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Chapter 47 The Child with a Hematologic Alteration
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Chapter 47 The Child with a Hematologic Alteration
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Chapter 47: The Child with a Hematologic AlterationTest Bank
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
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 later infancy. Iron-fortified
formula is still recommended.
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.
PTS: 1 DIF: Cognitive Level: Application REF: p. 1243
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
Feedback
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.
B A child with a hemoglobin level of 6.5 mg/dL has anemia. Infants with iron
deficiency anemia are not typically thin and energetic but do tend to sleep a lot.
C A child with a hemoglobin level of 6.5 mg/dL has anemia. Gastrointestinal
symptoms are not clinical manifestations associated with iron deficiency anemia.
D A child with a hemoglobin level of 6.5 mg/dL has anemia. 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.
PTS: 1 DIF: Cognitive Level: Application REF: p. 1242
, OBJ: Nursing Process: Assessment MSC: Client Needs: Physiologic Integrity
3. What action is not appropriate for a 14-month-old child with iron deficiency anemia?
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
Feedback
A A daily milk intake in toddlers of less than 24 oz 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.
PTS: 1 DIF: Cognitive Level: Application REF: p. 1243
OBJ: Nursing Process: Planning MSC: Client Needs: Physiologic Integrity
4. An accurate description of anemia is
a. Increased blood viscosity
b. Depressed hematopoietic system
c. Presence of abnormal hemoglobin
d. Decreased oxygen-carrying capacity of blood
ANS: D
Feedback
A Increased blood viscosity is usually a function of too many cells or of
dehydration, not of anemia.
B 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.
C 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.
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.
PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 1243
OBJ: Nursing Process: Assessment MSC: Client Needs: Physiologic Integrity
5. What is true about the genetic transmission of sickle cell disease?
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