Nokea
What statement best describes iron deficiency anemia in infants?
- A. It is caused by depression of the hematopoietic system.
- B. Diagnosis is easily made because of the infants emaciated appearance.
- C. It results from a decreased intake of milk and the premature addition of solid foods.
- D. Clinical manifestations are related to a reduction in the amount of oxygen available to tissues.
Correct Answer: D
Rationale: Iron deficiency anemia reduces oxygen availability to tissues, causing symptoms like pallor and fatigue. The hematopoietic system produces smaller, less hemoglobin-rich RBCs, infants are often overweight from milk, and diagnosis requires lab confirmation, not appearance.
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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.
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.
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.
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.