Deck 21: Alterations of Hematologic Function in Children

Question 1

A 25-year-old female has a child that is diagnosed with sickle cell anemia.She does not have the disease.Which of the following characterizes the genetic makeup of the parents with regard to this trait?

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

Answer 1

Hb S and Hb A

Question 2

A 2-year-old male presented with growth and maturation retardation and splenomegaly.He died shortly after arriving at the ER.Autopsy revealed thalassemia secondary to defective:

A) Erythrocyte membranes
B) Iron metabolism
C) Stem cell formation
D) Hemoglobin synthesis

Answer 2

Hemoglobin synthesis

Question 3

A geneticist is discussing thalassemias.Which information should be included? The alpha and beta thalassemias are inherited in an _____ fashion.

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

Answer 3

Autosomal recessive

Question 4

A 22-year-old female gives birth at 20 weeks' gestation to a stillborn fetus.Physical exam of the fetus by the nurse reveals gross edema of the entire body and anemia.This condition is referred to as:

A) Hyperbilirubinemia.
B) Hydrops fetalis.
C) Erythroblastosis fetalis.
D) Ascites.

Question 5

A 5-year-old female dies from sickle cell disease.The pediatrician will document the most likely cause of death is:

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

Question 6

When should the nurse start closely monitoring the patient with sickle cell anemia? If:

A) Oxygen tension is low
B) pH is increased
C) Plasma osmolality is decreased
D) Fever develops

Question 7

A 12-month-old toddler weighing 18 pounds 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.Considering this information,the nurse decides that the child probably has _____ anemia.

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

Question 8

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

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

Question 9

In the United States,which group of people should be assessed first for sickle cell disease?

A) Asians
B) African-Americans
C) Hispanics
D) Caucasians

Question 10

Sickle cell disease is characterized by the presence of Hb S.A nurse is trying to differentiate between Hb S and normal Hb.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 11

The mother of a 3-year-old child speaks to the pediatrician because the child took several hours to stop bleeding following a minor scrape.Testing reveals that the child has hemophilia A resulting from a deficiency in factor:

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

Question 12

For which type of sickle cell crisis should the nurse assess for in young children?

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

Question 13

If an infant has hydrops fetalis,which type of thalassemia does the nurse suspect?

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

Question 14

A 12-year-old male is diagnosed with sickle cell anemia.A blood smear reveals severely sickled cells.A nurse recalls the sickled cells will be removed from circulation mostly by the:

A) Liver
B) Pancreas
C) Kidney
D) Spleen

Question 15

A 1-year-old female is diagnosed with anemia secondary to insufficient erythropoiesis.When the parents asked what caused this,how should the nurse respond? The most likely cause(s)is (are):

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

Question 16

A 10-year-old male is diagnosed with sickle cell anemia.When the parents ask who is responsible for this disease,what is the nurse's best response? He most likely inherited it from:

A) His mother
B) His father
C) Noth his mother and father
D) None of the above; sickle cell disease is not clearly an inherited disease.

Question 17

A 6-year-old male presents with 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 18

Which mother 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 19

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

A) 5
B) 7
C) 10
D) 14

Question 20

A 38-year-old female gives birth to a stillborn fetus.Autopsy reveals cardiomegaly,hepatomegaly,edema,and ascites.Which of the following does the nurse suspect caused the death?

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

Question 21

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 22

Which of the following clusters of symptoms would lead the nurse to suspect a child has idiopathic 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, petechiae
D) Increased platelet count; recent-onset venous thrombosis

Question 23

A nurse wants to chart the other name for hemophilia B.Which term should the nurse write?

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

Question 24

A 1-year-old is diagnosed with idiopathic thrombocytopenic purpura (ITP).The nurse assesses for the most serious concern,which is development of:

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

Question 25

Which condition makes the patient most prone for developing non-Hodgkin lymphoma (NHL)?

A) Sickle cell disease
B) Sickle cell trait
C) Renal failure
D) AIDS

Question 26

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 27

A 5-year-old male is diagnosed with idiopathic thrombocytic purpura (ITP).Which information should the nurse give the staff regarding the 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 28

A nurse monitors for the most common childhood cancer,which is:

A) Acute lymphoblastic leukemia (ALL)
B) Chronic myelocytic leukemia (CML)
C) Non-Hodgkin lymphoma
D) Hodgkin lymphoma

Question 29

A 10-year-old male with Down syndrome undergoes chemotherapy for cancer.Following treatment,monitoring for which condition is priority?

A) Acute lymphoblastic leukemia (ALL)
B) Acute myelogenous leukemia (AML)
C) Non-Hodgkin lymphoma (NHL)
D) Hodgkin lymphoma

Question 30

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 31

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.Which is the most likely diagnosis the nurse will see documented on the chart?

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

Question 32

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 33

A 10-year-old female is diagnosed with a malignancy in the brain and lung.DNA analysis reveals translocation at chromosome 7 and 14.The most likely medical diagnosis the primary care provider will make is:

A) Lymphoblastic non-Hodgkin lymphoma (NHL)
B) Nodular NHL
C) Hodgkin lymphoma
D) Small noncleaved cell NHL