Chapter 23: Aplastic Anemia Flashcards
What is the primary pathophysiology of aplastic anemia?
A. Overproduction of immature blood cells
B. Failure of bone marrow to produce sufficient blood cells
C. Increased destruction of red blood cells
D. Excessive bleeding leading to anemia
B. Failure of bone marrow to produce sufficient blood cells
Rationale: Aplastic anemia results from the bone marrow’s inability to produce adequate amounts of blood cells, leading to pancytopenia.
Which of the following is a common cause of acquired aplastic anemia in children?
A. Sickle cell trait
B. Nutritional deficiencies in vitamin B12 and folic acid
C. Overuse of corticosteroids
D. Prolonged exposure to ultraviolet radiation
B. Nutritional deficiencies in vitamin B12 and folic acid
Rationale: Acquired aplastic anemia may result from deficiencies in vitamin B12 or folic acid, exposure to chemicals, infections, or certain drugs.
Which drug is most associated with acquired aplastic anemia in children?
A. Ibuprofen
B. Aspirin
C. Chloramphenicol
D. Penicillin
C. Chloramphenicol
Rationale: Chloramphenicol is one of the drugs most frequently linked to acquired aplastic anemia.
Which of the following symptoms is associated with neutropenia in aplastic anemia?
A. Petechiae
B. Purpura
C. Fever
D. Exercise intolerance
C. Fever
Rationale: Fever and bacterial infections are symptoms related to neutropenia, a component of pancytopenia in aplastic anemia.
What is the primary diagnostic test to confirm aplastic anemia?
A. Bone marrow aspiration
B. Peripheral blood smear
C. Hemoglobin electrophoresis
D. Coagulation studies
A. Bone marrow aspiration
Rationale: Bone marrow aspiration revealing yellow, fatty marrow instead of red marrow confirms aplastic anemia.
What is the definitive treatment for severe aplastic anemia in children?
A. Transfusion of platelets and packed red blood cells
B. Immunosuppressive drug therapy
C. Administration of vitamin B12
D. Hematopoietic stem cell transplantation (HSCT)
D. Hematopoietic stem cell transplantation (HSCT)
Rationale: HSCT from an HLA-matched sibling donor is the treatment of choice for severe aplastic anemia.
Which complication is the most common cause of death in aplastic anemia?
A. Hemorrhage and sepsis
B. Cardiopulmonary arrest
C. Acute kidney failure
D. Malnutrition
A. Hemorrhage and sepsis
Rationale: Hemorrhage and sepsis are the primary causes of death in patients with aplastic anemia due to pancytopenia.
Which immunosuppressive agent is commonly used in the treatment of aplastic anemia?
A. Methotrexate
B. Prednisone
C. Mycophenolate mofetil
D. Cyclosporine
D. Cyclosporine
Rationale: Cyclosporine and antithymocyte globulin (ATG) are commonly used immunosuppressive agents for aplastic anemia.
What clinical sign is indicative of thrombocytopenia in a child with aplastic anemia?
A. Fatigue
B. Fever
C. Jaundice
D. Petechiae
D. Petechiae
Rationale: Petechiae and purpura are characteristic of thrombocytopenia due to reduced platelet levels.
Which of the following infections is associated with acquired aplastic anemia?
A. Epstein-Barr virus
B. Clostridioides difficile
C. Helicobacter pylori
D. Varicella-zoster virus
A. Epstein-Barr virus
Rationale: Epstein-Barr virus (causing mononucleosis), cytomegalovirus, and viral hepatitis can lead to acquired aplastic anemia.
Which laboratory finding is expected in aplastic anemia?
A. Increased reticulocyte count
B. Elevated hemoglobin levels
C. Pancytopenia
D. Hypersegmented neutrophils
C. Pancytopenia
Rationale: Pancytopenia, including leukopenia, thrombocytopenia, and decreased red blood cells, is a hallmark of aplastic anemia.
Which intervention is prioritized in the nursing care plan for a child with aplastic anemia?
A. Providing dietary supplements for vitamin B12
B. Monitoring for signs of infection or bleeding
C. Encouraging participation in vigorous physical activities
D. Administering routine vaccinations
B. Monitoring for signs of infection or bleeding
Rationale: Preventing and monitoring for complications such as infection and bleeding is critical in managing aplastic anemia.
What is the primary purpose of antithymocyte globulin (ATG) in treating aplastic anemia?
A. To stimulate erythropoiesis in the bone marrow
B. To suppress the immune response attacking the bone marrow
C. To provide temporary relief from anemia
D. To replace deficient vitamins
B. To suppress the immune response attacking the bone marrow
Rationale: ATG is used to suppress the immune system, which is thought to attack bone marrow in aplastic anemia.
Which chemical exposure is linked to acquired aplastic anemia?
A. Benzene
B. Sulfates
C. Nitrates
D. Ammonia
A. Benzene
Rationale: Benzene, found in pesticides and insecticides, is a known chemical associated with acquired aplastic anemia.
What nursing teaching is critical for a child undergoing HSCT for aplastic anemia?
A. “You will need lifelong transfusions after the transplant.”
B. “You will need frequent corticosteroid injections post-transplant.”
C. “The transplant will eliminate the risk of future infections.”
D. “Your immune system will be weakened for several months.”
D. “Your immune system will be weakened for several months.”
Rationale: After HSCT, the child’s immune system is suppressed, requiring protective measures to reduce the risk of infection.
What is the primary nursing intervention for a child with aplastic anemia?
A. Encouraging a high-protein diet to improve hemoglobin levels
B. Preventing bleeding by minimizing invasive procedures
C. Initiating early ambulation to prevent muscle atrophy
D. Administering antibiotics prophylactically to prevent infection
B. Preventing bleeding by minimizing invasive procedures
Rationale: Preventing bleeding is a priority in managing aplastic anemia due to the risk of thrombocytopenia, which increases susceptibility to hemorrhage.
Which outcome would indicate that a nursing goal for a child with aplastic anemia has been achieved?
A. The child’s hemoglobin level remains stable at 7 g/dL.
B. The child reports no episodes of fever or signs of infection.
C. The parents express an understanding of iron-rich food options.
D. The child tolerates frequent ambulation without fatigue.
B. The child reports no episodes of fever or signs of infection.
Rationale: An absence of fever and infection indicates that neutropenia-related complications are being effectively managed.
When educating parents of a child with aplastic anemia, which topic is most important to include?
A. Strategies to manage episodes of hypoglycemia
B. How to administer subcutaneous injections of deferoxamine
C. Recognizing early signs of bleeding or infection
D. Dietary recommendations to increase red blood cell production
C. Recognizing early signs of bleeding or infection
Rationale: Early identification of bleeding or infection is critical in preventing life-threatening complications in children with aplastic anemia.
What is the nurse’s primary role when preparing a child with aplastic anemia for a blood transfusion?
A. Monitoring the child’s heart rate before, during, and after the transfusion
B. Educating the child about iron chelation therapy
C. Verifying blood compatibility and observing for signs of transfusion reactions
D. Encouraging fluid intake before starting the transfusion
C. Verifying blood compatibility and observing for signs of transfusion reactions
Rationale: The nurse must ensure safe transfusion practices, including verifying compatibility and monitoring for reactions, as these are critical aspects of care.
Which nursing intervention helps improve mobility for a child with aplastic anemia while minimizing risk?
A. Encouraging bedrest until blood counts normalize
B. Implementing passive range-of-motion exercises as tolerated
C. Allowing unrestricted ambulation to build muscle strength
D. Limiting all physical activity to prevent fatigue
B. Implementing passive range-of-motion exercises as tolerated
Rationale: Passive range-of-motion exercises promote mobility while reducing the risk of injury or fatigue associated with thrombocytopenia and anemia.
Which clinical manifestation is most indicative of thrombocytopenia in a child with aplastic anemia?
A. Fatigue and pallor
B. Petechiae and epistaxis
C. Fever and bacterial infections
D. Menorrhagia and growth retardation
B. Petechiae and epistaxis
Rationale: Petechiae and epistaxis are hallmark signs of bleeding associated with thrombocytopenia, which is common in aplastic anemia.
What is the primary nursing intervention for a child with aplastic anemia experiencing pallor and fatigue?
A. Administering blood transfusions as ordered
B. Encouraging physical activity to increase circulation
C. Providing iron-rich foods to enhance hemoglobin synthesis
D. Monitoring vital signs for signs of hypovolemic shock
A. Administering blood transfusions as ordered
Rationale: Blood transfusions help restore red blood cells, improving oxygen delivery and alleviating symptoms of anemia such as pallor and fatigue.
What is the priority nursing goal for a child with neutropenia secondary to aplastic anemia?
A. Promoting adequate tissue perfusion
B. Maintaining hydration status
C. Preventing bacterial infections
D. Ensuring adequate nutrition
C. Preventing bacterial infections
Rationale: Neutropenia increases the risk of bacterial infections, making infection prevention the primary goal.
Which nursing intervention promotes growth and development in a child with aplastic anemia?
A. Encouraging age-appropriate activities while monitoring for fatigue
B. Restricting physical activities to prevent injury
C. Allowing unrestricted screen time to compensate for physical limitations
D. Delaying education about the disease until adolescence
A. Encouraging age-appropriate activities while monitoring for fatigue
Rationale: Age-appropriate activities support physical, emotional, and cognitive development while considering the child’s energy level.
