Patho Chap 21

question

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):
answer

An iron deficiency
question

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.
answer

Iron deficiency
question

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.
answer

5
question

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

Mother is Rh-negative, and fetus is Rh-positive.
question

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:
answer

Hydrops fetalis
question

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?
answer

Valine
question

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:
answer

Both his mother and father
question

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

African-Americans
question

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?
answer

Hb S and Hb A
question

When should the nurse start closely monitoring the patient with sickle cell anemia? If:
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Oxygen tension is low
question

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:
answer

Spleen
question

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

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

Sequestration crisis
question

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?
answer

Aplastic crisis
question

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

Infection
question

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

Autosomal recessive
question

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:
answer

Hemoglobin synthesis
question

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?
answer

Alpha thalassemia major
question

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

Alpha major
question

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:
answer

VIII
question

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

Christmas disease
question

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?
answer

Idiopathic thrombocytopenic purpura (ITP)
question

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?
answer

Virally induced antibody destruction of platelets
question

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

Spontaneous nosebleeds, bruising, petechiae
question

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

A nurse monitors for the most common childhood cancer, which is:
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Acute lymphoblastic leukemia (ALL)
question

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

Acute myelogenous leukemia (AML)
question

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:
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Lymphoblastic non-Hodgkin lymphoma (NHL)
question

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

AIDS
question

What is a priority assessment for Hodgkin lymphoma in children?
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Painless adenopathy in cervical nodes
question

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

Coombs
question

A nurse is planning care for a child with iron deficiency anemia. What are characteristics of iron deficiency?
answer

It is most common between the ages of 6 months and 2 years. It may be related to socioeconomic factors. It is difficult to diagnose in early stages.
question

A 5-year-old male is diagnosed with leukemia. Which symptoms would the nurse expect?
answer

Fatigue Pallor Petechiae

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