Chapter 32 Caring for the Child With a Hematological Condition

Chapter 32  Caring for the Child With a Hematological Condition

Complete Chapter Questions And Answers
 

Sample Questions

MULTIPLE CHOICE

1. A nursing student asks the instructor why he was marked off on his care plan when explaining a low hemoglobin level as being caused by “anemia.” What response by the instructor is best?
A.
Anemia is a symptom, not a disease.
B.
Anemia only refers to a low red blood cell count.
C.
Hemoglobin and anemia are unrelated.
D.
The hemoglobin must not be too low.

ANS: A
Anemia is a symptom that can be caused by many disease states. It is not a disease that explains low hemoglobin. The other answers are incorrect.

Cognitive Level: Comprehension/Understanding
Content Area: Pediatrics/Maternity
Patient Needs: Physiological Integrity: Physiological Adaptation
Integrated Process: Teaching/Learning
Difficulty: Easy

PTS: 1

2. A child has mild anemia and the parent asks why this makes the child have difficulty concentrating. What response by the nurse is best?
A.
“All sick children have trouble concentrating.”
B.
“Her anemia makes her too tired to think.”
C.
“She may have another problem with her brain.”
D.
“The brain isn’t getting enough oxygen.”

ANS: D
Anemia leads to decreased oxygenation of body tissues, including the brain. A lowered cerebral oxygen concentration can lead to dizziness and difficulty concentrating. Stating that all sick children have this problem is inaccurate and vague. The child may be tired, but this answer is also vague and does not really address the question. Describing the possibility of another medical problem is not warranted at this time.

Cognitive Level: Application/Applying
Content Area: Pediatrics/Maternity
Patient Needs: Physiological Integrity: Physiological Adaptation
Integrated Process: Teaching/Learning
Difficulty: Moderate

PTS: 1

3. A 2-year-old child’s hemoglobin is 8.2 g/dL. What action by the nurse is best?
A.
Ask the parents about activity level.
B.
Document findings in the chart.
C.
Notify the provider immediately.
D.
Schedule a re-draw of blood in 6 months.

ANS: A
The normal hemoglobin for a child this age is 10.55–12.7 g/dL, so this child is somewhat anemic. The nurse should assess for other manifestations of anemia, including normal activity level. The findings should be documented, but this is not the only action that the nurse should take. The provider needs to be notified, but it does not have to be done immediately, as this is not an emergency. After a full evaluation, the provider may or may not want to repeat the laboratory work in 6 months.

Cognitive Level: Application/Applying
Content Area: Pediatrics/Maternity
Patient Needs: Physiological Integrity: Reduction of Risk Potential
Integrated Process: Nursing Process: Assessment
Difficulty: Moderate

PTS: 1

4. A nurse working in pediatrics learns that the normal hemoglobin value for an infant is high at birth, then decreases by 2 months of age before increasing again as the child grows. The nurse knows the reason for this shift is which of the following?
A.
Hemodilution from starting oral nutrition
B.
Lower available oxygen while in utero
C.
Rapid hemoglobin destruction at birth
D.
Slower hemoglobin production after birth

ANS: B
The fetus needs a higher hemoglobin level to compensate for the relatively low-oxygen environment of the uterus. The other answers are incorrect.

Cognitive Level: Analysis/Analyzing
Content Area: Pediatrics/Maternity
Patient Needs: Physiological Integrity: Physiological Adaptation
Integrated Process: Teaching/Learning
Difficulty: Difficult

PTS: 1

5. A nurse is assessing an infant for the most common type of anemia worldwide. What action by the nurse is most helpful?
A.
Assess if formula is iron-fortified.
B.
Determine family history of anemia.
C.
Look at mucous membranes for pallor.
D.
Perform range of motion on the hips.

ANS: A
The most common type of anemia worldwide is iron-deficiency anemia, which can be caused by ingesting non-iron-fortified formula if the child is not breastfed. This type of anemia is not genetic. Pallor, either of the skin or mucous membranes, would be seen in any type of anemia. Range of motion of the hips or shoulders is an important assessment in sickle cell disease, in which avascular necrosis can occur.

Cognitive Level: Application/Applying
Content Area: Pediatrics/Maternity
Patient Needs: Physiological Integrity: Physiological Adaptation
Integrated Process: Nursing Process: Assessment
Difficulty: Moderate

PTS: 1