11. The nurse is conducting a staff in-service on sickle cell anemia. Which describes the pathologic changes of sickle cell anemia?

a. Sickle-shaped cells carry excess oxygen.

b. Sickle-shaped cells decrease blood viscosity.

c. Increased red blood cell destruction occurs.

d. Decreased adhesion of sickle-shaped cells occurs.

12. Which clinical manifestation should the nurse expect when a child with sickle cell anemia experiences an acute vasoocclusive crisis?

a. Circulatory collapse

b. Cardiomegaly, systolic murmurs

c. Hepatomegaly, intrahepatic cholestasis

d. Painful swelling of hands and feet; painful joints

13. Meperidine (Demerol) is not recommended for children in sickle cell crisis because it:

a. may induce seizures.

b. is easily addictive.

c. is not adequate for pain relief.

d. is given by intramuscular injection.

14. A school-age child is admitted in vasoocclusive sickle cell crisis. The child’s care should include:

a. correction of acidosis.

b. adequate hydration and pain management.

c. pain management and administration of heparin.

d. adequate oxygenation and replacement of factor VIII.

15. The parents of a child hospitalized with sickle cell anemia tell the nurse that they are concerned about narcotic analgesics causing addiction. Which is appropriate for the nurse to explain about narcotic analgesics?

a. Are often ordered but not usually needed

b. Rarely cause addiction because they are medically indicated

c. Are given as a last resort because of the threat of addiction

d. Are used only if other measures, such as ice packs, are ineffective

16. Which statement best describes b-thalassemia major (Cooley anemia)?

a. All formed elements of the blood are depressed.

b. Inadequate numbers of red blood cells are present.

c. Increased incidence occurs in families of Mediterranean extraction.

d. Increased incidence occurs in persons of West African descent.

17. Chelation therapy is begun on a child with b-thalassemia major. The purpose of this therapy is to:

a. treat the disease.

b. eliminate excess iron.

c. decrease risk of hypoxia.

d. manage nausea and vomiting.

18. In which of the conditions are all the formed elements of the blood simultaneously depressed?

a. Aplastic anemia

b. Sickle cell anemia

c. Thalassemia major

d. Iron deficiency anemia

19. A possible cause of acquired aplastic anemia in children is:

a. drugs.

b. injury.

c. deficient diet.

d. congenital defect.

20. Parents of a hemophiliac child ask the nurse, “Can you describe hemophilia to us?” Which response by the nurse is descriptive of most cases of hemophilia?

a. Autosomal dominant disorder causing deficiency in a factor involved in the blood-clotting reaction

b. X-linked recessive inherited disorder causing deficiency of platelets and prolonged bleeding

c. X-linked recessive inherited disorder in which a blood-clotting factor is deficient

d. Y-linked recessive inherited disorder in which the red blood cells become moon-shaped