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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.
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How has synthetic recombinant antihemophilic factor improved the management of hemophilia? (Select all that apply.)
- A. Eliminates the need for frequent transfusions.
- B. Can be administered by family at home.
- C. Prevents hemorrhage.
- D. Reduces cost of care of the hemophiliac.
- E. Reduces risk of HIV and hepatitis A and B transmission.
Correct Answer: A,B,D,E
Rationale: Synthetic recombinant antihemophilic factor reduces transfusion needs, allows home administration, lowers costs, and minimizes infection risks.
What important focus of nursing care for the dying child and the family should the nurse implement?
- A. Nursing care should be organized to minimize contact with the child.
- B. Adequate oral intake is crucial to the dying child.
- C. Families should be made aware that hearing is the last sense to stop functioning before death.
- D. It is best for the family if the nursing staff provides all of the child's care.
Correct Answer: C
Rationale: Hearing is intact even when there is a loss of consciousness.
An adolescent is diagnosed with Hodgkin's disease. Lymph nodes on both sides of her diaphragm have been found to be involved, including cervical and inguinal nodes. Which disease stage is this?
- A. I
- B. II
- C. III
- D. IV
Correct Answer: C
Rationale: Lymph node regions on both sides of the diaphragm are consistent with a diagnosis of stage-III Hodgkin's disease.
The child receiving a transfusion complains of back pain and itching. What is the best initial action by the nurse?
- A. Notify the charge nurse.
- B. Disconnect intravenous lines immediately.
- C. Give diphenhydramine (Benadryl).
- D. Clamp off blood and keep line open with normal saline.
Correct Answer: D
Rationale: If a blood transfusion reaction occurs, the first action is to stop the blood infusion, keep the line open with normal saline, and notify the charge nurse.
On admission, a child with leukemia has widespread purpura and a platelet count of 19,000/mm?³. What is the priority nursing intervention?
- A. Assessing neurological status
- B. Inserting an intravenous line
- C. Monitoring vital signs during platelet transfusions
- D. Providing family education about how to prevent bleeding
Correct Answer: A
Rationale: When platelets are low, the greatest danger is spontaneous intracranial bleeding. Neurological assessments are therefore a priority of care.