CLINICAL REASONING CASES IN
NURSING 7TH EDITION HARDING SNYDER
REVIEW QUESTION SET WITH ACCURATE
ANSWERS
◉ Pediatric anemia morphologic classification — normocytic
causes?
Answer: Hemolysis, acute blood loss, early chronic disease, bone
marrow disorders, and TEC
◉ Pediatric anemia morphologic classification — macrocytic
causes?
Answer: B12/folate deficiency, Diamond-Blackfan syndrome, liver
disease, and hypothyroidism
◉ Neonatal anemia — common etiologies?
Answer: Blood loss (maternal-fetal transfusion), isoimmunization
(Rh/ABO incompatibility), or congenital infections
◉ Infancy/toddlerhood anemia — dominant etiology and peak
risk age?
Answer: Iron deficiency, with peak risk at 6-36 months; also
structural hemoglobin disorders and TEC
, ◉ Adolescent anemia — common causes?
Answer: Growth spurts, menstruation, and poor dietary intake
◉ How does history help differentiate iron deficiency from
thalassemia in a child with microcytic anemia?
Answer: Iron deficiency is suggested by poor dietary intake
(toddlers) or menorrhagia (adolescent females); thalassemia
presents with microcytosis from unbalanced hemoglobin chain
synthesis, often with a family history
◉ In a child with sickle cell disease, what does acute anemia with
tachycardia and a spleen palpable in the pelvis suggest?
Answer: Splenic sequestration
◉ In an 18-month-old, gradual pallor and fatigue is more likely
due to what mechanism?
Answer: Production issues, such as nutritional deficiencies, rather
than acute sequestration
◉ How are bleeding-disorder-related causes of pediatric anemia
differentiated?
Answer: By the pattern of bleeding — mucosal bleeding (primary
hemostasis disorders) vs deep tissue hemorrhage (secondary
hemostasis/coagulation factor disorders)
NURSING 7TH EDITION HARDING SNYDER
REVIEW QUESTION SET WITH ACCURATE
ANSWERS
◉ Pediatric anemia morphologic classification — normocytic
causes?
Answer: Hemolysis, acute blood loss, early chronic disease, bone
marrow disorders, and TEC
◉ Pediatric anemia morphologic classification — macrocytic
causes?
Answer: B12/folate deficiency, Diamond-Blackfan syndrome, liver
disease, and hypothyroidism
◉ Neonatal anemia — common etiologies?
Answer: Blood loss (maternal-fetal transfusion), isoimmunization
(Rh/ABO incompatibility), or congenital infections
◉ Infancy/toddlerhood anemia — dominant etiology and peak
risk age?
Answer: Iron deficiency, with peak risk at 6-36 months; also
structural hemoglobin disorders and TEC
, ◉ Adolescent anemia — common causes?
Answer: Growth spurts, menstruation, and poor dietary intake
◉ How does history help differentiate iron deficiency from
thalassemia in a child with microcytic anemia?
Answer: Iron deficiency is suggested by poor dietary intake
(toddlers) or menorrhagia (adolescent females); thalassemia
presents with microcytosis from unbalanced hemoglobin chain
synthesis, often with a family history
◉ In a child with sickle cell disease, what does acute anemia with
tachycardia and a spleen palpable in the pelvis suggest?
Answer: Splenic sequestration
◉ In an 18-month-old, gradual pallor and fatigue is more likely
due to what mechanism?
Answer: Production issues, such as nutritional deficiencies, rather
than acute sequestration
◉ How are bleeding-disorder-related causes of pediatric anemia
differentiated?
Answer: By the pattern of bleeding — mucosal bleeding (primary
hemostasis disorders) vs deep tissue hemorrhage (secondary
hemostasis/coagulation factor disorders)
