Hematologic System Assessment Questions

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Hemolytic disease of the newborn caused by Rh blood group incompatibility requires maternal antibody to enter the fetal bloodstream. Therefore, the mediator of this disease is

  • A. IgE antibody
  • B. IgG antibody
  • C. IgM antibody
  • D. IgA antibody
Correct Answer: B

Rationale: The correct answer is B: IgG antibody. In hemolytic disease of the newborn, maternal IgG antibodies against fetal Rh-positive red blood cells can cross the placenta and attack the fetal RBCs, leading to hemolysis. IgE is primarily involved in allergic reactions, not hemolytic disease. IgM antibodies are too large to cross the placenta efficiently. IgA is not typically involved in hemolytic diseases. Therefore, IgG is the most likely mediator of hemolytic disease of the newborn in cases of Rh blood group incompatibility.

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A child with acute lymphoblastic leukemia (ALL) who is receiving chemotherapy has the following lab results: WBC 9,000, Hemoglobin 12, and Platelets 20,000. When planning this child’s care, which risk should the nurse consider most significant?

  • A. Infection
  • B. Pain
  • C. Hemorrhage
  • D. Anemia
Correct Answer: C

Rationale: Correct Answer: C - Hemorrhage

Rationale:
1. Platelets are critically low at 20,000, putting the child at high risk for bleeding.
2. Hemorrhage is a major concern due to impaired clotting ability.
3. Anemia (low hemoglobin) can contribute to bleeding but is not the primary concern.
4. Infection risk is elevated but not as immediate as the risk of hemorrhage with such low platelets.

The mother asks the nurse if her child's iron deficiency anemia is related to the child's frequent infections. The nurse responds based on the understanding of which of the following?

  • A. Little is known about iron-deficiency anemia and its relationship to infection in children.
  • B. Children with iron deficiency anemia are more susceptible to infection than are other children.
  • C. Children with iron-deficiency anemia are less susceptible to infection than are other children.
  • D. Children with iron-deficient anemia are equally as susceptible to infection as are other children.
Correct Answer: B

Rationale: The correct answer is B: Children with iron deficiency anemia are more susceptible to infection than are other children. Iron is crucial for the immune system to function optimally. In iron deficiency anemia, the body lacks enough iron to produce hemoglobin, which can impair the immune response, making individuals more prone to infections. Therefore, children with iron deficiency anemia are indeed more susceptible to infections.

Explanation of other choices:
A: Little is known about iron-deficiency anemia and its relationship to infection in children - This is incorrect as there is a clear understanding of the link between iron deficiency anemia and susceptibility to infections.
C: Children with iron-deficiency anemia are less susceptible to infection than are other children - This is incorrect as iron deficiency impairs the immune response, making individuals more susceptible to infections.
D: Children with iron-deficient anemia are equally as susceptible to infection as are other children - This is incorrect as iron deficiency compromises the immune system, leading to increased susceptibility to

A child is diagnosed with sickle cell disease. The parents are unsure of how their child contracted the disease. What is the most appropriate explanation by the nurse?

  • A. The mother has the trait, but the father does not.
  • B. The father has the trait, but the mother does not.
  • C. The mother has the disease, but the father has neither the trait nor the disease.
  • D. The mother and father have the trait; therefore the child has a 25% chance for having the disease.
Correct Answer: D

Rationale: Rationale:
1. Sickle cell disease is an autosomal recessive genetic disorder.
2. Both parents must be carriers (have the trait) to pass on the disease.
3. If both parents have the trait, each child has a 25% chance of inheriting the disease.
4. Therefore, choice D is correct as it explains the genetic basis of sickle cell disease transmission.

Summary of Incorrect Choices:
A. Incorrect - Both parents need to be carriers for the child to inherit the disease.
B. Incorrect - Both parents need to be carriers for the child to inherit the disease.
C. Incorrect - If the mother has the disease, the child would have a 50% chance of inheriting it, not 25%.

A child, in renal failure, has hyperkalemia. The nurse plans to instruct that the child should avoid the following foods:

  • A. Carrots and green, leafy vegetables.
  • B. Chips, cold cuts, and canned foods.
  • C. Spaghetti and meat sauce, breadsticks.
  • D. Hamburger on a bun, cherry gelatin.
Correct Answer: A

Rationale: The correct answer is A because carrots and green, leafy vegetables are high in potassium, which can exacerbate hyperkalemia in a child with renal failure. Carrots and green, leafy vegetables should be avoided to help manage potassium levels.

Summary of other choices:
B: Chips, cold cuts, and canned foods are high in sodium and phosphorus, not potassium.
C: Spaghetti and meat sauce, breadsticks are moderate in potassium and can be included in the diet in moderation.
D: Hamburger on a bun, cherry gelatin are lower in potassium compared to carrots and green, leafy vegetables.

Which is the priority concern in developing a teaching plan for the parents of a 15-month-old child?

  • A. Toilet training guidelines
  • B. Guidelines for weaning children from bottles
  • C. Instructions on preschool readiness
  • D. Instructions on a home safety assessment
Correct Answer: D

Rationale: The correct answer is D, instructions on a home safety assessment. This is the priority concern because at 15 months, children are curious and mobile, making them prone to accidents. Conducting a home safety assessment helps identify potential hazards and allows parents to make necessary changes to create a safe environment for the child. Toilet training (A) and weaning from bottles (B) are important developmental milestones but are not as critical as ensuring the child's safety. Preschool readiness (C) is also important but can be addressed later, whereas immediate attention to home safety is crucial to prevent accidents.