Nokea
A child with severe anemia requires a unit of red blood cells (RBCs). The nurse explains to the child that the transfusion is necessary for which reason?
- A. Allow her parents to come visit her.
- B. Fight the infection that she now has.
- C. Increase her energy so she will not be so tired.
- D. Help her body stop bleeding by forming a clot (scab).
Correct Answer: C
Rationale: RBC transfusion increases oxygen-carrying capacity, reducing tissue hypoxia and fatigue, and preventing cardiac decompensation. It doesn?t affect visitation, isn?t for infection, and clotting is managed by platelets, not RBCs.
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What therapeutic intervention is most appropriate for a child with b-thalassemia major?
- A. Oxygen therapy
- B. Supplemental iron
- C. Adequate hydration
- D. Frequent blood transfusions
Correct Answer: D
Rationale: Frequent blood transfusions maintain hemoglobin above 9.5 g/dl to prevent bone marrow expansion in b-thalassemia major. Oxygen and hydration are supportive but not primary, and supplemental iron is harmful due to existing iron overload from transfusions.
In a child with sickle cell anemia (SCA), adequate hydration is essential to minimize sickling and delay the vasoocclusion and hypoxia-ischemia cycle. What information should the nurse share with parents in a teaching plan?
- A. Encourage drinking.
- B. Keep accurate records of output.
- C. Check for moist mucous membranes.
- D. Monitor the concentration of the childs urine.
Correct Answer: C
Rationale: Checking for moist mucous membranes assesses hydration in SCA, where impaired kidney function prevents urine concentration. General encouragement to drink is vague, output records don?t reflect fluid needs, and urine concentration is unreliable due to kidney dysfunction.
The parents of a child with sickle cell anemia (SCA) are concerned about subsequent children having the disease. What statement most accurately reflects inheritance of SCA?
- A. SCA is not inherited.
- B. All siblings will have SCA.
- C. Each sibling has a 25% chance of having SCA.
- D. There is a 50% chance of siblings having SCA.
Correct Answer: C
Rationale: SCA is an autosomal recessive disorder, so each sibling has a 25% chance of inheriting SCA, 25% chance of being unaffected, and 50% chance of having the trait. SCA is inherited, not all siblings will have it, and 50% applies to the trait, not the disease.
What statement best describes iron deficiency anemia in infants?
- A. It is caused by depression of the hematopoietic system.
- B. Diagnosis is easily made because of the infants emaciated appearance.
- C. It results from a decreased intake of milk and the premature addition of solid foods.
- D. Clinical manifestations are related to a reduction in the amount of oxygen available to tissues.
Correct Answer: D
Rationale: Iron deficiency anemia reduces oxygen availability to tissues, causing symptoms like pallor and fatigue. The hematopoietic system produces smaller, less hemoglobin-rich RBCs, infants are often overweight from milk, and diagnosis requires lab confirmation, not appearance.
What information should the nurse include when teaching the mother of a 9-month-old infant about administering liquid iron preparations?
- A. Give with meals.
- B. Stop immediately if nausea and vomiting occur.
- C. Adequate dosage will turn the stools a tarry green color.
- D. Allow preparation to mix with saliva and bathe the teeth before swallowing.
Correct Answer: C
Rationale: Adequate iron dosage turns stools tarry green, indicating sufficient absorption. Iron is best given between meals for acidic absorption, nausea may require dose adjustment, not cessation, and liquid iron should be given through a straw to avoid tooth staining.