A 10-year-old with severe factor VIII deficiency falls, injures an elbow, and is brought to the emergency department. The nurse should prepare which of the following?
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Question 2 of 56
A previously normal African-American army recruit was assigned to Southeast Asia and given malarial prophylaxis. He experienced pallor, fatigue, and dark urine. His hemoglobin level decreased from 14.8 to 9 g/dL. The most likely diagnosis is
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Question 3 of 56
Where is the primary site of origin for neuroblastoma in children?
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Question 4 of 56
Decisions about transfusion of a child with sickle cell disease should be made on the following bases EXCEPT
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Question 5 of 56
A nurse is caring for a child with von Willebrand disease. Which of the following is (are) clinical manifestation(s) of von Willebrand disease? (Select one that does not apply.)
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Question 6 of 56
The LEAST indicator for an underlying hematological problem is
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Question 7 of 56
All of the following are true about the reptilase time EXCEPT
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Question 8 of 56
Which of the following is correct regarding prognostic factors for determining survival for a child newly diagnosed with ALL?
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Question 9 of 56
A child receiving extensive radiation for Hodgkin disease may experience which side effect that requires nursing intervention?
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Question 10 of 56
Vitamin K-dependent clotting factors include all the following EXCEPT
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Question 11 of 56
Which of the following clinical conditions DOES NOT signify iron overload in children with β-thalassemia major?
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Question 12 of 56
Which of the following is TRUE regarding prevention of Iron deficiency anemia in infants?
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Question 13 of 56
A 48-year-old man presents to the emergency department with a 6-week history of progressively worsening abdominal pain and night sweats. Physical examination findings were significant for palpable bilateral 2-cm axillary lymph nodes and diffuse abdominal tenderness with no rebound or guarding. Computed tomography of the abdomen and pelvis showed retroperitoneal and mesenteric lymphadenopathy. Excisional biopsy of an axillary node was positive for diffuse, large B-cell lymphoma. Positron emission tomography showed fluorodeoxyglucose-avidity in the axillary, mesenteric, and retroperitoneal lymph nodes. Results of the bone marrow examination were normal. Which of the following is the best next step?
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Question 14 of 56
Which of the following central nervous system (CNS) abnormalities have been linked to iron deficiency anemia?
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Question 15 of 56
Matching: Hemolytic anemia - Spectrin deficiency
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Question 16 of 56
The best diagnostic test for paroxysmal nocturnal hemoglobinuria (PNH) is
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Question 17 of 56
Matching: Red blood cell aplasia - Elevated hemoglobin F
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Question 18 of 56
A 5-year-old child, with hemophilia A of severe type, presents to the emergency unit with a groin pain after a minor trauma to his back; his blood pressure is $60 / 30 \mathrm{~mm} \mathrm{Hg}$; his pulse rate is $180 / \mathrm{min}$; he holds his right hip in a flexion position with internal rotation. Of the following, the NEXT step in the management of this child is
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Question 19 of 56
A 5-year- old boy presented to the emergency department with sudden onset of skin ecchymoses and single attack of epistaxis, the history is negative for any significant event except for preceding upper respiratory tract infection. The examination showed an active healthy looking boy with diffuse skin petechial rash and ecchymoses over both lower and upper limbs, no lymphadenopathy and no organomegaly. The initial CBC is as follows: Hb 12.3 gm/dl, WBC 7.600/cmm, N 45%, L 51%, plt 17.000/cmm, and normal looking film except for rarely seen platelets. The most likely diagnosis is:
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Question 20 of 56
All the following are true regarding Transient Erythroblastopenia of Childhood (TEC) EXCEPT
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Question 21 of 56
Spontaneous intracranial hemorrhage is more likely to occur in
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Question 22 of 56
A child with leukemia receiving chemotherapy is complaining of nausea. The nurse has been giving scheduled antiemetics. Which of the following should the nurse do when the child is nauseated?
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Question 23 of 56
Ten years later, the patient described in Questions 3 and 4 experiences recurrent hemarthroses that become refractory to standard doses of factor VIII. The most likely cause of this is
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Question 24 of 56
Considering factor replacement therapy, what level of factor VIII is appropriate for mild bleeding?
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Question 25 of 56
In liver failure, one of the following usually shows normal value
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Question 26 of 56
A child who has just received chemotherapy for neuroblastoma is being discharged. Which statement by the parent indicates a need for additional teaching?
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Question 27 of 56
You are evaluating a 5-year-old male child with multiple ecchymoses distributed all over the extremities and trunk; examination reveal a palpable spleen $3 \mathrm{~cm}$ below the left costal margin. Lab findings include: hemoglobin, 11.3 g/dL; white blood cell count, 8700/mm3; platelets count, 21000/mm3. Of the following, the most proper NEXT step is
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Question 28 of 56
All the following conditions may be associated with iron deficiency EXCEPT
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Question 29 of 56
Hereditary intrinsic factor deficiency (HIFD), formerly called congenital pernicious anemia, differs from the typical adult pernicious anemia by all the following EXCEPT
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Question 30 of 56
The main reason behind gamma irradiation of the blood products is to prevent
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Question 31 of 56
Growth retardation is not evident in anemia of
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Question 32 of 56
A 70-year-old man presents with weakness of his right arm and leg. His symptoms began yesterday and are now resolved. He also reports a 6-month history of recurrent headaches and fatigue. He is a nonsmoker. His medical history is significant for high blood pressure. His blood pressure is 167/88 mm Hg, his oxygen saturation is 93% on room air, his face is plethoric, and a right carotid bruit is heard. Other findings on physical examination are normal. Diagnostic testing results are shown in Table 9.Q5. Carotid ultrasonography shows a 30% stenotic lesion in the right carotid. The patient is hospitalized and begins antiplatelet therapy. Which of the following should you order next?
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Question 33 of 56
The role of corticosteroid in autoimmune hemolytic anemia is to decrease
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Question 34 of 56
A 20-year-old white woman has been admitted to the hospital with pulmonary embolism. She has no chronic illnesses and is receiving no medications except for combination estrogen-progesterone birth control pills that she started using approximately 1 year earlier. Results were normal for a complete blood cell count, baseline prothrombin time, activated partial thromboplastin time (aPTT), and tests of kidney and liver function. The patient is currently receiving therapeutic doses of intravenous unfractionated heparin, and her aPTT is therapeutic at 72 seconds. A panel of thrombophilia tests has been performed. Which of the following statements about her thrombophilia test results is correct?
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Question 35 of 56
For the patient described in Questions 19 and 20, initial treatment at the time of diagnosis may include (may choose more than one)
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Question 36 of 56
One of the following factors is not available in cryoprecipitate
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Question 37 of 56
Ten years ago, a previously healthy 20-year-old woman presented to her physician with a 2-month history of pruritis, drenching night sweats, unintentional weight loss, and nonproductive cough. On examination, she had 2-cm cervical lymphadenopathy. A computed tomographic scan showed a 12-cm-diameter anterior mediastinal mass. An excisional biopsy of a cervical lymph node showed nodular sclerosing Hodgkin lymphoma. After she was treated with ABVD (doxorubicin [Adriamycin], bleomycin, vinblastine, and dacarbazine) combination chemotherapy followed by involved field radiotherapy, the disease was in complete remission. Now you see her for the first time for an annual physical examination. The disease remains in complete remission. Compared to her peers, this patient is at increased risk of which of the following conditions?
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Question 38 of 56
A true hematological index for a cord blood sample is
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Question 39 of 56
School-age children with cancer often experience body image disturbances due to hair loss, moon face, or debilitation. Which intervention is most appropriate?
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Question 40 of 56
The LEAST helpful historical clue in the diagnosis of hemolytic anemia is
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Question 41 of 56
You are evaluating a 7-year-old male child with cervical lymphadenopathy; the MOST likely finding that raise your suspicion of malignancy is
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Question 42 of 56
The criteria for successful bone marrow transplantation in thalassemic patients include all the following EXCEPT
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Question 43 of 56
The standard care for MOST children with severe hemophilia is
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Question 44 of 56
Which test provides a definitive diagnosis of aplastic anemia?
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Question 45 of 56
Of the following, the LEAST likely feature of Bernard-Soulier syndrome is
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Question 46 of 56
Which of the following results indicates Iron deficiency anemia?
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Question 47 of 56
If the patient described in Questions 10-12 does not experience improvement in his anemia, which of the following should be explored (choose as many as are appropriate)?
