NUR 307 - Immune, Heme, and Genetics Practice Questions

c. Ground beef with black beans, diced tomatoes, and strawberries

A nurse is providing dietary education to the parent of a 3-year-old child recently diagnosed with iron deficiency anemia. The parent states, “I want to improve her iron level with the foods she eats. She drinks a lot of milk and is a picky eater.” Which meal selection by the parent indicates the best understanding of the nurse’s teaching?

a. Oatmeal prepared with milk, sliced banana, and yogurt

b. Scrambled egg, whole-wheat toast, and a glass of milk

c. Ground beef with black beans, diced tomatoes, and strawberries

d. Cheese quesadilla, avocado, and applesauce

a. “I can give the iron with a small amount of orange juice to help my child absorb it.”

c. “I will use the medication dropper and place the liquid toward the back or side of my child’s mouth.”

e. “I will brush or rinse my child’s teeth after giving the liquid iron.”

f. “I need to keep this locked away because taking too much iron can be very dangerous for a child.”

A nurse is teaching the parent of a 2-year-old child with iron deficiency anemia who has been prescribed oral ferrous sulfate. Which statements by the parent indicate a correct understanding of the teaching? Select all that apply

a. “I can give the iron with a small amount of orange juice to help my child absorb it.”

b. “If my child’s stools become dark or greenish, I should stop the medication and call the provider.”

c. “I will use the medication dropper and place the liquid toward the back or side of my child’s mouth.”

d. “I should give the iron with milk if it causes an upset stomach.”

e. “I will brush or rinse my child’s teeth after giving the liquid iron.”

f. “I need to keep this locked away because taking too much iron can be very dangerous for a child.”

b. Notify the provider immediately and prepare for rapid treatment of hypovolemia and severe anemia

A 2-year-old with sickle cell disease becomes suddenly pale and lethargic. The nurse notes tachycardia and a rapidly enlarging spleen. Which action is the priority?

a. Encourage oral fluids and reassess in 30 minutes

b. Notify the provider immediately and prepare for rapid treatment of hypovolemia and severe anemia

c. Administer the prescribed oral opioid for vaso-occlusive pain

d. Apply oxygen and encourage the child to ambulate

b. Acute chest syndrome

A 8-year-old with sickle cell disease is hospitalized for a vaso-occlusive pain episide. Twelve hrs later, the child develops a temperature of 38.6°C (101.5°F), cough, chest pain, and an oxygen saturation of 89% on room air. Which complication should the nurse suspect first?

a. Splenic sequestration

b. Acute chest syndrome

c. Aplastic crisis

d. Iron deficiency anemia

a. The parent reports the child has recently been struggling academically and has difficulty concentrating

A 10-year-old with sickle cell disease comes to the clinic for routine follow-up. Which finding is most important for the nurse to investigate further?

a. The parent reports the child has recently been struggling academically and has difficulty concentrating

b. The child’s sclera has a mild yellow discoloration

c. The child reports occasional fatigue after school

d. The child reports drinking more water during soccer practice

d. Administer the prescribed opioid analgesic promptly and begin hydration as ordered.

A 9-year-old with sickle cell disease presents to the emergency department with severe bilateral leg and lower back pain after spending the afternoon playing outside. The child rates the pain 9/10, is crying and guarding both legs, and has dry mucous membranes. Vital signs are T 37.4°C (99.3°F), HR 126/min, RR 24/min, BP 108/68 mmHg, and Sp02 97% room air. Which nursing action is the priority?

a. Apply cold packs to the child’s legs to decrease inflammation and pain.

b. Encourage ambulation to increase circulation through the affected extremities.

c. Apply oxygen at 2L/min by nasal cannula to decrease red blood cell sickling.

d. Administer the prescribed opioid analgesic promptly and begin hydration as ordered.

c. “Repeated blood transfusions can cause excess iron to accumulate and damage organs over time.”

A 7-year-old with beta thalassemia major receives scheduled packed red blood cell transfusions. The parent asks, “If my child is anemic, why are you giving medicine to remove iron?” Which response by the nurse is best?

a. “Iron chelation helps the bone marrow produce normal beta-globin chains.”

b. “Children with thalassemia cannot absorb enough iron from their diet.”

c. “Repeated blood transfusions can cause excess iron to accumulate and damage organs over time.”

d. “The medication prevents the transfused red blood cells from being destroyed.”

c. Implement bleeding and infection precautions and closely monitor for fever.

A 10-year-old with aplastic anemia has a platelet count of 18,000/mm³, an absolute neutrophil count (ANC) of 400/mm³, and hemoglobin of 7.6 g/dL. Which nursing action is the priority?

a. Encourage participation in group activities to prevent social isolation.

b. Obtain a rectal temperature every 4 hours to accurately monitor for fever.

c. Implement bleeding and infection precautions and closely monitor for fever.

d. Implement fall precautions and closely monitor oxygen levels.

b. Administer the prescribed factor VIII replacement

An 8-year-old with hemophilia A falls during recess and later reports severe pain and swelling of the right knee. The child refuses to bear weight on the leg. Which action should the nurse take first?

a. Encourage gentle range-of-motion exercises to prevent joint stiffness

b. Administer the prescribed factor VIII replacement

c. Apply firm pressure and massage the knee to decrease swelling

d. Administer aspirin and elevate the affected extremity

a. Petechiae and easy bruising

b. Avoidance of contact sports and activities with risk for injury

e. Avoidance of intramuscular injections when possible

f. Expectation that the child will develop severe neutropenia

A 5-year-old is evaluated after the parent notices multiple bruises and “tiny red spots” on the child’s legs. The child had a viral upper respiratory infection 2 weeks ago. Laboratory results show a platelet count of 18,000/mm³ with normal hemoglobin and white blood cell counts. Which findings or interventions are consistent with immune thrombocytopenia (ITP)? Select all that apply.

a. Petechiae and easy bruising

b. Avoidance of contact sports and activities with risk for injury

c. Administration of aspirin for discomfort

d. Monitoring for headache, vomiting, or changes in neurologic status

e. Avoidance of intramusclar injections when possible

f. Expectation that the child will develop severe neutropenia

a. “I’ll encourage a warm shower and gently activity in the morning.”

A 9-year-old with juvenile idiopathic arthritis (JIA) reports increased joint stiffness every morning. Which parent statement demonstrates the best understanding of home management?

a. “I’ll encourage a warm shower and gently activity in the morning.”

b. “I’ll have my child rest until the stiffness completely resolves.”

c. “We should avoid physical activity to prevent further joint damage.”

d. I’ll apply ice to the joints before my child gets out of bed.”

c. “When I feel better, I can stop my medications until another flare occurs.”

A 15-year-old with systemic lupus erythematosus (SLE) is preparing for discharge. Which statement by the adolescent requires further teaching?

a. “I should use sunscreen and protective clothing when I’m outside.”

b. “I should tell my provider if my urine becomes dark or foamy.”

c. “When I feel better, I can stop my medications until another flare occurs.”

d. “I should balance my activities with periods of rest when I’m fatigued.”