Nokea
In which condition are all the formed elements of the blood simultaneously depressed?
- A. Aplastic anemia
- B. Sickle cell anemia
- C. Thalassemia major
- D. Iron deficiency anemia
Correct Answer: A
Rationale: Aplastic anemia involves bone marrow failure, depressing all blood elements (RBCs, WBCs, platelets). Sickle cell anemia affects hemoglobin, thalassemia major impacts hemoglobin chain production, and iron deficiency reduces RBC size and hemoglobin, not all elements.
You may also like to solve these questions
What condition occurs when the normal adult hemoglobin is partly or completely replaced by abnormal hemoglobin?
- A. Aplastic anemia
- B. Sickle cell anemia
- C. Thalassemia major
- D. Iron deficiency anemia
Correct Answer: B
Rationale: Sickle cell anemia involves replacement of normal hemoglobin with abnormal sickled hemoglobin, a hemoglobinopathy. Aplastic anemia is bone marrow failure, thalassemia major involves reduced hemoglobin chain production, and iron deficiency affects RBC size, not hemoglobin type.
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.
Therapeutic management of a 6-year-old child with hereditary spherocytosis (HS) should include which therapeutic intervention?
- A. Perform a splenectomy.
- B. Supplement the diet with calcium.
- C. Institute a maintenance transfusion program.
- D. Increase intake of iron-rich foods such as meat.
Correct Answer: A
Rationale: Splenectomy corrects hemolysis in hereditary spherocytosis, typically for children over 5 with symptomatic anemia. Calcium doesn?t affect HS, transfusions suppress RBC production and carry risks, and iron supplementation is ineffective for this condition.
A child with sickle cell anemia (SCA) develops severe chest and back pain, fever, a cough, and dyspnea. What should be the first action by the nurse?
- A. Administer 100% oxygen to relieve hypoxia.
- B. Notify the practitioner because chest syndrome is suspected.
- C. Infuse intravenous antibiotics as soon as cultures are obtained.
- D. Give ordered pain medication to relieve symptoms of pain episode.
Correct Answer: B
Rationale: Symptoms suggest acute chest syndrome, a medical emergency in SCA, requiring immediate practitioner notification. Oxygen may be needed but doesn?t reverse sickling, antibiotics follow evaluation, and pain management is secondary to addressing the emergency.
A mother states that she brought her child to the clinic because the 3-year-old girl was not keeping up with her siblings. During physical assessment, the nurse notes that the child has pale skin and conjunctiva and has muscle weakness. The hemoglobin on admission is 6.4 g/dl. After notifying the practitioner of the results, what nursing priority intervention should occur next?
- A. Reduce environmental stimulation to prevent seizures.
- B. Have the laboratory repeat the analysis with a new specimen.
- C. Minimize energy expenditure to decrease cardiac workload.
- D. Administer intravenous fluids to correct the dehydration.
Correct Answer: C
Rationale: A hemoglobin of 6.4 g/dl (normal 11.5-15.5 g/dl) indicates severe anemia, increasing cardiac workload to compensate for reduced oxygen delivery. Minimizing energy expenditure reduces cardiac strain. Seizures aren?t a risk, repeat testing is unnecessary, and dehydration isn?t evident.