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The nurse is assessing a school-aged child with sickle-cell anemia. Which assessment finding is consistent with this child’s diagnosis?

A.

Slightly yellow sclera.

B.

Depigmented areas on the abdomen.

C.

Enlarged mandibular growth.

D.

Increased growth of long bones.

Answer and Explanation

The Correct Answer is A

Choice A rationale

 

Slightly yellow sclera, or jaundice, is a common finding in children with sickle cell anemia. The breakdown of sickled red blood cells leads to increased bilirubin levels in the blood, which can cause jaundice. This yellowing is often most noticeable in the sclera of the eyes. Jaundice is a result of hemolysis, a hallmark of sickle cell anemia, where red blood cells are destroyed faster than they can be produced.

 

Choice B rationale

 

Depigmented areas on the abdomen are not typically associated with sickle cell anemia. Sickle cell anemia primarily affects the blood and organs, leading to complications such as pain crises, anemia, and organ damage. Skin changes like depigmentation are not characteristic of this condition and may indicate other underlying issues.

 

Choice C rationale

 

Enlarged mandibular growth is not a common finding in sickle cell anemia. While children with sickle cell anemia may experience growth delays and skeletal abnormalities due to chronic anemia and bone marrow hyperactivity, mandibular enlargement is not a typical feature. Skeletal changes in sickle cell anemia are more likely to involve long bones and vertebrae.

 

Choice D rationale

 

Increased growth of long bones is not a characteristic finding in sickle cell anemia. In fact, children with sickle cell anemia may experience growth delays and shorter stature due to chronic anemia and the body’s increased demand for red blood cell production. The condition can lead to skeletal abnormalities, but these typically involve bone infarctions and deformities rather than increased growth.


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View Related questions

Correct Answer is D

Explanation

Choice A rationale

A diastolic murmur is not a typical finding in coarctation of the aorta. This condition is more commonly associated with systolic murmurs.

Choice B rationale

Hypotension is not a common finding in coarctation of the aorta. In fact, hypertension in the upper extremities is more typical due to the narrowing of the aorta.

Choice C rationale

Excessive crying is not a specific indicator of coarctation of the aorta. It can be a symptom of many different conditions and is not diagnostic.

Choice D rationale

Unequal upper and lower extremity pulses are a key finding in coarctation of the aorta. The narrowing of the aorta causes reduced blood flow to the lower extremities, resulting in weaker pulses compared to the upper extremities.

Correct Answer is D

Explanation

Choice A rationale

A sputum culture can help identify respiratory infections but is not definitive for diagnosing cystic fibrosis.

Choice B rationale

Stool fat content analysis can indicate malabsorption issues but is not specific to cystic fibrosis.

Choice C rationale

Pulmonary function tests assess lung function but do not confirm a diagnosis of cystic fibrosis.

Choice D rationale

The sweat chloride test is the gold standard for diagnosing cystic fibrosis. It measures the concentration of chloride in sweat, which is elevated in individuals with cystic fibrosis due to defective chloride transport in sweat glands.

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