Which statement made by a parent indicates an understanding of health maintenance of a child with sickle cell disease?
- A. I should give my child a daily iron supplement.'
- B. It is important for my child to drink plenty of fluids.'
- C. He needs to wear protective equipment if he plays contact sports.'
- D. He shouldn't receive any immunizations until he is older.'
Correct Answer: B
Rationale: Prevention of dehydration, which can trigger the sickling process, is a priority goal in the care of a child with sickle cell disease.
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A newly married couple is seeking genetic counseling because they are both carriers of the sickle cell trait. How can the nurse best explain the children's risk of inheriting this disease?
- A. Every fourth child will have the disease; two others will be carriers.
- B. All of their children will be carriers, just as they are.
- C. Each child has a one in four chance of having the disease and a two in four chance of being a carrier.
- D. The risk levels of their children cannot be determined by this information.
Correct Answer: C
Rationale: The sickle cell gene is inherited from both parents; therefore, each offspring has a one in four chance of inheriting the disease.
Why would the nurse urge the family of a dying 12-year-old boy to include his 8-year-old sister in care? (Select all that apply.)
- A. She will feel less neglected by the parents.
- B. She can make amends for past hostilities to her brother.
- C. She will feel increased helplessness.
- D. She can express her feelings through care.
- E. She can experience being supportive of her parents and brother.
Correct Answer: A,B,D,E
Rationale: Including the sibling in care helps reduce feelings of neglect, allows expression of feelings, and fosters a sense of support and connection.
The nurse, caring for a child receiving chemotherapy, notes that the child's abdomen is firm and slightly distended. There is no record of a bowel movement for the last 2 days. What do these assessment findings suggest?
- A. Peripheral neuropathy
- B. Stomatitis
- C. Myelosuppression
- D. Hemorrhage
Correct Answer: A
Rationale: Peripheral neuropathy may be signaled by severe constipation resulting from decreased nerve sensations in the bowel.
A child with thalassemia major receives blood transfusions frequently. What is a complication of repeated blood transfusions?
- A. Hemarthrosis
- B. Hematuria
- C. Hemoptysis
- D. Hemosiderosis
Correct Answer: D
Rationale: As a result of repeated blood transfusions, excessive deposits of iron (hemosiderosis) are stored in tissues.
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.
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