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Nclex questions...good...Hematology Nursing III sickle cell anemia, anemia, thrombocytopenia, IVS

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A child is suspected of having sickle cell disease is seen in a clinic, and laboratory studies are performed. A nurse checks the laboratory results, knowing that which of the following would be increased in this disease?
1. platelet count
2. hematocrit level
3. reticulocyte count
4. Hemoglobin level
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A child is suspected of having sickle cell disease is seen in a clinic, and laboratory studies are performed. A nurse checks the laboratory results, knowing that which of the following would be increased in this disease?
1. platelet count
2. hematocrit level
3. reticulocyte count
4. Hemoglobin level
answer: 3
Rationale: A diagnosis is established based on a complete blood count, examination for sickled red blood cells in the peripheral smear, and hemoglobin electrophoresis. Laboratory studies will show decreased hemoglobin and hematocrit levels and a decreased platelet count, an INCREASED reticulocyte count and the presence of nucleated red blood cells. Increased reticulocyte counts occur in children with sickle cell disease because the life span of their sickled red blood cells is shortened.
A pediatric nursing instructor asks a nursing student to describe the cause of the clinical manifestations that occur in sickle cell disease. The student responds correctly by telling the instructor that
1. Sickled cells increase the blood flow through the body and cause a great deal of pain.
2. sickled cells mix with the unsickled cells and cause the immune system to become depressed.
3. bone marrow depression occurs because of the development of sickled cells.
4. sickled cells are unable to flow easily through the microvasculature and their clumping obstructs blood flow.
Answer: 4
Rationale: all of the clinical manifestations of sickle cell disease result from the sickled cells being unable to flow easily through the microvasculature, and their clumping obstructs blood flow. With re-oxygenation, most of the sickled red blood cells resume their normal shape. Options 1, 2, and 3 are incorrect statements.
A clinic nurse instructs the mother of a child with sickle cell disease about the precipitating factors related to pain crisis. Which of the following, if identified by the mother as e precipitating factor, indicates the need for further instructions?
1. infection
2. trauma
3. fluid overload
4. stress
answer: 3
Pain crisis may be precipitated by infection, dehydration, hypoxia, trauma, or physical or emotional stress. THe mother of a child with sickle cell disease should encourage fluid intake of 1.5-2 times the daily requirement to prevent dehydration!
Laboratory studies are performed for a child suspected of having iron deficiency anemia. THe nurse reviews the laboratory results, knowing that which of the following results would indicate this type of anemia?
1. An elevated hemoglobin level
2. a decreased reticulocyte count
3. an elevated rbc count
4. rbc that are microcytic and hypochromic
Answer: 4
The results of a cbc in children with iron deficiency anemia will show a decreased hemoglobin level and and microcytic and hypochromic rbc the rbc count is decreased, the reticulocyte count is usually normal or elevated.
A home care nurse is instructing the parents of a child with iron deciciency anemia regarding the administration of a liquid oral iron supplement. The nurse tells the mother to
1. administer the iron through a straw
2. administer iron at meal times
3. add the iron to the formula for easy administration
4. mix the iron with cereal to administer
answer: 1
Iron should be administered through the straw or with a medicine dropper placed at the back of the mouth because the iron will stain the teeth. the parent should be instructed to brush or wipe the teeth after administration. Iron is administered between meals because absorption is decreased if there is food in the stomach. Iron requires an acid environment to facilitate its absorption in duodenum. Iron is not added to formula or mixed with cereal or other food items.