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CHAPTER 25: ALTERATIONS IN HEMATOLOGICAL FUNCTION

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1. The majority of children in the United States with human immunodeficiency virus (HIV) infection acquired the disease by which means? a. Through sexual contact b. From a blood transfusion c. By using intravenous (IV) drugs d. Perinatally from their mothers ANS: D More than 90% of the children with HIV under 13 years who were reported to the Centers for Disease Control and Prevention acquired the infection during the perinatal period. With intervention, the number of children infected can be decreased. Sexual contact and IV drug use are the leading causes of infection in the 14- to 19-year age group. This number is less than the number of cases in the under 13-year age group. Transfusion has accounted for 3% to 6% of all pediatric acquired immunodeficiency syndrome cases to date. Before 1985 and routine screening of donated blood products, children with hemophilia were at great risk from pooled plasma products. 2. A young child with human immunodeficiency virus (HIV) is receiving several antiretroviral drugs. What is the purpose of these drugs? a. Cure the disease. b. Delay disease progression. c. Prevent spread of infection. d. Treat Pneumocystis carinii pneumonia. ANS: B Although not a cure, these antiretroviral drugs can suppress viral replication, preventing further deterioration of the immune system, and delay disease progression. At this time, cure is not possible. Antiretroviral drugs do not prevent the spread of the disease. P. carinii prophylaxis is accomplished with antibiotics. 3. The nurse is planning care for an adolescent with acquired immunodeficiency syndrome. What is the priority nursing goal? a. Prevent infection. b. Prevent secondary cancers. c. Identify source of infection. d. Restore immunologic defenses.

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C HAPTER 25: A LTERATIONS IN
H EMATOLOGICAL F UNCTION

1. The majority of children in the United States with human immunodeficiency
virus (HIV) infection acquired the disease by which means?
a. Through sexual contact
b. From a blood transfusion
c. By using intravenous (IV) drugs
d. Perinatally from their mothers



ANS: D



More than 90% of the children with HIV under 13 years who were reported to
the Centers for Disease Control and Prevention acquired the infection during
the perinatal period. With intervention, the number of children infected can be
decreased. Sexual contact and IV drug use are the leading causes of infection
in the 14- to 19-year age group. This number is less than the number of cases
in the under 13-year age group. Transfusion has accounted for 3% to 6% of
all pediatric acquired immunodeficiency syndrome cases to date. Before 1985
and routine screening of donated blood products, children with hemophilia
were at great risk from pooled plasma products.



2. A young child with human immunodeficiency virus (HIV) is receiving several
antiretroviral drugs. What is the purpose of these drugs?
a. Cure the disease.
b. Delay disease progression.
c. Prevent spread of infection.
d. Treat Pneumocystis carinii pneumonia.

, ANS: B



Although not a cure, these antiretroviral drugs can suppress viral replication,
preventing further deterioration of the immune system, and delay disease
progression. At this time, cure is not possible. Antiretroviral drugs do not
prevent the spread of the disease. P. carinii prophylaxis is accomplished with
antibiotics.



3. The nurse is planning care for an adolescent with acquired immunodeficiency
syndrome. What is the priority nursing goal?
a. Prevent infection.
b. Prevent secondary cancers.
c. Identify source of infection.
d. Restore immunologic defenses.



ANS: A



As a result of the immunocompromise that is associated with human
immunodeficiency virus (HIV) infection, the prevention of infection is
paramount. Although certain precautions are justified in limiti ng exposure to
infection, these must be balanced with the concern for the childs normal
developmental needs. Preventing secondary cancers is not currently possible.
Case finding is not a priority nursing goal in planning care for an individual.
Current drug therapy is affecting the disease progression; although not a cure,
these drugs can suppress viral replication, preventing further deterioration but
not actually restoring immunologic defenses.



4. The school nurse is informed that a child with human immunod eficiency virus
(HIV) infection will be attending school soon. What is an important nursing
intervention to include in the plan of care?

, a. Carefully follow universal precautions.
b. Inform the parents of the other children.
c. Determine how the child became infected.
d. Reassure other children that they will not become infected.



ANS: A



Universal precautions are necessary to prevent further transmission of the
disease. Informing the parents of the other children would violate the childs
right to privacy. It is not within the role of the school nurse to determine how
the child became infected. Reassuring other children that they will not
become infected violates the childs privacy. General health classes can
discuss prevention of HIV transmission.



5. What condition is an inherited immunodeficiency disorder characterized by
absence of both humoral and cell-mediated immunity?
a. Fanconi syndrome
b. Wiskott-Aldrich syndrome
c. Acquired immunodeficiency syndrome (AIDS)
d. Severe combined immunodeficiency syndrome (SCIDS)



ANS: D



SCIDS is a genetic disorder that results in deficits of both humoral and
cellular immunity. Fanconi syndrome is a hereditary disorder of red blood cell
production. Wiskott-Aldrich syndrome is an X-linked recessive disorder with
selected deficiencies of T and B lymphocytes. AIDS is not inherited.



6. The nurse is preparing a community outreach program about the prevention of
iron- deficiency anemia in infants. What statement should the nurse include in

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