NUR 254 EXAM 4 EXAM QUESTIONS
AND ANSWERS 2025
Iron deficiency Anemia:Etiology/Diagnostics - ANSWERSinadequate amount of iron,
children 12-36 months at risk
Iron deficiency Anemia: S/S - ANSWERS-tachy
-can be underweight or overweight
Iron deficiency Anemia: treatment - ANSWERS-Iron rich foods (green leafy),
supplements, dietary supplements, organ meats, rice cereal at 6 months,
Iron deficiency Anemia: Teaching - ANSWERS- No cow's milk until the baby is 1 years
old
-NO iron supplements with milk, give on empty stomach acid makes it absorb beer*
o Liquid supplement can stain teach, use straw or regular iron supplement capsule/pill
o Black tarry green stools
o Keep away from children, never keep more than a month supply at home
o Infants 30 mins before on empty, older child with something citric for the acid*
o Dietary counseling
Sickle Cell Anemia: Important* - ANSWERSPrevent Dehydration
Sickle Cell Anemia: Etiology/Diagnostics - ANSWERS-Hereditary, Autosomal recessive
trait.
-Cells are sickle shaped. -Repetitive decrease in 02 cell walls become rigid.
-Cells are getting jammed, causing an obstruction of RBC's, resulting in PAIN.
-The normal HGB is replaced with abnormal HGB.
-Effects the spleen.
o Organ that's mostly effected is the spleen*
o Newborn Screening in the US
Sickle Cell Anemia: S/S - ANSWERSo Vascular inflammation
o Pain-> severe abdominal pain or chest. Mid to severe from 1 min-days -> crisis
o Stroke -> Severe unrelieved headache**
o Painful Swelling: hands, feet, joint pain
o Headache. Doesn't go away with meds? Possible CVA. EMERGENCY*
o One CVA? R/F another** (stroke)
o Visual disturbances
o Obstructive jaundice
o Fever 101.3 or higher
o Severe hypoxia
,Sickle Cell Anemia: VASOCCLUSIVE Crisis - ANSWERS-: Acute chest syndrome
-mimics pneumonia "painful episode"
Sickle Cell Anemia: Splenic Sequestration - ANSWERS-Pooling of blood in the spleen
-Causes infection, stress, dehydration, *USE IV FLUIDS***
-trauma
Sickle Cell Anemia: treatment - ANSWERSo DON'T over oxygenate o Heat
o Prophylactic antibiotics: R/F infection* Preventing Infection* ( Vaccines, Anbiocs
(PCN))
o If they've had a stroke, every 3-4 weeks for transfusions* to prevent CVA
o Decrease 02 demands
o Oral/IV hydration, Oral at home to prevent hospitalization
o Splenectomy (severe)
o Stem cell Transplant: considered curative (severe)
o Rest
o Control Pain: Morphine
o Electrolyte replacement
Sickle Cell Anemia: Teaching - ANSWERSo Prevent hydration
o Rest
o Improve oxygen but don't over oxygenate
o Educate importance of vaccines
o Know s/s of a stroke
o Child is normal just gets sicker easier
Hemophilia: term - ANSWERSMIssing clotting factors
Hemophilia:Etiology/Diagnostics - ANSWERSDeficiency of factor VIII, produced by the
liver, bleeding disorder
Hemophilia: education - ANSWERSParents -> genetic counseling
Hemophilia: S/S - ANSWERSo PROLONGED bleeding, kid will bleed longer than other
kids, gums, cuts, injections
o Hemorrhage: At higher risk
o Bruising
o Hemarthrosis: blood in joints (knees, elbows, ankles)
o Spontaneous Hematuria: dark urine, blood
o Hematomas -> pain, swelling, limited motion
o Headache
o Slurred Speech
o Loss of Consciousness
o Black Tarry Stools= Bleed
o Vomiting coffee ground emesis
o Bleeding gyms with teeth brushing
, Hemophilia: Treatment - ANSWERS-NO cure; lifelong
o Replace VIII factor:
o Prevent bleeding: No IM vaccines, try subQ or less invasive first
o Medications
Steroids
NSAIDS
DDAVP
o Wear helmets
o Safety, protective equipment
o Regular Exercise and Physical Therapy
o Go to doctor for sprains
o Control Bleeding
R: Rest
I: ICE
C: Compress (cold)**
E: Elevate
Pediatric Oncology: Etiology/Diagnostics - ANSWERS-Unknown
o Some genetic alterations, chromosomal abnormalities identified
o Lifestyle factors in adult cancer generally aren't present in childhood cancers (lung
cancer), but not in adolescents
o Labs: CBC, CMP, LFT, coags (coagulation profile)
o Lumbar Puncture: Leukemia, brain tumors, Mets to CNS
o Radiology: X-ray, CT, MRI, PET
o Biopsy
Pediatric Oncology: Treatment: - ANSWERSSurgery, Chemo, radiation, BMT
Pediatric Oncology: S/S of treatment - ANSWERSo Infection
o Hemorrhage
o Anemia
o N/V
o Altered nutrition
o Mucosal Ulceration: GI tract is one big mucosal membrane; kid can have ulcer from
mouth to anus (don't want constipation)
o Stool Softeners ^
o Neurological Problems
o Hair Loss
Pediatric Oncology: Chemo - ANSWERS-No live vaccines
-Thrombocytopenia (low platelets, bleeding risk)
-Monitor for bleeding
AND ANSWERS 2025
Iron deficiency Anemia:Etiology/Diagnostics - ANSWERSinadequate amount of iron,
children 12-36 months at risk
Iron deficiency Anemia: S/S - ANSWERS-tachy
-can be underweight or overweight
Iron deficiency Anemia: treatment - ANSWERS-Iron rich foods (green leafy),
supplements, dietary supplements, organ meats, rice cereal at 6 months,
Iron deficiency Anemia: Teaching - ANSWERS- No cow's milk until the baby is 1 years
old
-NO iron supplements with milk, give on empty stomach acid makes it absorb beer*
o Liquid supplement can stain teach, use straw or regular iron supplement capsule/pill
o Black tarry green stools
o Keep away from children, never keep more than a month supply at home
o Infants 30 mins before on empty, older child with something citric for the acid*
o Dietary counseling
Sickle Cell Anemia: Important* - ANSWERSPrevent Dehydration
Sickle Cell Anemia: Etiology/Diagnostics - ANSWERS-Hereditary, Autosomal recessive
trait.
-Cells are sickle shaped. -Repetitive decrease in 02 cell walls become rigid.
-Cells are getting jammed, causing an obstruction of RBC's, resulting in PAIN.
-The normal HGB is replaced with abnormal HGB.
-Effects the spleen.
o Organ that's mostly effected is the spleen*
o Newborn Screening in the US
Sickle Cell Anemia: S/S - ANSWERSo Vascular inflammation
o Pain-> severe abdominal pain or chest. Mid to severe from 1 min-days -> crisis
o Stroke -> Severe unrelieved headache**
o Painful Swelling: hands, feet, joint pain
o Headache. Doesn't go away with meds? Possible CVA. EMERGENCY*
o One CVA? R/F another** (stroke)
o Visual disturbances
o Obstructive jaundice
o Fever 101.3 or higher
o Severe hypoxia
,Sickle Cell Anemia: VASOCCLUSIVE Crisis - ANSWERS-: Acute chest syndrome
-mimics pneumonia "painful episode"
Sickle Cell Anemia: Splenic Sequestration - ANSWERS-Pooling of blood in the spleen
-Causes infection, stress, dehydration, *USE IV FLUIDS***
-trauma
Sickle Cell Anemia: treatment - ANSWERSo DON'T over oxygenate o Heat
o Prophylactic antibiotics: R/F infection* Preventing Infection* ( Vaccines, Anbiocs
(PCN))
o If they've had a stroke, every 3-4 weeks for transfusions* to prevent CVA
o Decrease 02 demands
o Oral/IV hydration, Oral at home to prevent hospitalization
o Splenectomy (severe)
o Stem cell Transplant: considered curative (severe)
o Rest
o Control Pain: Morphine
o Electrolyte replacement
Sickle Cell Anemia: Teaching - ANSWERSo Prevent hydration
o Rest
o Improve oxygen but don't over oxygenate
o Educate importance of vaccines
o Know s/s of a stroke
o Child is normal just gets sicker easier
Hemophilia: term - ANSWERSMIssing clotting factors
Hemophilia:Etiology/Diagnostics - ANSWERSDeficiency of factor VIII, produced by the
liver, bleeding disorder
Hemophilia: education - ANSWERSParents -> genetic counseling
Hemophilia: S/S - ANSWERSo PROLONGED bleeding, kid will bleed longer than other
kids, gums, cuts, injections
o Hemorrhage: At higher risk
o Bruising
o Hemarthrosis: blood in joints (knees, elbows, ankles)
o Spontaneous Hematuria: dark urine, blood
o Hematomas -> pain, swelling, limited motion
o Headache
o Slurred Speech
o Loss of Consciousness
o Black Tarry Stools= Bleed
o Vomiting coffee ground emesis
o Bleeding gyms with teeth brushing
, Hemophilia: Treatment - ANSWERS-NO cure; lifelong
o Replace VIII factor:
o Prevent bleeding: No IM vaccines, try subQ or less invasive first
o Medications
Steroids
NSAIDS
DDAVP
o Wear helmets
o Safety, protective equipment
o Regular Exercise and Physical Therapy
o Go to doctor for sprains
o Control Bleeding
R: Rest
I: ICE
C: Compress (cold)**
E: Elevate
Pediatric Oncology: Etiology/Diagnostics - ANSWERS-Unknown
o Some genetic alterations, chromosomal abnormalities identified
o Lifestyle factors in adult cancer generally aren't present in childhood cancers (lung
cancer), but not in adolescents
o Labs: CBC, CMP, LFT, coags (coagulation profile)
o Lumbar Puncture: Leukemia, brain tumors, Mets to CNS
o Radiology: X-ray, CT, MRI, PET
o Biopsy
Pediatric Oncology: Treatment: - ANSWERSSurgery, Chemo, radiation, BMT
Pediatric Oncology: S/S of treatment - ANSWERSo Infection
o Hemorrhage
o Anemia
o N/V
o Altered nutrition
o Mucosal Ulceration: GI tract is one big mucosal membrane; kid can have ulcer from
mouth to anus (don't want constipation)
o Stool Softeners ^
o Neurological Problems
o Hair Loss
Pediatric Oncology: Chemo - ANSWERS-No live vaccines
-Thrombocytopenia (low platelets, bleeding risk)
-Monitor for bleeding
