ATI LPN
Wong's Essentials of Pediatric Nursing 11th Edition Test Bank
Chapter 24 Questions
Question 1 of 5
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?
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.
Question 2 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.
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
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
What explanation provides the rationale for why iron-deficiency anemia is common during infancy?
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.