NSG-434 FINAL EXAM QUESTIONS WITH CORRECT ANSWERS 2025

NSG-434 FINAL EXAM QUESTIONS
WITH CORRECT ANSWERS 2025
Hematologicmandmimmunologicmdysfunctionmassessmentm-MCORRECTMANSWERM--
completembloodmcellmcount

-historymandmphysicalmexamination

-commentsmbymthemparentmregardingmchild'smlackmofmenergy

-foodmdiarymofmpoormironmsources

-frequentminfections

-bleedingmthatmismdifficultmtomcontrol

-examinemskinmformpallor,Mpetechiae,mandmbruising



Anemiam-MCORRECTMANSWERM--themmostmcommonmhematologicmdisordermofmchildhood

-decreaseminmnumbermofmrbcsmormhemoglobinm(Hgb)mconcentrationmbelowmnormal,mormboth

-decreasedmoxygen-carryingmcapacitymofmblood

-
causesmandmphysiology:mdepletionmofmrbcsmormhgb,mormboth;mmaymbemcausedmbymamdietarymdepletionmofmi
ron

-Morphology:

Characteristicmchangesminmrbcmsize,Mshape,mormcolor,mormamcombinationmofmthese

-signsmandmsymptoms:mlackmofmenergy,measymfatigability,mandmpallor;mcyanosismismtypicallymnotmevident

-diagnosticmevaluation:

Sometimesmdefinedmasmhgbm<10morm11mg/dl;Mhowever,mthismcutoffmmaymbeminappropriatemformchildren



Aplasticmanemia:

-amconditionmthatmoccursmwhenmyourmbodymstopsmproducingmenoughmnewmbloodmcells.M

-
treatmentmformaplasticmanemiammaymincludemmedications,mbloodmtransfusions,mormamstemmcellmtransplant
,malsomknownmasmambonemmarrowmtransplant.

-
puremredmcellmaplasiam(PRCA)mormerythroblastopeniamrefersmtomamtypemofmanemiamaffectingmthemprecursor
smtomredmbloodmcellsmbutmnotmtomwhitembloodmcells.M

,-inmprca,mthembonemmarrowmceasesmtomproducemredmbloodmcells.



-
immunemthrombocytopenicmpurpuram(ITP)mismambleedingmdisorderminmwhichmthemimmunemsystemmdestroy
smplatelets,mwhichmaremnecessarymformnormalmbloodmclotting.M

-peoplemwithmthemdiseasemhavemtoomfewmplateletsminmthemblood.



-disseminatedmintravascularmcoagulationm(DIC)mismamrare,Mlife-threateningmcondition.M

-inmthemearlymstagesmofmthemcondition,mdicmcausesmyourmbloodmtomclotmexcessively.M

-asmamresult,mbloodmclotsmmaymreducembloodmflowmandmblockmbloodmfrommreachingmbodilymorgans.



Therapeuticmmanagementmofmanemia:

-Diagnosis:mhistorymandmphysical,MCBC

-
treatmentmofmunderlyingmcause:mtransfusionmaftermhemorrhagemifmneeded;mnutritionalminterventionmformd
eficiencymanemias

-supportivemcare:mintravenousm(IV)mfluidsmtomreplacemintravascularmvolume;moxygenmtherapy;mbedmrest



Caremmanagementmof



Ironmdeficiencymanemiam-MCORRECTMANSWERM--causedmbyminadequatemsupplymofmdietarymiron

-generallympreventable:

•Iron-fortifiedmcerealsmandmformulasmforminfantsm(wicmprograms)

•specialmneedsmofmprematureminfants:mreducedmfetalmironmsupply

•adolescentsmatmriskmbecausemofmrapidmgrowthmandmpoormeatingmhabits

-canmgetmironmfrommredmmeat,Mbeans,Mkale,Mraisins,msomemfruits



Pathophysiology:

-causedmbymanymnumbermofmfactors:mduringmlastmtrimester,mironmismtransferredmfrommmothermtomfetus

•adequatem5mtom6mmonthsminmfullmterm

,•onlym2mtom3mmonthsminmpreemies

-"milkmbabies":M•overweightminfantmbecausemofmexcessivemmilkmingestion

•2mreasonsmbecomemanemic:mmilkm(poormsourcemofmiron)Mand

Increasedmfecalmloss




-therapeuticmmanagement:mincreaseminmthemamountmofmironmthemchildmreceives

-Prognosis:mverymgood



-nursingmcaremmanagement:

-Diet

-ironmsupplementation:

•adherencemtomoralmironmsupplementmwithmappropriatemadministration

•liquidmpreparation:mmaymtemporarilymstainmteeth;mbrushmteethmaftermadminmtomlessenmstaining



Ifmyourmchildmhasmironmdeficiencymanemia:

-makemsuremyourmchildmtakesmthemironmsupplementsmexactlymasmprescribed.

-includemiron-richmfoodsminmthemfamily'smdiet.M

-goodmsourcesmofmironminclude:

Iron-fortifiedmcereals,mleanmmeat,Mpoultry,Mfish,Mtofu,meggmyolks,Mbeans,mandm

Raisins

-
servemfruitsmandmvegetablesmhighminmvitaminmcmormamglassmofmorangemjuicematmmealtimes.mthismhelpsmthemi
ronmgetmabsorbed.

-
talkmtomamdietitianmormyourmdoctormifmyourmchildmismamvegetarian.mtheymcanmrecommendmfoodsmtomhelpmyo
urmchildmgetmenoughmiron.

-tomhelpmpreventmiron-deficiencymanemiaminmyoungmchildren:

•Don'tMgiveMcow'sMmilkMtoMbabiesMunderM1MyearMold.

•limitmcow'smmilkminmkidsmoverm1myearmoldmtomlessmthanm2mcupsmofmmilkmamday.M

, •givingmthemmmoremcanmmakemthemmfeelmfullmandmlowermthemamountmofmiron-richmfoodsmtheymeat.



Sicklemcellmanemiam-MCORRECTMANSWERM--
partialmormcompletemreplacementmofmnormalmhgbmwithmabnormalmhbs

-defectmisminherited

-newbornsmwithmscamaremgenerallymasymptomaticmbecausemofmthemprotectivemeffectmfrommthemmother

-rapidlymdecreasesmduringmthemfirstmyear,mthenmchildmmanifestsmsymptoms



Causes:

-autosomalmrecessivemdisorder:

•9%mofmafrican-americansmaremcarriersm(havemsicklemcellmtrait)

•40%mofmnativemafricansmaremcarriers

•ifmbothmparentsmhavemthemtrait,meachmofmtheirmchildrenmhasmam25%mchancemofmhavingmthemdisease

-
inmareasmofmthemworldmwheremmalariamismcommon,mindividualsmwithmsicklemcellmtraitmtendmtomhavemamsurv
ivalmadvantagemovermthosemwithoutmthemtrait



Clinicalmmanifestations:

-obstructionmcausedmbymsickledmrbcs

-vascularminflammation

-increasedmrbcmdestruction

-abnormalmadhesion,Mentanglement,mandmmeshingmofmrigidmsickle-shapedmcells

-localmhypoxia

-cellularmdeath

-
dactylitismisminflammationmofmamdigitm(eithermfingermormtoe)mandmismderivedmfrommthemgreekmwordmdactylo
smmeaningmfinger.mthemaffectedmfingersmandmtoesmswellmupmintomamsausagemshapemandmcanmbecomempainf
ul.

-
priapismmismamprolongedmerectionmofmthempenis.mthempersistentmerectionmcontinuesmhoursmbeyondmormisn'
tmcausedmbymsexualmstimulation.M