Chapter 31: Care of the Child with a
Physical and Mental or Cognitive
Disorder Questions and Actual
Detailed Answers 2025-2026 Updated.
1. The nurse uses a diagram to show that the tetralogy of Fallot involves a combination of four
congenital defects. What are the defects?
a. Aortic stenosis, atrial septal defect, overriding aorta, left ventricular hypertrophy
b. Pulmonary stenosis, ventricular septal defect, overriding aorta, right ventricular
hypertrophy
c. Aortic stenosis, atrial septal defect, overriding aorta, right ventricular hypertrophy
d. Pulmonary stenosis, ventricular septal defect, aortic hypertrophy, left ventricular
hypertrophy - Answer ANS: B
Tetralogy of Fallot involves a combination of four congenital defects: pulmonary stenosis,
ventricular septal defect, overriding aorta, and right ventricular hypertrophy.
PTS: 1 DIF: Cognitive Level: Knowledge REF: Page 982
OBJ: 1 TOP: Heart defect KEY: Nursing Process Step: Implementation
2. What is the most common clinical manifestation of coarctation of the aorta?
a. Clubbing of the digits
b. Upper extremity hypertension
c. Pedal edema and portal congestion
d. Loud systolic ejection murmur - Answer ANS: B
Coarctation of the aorta results in hypertension in the upper extremities. The pressure in the
arms is typically 20 mm Hg higher than in the legs.
PTS: 1 DIF: Cognitive Level: Knowledge REF: Page 983 OBJ: 1 TOP: Heart defect KEY: Nursing
Process Step: Assessment
3. Parents of a 6-month-old child, who has just been diagnosed with iron deficiency anemia, ask
why it was not diagnosed earlier. What would be the best response by the nurse?
,Iron deficiency anemia becomes apparent at about 6 months of age in a full-term infant, when
maternal stores of iron are depleted.
PTS: 1 DIF: Cognitive Level: Application REF: Page 983
OBJ: 2 TOP: Anemia KEY: Nursing Process Step: Implementation
4. What should the therapeutic management of iron deficiency anemia include?
a. Multivitamins
b. Calcium
c. Ferrous sulfate
d. Iodine - Answer ANS: C
Therapeutic management of iron deficiency anemia is iron (ferrous sulfate) supplementation,
nutritional counseling, and treatment of any underlying condition.
PTS: 1 DIF: Cognitive Level: Knowledge REF: Page 984
OBJ: 2 TOP: Anemia KEY: Nursing Process Step: Implementation
5. The parents of a child who has been diagnosed with sickle cell anemia ask why their child
experiences pain. What is the most likely cause of the pain?
a. Inflammation of the vessels
b. Obstructed blood flow
c. Overhydration
d. Stress-related headaches - Answer ANS: B
The signs and symptoms of sickle cell anemia include the sickle-shaped cells clumping and
obstructing blood flow, which causes severe tissue hypoxia and necrosis leading to pain.
PTS: 1 DIF: Cognitive Level: Application REF: Page 985 OBJ: 2 TOP: Blood disorders
KEY: Nursing Process Step: Implementation
6. The parents of a child recently diagnosed with sickle cell anemia ask what can be done to
avoid a sickle cell crisis. What should be included in the medical management of sickle cell
crisis?
a. Information for the parents including home care
, PTS: 1 DIF: Cognitive Level: Application REF: Page 986 OBJ: 2 TOP: Blood disorders
KEY: Nursing Process Step: Implementation
7. Which laboratory results should the nurse anticipate to be abnormal in a child with
hemophilia?
a. Prothrombin time
b. Bleeding time
c. Platelet count
d. Partial thromboplastin time - Answer ANS: D
Expected laboratory findings for a child with hemophilia include a prolonged partial
thromboplastin time. The prothrombin time, bleeding time, and platelet count are typically
normal.
PTS: 1 DIF: Cognitive Level: Comprehension REF: Page 987 OBJ: 3 TOP: Blood disorders
KEY: Nursing Process Step: Assessment
8. The parents of a child with acute lymphoblastic leukemia ask about the best approach for
maintaining remission of the disease. What would be the most effective therapy?
a. Surgery to remove enlarged lymph nodes
b. Long-term chemotherapy
c. Nutritional supplements to enhance blood cell production
d. Blood transfusions to replace ineffective red cells - Answer ANS: B
The treatment of choice is methotrexate, a chemotherapeutic agent, to produce remission.
PTS: 1 DIF: Cognitive Level: Application REF: Page 989 OBJ: 4 TOP: Blood disorders
KEY: Nursing Process Step: Implementation
9. What most influences the severity of respiratory distress syndrome (RDS)?
a. Poor cough and gag reflex
b. The gestational age at birth
Physical and Mental or Cognitive
Disorder Questions and Actual
Detailed Answers 2025-2026 Updated.
1. The nurse uses a diagram to show that the tetralogy of Fallot involves a combination of four
congenital defects. What are the defects?
a. Aortic stenosis, atrial septal defect, overriding aorta, left ventricular hypertrophy
b. Pulmonary stenosis, ventricular septal defect, overriding aorta, right ventricular
hypertrophy
c. Aortic stenosis, atrial septal defect, overriding aorta, right ventricular hypertrophy
d. Pulmonary stenosis, ventricular septal defect, aortic hypertrophy, left ventricular
hypertrophy - Answer ANS: B
Tetralogy of Fallot involves a combination of four congenital defects: pulmonary stenosis,
ventricular septal defect, overriding aorta, and right ventricular hypertrophy.
PTS: 1 DIF: Cognitive Level: Knowledge REF: Page 982
OBJ: 1 TOP: Heart defect KEY: Nursing Process Step: Implementation
2. What is the most common clinical manifestation of coarctation of the aorta?
a. Clubbing of the digits
b. Upper extremity hypertension
c. Pedal edema and portal congestion
d. Loud systolic ejection murmur - Answer ANS: B
Coarctation of the aorta results in hypertension in the upper extremities. The pressure in the
arms is typically 20 mm Hg higher than in the legs.
PTS: 1 DIF: Cognitive Level: Knowledge REF: Page 983 OBJ: 1 TOP: Heart defect KEY: Nursing
Process Step: Assessment
3. Parents of a 6-month-old child, who has just been diagnosed with iron deficiency anemia, ask
why it was not diagnosed earlier. What would be the best response by the nurse?
,Iron deficiency anemia becomes apparent at about 6 months of age in a full-term infant, when
maternal stores of iron are depleted.
PTS: 1 DIF: Cognitive Level: Application REF: Page 983
OBJ: 2 TOP: Anemia KEY: Nursing Process Step: Implementation
4. What should the therapeutic management of iron deficiency anemia include?
a. Multivitamins
b. Calcium
c. Ferrous sulfate
d. Iodine - Answer ANS: C
Therapeutic management of iron deficiency anemia is iron (ferrous sulfate) supplementation,
nutritional counseling, and treatment of any underlying condition.
PTS: 1 DIF: Cognitive Level: Knowledge REF: Page 984
OBJ: 2 TOP: Anemia KEY: Nursing Process Step: Implementation
5. The parents of a child who has been diagnosed with sickle cell anemia ask why their child
experiences pain. What is the most likely cause of the pain?
a. Inflammation of the vessels
b. Obstructed blood flow
c. Overhydration
d. Stress-related headaches - Answer ANS: B
The signs and symptoms of sickle cell anemia include the sickle-shaped cells clumping and
obstructing blood flow, which causes severe tissue hypoxia and necrosis leading to pain.
PTS: 1 DIF: Cognitive Level: Application REF: Page 985 OBJ: 2 TOP: Blood disorders
KEY: Nursing Process Step: Implementation
6. The parents of a child recently diagnosed with sickle cell anemia ask what can be done to
avoid a sickle cell crisis. What should be included in the medical management of sickle cell
crisis?
a. Information for the parents including home care
, PTS: 1 DIF: Cognitive Level: Application REF: Page 986 OBJ: 2 TOP: Blood disorders
KEY: Nursing Process Step: Implementation
7. Which laboratory results should the nurse anticipate to be abnormal in a child with
hemophilia?
a. Prothrombin time
b. Bleeding time
c. Platelet count
d. Partial thromboplastin time - Answer ANS: D
Expected laboratory findings for a child with hemophilia include a prolonged partial
thromboplastin time. The prothrombin time, bleeding time, and platelet count are typically
normal.
PTS: 1 DIF: Cognitive Level: Comprehension REF: Page 987 OBJ: 3 TOP: Blood disorders
KEY: Nursing Process Step: Assessment
8. The parents of a child with acute lymphoblastic leukemia ask about the best approach for
maintaining remission of the disease. What would be the most effective therapy?
a. Surgery to remove enlarged lymph nodes
b. Long-term chemotherapy
c. Nutritional supplements to enhance blood cell production
d. Blood transfusions to replace ineffective red cells - Answer ANS: B
The treatment of choice is methotrexate, a chemotherapeutic agent, to produce remission.
PTS: 1 DIF: Cognitive Level: Application REF: Page 989 OBJ: 4 TOP: Blood disorders
KEY: Nursing Process Step: Implementation
9. What most influences the severity of respiratory distress syndrome (RDS)?
a. Poor cough and gag reflex
b. The gestational age at birth
