Nokea
A 3-year-old child with sickle cell disease is admitted to the hospital in sickle cell crisis with severe abdominal pain. Which type of crisis is the child most likely experiencing?
- A. Aplastic
- B. Hyperhemolytic
- C. Vaso-occlusive
- D. Splenic sequestration
Correct Answer: C
Rationale: Vaso-occlusive crisis, or painful crisis, is caused by obstruction of blood flow by sickle cells, infarctions, and some degrees of vasospasm.
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Which statement by a mother may indicate a cause for her 9-month-old's iron deficiency anemia?
- A. Formula is so expensive. We switched to regular milk right away.'
- B. She almost never drinks water.'
- C. She doesn't really like peaches or pears, so we stick to bananas for fruit.'
- D. I give her a piece of bread now and then. She likes to chew on it.'
Correct Answer: A
Rationale: Because cow's milk contains very little iron, infants should drink iron-fortified formula for the first year of life.
What are the classic symptoms of thalassemia major (Cooley's anemia)? (Select all that apply.)
- A. Hepatomegaly
- B. Jaundice
- C. Protruding teeth
- D. Pathological fractures
- E. Renal failure
Correct Answer: A,B,C,D
Rationale: Classic symptoms of thalassemia major include hepatomegaly, jaundice, protruding teeth, and pathological fractures due to bone marrow expansion.
The family of a child receiving chemotherapy for leukemia should be taught to focus on which aspect(s) of the child's care? (Select all that apply.)
- A. Using a support group
- B. Stimulating appetite
- C. Maintaining adequate hydration
- D. Continuing with scheduled immunizations
- E. Reporting exposure to infectious diseases
Correct Answer: A,B,C,E
Rationale: Support groups, appetite stimulation, hydration, and infection vigilance are critical for a child on chemotherapy.
The nurse finds an adolescent with Hodgkin's disease crying. The adolescent says, 'I am so scared.' What is the most appropriate nursing response to this comment?
- A. I understand how you must feel.'
- B. You shouldn't feel that way.'
- C. Is this the strongest feeling you've had today?'
- D. Tell me what's got you scared.'
Correct Answer: D
Rationale: The nurse should encourage the adolescent to express her feelings and concerns.
The nurse is teaching the parents of a young child with iron deficiency anemia about nutrition. What food would the nurse emphasize as being a rich source of iron?
- A. An egg white
- B. Cream of Wheat
- C. A banana
- D. A carrot
Correct Answer: B
Rationale: Good nutritional sources of iron include boiled egg yolk, liver, green leafy vegetables, Cream of Wheat, dried fruits, beans, nuts, and whole-grain breads.