Chapter 47 The Child with a Hematologic Alteration

Chapter 47  The Child with a Hematologic Alteration

Complete Chapter Questions And Answers
 

Sample Questions

MULTIPLE CHOICE

1. What is the best response to a parent who asks the nurse whether her 5-month-old infant can

have cow’s milk?
a. “You need to wait until she is 8 months old and eating solids well.”
b. “Yes, if you think that she will eat enough meat to get the iron she needs.”
c. “Infants younger than 12 months need iron-rich formula to get the iron they need.”
d. “Try it and see how she tolerates it.”

ANS: C
Infants younger than 12 months need iron-fortified formula or breast milk. Infants who drink
cow’s milk do not get adequate iron and are at risk for iron-deficiency anemia. A 5-month-old
infant cannot get adequate iron without drinking an iron-fortified formula or taking an iron
supplement. Counseling a parent to give a 5-month-old infant cow’s milk is inappropriate.

PTS: 1 DIF: Cognitive Level: Application/Applying
REF: pp. 1120-1121 | p. 1122 OBJ: Nursing Process: Implementation
MSC: Client Needs: Health Promotion and Maintenance

2. An assessment of a 7-month-old infant with a hemoglobin level of 6.5 mg/dL is likely to

reveal an infant who is
a. lethargic, pale, and irritable.
b. thin, energetic, and sleeps little.
c. anorexic, vomiting, and has watery stools.
d. flushed, fussy, and tired.

ANS: A
Pallor, lethargy, irritability, and tachycardia are clinical manifestations of iron-deficiency
anemia. A child with a hemoglobin level of 6.5 mg/dL has anemia. Typically these children
will not be thin, energetic, anorexic, have GI complaints, or flushed. They may be tired, fussy,
and sleep a lot.

PTS: 1 DIF: Cognitive Level: Knowledge/Remembering
REF: p. 1121 | Parents Want to Know Box
OBJ: Nursing Process: Assessment MSC: Client Needs: Physiologic Integrity

3. A nurse is evaluating parents’ knowledge about caring for their child who has iron-deficiency

anemia. Which action shows the parents need further education?
a. Decreasing the infant’s daily milk intake to 24 oz or less
b. Giving oral iron supplements between meals with orange juice
c. Including apricots, dark-green leafy vegetables, and egg yolk in the infant’s diet
d. Allowing the infant to drink the iron supplement from a small medicine cup

ANS: D

Iron supplements should be administered through a straw or by a medicine dropper placed at
the back of the mouth because iron temporarily stains the teeth. A daily milk intake in toddlers
of less than 24 oz will encourage the consumption of iron-rich solid foods. Because food
interferes with the absorption of iron, iron supplements are taken between meals.
Administering this medication with foods rich in vitamin C facilitates absorption of iron.
Apricots, dark-green leafy vegetables, and egg yolks are rich sources of iron. Other iron-rich
foods include liver, dried beans, Cream of Wheat, iron-fortified cereal, and prunes.

PTS: 1 DIF: Cognitive Level: Evaluation/Evaluating
REF: p. 1118 | p. 1121 OBJ: Nursing Process: Evaluation
MSC: Client Needs: Physiologic Integrity

4. Which of the following is an accurate description of anemia?

a. Increased blood viscosity
b. Depressed hematopoietic system
c. Presence of abnormal hemoglobin
d. Decreased oxygen-carrying capacity of blood

ANS: D
Anemia is a condition in which the number of red blood cells or hemoglobin concentration is
reduced below the normal values for age. This results in a decreased oxygen-carrying capacity
of blood. Increased blood viscosity is usually a function of too many cells or of dehydration,
not of anemia. A depressed hematopoietic system or abnormal hemoglobin can contribute to
anemia, but the definition is dependent on the deceased oxygen-carrying capacity of the
blood. A depressed hematopoietic system or abnormal hemoglobin can contribute to anemia,
but the definition is dependent on the decreased oxygen-carrying capacity of the blood.

PTS: 1 DIF: Cognitive Level: Knowledge/Remembering
REF: p. 1118 | p. 1121 OBJ: Nursing Process: Assessment
MSC: Client Needs: Physiologic Integrity

5. What is true about the genetic transmission of sickle cell disease?

a. Both parents must carry the sickle cell trait.
b. Both parents must have sickle cell disease.
c. One parent must have the sickle cell trait.
d. Sickle cell disease has no known pattern of inheritance.

ANS: A
In this scenario, there is a 50% risk of having a child with sickle cell disease. The sickle cell
trait, not the disease itself, must be present in the parents for the child to have the disease. An
autosomal recessive pattern of inheritance means that both parents must be carriers of the
sickle cell trait. Sickle cell disease is known to have an autosomal recessive pattern of
inheritance.

PTS: 1 DIF: Cognitive Level: Knowledge/Remembering
REF: p. 1121 OBJ: Nursing Process: Assessment
MSC: Client Needs: Physiologic Integrity