Nurs 611 Exam 3 Advanced Pathophysiology
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What treatment prevents the development of kernicterus in
an infant born with hemolytic disease of the newborn
(HDN)?
a.
Administration of intravenous fluids to dilute the blood
b.
Replacement transfusion of new Rh-positive blood that is
not contaminated with anti-Rh antibodies
c.
Performance of a splenectomy to prevent the destruction
of abnormal erythrocytes
d.
Replacement transfusion of Rh-neg - ANSWER-B
If antigenic incompatibility of the mother's erythrocytes is
not discovered in time to administer Rh immunoglobulin
and the child is born with HDN, then the treatment
consists of exchange transfusions in which the neonate's
blood is replaced with new Rh-positive blood that is not
contaminated with anti-Rh antibodies. This treatment is
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administered during the first 24 hours of extrauterine life to
prevent kernicterus. This selection is the only option that
accurately prevents kernicterus.
Sickle cell disease is classified as a(an):
a.
Inherited X-linked recessive disorder
b.
Inherited autosomal recessive disorder
c.
Disorder initiated by hypoxemia and acidosis
d.
Disorder that is diagnosed equally in men and women -
ANSWER-C
Sickling is an occasional, intermittent phenomenon that
can be triggered or sustained by one or more of the
following stressors: decreased oxygen tension (PO2) of
the blood (hypoxemia), increased hydrogen ion
concentration in the blood (decreased pH), increased
plasma osmolality, decreased plasma volume, and low
temperature (see Figure 30-7). This selection is the only
option that accurately identifies the classification of the
stated disorders.
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Hemoglobin S (HbS) is formed in sickle cell disease as a
result of which process?
a.
Deficiency in glucose 6-phosphate dehydrogenase
(G6PD) that changes hemoglobin A (HbA) to HbS.
b.
Genetic mutation in which two amino acids (histidine and
leucine) are missing.
c.
Genetic mutation in which one amino acid (valine) is
replaced by another (glutamic acid).
d.
Autoimmune response in which one amino acid (proline) is
detected as an antigen by abnormal immunoglobulin G
(IgG). - ANSWER-C
HbS is formed by a genetic mutation in which one amino
acid (valine) replaces another (glutamic acid) (see Figure
30-5, A). This selection is the only option that accurately
identifies how HbS is formed in sickle cell disease.
Sickle cell disease (SCD) is what type of inherited
disorder?
a.
Autosomal dominant
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c.
X-linked dominant
b.
Autosomal recessive
d.
X-linked recessive - ANSWER-B
SCD is an inherited autosomal recessive disorder that is
expressed as sickle cell anemia, sickle cell-thalassemia
disease, or sickle cell-hemoglobin C (HbC) disease,
depending on mode of inheritance. This selection is the
only option that accurately identifies the mode of
inheritance for the stated disorder.
What is the reason most children diagnosed with sickle
cell anemia are not candidates for either bone marrow or
stem cell transplants?
a.
Well-matched stem cell donors are difficult to find.
b.
The child is usually too weak to survive the procedure.
c.
The child's immune system will not appropriately respond
to the antirejection medications.