A nurse is caring for a 7-year-old child who has a fever, tachycardia, and low oxygen saturation. The nurse reviews the child's laboratory results and notes the following:
- WBC count 15,000/mm^3^ (normal range: 5,000 to 10,000/mm^3^)
- Hgb 8 g/dL (normal range: 10 to 15.5 g/dL)
- Hct 32% (normal range: 32% to 44%)
The nurse should suspect that the child has which of the following conditions?
Leukemia.
Sickle cell anemia.
Hemophilia.
Iron deficiency anemia.
The Correct Answer is B
Choice A reason: Leukemia is not a probable condition, as it is a cancer of the white blood cells that causes abnormal proliferation and accumulation of immature or dysfunctional white blood cells. The child has a high WBC count, which can indicate leukemia, but not necessarily. The child does not have other signs of leukemia, such as bleeding, bruising, bone pain, or lymphadenopathy.
Choice B reason: Sickle cell anemia is a possible condition, as it is an inherited disorder that affects the shape and function of the red blood cells, causing them to become sickle-shaped and rigid. The child has a low Hgb and Hct, which can indicate anemia, and a fever, tachycardia, and low oxygen saturation, which can indicate a sickle cell crisis. A sickle cell crisis is a condition where the sickle-shaped red blood cells block the blood flow and cause tissue ischemia and inflammation.
Choice C reason: Hemophilia is not a likely condition, as it is an inherited disorder that affects the clotting factors, causing impaired blood clotting and increased risk of bleeding. The child has a low Hgb and Hct, which can indicate anemia, but not necessarily hemophilia. The child does not have other signs of hemophilia, such as bleeding, bruising, hemarthrosis, or hematuria.
Choice D reason: Iron deficiency anemia is not a definite condition, as it is a type of anemia that occurs when the body does not have enough iron to produce hemoglobin, the protein that carries oxygen in the blood. The child has a low Hgb and Hct, which can indicate iron deficiency anemia, but not necessarily. The child does not have other signs of iron deficiency anemia, such as pallor, fatigue, weakness, or pica.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: Your baby will receive a hepatitis B vaccine prior to discharge is correct, as this is the recommended schedule for the first dose of the hepatitis B vaccine for all newborns, regardless of maternal hepatitis B status.
Choice B reason: Your baby will have the first diphtheria, tetanus, pertussis vaccine at the 2 week well-baby visit is incorrect, as this is too early for the first dose of the DTaP vaccine. The first dose of the DTaP vaccine should be given at 2 months of age.
Choice C reason: Your baby should receive the pneumococcal conjugate vaccine on his first birthday is incorrect, as this is too late for the first dose of the PCV13 vaccine. The first dose of the PCV13 vaccine should be given at 2 months of age, followed by three more doses at 4, 6, and 12-15 months of age.
Choice D reason: Your baby should receive the measles, mumps, rubella vaccine at 6 months is incorrect, as this is too early for the first dose of the MMR vaccine. The first dose of the MMR vaccine should be given at 12-15 months of age, followed by a second dose at 4-6 years of age.
Correct Answer is B
Explanation
Choice A reason: Changes in the voice signal the beginning of puberty is incorrect, as voice changes usually occur in the middle or late stages of puberty, not the beginning. The first sign of puberty in boys is usually testicular enlargement, followed by pubic hair growth and penile enlargement.
Choice B reason: Growth spurts in height occur toward the end of mid-puberty is correct, as this is the typical pattern of growth for boys during puberty. Boys usually start their growth spurt later than girls, but grow faster and for a longer period of time.
Choice C reason: Puberty might be delayed if scrotal changes have not occurred by the age of 11 years is incorrect, as this is not a definitive indicator of delayed puberty. Puberty can vary widely among individuals, and some boys may start later than others without any underlying problem. Delayed puberty is usually diagnosed if there is no sign of puberty by the age of 14 years.
Choice D reason: Gynecomastia commonly occurs during late puberty is incorrect, as gynecomastia, or the enlargement of breast tissue in males, usually occurs in the early or middle stages of puberty, not the late stage. It is caused by hormonal changes and usually resolves on its own within a few months or years.
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