🧪 Hematology (Iron-Deficiency Anemia, Sickle Cell Disease, Hemophilia)
1. A nurse is assessing a toddler with iron-deficiency anemia. Which food should the nurse
recommend?
oA. Apple slices
oB. Fortified cereal ✅
oC. Yogurt
oD. Carrots
Rationale: Fortified cereal is high in iron, making it ideal for children with iron-
deficiency anemia.
2. Which of the following is a late sign of anemia in a child?
oA. Fatigue
oB. Pallor
oC. Murmur ✅
oD. Tachycardia
Rationale: A systolic murmur may occur with severe anemia due to increased
cardiac workload.
3. The mother of a child with iron-deficiency anemia asks how to give iron supplements.
What is the best response?
oA. Give with milk
oB. Administer with food
oC. Give on an empty stomach with juice ✅
oD. Give with water only
Rationale: Iron is best absorbed on an empty stomach with vitamin C (like
orange juice).
4. A 4-month-old exclusively breastfed infant is diagnosed with anemia. What is the most
likely cause?
oA. Milk allergy
oB. Inadequate iron intake ✅
oC. Lead poisoning
oD. Vitamin K deficiency
Rationale: Breast milk is low in iron; supplementation is needed starting at 4
months.
5. A child with sickle cell disease is experiencing a painful crisis. What is the nurse's
priority intervention?
oA. Administer oxygen
oB. Start IV fluids ✅
oC. Apply ice packs
oD. Limit activity
Rationale: Hydration is the first priority to reduce blood viscosity and prevent
further sickling.
6. What is the most common cause of sickle cell crisis?
, oA. Exercise
oB. Infection ✅
oC. Sleep
oD. High fat diet
Rationale: Infections can trigger increased sickling and inflammation.
7. A school-age child with hemophilia falls and reports knee pain. What should the nurse do
first?
oA. Apply heat
oB. Perform range-of-motion exercises
oC. Administer NSAIDs
oD. Apply ice and elevate the leg ✅
Rationale: RICE is the standard initial treatment for joint bleeds in hemophilia.
8. Which medication should the nurse question for a child with hemophilia?
oA. Acetaminophen
oB. Corticosteroids
oC. Ibuprofen ✅
oD. Factor VIII
Rationale: NSAIDs like ibuprofen can increase bleeding risk and should be
avoided.
9. What teaching should be included for a child with hemophilia and their parents?
oA. Use soft toothbrush
oB. Avoid contact sports
oC. Wear medical ID bracelet
oD. All of the above ✅
Rationale: Safety education is key in preventing injury and managing bleeds.
10. DDAVP (desmopressin) is useful for children with:
A. Sickle cell disease
B. Iron-deficiency anemia
C. Mild hemophilia A ✅
D. Leukemia
Rationale: DDAVP increases levels of Factor VIII in mild hemophilia A.
🧬 Oncology (Leukemia, Wilms Tumor, Neuroblastoma, Bone Cancers,
Retinoblastoma)
11. A child undergoing chemotherapy is at risk for:
A. Hypercalcemia
B. Infection ✅
C. Elevated red blood cells
D. Muscle spasms
Rationale: Chemotherapy suppresses bone marrow, increasing infection risk.
1. A nurse is assessing a toddler with iron-deficiency anemia. Which food should the nurse
recommend?
oA. Apple slices
oB. Fortified cereal ✅
oC. Yogurt
oD. Carrots
Rationale: Fortified cereal is high in iron, making it ideal for children with iron-
deficiency anemia.
2. Which of the following is a late sign of anemia in a child?
oA. Fatigue
oB. Pallor
oC. Murmur ✅
oD. Tachycardia
Rationale: A systolic murmur may occur with severe anemia due to increased
cardiac workload.
3. The mother of a child with iron-deficiency anemia asks how to give iron supplements.
What is the best response?
oA. Give with milk
oB. Administer with food
oC. Give on an empty stomach with juice ✅
oD. Give with water only
Rationale: Iron is best absorbed on an empty stomach with vitamin C (like
orange juice).
4. A 4-month-old exclusively breastfed infant is diagnosed with anemia. What is the most
likely cause?
oA. Milk allergy
oB. Inadequate iron intake ✅
oC. Lead poisoning
oD. Vitamin K deficiency
Rationale: Breast milk is low in iron; supplementation is needed starting at 4
months.
5. A child with sickle cell disease is experiencing a painful crisis. What is the nurse's
priority intervention?
oA. Administer oxygen
oB. Start IV fluids ✅
oC. Apply ice packs
oD. Limit activity
Rationale: Hydration is the first priority to reduce blood viscosity and prevent
further sickling.
6. What is the most common cause of sickle cell crisis?
, oA. Exercise
oB. Infection ✅
oC. Sleep
oD. High fat diet
Rationale: Infections can trigger increased sickling and inflammation.
7. A school-age child with hemophilia falls and reports knee pain. What should the nurse do
first?
oA. Apply heat
oB. Perform range-of-motion exercises
oC. Administer NSAIDs
oD. Apply ice and elevate the leg ✅
Rationale: RICE is the standard initial treatment for joint bleeds in hemophilia.
8. Which medication should the nurse question for a child with hemophilia?
oA. Acetaminophen
oB. Corticosteroids
oC. Ibuprofen ✅
oD. Factor VIII
Rationale: NSAIDs like ibuprofen can increase bleeding risk and should be
avoided.
9. What teaching should be included for a child with hemophilia and their parents?
oA. Use soft toothbrush
oB. Avoid contact sports
oC. Wear medical ID bracelet
oD. All of the above ✅
Rationale: Safety education is key in preventing injury and managing bleeds.
10. DDAVP (desmopressin) is useful for children with:
A. Sickle cell disease
B. Iron-deficiency anemia
C. Mild hemophilia A ✅
D. Leukemia
Rationale: DDAVP increases levels of Factor VIII in mild hemophilia A.
🧬 Oncology (Leukemia, Wilms Tumor, Neuroblastoma, Bone Cancers,
Retinoblastoma)
11. A child undergoing chemotherapy is at risk for:
A. Hypercalcemia
B. Infection ✅
C. Elevated red blood cells
D. Muscle spasms
Rationale: Chemotherapy suppresses bone marrow, increasing infection risk.
