Chapter 43: HematologŤc
and ImmunologŤc
DysfunctŤon NursŤng
School Test Banks
Chapter 43: Hematologic and Immunologic Dysfunction
MULTIPLE CHOICE
1. An accurate description of anemia is:
a. Increased blood viscosity.
b. Depressed hematopoietic system.
c. Presence of abnormal hemoglobin.
d. Decreased oxygen-carrying capacity of blood.
ANS: D
Anemia is a condition in which the number of red blood cells or
hemoglobin concentration is reduced below the normal values
for age. This results in a decreased oxygen-carrying capacity of
blood. Increased blood viscosity is usually a function of too
many cells or of dehydration, not of anemia. A depressed
hematopoietic system or abnormal hemoglobin can contribute to
1/37
,anemia, but the definition depends on the deceased oxygen-
carrying capacity of the blood.
PTS: 1 DIF: Cognitive Level: Comprehension REF: 1362
OBJ: Nursing Process: Assessment MSC: Client Needs: Physiologic
Integrity
2. Several blood tests are ordered for a preschool child with
severe anemia. She is crying and upset because she remembers
the venipuncture done at the clinic 2 days ago. The nurse should
explain that:
a. Venipuncture discomfort is very brief.
b. Only one venipuncture will be needed.
c. Topical application of local anesthetic can eliminate
venipuncture pain.
d. Most blood tests on children require only a finger
puncture because a small amount of blood is needed.
ANS: C
Preschool children are very concerned about both pain and the
loss of blood. When preparing the child for venipuncture, a
topical anesthetic will be used to eliminate any pain. This is a
very traumatic experience for preschool children. They are
concerned about their bodily integrity. A local anesthetic should
be used, and a bandage should be applied to maintain bodily
integrity. A promise that only one venipuncture will be needed
should not be made in case multiple attempts are required. Both
finger punctures and venipunctures are traumatic for children.
Both require preparation.
PTS: 1 DIF: Cognitive Level: Application REF: 1365
OBJ: Nursing Process: Implementation MSC: Client Needs: Health
Promotion and Maintenance
2/37
,3. The most appropriate nursing diagnosis for a child with
anemia is:
a. Activity Intolerance related to generalized weakness.
b. Decreased Cardiac Output related to abnormal
hemoglobin.
c. Risk for Injury related to depressed sensorium.
d. Risk for Injury related to dehydration and abnormal
hemoglobin.
ANS: A
The basic pathology in anemia is the decreased oxygen-carrying
capacity of the blood. The nurse must assess the childs activity
level (response to the physiologic state). The nursing diagnosis
would reflect the activity intolerance. In generalized anemia no
abnormal hemoglobin may be present. Only at a level of very
severe anemia does cardiac output become altered. No decreased
sensorium exists until profound anemia occurs. Dehydration and
abnormal hemoglobin are not usually part of anemia.
PTS: 1 DIF: Cognitive Level: Analysis REF: 1365
OBJ: Nursing Process: Diagnosis MSC: Client Needs: Physiologic Integrity
4. Which statement best explains why iron deficiency anemia is
common during toddlerhood?
a. Milk is a poor source of iron. View Details
b. Iron cannot be stored during fetal development.
c. Fetal iron stores are depleted by age 1 month.
d. Dietary iron cannot be started until age 12 months.
3/37
, ANS: A
Children between the ages of 12 and 36 months are at risk for
anemia because cows milk is a major component of their diet,
and it is a poor source of iron. Iron is stored during fetal
development, but the amount stored depends on maternal iron
stores. Fetal iron stores are usually depleted by age 5 to 6
months. Dietary iron can be introduced by breastfeeding, iron-
fortified formula, and cereals during the first 12 months of life.
PTS: 1 DIF: Cognitive Level: Analysis REF: 1365
OBJ: Nursing Process: Assessment MSC: Client Needs: Physiologic
Integrity
5. When teaching the mother of a 9-month-old infant about
administering liquid iron preparations, the nurse should include
that:
a. They should be given with meals.
b. They should be stopped immediately if nausea and
vomiting occur.
c. Adequate dosage will turn the stools a tarry green
color.
d. Preparation should be allowed to mix with saliva and
bathe the teeth before swallowing.
ANS: C
The nurse should prepare the mother for the anticipated change
in the childs stools. If the iron dose is adequate, the stools will
become a tarry green color. The lack of the color change may
indicate insufficient iron. The iron should be given in two
divided doses between meals, when the presence of free
hydrochloric acid is greatest. Iron is absorbed best in an acidic
environment. Vomiting and diarrhea may occur with iron
administration. If these occur, the iron should be given with
4/37
and ImmunologŤc
DysfunctŤon NursŤng
School Test Banks
Chapter 43: Hematologic and Immunologic Dysfunction
MULTIPLE CHOICE
1. An accurate description of anemia is:
a. Increased blood viscosity.
b. Depressed hematopoietic system.
c. Presence of abnormal hemoglobin.
d. Decreased oxygen-carrying capacity of blood.
ANS: D
Anemia is a condition in which the number of red blood cells or
hemoglobin concentration is reduced below the normal values
for age. This results in a decreased oxygen-carrying capacity of
blood. Increased blood viscosity is usually a function of too
many cells or of dehydration, not of anemia. A depressed
hematopoietic system or abnormal hemoglobin can contribute to
1/37
,anemia, but the definition depends on the deceased oxygen-
carrying capacity of the blood.
PTS: 1 DIF: Cognitive Level: Comprehension REF: 1362
OBJ: Nursing Process: Assessment MSC: Client Needs: Physiologic
Integrity
2. Several blood tests are ordered for a preschool child with
severe anemia. She is crying and upset because she remembers
the venipuncture done at the clinic 2 days ago. The nurse should
explain that:
a. Venipuncture discomfort is very brief.
b. Only one venipuncture will be needed.
c. Topical application of local anesthetic can eliminate
venipuncture pain.
d. Most blood tests on children require only a finger
puncture because a small amount of blood is needed.
ANS: C
Preschool children are very concerned about both pain and the
loss of blood. When preparing the child for venipuncture, a
topical anesthetic will be used to eliminate any pain. This is a
very traumatic experience for preschool children. They are
concerned about their bodily integrity. A local anesthetic should
be used, and a bandage should be applied to maintain bodily
integrity. A promise that only one venipuncture will be needed
should not be made in case multiple attempts are required. Both
finger punctures and venipunctures are traumatic for children.
Both require preparation.
PTS: 1 DIF: Cognitive Level: Application REF: 1365
OBJ: Nursing Process: Implementation MSC: Client Needs: Health
Promotion and Maintenance
2/37
,3. The most appropriate nursing diagnosis for a child with
anemia is:
a. Activity Intolerance related to generalized weakness.
b. Decreased Cardiac Output related to abnormal
hemoglobin.
c. Risk for Injury related to depressed sensorium.
d. Risk for Injury related to dehydration and abnormal
hemoglobin.
ANS: A
The basic pathology in anemia is the decreased oxygen-carrying
capacity of the blood. The nurse must assess the childs activity
level (response to the physiologic state). The nursing diagnosis
would reflect the activity intolerance. In generalized anemia no
abnormal hemoglobin may be present. Only at a level of very
severe anemia does cardiac output become altered. No decreased
sensorium exists until profound anemia occurs. Dehydration and
abnormal hemoglobin are not usually part of anemia.
PTS: 1 DIF: Cognitive Level: Analysis REF: 1365
OBJ: Nursing Process: Diagnosis MSC: Client Needs: Physiologic Integrity
4. Which statement best explains why iron deficiency anemia is
common during toddlerhood?
a. Milk is a poor source of iron. View Details
b. Iron cannot be stored during fetal development.
c. Fetal iron stores are depleted by age 1 month.
d. Dietary iron cannot be started until age 12 months.
3/37
, ANS: A
Children between the ages of 12 and 36 months are at risk for
anemia because cows milk is a major component of their diet,
and it is a poor source of iron. Iron is stored during fetal
development, but the amount stored depends on maternal iron
stores. Fetal iron stores are usually depleted by age 5 to 6
months. Dietary iron can be introduced by breastfeeding, iron-
fortified formula, and cereals during the first 12 months of life.
PTS: 1 DIF: Cognitive Level: Analysis REF: 1365
OBJ: Nursing Process: Assessment MSC: Client Needs: Physiologic
Integrity
5. When teaching the mother of a 9-month-old infant about
administering liquid iron preparations, the nurse should include
that:
a. They should be given with meals.
b. They should be stopped immediately if nausea and
vomiting occur.
c. Adequate dosage will turn the stools a tarry green
color.
d. Preparation should be allowed to mix with saliva and
bathe the teeth before swallowing.
ANS: C
The nurse should prepare the mother for the anticipated change
in the childs stools. If the iron dose is adequate, the stools will
become a tarry green color. The lack of the color change may
indicate insufficient iron. The iron should be given in two
divided doses between meals, when the presence of free
hydrochloric acid is greatest. Iron is absorbed best in an acidic
environment. Vomiting and diarrhea may occur with iron
administration. If these occur, the iron should be given with
4/37
