PEDS NR328 EXAM 2026 UPDATE
QUESTIONS AND CORRECT VERIFIED
ANSWERS ALREADY GRADED A+
(BRAND NEW VISION)
Chronic renal failure planning & implementation - ans-•Mgmt is aimed
at maintenance of electrolyte and fluid balance as close to nml as
possible
•Dialysis used to maintain fluid status, electrolytes and
elimination of wastes
•Permanent damage, only cure is transplant
Provide emotional support, community &
Urine specimen - ans-1.Clean-catch: urine specimen is collected in a
clean specimen container following appropriate cleansing of
urethral meatus and surrounding tissue. In patients < 2 yo who
aren't toilet trained perform straight-cath or bag method. In
school-age and older, adult assistance is needed. Adolescents can
obtain with teaching first
2.Sterile specimen: is obtained through straight catheterization
only
Anemia - ans--Lower than normal hemoglobin and fewer than
normal circulating erythrocytes; a sign of an underlying disorder
Hypo proliferative - ans--defect in production of RBCs
-Caused by iron, vitamin B12, or folate deficiency, decreased
erythropoietin production, cancer
Hemolytic - ans--excess destruction of RBCs
,**This occurs when RBC replacement outpaces a person's own
bone marrow production of these cells
-The erythrocytes in the circulation have a shortened lifespan,
thus their number in the circulation is reduced
Hemolytic anemia inherited vs. acquired form - ans--Inherited forms-
sickle cell disease (SCD), thalassemia, G6-PD deficiency
-Acquired forms- heart valve hemolysis, autoimmune hemolytic
anemia etc.
Causes of Anemia - ans--Nutritional deficiency - iron, folate, B12
-Increased destruction of RBCs - sickle
cell anemia
-Impaired or decreased rate of
production - aplastic anemia
-Excessive blood loss - hemophilia
Iron deficiency Anemia - ans--Usually caused by↓ dietary intake or
blood loss
-Cow's milk anemia
-diagnosis = CBC with diff, red cell indices (MCV, MCH, MCHC),
iron studies, physical exam
symptoms of iron deficiency anemia - ans--Gradual lethargy
-Irritability, weakness
-Pallor, hair loss, brittle nails
-Lack of interest in play
-Tachycardia, murmur
-Increased O2 demand
,*due to tissue hypoxia = lack of energy, easy fatigability, pallor
treatment for iron deficiency anemia - ans--Iron fortified foods
(Spinach, peas, legumes, beef, grains, broccoli)
-Iron Supplements
-Take with Vit C foods, not Calcium
-Constipation, nausea
-Prevent blood loss
´Medical Treatment: supplement with ferrous sulfate (dosages
vary with age), dietary counseling
food rich in iron - ans--red meat
-tuna and salmon
-eggs
-tofu
-enriched grains
-dried beans, peas, and fruits
-leafy green vegetables
-iron-fortified breakfast cereals
Aplastic anemia - ans--Abnormality in stem cell expression leads to
inadequate production of blood cells
-Pancytopenia
-Increased bruising (↓platelets)
-Increased risk of infection (↓ leukocytes)
-S/Sx anemia (↓RBCs)
-For acquired type, treat underlying cause
-BMT best treatment option for inherited type
, Nursing management of aplastic anemia - ans--SAFETY
-avoid hemorrhage/injury - no rectal temps
-administer only irradiated and leukocyte-depleted PRBCs or
platelet transfusions as necessary
Pathophysiology sickle cell anemia - ans-- Vaso-occlusion from sickled
RBCs
- Increased RBC destruction
- Splenic congestion and enlargement
- Hepatomegaly, liver failure
- Renal ischemia, hematuria
- Osteoporosis, lordosis, kyphosis
- Cardiomegaly, heart failure, stroke
Laboratory and Diagnostic Studies to Assess Sickle Cell Disease - ans--
Hemoglobin: baseline is usually 7 to 10 mg/dL; will be significantly lower
with splenic sequestration, acute chest syndrome, or aplastic crisis.
-Hgb electrophoresis: measures the type of Hgb (Hgb S, Hgb SS or Hbg F).
-Reticulocyte count: greatly elevated.
-Peripheral blood smear: presence of sickle-shaped cells and target cells.
-Platelet count: increased.
-Erythrocyte sedimentation rate: elevated.
-Abnormal liver function tests with elevated bilirubin.
Manifestations of Sickle Cell Anemia - ans--Cells unable to pass thru
microcirculation
-Infarction of splenic vessels = blood pools in spleen
-RBC destruction causes more anemia
-Sickling is intermittent
-Caused by episodes of ↓ O2, ↓ pH, or ↓ volume in blood, stress, illness
QUESTIONS AND CORRECT VERIFIED
ANSWERS ALREADY GRADED A+
(BRAND NEW VISION)
Chronic renal failure planning & implementation - ans-•Mgmt is aimed
at maintenance of electrolyte and fluid balance as close to nml as
possible
•Dialysis used to maintain fluid status, electrolytes and
elimination of wastes
•Permanent damage, only cure is transplant
Provide emotional support, community &
Urine specimen - ans-1.Clean-catch: urine specimen is collected in a
clean specimen container following appropriate cleansing of
urethral meatus and surrounding tissue. In patients < 2 yo who
aren't toilet trained perform straight-cath or bag method. In
school-age and older, adult assistance is needed. Adolescents can
obtain with teaching first
2.Sterile specimen: is obtained through straight catheterization
only
Anemia - ans--Lower than normal hemoglobin and fewer than
normal circulating erythrocytes; a sign of an underlying disorder
Hypo proliferative - ans--defect in production of RBCs
-Caused by iron, vitamin B12, or folate deficiency, decreased
erythropoietin production, cancer
Hemolytic - ans--excess destruction of RBCs
,**This occurs when RBC replacement outpaces a person's own
bone marrow production of these cells
-The erythrocytes in the circulation have a shortened lifespan,
thus their number in the circulation is reduced
Hemolytic anemia inherited vs. acquired form - ans--Inherited forms-
sickle cell disease (SCD), thalassemia, G6-PD deficiency
-Acquired forms- heart valve hemolysis, autoimmune hemolytic
anemia etc.
Causes of Anemia - ans--Nutritional deficiency - iron, folate, B12
-Increased destruction of RBCs - sickle
cell anemia
-Impaired or decreased rate of
production - aplastic anemia
-Excessive blood loss - hemophilia
Iron deficiency Anemia - ans--Usually caused by↓ dietary intake or
blood loss
-Cow's milk anemia
-diagnosis = CBC with diff, red cell indices (MCV, MCH, MCHC),
iron studies, physical exam
symptoms of iron deficiency anemia - ans--Gradual lethargy
-Irritability, weakness
-Pallor, hair loss, brittle nails
-Lack of interest in play
-Tachycardia, murmur
-Increased O2 demand
,*due to tissue hypoxia = lack of energy, easy fatigability, pallor
treatment for iron deficiency anemia - ans--Iron fortified foods
(Spinach, peas, legumes, beef, grains, broccoli)
-Iron Supplements
-Take with Vit C foods, not Calcium
-Constipation, nausea
-Prevent blood loss
´Medical Treatment: supplement with ferrous sulfate (dosages
vary with age), dietary counseling
food rich in iron - ans--red meat
-tuna and salmon
-eggs
-tofu
-enriched grains
-dried beans, peas, and fruits
-leafy green vegetables
-iron-fortified breakfast cereals
Aplastic anemia - ans--Abnormality in stem cell expression leads to
inadequate production of blood cells
-Pancytopenia
-Increased bruising (↓platelets)
-Increased risk of infection (↓ leukocytes)
-S/Sx anemia (↓RBCs)
-For acquired type, treat underlying cause
-BMT best treatment option for inherited type
, Nursing management of aplastic anemia - ans--SAFETY
-avoid hemorrhage/injury - no rectal temps
-administer only irradiated and leukocyte-depleted PRBCs or
platelet transfusions as necessary
Pathophysiology sickle cell anemia - ans-- Vaso-occlusion from sickled
RBCs
- Increased RBC destruction
- Splenic congestion and enlargement
- Hepatomegaly, liver failure
- Renal ischemia, hematuria
- Osteoporosis, lordosis, kyphosis
- Cardiomegaly, heart failure, stroke
Laboratory and Diagnostic Studies to Assess Sickle Cell Disease - ans--
Hemoglobin: baseline is usually 7 to 10 mg/dL; will be significantly lower
with splenic sequestration, acute chest syndrome, or aplastic crisis.
-Hgb electrophoresis: measures the type of Hgb (Hgb S, Hgb SS or Hbg F).
-Reticulocyte count: greatly elevated.
-Peripheral blood smear: presence of sickle-shaped cells and target cells.
-Platelet count: increased.
-Erythrocyte sedimentation rate: elevated.
-Abnormal liver function tests with elevated bilirubin.
Manifestations of Sickle Cell Anemia - ans--Cells unable to pass thru
microcirculation
-Infarction of splenic vessels = blood pools in spleen
-RBC destruction causes more anemia
-Sickling is intermittent
-Caused by episodes of ↓ O2, ↓ pH, or ↓ volume in blood, stress, illness
