ATI LPN
Wong's Essentials of Pediatric Nursing 11th Edition Test Bank
Chapter 24 : The Child with Hematologic or Immunologic Dysfunction Questions
Question 1 of 5
The clinical manifestations of sickle cell anemia (SCA) are primarily the result of which physiologic alteration?
Correct Answer: C
Rationale: SCA causes increased RBC destruction due to sickled cells, leading to vasoocclusion and hemolysis. Sickled cells increase viscosity, not decrease it; coagulation is unaffected; and sickled hemoglobin has reduced oxygen affinity, transforming under low oxygen tension.
Question 2 of 5
A school-age child is admitted in vasoocclusive sickle cell crisis (pain episode). The childs care should include which therapeutic interventions?
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.
Question 3 of 5
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?
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.
Question 4 of 5
In a child with sickle cell anemia (SCA), adequate hydration is essential to minimize sickling and delay the vasoocclusion and hypoxia-ischemia cycle. What information should the nurse share with parents in a teaching plan?
Correct Answer: C
Rationale: Checking for moist mucous membranes assesses hydration in SCA, where impaired kidney function prevents urine concentration. General encouragement to drink is vague, output records don?t reflect fluid needs, and urine concentration is unreliable due to kidney dysfunction.
Question 5 of 5
What statement best describes b-thalassemia major (Cooley anemia)?
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.