Take Pediatric Nursing NCLEX Questions

1. 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?

Health teaching to help reduce sickling crises

Avoidance of the use of opioids

Administration of an anticoagulant to prevent sickling

Observation of the imposed fluid restriction

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.

Explanation

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.

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

Aerobic exercise to improve oxygenation

Fluid restraint to 1 qt (1 L)/day

A high-iron. high-protein diet

Proper hand washing and infection avoidance

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of infection is vital in the prevention of sickle cell crisis.Option A: Strenuous activities and exercises should be withdrawn to lessen the risk of increased tissue ischemia.Option B: Proper hydration should be encouraged to prevent crisis secondary to dehydration.Option C: A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.

Explanation

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of infection is vital in the prevention of sickle cell crisis.Option A: Strenuous activities and exercises should be withdrawn to lessen the risk of increased tissue ischemia.Option B: Proper hydration should be encouraged to prevent crisis secondary to dehydration.Option C: A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.

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

Air hunger and respiratory alkalosis due to deoxygenated red blood cells.

Hypersensitivity of the central nervous system (CNS) due to elevated serum bilirubin levels

A general inflammatory response due to an autoimmune reaction from hypoxia

Local tissue damage with ischemia and necrosis due to obstructed circulation

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.

Explanation

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.

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

Bleeding time

Complete blood count (CBC)

Partial thromboplastin time (PTT)

Platelet count

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.

Explanation

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.

5. Sickle cell disease (SCD) primarily affects:

Children of African descent and Hispanics of Caribbean ancestry.

Children of Middle-Eastern and Indian descent.

Children of Asian descent.

Both African descent and Hispanics of Caribbean ancestry and Middle-Eastern and Indian descent.

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.

Explanation

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.

6. 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?

Fish

Lean meats

Whole-grain breads

Yellow vegetables

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.

Explanation

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.

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

Immobilizing the joint

Lowering the injured area

Applying cold to the area

Applying pressure

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.

Explanation

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.

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

Decreased hearing

Hypertension

Red urine

Vomiting

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 desferoxamine.Option D: Vomiting is not an emergency with this drug.

Explanation

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 desferoxamine.Option D: Vomiting is not an emergency with this drug.

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

Toddlers

School-age children

Adolescents

Pregnant women

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.

Explanation

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

Sickle cell anemia (SCD) is an inherited disorder of the hemoglobin in blood.

Sickle cell anemia 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 obstructing 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.

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.

Explanation

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.

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