CAPSTONE NURSING CARE OF CHILDREN
ACTUAL TEST 2026 FULL SOLUTION VIEW AND
ANSWERS
▶ Folate Deficiency Anemia. Answer: People at risk: Pregnant/ lactating,
alcoholics, chronic malnourishment,
▶ Labs for Iron def. anemia. Answer: - Low- HGB/Hct/ mcv/plasma
iron/ferritin, transferrin
- High- Total iron binding capacity/free erythrocyte protoporphyrin
-Normal- reticulocyte count/B12, Folate, Bili
▶ sickle cell anemia. Answer: a genetic disorder that causes abnormal
hemoglobin, resulting in some red blood cells assuming an abnormal sickle
shape
-Chronic hemolysis, microvascular occlusions, and tissue damage, vaso
occlusive crisis
-abnormal or absent splenic function
▶ Cause of aplastic anemia. Answer: Failure of bone marrow to produce
mature cells causing pancytopenia (reduction of all 3 blood cell types)
- Idiopathic, acquired stem cell defects, immune mediated
- whole-body irradiation, viral infections, hepatitis, CMV, epstein-barr virus,
herpes zoster, inherited
-Chemica: alkylating agents, antimetabolites, benzene, chloramphenicol,
arsenicals, carbamazepine, gold salts
▶ Autoimmune Hemolytic Anemia. Answer: 1) Warm reactive antibody
type- IgG binds optimally to erythrocytes at a normal body temperature.
2) Cold agglutinin type- IgM antibodies optimally bind to erythrocytes at
colder temps (lower than 31 deg. Celsius). Recognized by phagocytes in
the liver and spleen. Fingers, toes, ears, may have obstructed blood flow
3) Cold hemolysin type- Hemoglobinuria
Acquired disorders caused by autoantibodies or complement or both, on
RBCs against antigens normally on the surface of erythrocytes.
,▶ Secondary Polycythemia. Answer: -physiologic response from increased
erythropoietin secretion in response to chronic hypoxia.
-Noted in people living in high altitudes, smokers, COPD, CHF
-Abnormal hgb
▶ Anemia of chronic renal failure. Answer: - Kidney damage affects
secretion of erythropoietin, diminishes bone marrow erythropoiesis.
- Uremic toxins that increase in the blood d/t renal failure may suppress
bone marrow function and damage erythrocytes
- Platelet dysfunction (bleeding)
- loss of erythrocytes
▶ Hypovolemic shock. Answer: Loss of whole blood (hemorrhage), plasma
(burns), or interstitial fluid (sweat, DM, DI, emesis, diuresis) in large
amounts.
-When intravascular volume decreases by 15%
▶ Glucose regulation in shock. Answer: glycogenolysis, gluconeogenesis,
and lipolysis.
-total body stores can fuel metabolism for 10 hours
▶ Ovulation. Answer: - Marks the beginning of the luteal/secretory phase
of the cycle.
▶ Uterine prolapse. Answer: descent of cervix or entire uterus into the
vaginal canal
▶ polycystic ovary syndrome. Answer: -at least two of these features:
irregular ovulation, elevated levels of androgens (testosterone), and
appearance of polycystic ovaries on ultrasound.
-strong genetic component
-Low FSH, high LH (causes high androgens), and high LH bioactivity
-s/s: anovulation, hyperandrogenism, insulin resistance, amenorrhea,
hirsutism, acne, infertility, dysfunctional bleeding, sleep apnea
-60% of women with PCOS are obese
- Tx: Oral contraceptives, weight loss, exercise, progesterone therapy,
metformin, lifestyle modification
▶ Testicular cancer. Answer: - Complication of cryptorchidism. Tx= giving
GnRH or Hgc or surgery
, - HIV
-Aids
▶ Breast cancer. Answer: Lumps, retraction of tissue, palpable notes in
the axilla, nipple discharge, ulceration, local pain
▶ Premenstrual Dysphoric Disorder (PMDD). Answer: Symptoms:
Depression, anger, irritability, fatigue, breast tenderness, abdominal
bloating, headache, swelling of extremities.
aggravation of underlying physical or psychological disease
▶ Abnormal Uterine Bleeding. Answer: - Bleeding that is abnormal in
duration, volume, frequency, or regularity > 6 months
-PALM(structural)-COEIN (nonstructural)
-Major cause: lack of ovulation
- commonly seen in perimenopausal women and adolescents
-Tx: NSAIDs (reduce prostaglandin synthesis within endometrial tissues-
cause vasoconstriction and dec. blood loss), regulating cycles, hormone
therapy
▶ Prostate Cancer. Answer: - Rely on androgen-dependent signaling for
development and progression.
-alterations in autocrine/paracrine growth-stimulating and growth-inhibiting
factors between the prostate tumor cells and microenvironment influence
cancer pathogenesis
-Occur in the periphery of the prostate
- Risk fx: chronic arsenic exposure, genetic
▶ HPV and Cervical CA. Answer: - Strains 16 and 18 are most cancerous
-Transformation zone is susceptible to HPV
▶ Deep tissue pressure ulcer healing. Answer: Bacteria colonize the dead
tissue, and infection is usually localized and self-limiting. Proteolytic
enzymes from bacteria and macrophages dissolve necrotic tissues and
cause a foul-smelling discharge that resembles, but is not, pus. The
necrotic tissue initiates an inflammatory response with potential pain, fever,
and leukocytosis.
▶ Contractures and wound healing. Answer: - Burn wounds are
susceptible to contractures.
ACTUAL TEST 2026 FULL SOLUTION VIEW AND
ANSWERS
▶ Folate Deficiency Anemia. Answer: People at risk: Pregnant/ lactating,
alcoholics, chronic malnourishment,
▶ Labs for Iron def. anemia. Answer: - Low- HGB/Hct/ mcv/plasma
iron/ferritin, transferrin
- High- Total iron binding capacity/free erythrocyte protoporphyrin
-Normal- reticulocyte count/B12, Folate, Bili
▶ sickle cell anemia. Answer: a genetic disorder that causes abnormal
hemoglobin, resulting in some red blood cells assuming an abnormal sickle
shape
-Chronic hemolysis, microvascular occlusions, and tissue damage, vaso
occlusive crisis
-abnormal or absent splenic function
▶ Cause of aplastic anemia. Answer: Failure of bone marrow to produce
mature cells causing pancytopenia (reduction of all 3 blood cell types)
- Idiopathic, acquired stem cell defects, immune mediated
- whole-body irradiation, viral infections, hepatitis, CMV, epstein-barr virus,
herpes zoster, inherited
-Chemica: alkylating agents, antimetabolites, benzene, chloramphenicol,
arsenicals, carbamazepine, gold salts
▶ Autoimmune Hemolytic Anemia. Answer: 1) Warm reactive antibody
type- IgG binds optimally to erythrocytes at a normal body temperature.
2) Cold agglutinin type- IgM antibodies optimally bind to erythrocytes at
colder temps (lower than 31 deg. Celsius). Recognized by phagocytes in
the liver and spleen. Fingers, toes, ears, may have obstructed blood flow
3) Cold hemolysin type- Hemoglobinuria
Acquired disorders caused by autoantibodies or complement or both, on
RBCs against antigens normally on the surface of erythrocytes.
,▶ Secondary Polycythemia. Answer: -physiologic response from increased
erythropoietin secretion in response to chronic hypoxia.
-Noted in people living in high altitudes, smokers, COPD, CHF
-Abnormal hgb
▶ Anemia of chronic renal failure. Answer: - Kidney damage affects
secretion of erythropoietin, diminishes bone marrow erythropoiesis.
- Uremic toxins that increase in the blood d/t renal failure may suppress
bone marrow function and damage erythrocytes
- Platelet dysfunction (bleeding)
- loss of erythrocytes
▶ Hypovolemic shock. Answer: Loss of whole blood (hemorrhage), plasma
(burns), or interstitial fluid (sweat, DM, DI, emesis, diuresis) in large
amounts.
-When intravascular volume decreases by 15%
▶ Glucose regulation in shock. Answer: glycogenolysis, gluconeogenesis,
and lipolysis.
-total body stores can fuel metabolism for 10 hours
▶ Ovulation. Answer: - Marks the beginning of the luteal/secretory phase
of the cycle.
▶ Uterine prolapse. Answer: descent of cervix or entire uterus into the
vaginal canal
▶ polycystic ovary syndrome. Answer: -at least two of these features:
irregular ovulation, elevated levels of androgens (testosterone), and
appearance of polycystic ovaries on ultrasound.
-strong genetic component
-Low FSH, high LH (causes high androgens), and high LH bioactivity
-s/s: anovulation, hyperandrogenism, insulin resistance, amenorrhea,
hirsutism, acne, infertility, dysfunctional bleeding, sleep apnea
-60% of women with PCOS are obese
- Tx: Oral contraceptives, weight loss, exercise, progesterone therapy,
metformin, lifestyle modification
▶ Testicular cancer. Answer: - Complication of cryptorchidism. Tx= giving
GnRH or Hgc or surgery
, - HIV
-Aids
▶ Breast cancer. Answer: Lumps, retraction of tissue, palpable notes in
the axilla, nipple discharge, ulceration, local pain
▶ Premenstrual Dysphoric Disorder (PMDD). Answer: Symptoms:
Depression, anger, irritability, fatigue, breast tenderness, abdominal
bloating, headache, swelling of extremities.
aggravation of underlying physical or psychological disease
▶ Abnormal Uterine Bleeding. Answer: - Bleeding that is abnormal in
duration, volume, frequency, or regularity > 6 months
-PALM(structural)-COEIN (nonstructural)
-Major cause: lack of ovulation
- commonly seen in perimenopausal women and adolescents
-Tx: NSAIDs (reduce prostaglandin synthesis within endometrial tissues-
cause vasoconstriction and dec. blood loss), regulating cycles, hormone
therapy
▶ Prostate Cancer. Answer: - Rely on androgen-dependent signaling for
development and progression.
-alterations in autocrine/paracrine growth-stimulating and growth-inhibiting
factors between the prostate tumor cells and microenvironment influence
cancer pathogenesis
-Occur in the periphery of the prostate
- Risk fx: chronic arsenic exposure, genetic
▶ HPV and Cervical CA. Answer: - Strains 16 and 18 are most cancerous
-Transformation zone is susceptible to HPV
▶ Deep tissue pressure ulcer healing. Answer: Bacteria colonize the dead
tissue, and infection is usually localized and self-limiting. Proteolytic
enzymes from bacteria and macrophages dissolve necrotic tissues and
cause a foul-smelling discharge that resembles, but is not, pus. The
necrotic tissue initiates an inflammatory response with potential pain, fever,
and leukocytosis.
▶ Contractures and wound healing. Answer: - Burn wounds are
susceptible to contractures.
