The nurse is reviewing information about hemophilia with an adolescent client. The client demonstrates understanding of the information when identifying hemophilia A as a deficiency of which factor?
Factor IX
Factor VIII
Factor X
Stuart's Factor
The Correct Answer is B
A. Deficiency of Factor IX is responsible for hemophilia B, also called Christmas disease. Like hemophilia A, it is X-linked recessive and primarily affects males, but treatment and factor replacement differ because Factor IX is administered instead of Factor VIII. Misidentifying the factor could lead to inappropriate treatment.
B. Hemophilia A results from a deficiency of Factor VIII, a key protein in the intrinsic pathway of the coagulation cascade. Factor VIII works with Factor IX to activate Factor X, ultimately converting prothrombin to thrombin and fibrinogen to fibrin, forming a stable clot. Without sufficient Factor VIII, the child experiences: Prolonged bleeding after minor cuts or injuries, Spontaneous bleeding episodes, often into joints (hemarthroses) or muscles, Easy bruising, Nosebleeds and prolonged bleeding after dental procedures, Potential life-threatening bleeding if untreated. Factor VIII replacement therapy is the cornerstone of treatment, either prophylactically or during acute bleeding episodes. Education includes proper administration, activity precautions, and early recognition of bleeding.
C. Factor X deficiency is a rare coagulation disorder unrelated to hemophilia A. Deficiency causes bleeding tendencies but involves a different pathway and treatment approach.
D. Stuart-Prower factor refers to Factor X, also not involved in hemophilia A. Confusing this could delay correct treatment and risk severe bleeding.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. A BMI at or above the 90th percentile is generally considered overweight, not obese. Using the 90th percentile as a cutoff would overestimate the number of children classified as obese, potentially leading to unnecessary interventions. The 90th percentile does not align with established CDC guidelines for obesity screening in children.
B. According to CDC growth charts, a child is considered obese if their BMI is equal to or greater than the 95th percentile for age and sex. This classification is evidence-based and correlates with increased risk for cardiometabolic complications (type 2 diabetes, hypertension, dyslipidemia) and psychosocial issues such as low self-esteem and bullying. It serves as a key threshold for initiating clinical assessment and targeted interventions, including nutrition counseling, increased physical activity, and behavioral support.
C. A BMI at the 70th percentile is within the normal weight range for children of the same age and sex. Children in this percentile are not considered overweight or obese and typically do not require weight-related interventions beyond routine healthy lifestyle guidance. Labeling a child with a BMI at the 70th percentile as obese would be inaccurate and could contribute to unnecessary anxiety or inappropriate treatment.
D. A BMI between the 85th and 94th percentile is classified as overweight, not obese. This distinction is important because children who are overweight may benefit from preventive lifestyle interventions, whereas children at or above the 95th percentile may require more intensive assessment and management. Misclassifying overweight children as obese could lead to inappropriate labeling or interventions.
Correct Answer is C
Explanation
A. Changes in respiratory rate, such as irregular or slowed breathing, typically occur later in the course of increasing intracranial pressure (ICP), often indicating severe brainstem involvement. It is not the first sign.
B. Bradycardia is a component of Cushing’s triad (bradycardia, hypertension, and irregular respirations) associated with advanced ICP, not an early sign. Relying on heart rate changes alone may delay recognition of ICP.
C. Altered mental status is the earliest and most sensitive indicator of increasing ICP in children. This can include irritability, restlessness, confusion, or decreased responsiveness. Early recognition of changes in level of consciousness allows prompt intervention to prevent further neurological compromise.
D. Tachycardia is not a primary indicator of rising ICP. Heart rate changes are nonspecific and usually occur secondary to pain, anxiety, or systemic stress, rather than as an early ICP sign.
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