A nurse is caring for a 7-year-old child who was brought in by parents due to unexplained bruising and red spots on the child’s shoulders, thighs, and back.

The parents report that the child has had a cold for more than 2 months and over-the-counter medications have not helped relieve the cold symptoms. The child had a small nosebleed “a few minutes ago” and reports “my arms and legs hurt all over.”. The nurse is reviewing the assessment findings and diagnostic results.

For each assessment finding, specify if the finding is consistent with sickle cell anemia or hemophilia.

WBC count

Temperature

Bleeding

Reported pain

Answer and Explanation

The Correct Answer is {"A":{"answers":"A"},"B":{"answers":"A"},"C":{"answers":"B"},"D":{"answers":"A"}}

WBC count: This finding is not consistent with either sickle cell anemia or hemophilia. Both conditions do not typically cause an increase in white blood cell count.
Temperature: This finding is not consistent with either sickle cell anemia or hemophilia. Neither condition is associated with an elevated body temperature unless there is a concurrent infection.
Bleeding: This finding is consistent with hemophilia. Hemophilia is a bleeding disorder where the blood does not clot properly. This can lead to spontaneous bleeding as well as bleeding following injuries or surgery.
Reported pain: This finding is consistent with sickle cell anemia. Sickle cell anemia can cause episodes of pain when sickle-shaped red blood cells block blood flow through tiny blood vessels to your chest, abdomen and joints. Pain can also occur in your bones.

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Correct Answer is ["C","D","E"]

Explanation

Choice A rationale
A newborn born at 32 weeks of gestation and weighing 1,100 g is considered preterm and is likely to have a thin, fragile appearance rather than a plump face.
Choice B rationale
Dehydration is not a typical finding in a preterm newborn unless there are underlying health issues or complications.
Choice C rationale
Long nails are a common finding in preterm newborns. This is because nail growth begins in the womb and preterm babies have had less time to wear down their nails through movement.
Choice D rationale
A weak grasp reflex is common in preterm newborns. This is due to their immature nervous system.
Choice E rationale
The presence of lanugo, or fine hair, is common in preterm newborns. Lanugo usually begins to disappear around 32 weeks of gestation, so a baby born at this time may still have a significant amount.

A. “You may hold your baby as long as you want.”. B. “This is for the best. Your baby was very ill.”. C. “I understand your grief. I lost a baby also.”. D. “I have called for the chaplain to come and stay with you.”.

Correct Answer is A

Explanation

Choice A rationale
Offering the parent the opportunity to hold their stillborn baby can be a crucial part of the grieving process. It allows the parent to acknowledge the reality of the loss and begin to say goodbye.
Choice B rationale
Telling a grieving parent that “this is for the best” can be perceived as dismissive and insensitive. It’s important to validate the parent’s feelings of loss and grief.
Choice C rationale
Sharing personal experiences of loss can shift the focus away from the grieving parent. It’s more helpful to provide empathetic support and allow the parent to share their feelings.
Choice D rationale
While spiritual support can be helpful for some, it’s not appropriate to assume that every parent will want this. It’s better to ask the parent if they would like to speak with a chaplain or other spiritual advisor.

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Naxlex Comprehensive Predictor Exams

A nurse is assisting with the assessment of a newborn who was born at 32 weeks of gestation. The newborn’s birth weight is 1,100 g. What are the expected findings in this newborn? (Select all that apply.)

Correct Answer is ["C","D","E"]

Explanation

A client at 36 weeks gestation has just delivered a stillborn baby. What should the nurse say?

Correct Answer is A

Explanation

A community health nurse is developing a pamphlet about breast self-examination (BSE) for a local health fair. Which of the following instructions should the nurse include?

A nurse is caring for a newborn and hears an apical heart rate of 130/min. What should the nurse do next?

A nurse is discharging a child who has recovered from an acute crisis episode of sickle cell anemia. What instructions should the nurse include in the teaching?

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