Question 1

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?

Accepted Answer

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

Question 2

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

Accepted Answer

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 C

Question 3

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

Accepted Answer

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

Question 4

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

Accepted Answer

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

Question 5

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

Accepted Answer

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

Question 6

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

Accepted Answer

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

Question 7

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.

Accepted Answer

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

Question 8

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

Accepted Answer

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

Question 9

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

Accepted Answer

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

Question 10

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

Accepted Answer

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

Question 11

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

Accepted Answer

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

Question 12

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?

Accepted Answer

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

Question 13

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

Accepted Answer

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

Question 14

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?

Accepted Answer

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 15

What is a priority assessment for Hodgkin lymphoma in children?

Accepted Answer

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

Question 16

What is the most common form of childhood leukemia?

Accepted Answer

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

Question 17

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

Accepted Answer

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

Question 18

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

Accepted Answer

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

Accepted Answer

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 20

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

Accepted Answer

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

Exam 22: Alterations of Hematological Function in Children