occlusive crisis?

A) Peripheral edema
B) Pain
C) Petechiae
D) An enlarged spleen

Question 12

A 5-year-old male is diagnosed with immune thrombocytopenic purpura (ITP). What is the most common cause of this condition?

A) Normal postnatal platelet lysis
B) Virally induced antibody destruction of platelets
C) An allergic reaction to vaccinations
D) Maternal antibodies that target platelets in the neonate

Question 13

In Canada, which group of people should be assessed first for sickle cell disease?

A) People of Asian descent
B) Black people of African descent
C) People of Central American descent
D) White people

Question 14

A 16-month-old female presents with tachycardia, pallor, anorexia, and systolic murmur. The nurse is checking the laboratory results, and the hemoglobin determination indicates a level below _____ mmol/L.

A) 50
B) 70
C) 10
D) 14

Question 15

Which of the following amino acids is present in Hb S and not present in normal Hb?

A) Valine
B) Glutamic acid
C) Proline
D) Histidine

Question 16

Autopsy on a stillborn fetus reveals cardiomegaly, hepatomegaly, edema, and ascites as well as fulminant intrauterine heart failure. Considering these findings, what is the most likely cause of death?

A) Alpha thalassemia minor
B) Alpha thalassemia major
C) Hemoglobin H disease
D) Alpha trait

Question 17

A 3-year-old child presents with bruising on the legs and trunk and a petechial rash. The mother also reports frequent nosebleeds. Lab tests reveal a decreased platelet count. This symptomology supports which medical diagnosis?

A) Immune thrombocytopenic purpura (ITP)
B) Leukemia
C) Thalassemia
D) Hemophilia

Question 18

What is the most likely cause of death associated with sickle cell disease?

A) Decreased hemoglobin
B) Infection
C) An obstructive crisis
D) A hyperhemolytic crisis

Question 19

Which type of sickle cell crisis occurs only in young children?

A) Hyperhemolytic crisis
B) Vaso-occlusive crisis
C) Aplastic crisis
D) Sequestration crisis

Question 20

A 12-month-old toddler weighing 8 kilograms is brought to the clinic because of weakness, slow physical growth, and developmental delays. His mother reports that the only food he will consume is cow's milk. The symptoms support a diagnosis of which form of anemia?

A) Pernicious
B) Iron deficiency
C) Aplastic
D) Hemolytic

Question 21

Which of the following clusters of symptoms would lead the nurse to suspect a child has immune thrombocytopenic purpura (ITP)?

A) Multiple infections, bruising, abnormal bone marrow aspiration
B) Lower extremity that is warm to touch, edematous, and painful
C) Spontaneous nosebleeds, bruising, and petechiae
D) Increased platelet count, recent-onset venous thrombosis

Question 22

What is the most serious complication of immune thrombocytopenic purpura (ITP)?

A) Respiratory infection
B) Asymmetrical bruising
C) Intracranial bleeding
D) Immunosuppression

Question 23

Which laboratory test will assist the nurse in identifying infants who are prone to develop hemolytic disease of the newborn (HDN)?

A) Total bilirubin
B) Coombs
C) Rh antibodies
D) Platelets

Question 24

A 5-year-old male is diagnosed with leukemia. Which of the following symptoms would the nurse expect? (Select all that apply.)

A) Fatigue
B) Jaundice
C) Pallor
D) Petechiae
E) Fever

Question 25

What is a priority assessment for Hodgkin lymphoma in children?

A) Painless adenopathy in cervical nodes
B) Significant bruising
C) Weight gain
D) Petechiae

Question 26

A nurse is planning care for a child with iron deficiency anemia. Characteristics of iron deficiency anemia include which of the following? (Select all that apply.)

A) It is most common between the ages of 6 months and 2 years.
B) It is related to gender and race.
C) It may be related to socioeconomic factors.
D) It is rare among teenagers.
E) It is difficult to diagnose in early stages.

Question 27

What is the most common form of childhood leukemia?

A) Acute lymphoblastic leukemia (ALL)
B) Chronic myelocytic leukemia (CML)
C) Acute myeloid leukemia (AML)
D) Chronic lymphocytic leukemia (CLL)