Chapter 24: The Child with Hematologic or Immunologic Dysfunction

Chapter 24: The Child with Hematologic or Immunologic Dysfunction

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. Which child should the nurse document as being anemic?

a.	7-year-old child with a hemoglobin of 11.5 g/dl
b.	3-year-old child with a hemoglobin of 12 g/dl
c.	14-year-old child with a hemoglobin of 10 g/dl
d.	1-year-old child with a hemoglobin of 13 g/dl

 

 

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. Anemia is defined as a hemoglobin level below 10 or 11 g/dl. The child with a hemoglobin of 10 g/dl would be considered anemic. The normal hemoglobin for a child after 2 years of age is 11.5 to 15.5 g/dl.

 

DIF:    Cognitive Level: Understand            REF:   p. 789

TOP:   Integrated Process: Nursing Process: Assessment

MSC:  Area of Client Needs: Physiologic Integrity: Physiologic Adaptation

 

2. Several blood tests are ordered for a preschool child with severe anemia. The child is crying and upset because of memories of the venipuncture done at the clinic 2 days ago. What should the nurse explain?

a.	The venipuncture discomfort is very brief
b.	Only one venipuncture will be needed
c.	A topical application of local anesthetic can eliminate venipuncture pain
d.	Most blood tests on children require only a finger puncture because a small amount of blood is needed

 

 

ANS:  C

Preschool children are concerned with both pain and the loss of blood. When preparing the child for venipuncture, the nurse will use a topical anesthetic to eliminate any pain. This is a traumatic experience for preschool children. They are concerned about their bodily integrity. A local anesthetic should be used, and a bandage should be applied to maintain bodily integrity. The nurse should not promise one attempt in case multiple attempts are required. Both finger punctures and venipunctures are traumatic for children. Both require preparation.

 

DIF:    Cognitive Level: Apply                   REF:   p. 789

TOP:   Integrated Process: Teaching/Learning

MSC:  Area of Client Needs: Health Promotion and Maintenance

 

3. The nurse is planning activity for a 4-year-old child with anemia. Which activity should the nurse plan for this child?

a.	Game of “hide and seek” in the children’s outdoor play area
b.	Participation in dance activities in the playroom
c.	Puppet play in the child’s room
d.	A walk down to the hospital lobby

 

 

ANS:  C

Because the basic pathologic process in anemia is a decrease in oxygen-carrying capacity, an important nursing responsibility is to assess the child’s energy level and minimize excess demands. The child’s level of tolerance for activities of daily living and play is assessed, and adjustments are made to allow as much self-care as possible without undue exertion. Puppet play in the child’s room would not be overly tiring. Hide and seek, dancing, and walking to the lobby would not conserve the anemic child’s energy.

 

DIF:    Cognitive Level: Apply                   REF:   p. 789

TOP:   Integrated Process: Nursing Process: Implementation

MSC:  Area of Client Needs: Physiologic Integrity: Physiologic Adaptation

 

4. The nurse is teaching parents about the importance of iron in a toddler’s diet. Which explains why iron-deficiency anemia is common during toddlerhood?

a.	Milk is a poor source of iron.
b.	Iron cannot be stored during fetal development.
c.	Fetal iron stores are depleted by age 1 month.
d.	Dietary iron cannot be started until age 12 months.

 

 

ANS:  A

Children between the ages of 12 and 36 months are at risk for anemia because cow’s milk is a major component of their diet and it is a poor source of iron. Iron is stored during fetal development, but the amount stored depends on maternal iron stores. Fetal iron stores are usually depleted by age 5 to 6 months. Dietary iron can be introduced by breastfeeding, iron-fortified formula, and cereals during the first 12 months of life.

 

DIF:    Cognitive Level: Understand            REF:   p. 789

TOP:   Integrated Process: Teaching/Learning

MSC:  Area of Client Needs: Physiologic Integrity: Physiologic Adaptation