Nokea
A school-age child is admitted in vasoocclusive sickle cell crisis (pain episode). The childs care should include which therapeutic interventions?
- A. Hydration and pain management
- B. Oxygenation and factor VIII replacement
- C. Electrolyte replacement and administration of heparin
- D. Correction of alkalosis and reduction of energy expenditure
Correct Answer: A
Rationale: Vasoocclusive sickle cell crisis requires hydration to reduce blood viscosity and pain management to alleviate discomfort. Oxygen may prevent further sickling but doesn?t reverse it, factor VIII and heparin are irrelevant, and acidosis, not alkalosis, needs correction.
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What physiologic defect is responsible for causing anemia?
- A. Increased blood viscosity
- B. Depressed hematopoietic system
- C. Presence of abnormal hemoglobin
- D. Decreased oxygen-carrying capacity of blood
Correct Answer: D
Rationale: Anemia is defined by reduced RBCs or hemoglobin, leading to decreased oxygen-carrying capacity. Increased viscosity occurs with too many cells, a depressed hematopoietic system or abnormal hemoglobin may contribute, but the core defect is reduced oxygen delivery.
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.
The regulation of red blood cell (RBC) production is thought to be controlled by which physiologic factor?
- A. Hemoglobin
- B. Tissue hypoxia
- C. Reticulocyte count
- D. Number of RBCs
Correct Answer: B
Rationale: Tissue hypoxia triggers the kidneys to release erythropoietin, stimulating bone marrow to produce RBCs. Hemoglobin levels indirectly influence this through oxygen delivery, reticulocyte count monitors production, and RBC numbers don?t directly control production.
Iron overload is a side effect of chronic transfusion therapy. What treatment assists in minimizing this complication?
- A. Magnetic therapy
- B. Infusion of deferoxamine
- C. Hemoglobin electrophoresis
- D. Washing red blood cells (RBCs) to reduce iron
Correct Answer: B
Rationale: Deferoxamine infusions chelate and excrete excess iron, minimizing overload from chronic transfusions. Magnetic therapy is ineffective, hemoglobin electrophoresis is diagnostic, and washing RBCs removes other components, not iron.
What statement best describes b-thalassemia major (Cooley anemia)?
- A. It is an acquired hemolytic anemia.
- B. Inadequate numbers of red blood cells (RBCs) are present.
- C. Increased incidence occurs in families of Mediterranean extraction.
- D. It commonly occurs in individuals from West Africa.
Correct Answer: C
Rationale: B-thalassemia major has a higher incidence in Mediterranean populations and is inherited, not acquired. It involves overproduction of unstable RBCs, not inadequate numbers, and is distinct from sickle cell anemia, which is common in West African populations.