Chapter 23: The Child with a Hematologic Alteration

Chapter 23: The Child with a Hematologic Alteration

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

1. Which of the following statements about red blood cells is the most accurate?

a.	Red blood cells are produced in fetal life primarily by long bones.
b.	Erythropoietin stimulates red blood cell production and maturation.
c.	The oxygen-carrying capacity of blood is affected by the child’s activity.
d.	Fetal blood is replaced by adult blood within 24 hours after birth.

 

 

ANS:   B

 

	Feedback
A	Various tissues produce red blood cells in fetal life. After birth, erythrocytes are produced initially in the marrow of all bones.
B	Decreased circulating oxygen stimulates the kidneys to produce erythropoietin, which in turn stimulates production of red blood cells.
C	The oxygen-carrying capacity of the blood is not affected by activity.
D	Fetal blood is replaced by adult blood by 6 months of age.

 

 

DIF:    Cognitive Level: Knowledge             REF:    Text Reference: pg 720

OBJ:    Nursing Process Step: Assessment

MSC:   NCLEX: Health Promotion and Maintenance

 

2. 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

 

	Feedback
A	A 5-month-old infant cannot get adequate iron without drinking an iron-fortified formula or taking an iron supplement.
B	The American Academy of Pediatrics recommends beginning solid foods at 4 to 6 months of age. Meats are typically introduced in late infancy.
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.
D	Counseling a parent to give a 5-month-old infant cow’s milk is inappropriate.

 

 

DIF:    Cognitive Level: Application             REF:    Text Reference: pg 723

OBJ:    Nursing Process Step: Implementation

MSC:   NCLEX: Health Promotion and Maintenance

 

3. An assessment of a 7-month-old infant with a hemoglobin level of 6.5 mg/dl is likely to reveal which of the following?

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

 

 

ANS:   A

 

	Feedback
A	Pallor, lethargy, irritability, and tachycardia are clinical manifestations of iron-deficiency anemia.
B	Infants with iron deficiency anemia are not typically thin and energetic but do tend to sleep a lot.
C	Gastrointestinal symptoms are not clinical manifestations associated with iron-deficiency anemia.
D	Although the infant with iron-deficiency anemia may be tired and fussy, pallor, rather than a flushed appearance, is characteristic of a low hemoglobin level.

 

 

DIF:    Cognitive Level: Application             REF:    Text Reference: pg 722

OBJ:    Nursing Process Step: Assessment    MSC:   NCLEX: Physiological Integrity

 

4. Which of the following suggestions is not appropriate for a 14-month-old child with iron-deficiency anemia?

a.	Decrease the infant’s daily milk intake to 24 ounces or less.
b.	Give oral iron supplements between meals with orange juice.
c.	Include apricots, dark-green leafy vegetables, and egg yolk in the infant’s diet.
d.	Allow the infant to drink the iron supplement from a small medicine cup.

 

 

ANS:   D

 

	Feedback
A	A daily milk intake in toddlers of less than 24 ounces will encourage the consumption of iron-rich solid foods.
B	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.
C	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.
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.

 

 

DIF:    Cognitive Level: Application             REF:    Text Reference: pg 723

OBJ:    Nursing Process Step: Planning         MSC:   NCLEX: Physiological Integrity