NSG 6320 AGNP Board Exam – Hematology Assessment Exam

NSG 6320 AGNP Board Exam – Hematology Assessment Exam 1. Question: If a newborn develops a cephalohematoma, the newborn is at an increased risk for: infection. jaundice. Correct caput succedaneum. erythema toxicum. Explanation: Cephalohematomas are characterized by bleeding between the bone and the periosteum. Because of breakdown of the red blood cells within a hematoma, the infants are at greater risk for jaundice. They do not increase the risk for infections. Caput succedaneum is an edematous area on the head from pressure against the cervix. Erythema toxicum is a benign rash of unknown cause that consists of blotchy red areas. 2. Question: A twelve-month-old was recently diagnosed with Acquired Immunodeficiency Syndrome (AIDS). The mother asks the nurse practitioner: "How could my child have acquired AIDS?" The best response from the nurse practitioner should be that: "Children under two years of age usually acquire AIDS: by sharing car seats with an HIV infected toddler." because the child may have been sexually abused by someone who was HIV positive." perinatally through an HIV infected mother." Correct through casual contact with an HIV infected individual in a day care center." Explanation: Perinatally is the acquired mode for infants. Children usually over five years of age acquire AIDS through sexual abuse. HIV does not survive in the environment and there is no evidence to date to support the fact That AIDS is acquired through casual contact or by sharing car seats with HIV infected seats. 3. Question: Which ethnicity is associated with glucose-6-phosphate-dehydrogenase (G-6-PD) deficiency? American Indian black Correct Asian Hispanic Explanation: Glucose-6-phosphate-dehydrogenase (G-6-PD) deficiency is a condition in which red blood cells break down when the body is exposed to certain drugs (aspirin, antimalaria drugs) or the stress of infection. G-6-PD is most prevalent in people of Mediterranean and African descent, and specifically common in Saudi Arabian, African, and black patients. 4. Question: The blood lead level that requires further testing and monitoring in children is: 3 mcg/dL. 5 mcg/dL. Correct 7 mcg/dL. 9 mcg/dL. Explanation: In children, a blood lead level of 5 mcg/dL or 0.24 µmol/L or greater requires further testing and monitoring. The source of lead must be found and removed. A lead level greater than 45 mcg/dL or 2.17 µmol/L in a child's blood usually indicates the need for chelation. 5. Question: Which of the following foods contains the LEAST amount of folic acid? Dairy Correct Green leafy vegetables Liver Fruits Explanation: Dairy foods such as cheese, milk and yogurt do not contain folic acid unless they have been specifically fortified to include this vitamin. Foods high in folic acid include green leafy vegetables, meat from animal sources, fruits, nuts, liver, and foods containing yeast. 6. Question: Which assessment finding is consistent with pernicious anemia? Facial palsy Nuchal rigidity Priapism Peripheral neuropathy Correct Explanation: Pernicious anemia is associated with B12 deficiency. Vitamin B12 deficiency may lead to nerve damage attributable to pathology in the peripheral and optic nerves, posterior and lateral columns of the spinal cord (subacute combined degeneration), and in the brain. This can cause tingling and numbness in the hands and feet, muscle weakness, and loss of reflexes. Patients may feel unsteady and experience equilibrium problems and ataxia. Vitamin B12 deficiency can cause weakened bones and may lead to hip fractures. Vitamin B 12 deficiency does not cause facial palsy; however, vitamin B12 has been used in the treatment of Bell's Palsy. Nuchal rigidity and priapism are not associated with vitamin B12 deficiency. 7. Question: The infant with the lowest risk of developing elevated levels of bilirubin is the one who: is feeding poorly or whose feedings are delayed for several hours. has developed a cephalhematoma. is