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
What condition occurs when the normal adult hemoglobin is partly or completely replaced by abnormal hemoglobin?
Correct Answer: B
Rationale: Sickle cell anemia involves replacement of normal hemoglobin with abnormal sickled hemoglobin, a hemoglobinopathy. Aplastic anemia is bone marrow failure, thalassemia major involves reduced hemoglobin chain production, and iron deficiency affects RBC size, not hemoglobin type.
Question 2 of 5
The parents of a child with sickle cell anemia (SCA) are concerned about subsequent children having the disease. What statement most accurately reflects inheritance of SCA?
Correct Answer: C
Rationale: SCA is an autosomal recessive disorder, so each sibling has a 25% chance of inheriting SCA, 25% chance of being unaffected, and 50% chance of having the trait. SCA is inherited, not all siblings will have it, and 50% applies to the trait, not the disease.
Question 3 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 4 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 5 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.