Hematologic Disorders Pediatric Nursing NCLEX Exam

To pass the NCLEX-RN examination, create precise review goals each day and repay yourself once you complete them.

This 15-item practice exam is all about Hematologic disorders in Pediatric Nursing. It includes questions about the structure and function hematologic system, anemia, sickle cell disease, thalassemia, and more.

EXAM TIPJust before focusing on your review, do one fun thing like watching a comedy show, having a kickabout or fooling around with photos on Instagram. Smiling will relax you, lower stress and help you get ready for a serious moment with your books and handouts.

All the effort in the world won’t matter if you’re not inspired.
― Chuck Palahniuk, Diary

Topics

Topics or concepts included in this exam are:

  • Structure and function of the hematologic system
  • Sickle cell disease
  • Hemophilia
  • Iron deficiency anemia
  • Thalassemia
  • Aplastic anemia
  • Idiopathic thrombocytopenic purpura

Guidelines

To make the most out of this quiz, follow the guidelines below:

  • Read each question carefully and choose the best answer.
  • You are given one minute per question. Spend your time wisely!
  • Answers and rationales (if any) are given below. Be sure to read them.
  • If you need more clarifications, please direct them to the comments section.

Questions

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Pediatric Nursing: Hematologic Disorders NCLEX Practice Quiz (15 Questions)

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Pediatric Nursing: Hematologic Disorders NCLEX Practice Quiz (15 Questions)

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1. Nurse Katriz is planning a client education program for sickle cell disease (SCD); what topics should be included in the plan of care?

A. Aerobic exercise to improve oxygenation
B. Fluid restraint to 1 qt (1 L)/day
C. A high-iron, high-protein diet
D. Proper hand washing and infection avoidance

2. Sickle cell disease (SCD) primarily affects:

A. children of African descent and Hispanics of Caribbean ancestry.
B. children of Middle-Eastern and Indian descent.
C. children of Asian descent.
D. both African descent and Hispanics of Caribbean ancestry and Middle-Eastern and Indian descent.

3. Which of the following is TRUE about sickle cell disease (SCD)? Select all that apply.

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A. Sickle cell anemia (SCD) is an inherited disorder of the hemoglobin in blood.
B. Sickle cell anemia requires the inheritance of two sickle cell genes.
C. Sickle cell trait, which is the inheritance of one sickle gene, almost never causes problems.
D. Virtually all of the major symptoms of sickle cell anemia are the direct result of the abnormally shaped sickled red blood cells obstructing the flow of blood.
E. The contemporary treatment of sickle cell anemia is focused primarily toward managing the individual features of the illness as they occur.

4. In children diagnosed with sickle cell disease (SCD), tissue damage results from which of the following?

A. Air hunger and respiratory alkalosis due to deoxygenated red blood cells.
B. Hypersensitivity of the central nervous system (CNS) due to elevated serum bilirubin levels
C. A general inflammatory response due to an autoimmune reaction from hypoxia
D. Local tissue damage with ischemia and necrosis due to obstructed circulation

5. Nurse Christine is planning a client education program for sickle cell disease (SCD) in children; which of the following interventions would be included in the care plan?

A. Health teaching  to help reduce sickling crises
B. Avoidance of the use of opioids
C. Administration of an anticoagulant to prevent sickling
D. Observation of the imposed fluid restriction

6. Mr. and Mrs. Smith’s child has hemophilia; which of the following actions would you instruct them to avoid?

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A. Immobilizing the joint
B. Lowering the injured area
C. Applying cold to the area
D. Applying pressure

7. Which of the following tests is most effective in diagnosing hemophilia?

A. Bleeding time
B. Complete blood count (CBC)
C. Partial thromboplastin time (PTT)
D. Platelet count

8. Mrs. Baker was instructed by the nurse on foods to encourage her child’s diet concerning the latter’s iron deficiency anemia; which of the following if stated by the mother would indicate the need for further instruction?

A. Fish
B. Lean meats
C. Whole-grain breads
D. Yellow vegetables

9. Nurse Olenna is performing community assessment; which of the following age-groups would be inappropriate for her to monitor iron deficiency anemia?

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A. Toddlers
B. School-age children
C. Adolescents
D. Pregnant women

10. A child with thalassemia was given deferoxamine (Desferal); which of the following should alert the nurse to notify the physician?

A. Decreased hearing
B. Hypertension
C. Red urine
D. Vomiting

11. The long-term complications seen in thalassemia major are associated to which of the following?

A. Anemia
B. Growth retardation
C. Hemochromatosis
D. Splenomegaly

12. Nurse Hannah is administering a steroid to a child diagnosed with idiopathic thrombocytopenic purpura (ITP); which of the following should the nurse monitor?

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A. Infection
B. Anemia
C. Bleeding
D. Bruising

13. Mr. and Mrs. Robertson’s son was diagnosed with idiopathic thrombocytopenic purpura. They should be aware that the drug to be avoided is:

A. Acetaminophen
B. Aspirin
C. Codeine
D. Morphine

14. Archie is a child with iron deficiency anemia. He is required to receive elemental iron therapy at 6 mg/kg/day in three divided doses. He weighs 44 lbs. How many milligrams of iron should he receive per dose?

A. 20 mg/dose
B. 40 mg/dose
C. 60 mg/dose
D. 120 mg/dose

15. It is a serious condition in which the bone marrow does not produce enough new blood cells. It may be passed down from the parents or develop sometime during childhood:

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A. Iron deficiency anemia
B. Sickle cell disease
C. Aplastic anemia
D. Thalassemia
E. Hemophilia
F. Idiopathic thrombocytopenic purpura

Answers and Rationale

1. Answer: D. Proper hand washing and infection avoidance

  • Option D: Prevention of infection is vital in the prevention of sickle cell crisis.
  • Option A: Strenuous activities and exercises should be withdrawn to lessen the risk of increased tissue ischemia.
  • Option B: Proper hydration should be encouraged to prevent crisis secondary to dehydration.
  • Option C: A high-iron, high-protein diet would have no impact on the disease or prevention of a crisis.

2. Answer: D. both African descent and Hispanics of Caribbean ancestry and Middle-Eastern and Indian descent.

  • Option D: Sickle cell disease primarily affects children of African descent and Hispanics of Caribbean ancestry. It also occurs in children of Middle-Eastern and Indian descent.

3. Answer: A, B, C, D, and E

  • Options A, B, C, D, and E: Sickle cell anemia (SCD) is an inherited disorder of the hemoglobin in blood. It requires the inheritance of two sickle cell genes. Sickle cell trait, which is the inheritance of one sickle gene, almost never causes problems. Virtually all of the major symptoms of sickle cell anemia are the direct result of the abnormally shaped sickled red blood cells blocking the flow of blood. The contemporary treatment of sickle cell anemia is focused primarily toward managing the individual features of the illness as they occur.

4. Answer: D. Local tissue damage with ischemia and necrosis due to obstructed circulation

  • Option D: Characteristic sickle cells tend to clump, which results in weak and inadequate blood flow to tissue, local tissue damage, and eventual ischemia and necrosis.
  • Option A: Air hunger and respiratory alkalosis are not present.
  • Option B: The CNS effects result from ischemia
  • Option C: In sickle cell anemia, damage is not due to an inflammation response.

5. Answer: A. Health teaching  to help reduce sickling crises

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  • Option A: Prevention is one of the principal goals of therapeutic management because there is no cure for sickle cell disease. Consequently, health education to help lessen sickling crises is key.
  • Option B: Opioids usually are required for pain control.
  • Option C: Anticoagulants do not prevent sickling.
  • Option D: Fluids are encouraged to increase the fluid volume and prevent sickling.

6. Answer: B. Lowering the injured area

  • Option B: With hemophilia, the injured area must be elevated, not lowered.
  • Options A, C, and D: Immobilizing the joint and applying cold or pressure to the area are appropriate measures to control bleeding.

7. Answer: C. Partial thromboplastin time (PTT)

  • Option C: PTT is abnormal in hemophilia. Therefore, this test will be the most helpful in diagnosing the disorder.
  • Options A and D: Bleeding time and platelet count are normal in hemophilia.
  • Option B: The CBC is not affected in hemophilia.

8. Answer: D. Yellow vegetables

  • Option D: If a parent states that she should stress the intake of yellow vegetables, she needs additional teaching because yellow vegetables are not good source of iron.
  • Options A, B, and C: Fish, lean meats, and whole-grain breads are good food sources of iron and should be supported and encouraged.

9. Answer: B. School-age children

  • Option B: Periods of rapid growth predispose a person to iron deficiency anemia. Iron deficiency anemia is not prevalent in school-age children because this stage is not a period of rapid growth.
  • Options A, C, and D: Toddlerhood, adolescence, and pregnancy are periods of rapid growth. Thus, individuals in these groups are more likely to experience iron deficiency anemia. The “picky appetites” of toddlers and adolescents may also predispose them to this condition.

10. Answer: A. Decreased hearing

  • Option A: Desferoxamine is ototoxic. Thus, any hearing problem should be immediately addressed to the physician.
  • Option B: Hypotension, not hypertension, is a possible adverse effect.
  • Option C: Red urine is an expected occurrence with deferoxamine.
  • Option D: Vomiting is not an emergency with this drug.

11. Answer: C. Hemochromatosis

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  • Option C: Long-term complications arise from hemochromatosis, excessive iron deposits precipitating in the tissues and causing destruction.
  • Option A: Anemia is a sign of this disorder.
  • Options B and D: Cellular damage from hemochromatosis may lead to splenomegaly, growth retardation, skeletal complications, cardiac problems, gallbladder disease, hepatomegaly, and skin changes.

12. Answer: A. Infection

  • Option A: Steroids may promote immunosuppression, making the child more susceptible to infections.
  • Option B: Anemia is not connected to the disorder or medication.
  • Options C and D: Bleeding and bruising are recognized as a result of the disorder, not the steroid therapy.

13. Answer: B. Aspirin

  • Option B: Aspirin exerts an antiplatelet action and therefore may increase platelet destruction in ITP.
  • Options A, C, and D: Acetaminophen, codeine, and morphine have no effect on platelets and, therefore, are not contraindicated.

14. Answer: B. 40 mg/dose

  • Option B: The child weighs 44 lbs, which is equal to 20 kg (1 kg=2.2 lb;44/2.2=20kg). Elemental iron therapy is ordered at 6 mg/kg/day in three doses. Therefore, the child receives 120 mg/day (6 mg/20 kg/day=120), divided into three doses (120/3), which is equal to 40 mg/dose.

15. Answer: C. Aplastic anemia

  • Option C: Aplastic anemia is characterized by pancytopenia (anemia, granulocytopenia, and thrombocytopenia) and bone marrow hypoplasia.
  • Option A: Iron deficiency anemia is caused by an inadequate supply of iron for normal red blood cell (RBC) formation.
  • Option B: Sickle cell disease is a group of chronic, severe, genetic, hemolytic diseases associated with hemoglobin (Hb) S, which transform red blood cells (RBCs) into a sickle (crescent) shape when blood oxygenation is decreased.
  • Option D: Thalassemia is a group of inherited blood disorders characterized by a deficient synthesis of specific globulin chains of hemoglobin molecule.
  • Option E: Hemophilia is a group of hereditary bleeding disorders characterized by a deficiency in a blood-clotting factor.
  • Option F: Idiopathic thrombocytopenic purpura (ITP) is an acquired hemorrhagic disorder in which the number of circulating platelets is reduced.

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