Nokea
What explanation provides the rationale for why iron-deficiency anemia is common during infancy?
- A. Cows milk is a poor source of iron.
- B. Iron cannot be stored during fetal development.
- C. Fetal iron stores are depleted by 1 month of age.
- D. Dietary iron cannot be started until 12 months of age.
Correct Answer: A
Rationale: Cows milk, common in diets of 12-36-month-olds, is low in iron, increasing anemia risk. Fetal iron stores, dependent on maternal stores, last 5-6 months, and iron-fortified foods can be introduced before 12 months via breastfeeding or formula.
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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.
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.
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.
An 8-year-old girl is receiving a blood transfusion when the nurse notes that she has developed precordial pain, dyspnea, distended neck veins, slight cyanosis, and a dry cough. These manifestations are most suggestive of what complication?
- A. Air embolism
- B. Allergic reaction
- C. Hemolytic reaction
- D. Circulatory overload
Correct Answer: D
Rationale: Circulatory overload presents with precordial pain, dyspnea, distended neck veins, cyanosis, and dry cough due to fluid volume excess. Air embolism causes sudden respiratory distress, allergic reactions involve urticaria and wheezing, and hemolytic reactions include fever and shock.
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.