Which of the following is not a cause of iron deficiency anaemia?

Correct Answer: B

Rationale: The correct answer is B: Infection. Iron deficiency anemia is primarily caused by inadequate iron intake, chronic blood loss (e.g., gastrointestinal bleeding), and malabsorption issues. Infections do not directly lead to iron deficiency anemia. Infections can lead to anemia of chronic disease due to inflammation affecting iron utilization, but they do not cause iron deficiency anemia. Therefore, choice B is the correct answer. Choices A, C, and D are incorrect as chronic blood loss, malabsorption, and decreased intake are well-established causes of iron deficiency anemia, respectively.

Correct Answer: A

Rationale: The correct answer is A because educating parents and the child on how to minimize sickle cell crises is crucial in managing the disease effectively. By teaching them about triggers, symptoms, and preventive measures, they can proactively address potential crises and improve the child's quality of life. Referring for genetic counseling (B) is important but not the most immediate consideration. Observing for transfusion complications (C) is necessary but not the primary focus of teaching. Helping the family adjust (D) is important but not as urgent as minimizing crises.

Correct Answer: C

Rationale: The correct answer is C: Fever and petechiae. Fever and petechiae are indicative of a potential infection or bleeding, which can be life-threatening for a leukemia patient due to compromised immune system and low platelet count. Immediate nursing intervention would involve assessing the severity of the fever, monitoring for signs of sepsis, and addressing any bleeding issues. A: An enlarged liver and spleen may be common in leukemia but do not require immediate intervention unless associated with other symptoms. B: Fatigue is common in leukemia but not as urgent as signs of infection or bleeding. D: Swollen glands and lethargy are also common in leukemia but do not require immediate intervention unless accompanied by other concerning symptoms.

Correct Answer: D

Rationale: The correct answer is D: Muscle weakness. In infants with iron deficiency anemia, muscle weakness is a common sign of decreased activity tolerance. Iron deficiency leads to reduced oxygen delivery to muscles, causing weakness and fatigue during activity. A heart rate of 138 may be within normal range for a 9-month-old. Increased alertness suggests the infant is responsive and engaged, not necessarily an indicator of activity tolerance. A respiratory rate less than 40 with activity is also not necessarily abnormal and may indicate good respiratory function. Therefore, the presence of muscle weakness is the most specific and concerning sign of poor activity tolerance in this context.

Correct Answer: D

Rationale: The correct answer is D because in DIC, excessive clotting can lead to bleeding. Therefore, the absence of bleeding indicates successful care. Option A is not specific to DIC management. Option B indicates poor oxygenation, not related to DIC. Option C is insufficient urine output, not a direct indicator of DIC management.