Exam (elaborations)
Chapter 22 Alterations of Hematologic Function in Children
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- Galen College Of Nursing
Chapter 22 Alterations of Hematologic Function in Children
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Chapter 22: Alterations of Hematologic Function in ChildrenMULTIPLE CHOICE
1. A 2-year-old male presented with growth and maturation retardation and splenomegaly.
He died shortly after arriving at the ER. Autopsy revealed thalassemia secondary to
defective: a. erythrocyte membranes.
b. iron metabolism.
c. stem cell formation.
d. hemoglobin synthesis.
ANS: D
Thalassemia would be secondary to defective hemoglobin synthesis; it is not due to
erythrocyte membrane abnormalities, defective iron metabolism, or defective stem cell
formation.
REF: p. 561
2. A 1-year-old female is diagnosed with anemia secondary to insufficient erythropoiesis. The
most likely cause is:
a. genetic factors.
b. an iron deficiency.
c. a hemoglobin abnormality.
d. an erythrocyte structural abnormality.
ANS:
B
The most common cause of insufficient erythropoiesis is iron deficiency, not genetic
factors, not a hemoglobin abnormality, not an erythrocyte structural abnormality.
REF: p. 554
3. A 12-month-old toddler weighing 18 pounds is brought to the clinic because of weakness,
slow physical growth, and developmental delays. His mother reports that the only food he
will consume is cow’s milk. The symptoms support a diagnosis of which form of anemia?
a. Pernicious
b. Iron deficiency
c. Aplastic
d. Hemolytic
ANS: B
As many as one-third of infants with severe iron deficiency anemia have chronic intestinal
blood loss induced by exposure to a heat-labile protein in cow’s milk. Such exposure causes
an inflammatory gastrointestinal reaction that damages the mucosa and results in diffuse
hemorrhage. This situation does not lead to pernicious anemia, aplastic anemia, or to
hemolytic anemia.
REF: pp. 554-555
, 4. A 16-month-old female presents with tachycardia, pallor, anorexia, and systolic murmur.
The nurse is checking the lab results, and the hemoglobin determination indicates a level
below
grams per deciliter.
a. 5
b. 7
c. 10
d. 14
ANS: A
When hemoglobin levels fall below 5 grams per deciliter, pallor, anorexia, tachycardia,
and systolic murmurs may occur.
REF: pp. 555-556
5. Which mother-fetus combination is at most risk for a maternal-fetal blood incompatibility?
a. Mother is Rh-positive, and fetus is Rh-negative.
b. Mother is Rh-negative, and fetus is Rh-positive.
c. Mother has type A blood, and fetus has type O blood.
d. Mother has type AB blood, and fetus has type B blood.
ANS: B
Maternal-fetal incompatibility exists if mother and fetus differ in AB and O blood type or if
the fetus is Rh-positive and the mother is Rh-negative. Symptoms do not occur in a type O
fetus. Symptoms do not occur in type AB mothers.
REF: p. 556
6. Which of the following aminNU Rids Iis pGreseBnt.iCn HMb S and not present in
o acS
normal Hb? N T
a. Valine
b. Glutamic acid
c. Proline
d. Histidine
ANS: A
Hb S is formed by a genetic mutation in which one amino acid (valine) replaces glutamic
acid. Valine has replaced glutamic acid. Hb S is formed by a genetic mutation in the amino
acid (valine), not proline, or histidine.
REF: p. 557
7. In the United States, which group of people should be assessed first for sickle cell disease?
a. Asians
b. Blacks
c. Hispanics
d. Whites
ANS: B
In the United States, sickle cell disease is most common in Blacks.
REF: p. 558
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