Deck 23: Alterations in Hematologic Function

Question 1

A child who has beta-thalassemia is receiving numerous blood transfusions. The child is also receiving deferoxamine (Desferal) therapy. The parents ask how the deferoxamine will help their child. Which rationale does the nurse use when responding to the parents?
1) It prevents blood transfusion reactions.
2) It stimulates RBC production.
3) It provides vitamin supplementation.
4) It prevents iron overload.

Answer 1

4

Question 2

The nurse is caring for the 5-year-old just diagnosed with von Willebrand disease after a tooth extraction with increased bleeding. The family asks the nurse how the signs and symptoms of von Willebrand disease are manifested. What will the nurse tell the family? Select all that apply.
1) Decreased partial thromboplastin time
2) Factor VI deficiency
3) Frequent nosebleeds
4) Bleeding from mucous membranes
5) Frequent bruising

Answer 2

3, 4, 5

Question 3

The nurse is providing care for an adolescent client who is experiencing pain related to a sickle cell crisis. Which medication does the nurse prepare to administer to this client?
1) Morphine sulfate
2) Meperidine
3) Acetaminophen
4) Ibuprofen

Answer 3

1

Question 4

A child recently diagnosed with aplastic anemia is being prepared for discharge. When planning support for the family, which service should the nurse plan to include in the discharge plan?
1) Referrals to support groups and social services
2) Short-term support
3) Genetic counseling
4) Nutrition counseling

Question 5

The adolescent is admitted to the hospital in sickle cell crisis with a pain level of 10/10. The physician orders:
Morphine sulfate 5 mg IV q 2 hr prn
Medication on hand: morphine sulfate 10 mg/mL
Calculate how many ml of morphine sulfate will be given IV.

Question 6

The nurse is providing care to a school-age client with neutropenia. Which clinical manifestations does the nurse anticipate when assessing this client? Select all that apply.
1) Fever
2) Fatigue
3) Tachycardia
4) Hypertension
5) Tachypnea

Question 7

The nurse is providing an educational session for parents with children diagnosed with iron deficiency anemia. Which statements will the nurse include educate about the normal functions of RBCs? Select all that apply.
1) "RBCs transport oxygen from the lungs to the tissue."
2) "RBCs transport carbon dioxide to the lungs."
3) "RBCs protect the body against bacterial invaders."
4) "RBCs form hemostatic plugs to stop bleeding."
5) "RBCs are responsible for psychosocial development."

Question 8

The nurse is providing care to a school-age client diagnosed with idiopathic thrombocytopenic purpura (ITP). Which nursing diagnosis is the priority for this client?
1) Risk for Injury
2) Ineffective Breathing Pattern
3) Nausea
4) Fluid-Volume Deficit.

Question 9

A school-age child with hemophilia falls on the playground and goes to the nurse's office with superficial bleeding above the knee. Which action by the nurse is the most appropriate?
1) Apply a warm, moist pack to the area.
2) Perform some passive range of motion to the affected leg.
3) Apply pressure to the area for at least 15 minutes.
4) Keep the affected extremity in a dependent position.

Question 10

A child with meningococcemia is being admitted to the pediatric intensive-care unit. Which room assignment is the most appropriate for this child?
1) Semiprivate room
2) Private room, but not in isolation
3) Private room, in protective isolation
4) Private room, in respiratory isolation

Question 11

The nurse is caring for a child who is in a sickle cell crisis and has severe pain. Which nursing intervention is the most appropriate for this child?
1) Giving comfort measures, such as back rubs
2) Suggesting diversional activities, such as coloring
3) Administering pain medication
4) Preparing the child for painful procedures

Question 12

A child diagnosed with hemophilia plans on participating in a bicycling club. Which recommendation by the nurse is the most appropriate?
1) Consider a swim club instead of the bicycling club.
2) Wear kneepads, elbow pads, and a helmet while bicycling.
3) Participate only in the social activities of the club.
4) Not join the club.

Question 13

A child who has undergone a hematopoietic stem cell transplantation (HSCT) is ready for discharge. Which items will the nurse include in the discharge teaching for this child and family? Select all that apply.
1) Recognize the signs of graft-versus-host disease.
2) Return the child to school within six weeks.
3) Practice good handwashing.
4) Avoid obtaining influenza vaccinations.
5) Avoid live plants and fresh vegetables.

Question 14

The nurse is teaching parents how to prevent a sickle cell crisis in the child with sickle cell disease. Which precipitating factors to a sickle cell crisis will the nurse include in the explanation? Select all that apply.
1) Fever
2) Dehydration
3) Regular exercise
4) Altitude
5) Increased fluid intake

Question 15

The nurse is evaluating the activity tolerance of a 9-month-old with iron deficiency anemia. Which finding indicates that the infant is not tolerating activity?
1) Heart rate of 138
2) Increased alertness
3) Respiratory rate less than 40 with activity
4) Muscle weakness

Question 16

The nurse is caring for a child with disseminated intravascular coagulation (DIC). Which nursing intervention is a priority for this child?
1) Frequent ambulation
2) Maintenance of skin integrity
3) Monitoring of fluid restriction
4) Preparation for x-ray procedures

Question 17

A child is diagnosed with sickle cell disease. The parents are unsure how their child contracted the disease. Which explanation by the nurse is the most appropriate?
1) "Both the mother and the father have the sickle cell trait."
2) "The mother has the trait, but the father doesn't."
3) "The father has the trait, but the mother doesn't."
4) "The mother has sickle cell disease, but the father doesn't have the disease or the trait."

Question 18

Which action by the parents demonstrates an understanding of the nurse's teaching with regard to prevention of iron-deficient anemia?
1) Feeding their infant with a formula that is not iron fortified
2) Starting iron-fortified infant cereal at 4 to 6 months of age
3) Introducing cow's milk at 6 months of age
4) Limiting vitamin C consumption after 1 year of age

Question 19

The nurse is administering packed RBCs to a child with sickle cell disease (SCD). The nurse is monitoring for a transfusion reaction and knows it is most likely to occur during which time frame?
1) Six hours after the transfusion is given
2) Within the first 20 minutes of administration of the transfusion
3) At the end of the administration of the transfusion
4) Never; children with SCD do not have reactions.

Question 20

The charge nurse on a pediatric unit is making a room assignment for a school-age child diagnosed with sickle cell disease, who is in splenic sequestration crisis. Which room assignment is most appropriate for this client?
1) Semiprivate room
2) Reverse-isolation room
3) Contact-isolation room
4) Private room