NUR 202 Mod C Quiz
A child has been found to have acute myelogenous leukemia. The practitioner has discussed the diagnosis and prognosis with the parents. Later, after visiting their child, the parents have a bitter argument. The nurse identifies the defense mechanism of:
Displacement
A 4-year-old child is admitted to the pediatric unit with a tentative diagnosis of acute lymphocytic leukemia (ALL). The mother states that changes in her child's behavior and the "black and blue" marks were noticed several days ago. She blames herself for not bringing her child to the clinic sooner. On what information about the pathophysiology of leukemia should the nurse base a response?
Early signs and symptoms of leukemia are similar to those of other mild illnesses of childhood.
While receiving a blood transfusion, a client develops flank pain, chills, and fever. What type of transfusion reaction does the nurse conclude that the client probably is experiencing?
Hemolytic
A 4-year-old child is admitted to the pediatric unit with the diagnosis of acute lymphocytic leukemia (ALL). A blood transfusion is ordered and an intravenous line is started. What should the nurse do in regard to administering the transfusion?
Infuse the blood over no more than 4 hours
Laboratory results of a client's blood after chemotherapy indicate bone marrow depression. What should the nurse encourage the client to do? Select all that apply.
Use a soft toothbrush. Read the ingredients in over-the-counter drugs before taking them
To confirm a tentative diagnosis of leukemia a bone marrow aspiration and biopsy are to be performed on a 4-year-old boy. The nurse gives an age-appropriate explanation of the procedure to the child. What else is involved in caring for this child?
Explaining to the child that he will sleep during the procedure
During administration of a whole blood transfusion, the client begins to complain of shortness of breath. The nurse notes the presence of jugular venous distension, bibasilar crackles, and tachycardia. Prioritize the following nursing actions.
1.Elevate the head of the bed to 45 degrees 2.Apply oxygen via nasal cannula 3.Reduce the flow rate of the transfusion 4.Administer furosemide (Lasix) per provider prescription 5.Document findings in the client record
A blood transfusion of packed cells has been prescribed for a client with leukemia. The nurse will complete the following steps in what order?
Check health care provider's prescription, Obtain vital signs and history of transfusions, Ascertain that intravenous catheter size is 18 or 20 gauge, Change main line solution to normal saline, Check client identification before hanging unit of blood
A 6-year-old child is admitted to the pediatric unit with a tentative diagnosis of leukemia. What information is most important for the nurse to obtain during the assessment?
Child's experience with illness and hospitalization
The nurse is making rounds on a client who has developed severe bone marrow depression after receiving chemotherapy for cancer. Which of these actions by the nurse is appropriate? Select all that apply.
Wash hands before entering the client's room. Advise use of a soft toothbrush for oral hygiene. Report an elevation in temperature immediately.
The client is receiving multiple blood transfusions after having extensive abdominal surgery. If the client develops fever, chills, and lower back pain, and seems very nervous, what will be the nurse's first action?
Stop the blood and infuse normal saline.
A blood transfusion is initiated after a client had emergency surgery. What should the nurse do first when the client develops fever, chills, and low back pain?
Stop the blood and infuse saline
A client has a bone marrow aspiration performed. After the procedure, what is the first nursing action?
Briefly apply pressure over the aspiration site.
A 10-year-old boy who is about to begin chemotherapy for acute myelogenous leukemia (AML) tells the nurse that he is old enough to refuse treatment. What is the nurse's most appropriate response?
"You seem frightened. Let's talk about it."
Parents are considering a bone marrow transplant for their child who has recurrent leukemia. The parents ask the nurse for clarification about the procedure. What is the best response by the nurse?
"Your child's immune system must be destroyed before the transplantation can take place."
A nurse is teaching a 12-year-old child about a bone marrow aspiration. What statement indicates that the preadolescent needs further explanation of the procedure?
"I'll have to rest after the procedure."
A blood transfusion of packed cells has been prescribed for a client. The client shows signs of hemolytic reaction. Place the appropriate nursing actions in order.
1.Stop the transfusion 2.Change IV administration set 3.Run 0.9 normal saline at rapid rate 4.Notify health care provider and blood bank
A 4-year-old child is admitted to the pediatric unit with a tentative diagnosis of acute lymphocytic leukemia (ALL). What signs and symptoms does the nurse expect when obtaining the health history and performing a physical assessment? Select all that apply.
Anorexia, Petechiae
A nurse is caring for a toddler who has undergone bone marrow transplantation. What clinical finding(s) should the nurse anticipate if an infection develops?
Fever and lethargy
A 4-year-old boy with acute lymphocytic leukemia (ALL) is to undergo bone marrow aspiration. While involving the child in therapeutic play before the procedure, the nurse should help him understand that:
He did nothing to cause his current illness.
A blood transfusion of packed cells has been prescribed for a client. The transfusion started five minutes ago and the client is complaining of chest pain and nausea, having difficulty breathing, and chills. The blood pressure has dropped from 140/88 to 110/60 mm Hg, temperature is 99.2 degrees, and the client seems less alert. The nurse suspects
Hemolytic reaction
A nurse obtains a health history from the parents of a toddler who is admitted to the pediatric unit with the diagnosis of acute lymphocytic leukemia (ALL). What problems does the nurse expect the parents to report? Select all that apply.
Loss of appetite Paleness of the skin Purplish spots on the skin
A blood transfusion of packed cells has been prescribed for a client. The nursing unit is extremely busy. In delegating the task of blood administration:
Have all identification verified by registered nurses, then the registered nurse can hang the product and monitor client, staying with client during the initial 15 minutes.
An 11-year-old child is found to have acute lymphocytic leukemia (ALL), and the health care provider discusses the diagnosis and treatment with the child and family. What age-appropriate behavior does the nurse expect from the child regarding the life-threatening diagnosis?
Expressing anger by being insolent
