Elsevier- P&R (pt. 1)

Which disease process places a client at increased risk for infection? SATA 1. leukemia 2. lymphoma 3. emphysema 4. schizophrenia 5. osteoarthritis

correct: 1, 2, 3

Which interventions would the nurse implement to prevent infection in a preschool child with acute nonlymphoid leukemia who is admitted with a fever and neutropenia? a. placing the child in a private room, restricting ill visitors, and using strict hand-washing techniques b. encouraging a well-balanced diet, including iron-rich foods, and helping the child avoid overexertion c. avoiding taking rectal temperatures, limiting injections, and applying direct pressure for 5 minutes after venipuncture d. offering a moist, bland, soft diet; using toothettes rather than a toothbrush; and providing frequent saline mouthwashes

a. placing the child in a private room, restricting ill visitors, and using strict hand-washing techniques

The parents of a 4-year-old child with newly diagnosed acute lymphoblastic leukemia express confusion over the care plan. Which response would the nurse provide? a. 'There are support groups for parents with children who have leukemia." b. "The new treatment protocols have been shown to have excellent results.' c. 'Let me get you the telephone number of the Leukemia Society, where you can get some advice.' d. 'Maybe you could talk with your health care provider about getting a second opinion from a specialist in leukemia.'

d. 'Maybe you could talk with your health care provider about getting a second opinion from a specialist in leukemia.' Rationale: referring the parent back to the HCP with a suggestion that addresses the need for more info is an appropriate initial intervention

Which clinical manifestation would the nurse expect to find in a client with a new diagnosis of acute lymphocytic leukemia (ALL)? a. alopecia b. insomnia c. ecchymosis d. hypertension

c. ecchymosis Rationale: bleeding tendencies as shown in ecchymosis occur because of thrombocytopenia associated with overproduction of rapidly proliferating leukocytes

When providing care to a child with leukemia, the nurse notes blood on the pillowcase and several bloody tissues. Which blood component value on the child's laboratory results would the nurse verify? a. platelets b. neutrophils c. erythrocytes d. lypmhoblasts

a. platelets

Which nursing intervention would the nurse implement when providing care of pediatric clients with leukemia on chemotherapeutic protocols? a. prevention of physical activity during this time b. checking the clients' vital signs every 2hours c. having them avoid contact with infected persons d. reducing unnecessary stimuli in their environment

Correct: c. having them avoid contact with infected persons

Which clinical findings would the nurse expect of a child with acute nonlymphoid leukemia (acute myeloid leukemia)? SATA 1. oliguria 2. listlessness 3. few stem cells 4, difficulty swallowing 5. bone marrow depression

Correct: 2 & 5 Listlessness is caused by anemia; bone marrow depression is a characteristic of nonlymphoid leukemia

Which method would the nurse use to measure the temperature of a 4-year-old child with leukemia who has mucositis? SATA 1. digital, rectal 2. electronic, oral 3. infrared, tympanic 4. sensor, ear-based 5. temporal artery

Correct: 3 & 5 Infrared is safe to use for a child with leukemia; RECTAL TEMP CONTRAINDICATED due to trauma to rectal mucosa

The nurse is assessing a child receiving chemotherapy for treatment of leukemia. Which side effect would the nurse anticipate? a. epistaxis b. tachycardia c. flushed skin d. increased temperature

a. epistaxis Rationale: bone marrow is depressed and the number of platelets decreases substantially

A child with leukemia is to continue taking prednisone at home. The nurse discovers that the child's sibling is home from school with chickenpox. Which is the nurse's priority concern? a. the child must be immunized before going home b. chickenpox can be fatal to individuals with leukemia c. an individual receiving prednisone is immune to chickenpox d. prevention of direct contact between siblings permits discharge to the home

b. chickenpox can be fatal to individuals with leukemia

Which immunomodulatory agent is beneficial for the treatment of clients with multiple sclerosis? a. interleukin 2 b. interleukin 11 c. beta interferon d. alpha interferon

c. beta interferon

When a client with a history of chronic myelogenous leukemia and splenomegaly is admitted to the hospital, which finding will the nurse expect during the assessment? a. increased urinary output b. report of recent weight gain c. left upper quadrant tenderness d. elevated number of erythrocytes

c. left upper quadrant tenderness

Which information is most important for the nurse to obtain during the assessment of a child with a tentative diagnosis of leukemia? a. parents' knowledge concerning the diagnosis b. parents' ability to cope with stressful situations c. child's experience with illness and hospitalization d. child's growth percentile and developmental abilities

Correct: c. child's experience with illness and hospitalization

Which statements by a 17-year-old client who is diagnosed with leukemia reflects Piaget's cognitive processes associated with adolescence? SATA 1. 'My smoking pot probably caused the leukemia.' 2. 'I'm going to do my best to fight this awful disease.' 3. 'Now I can't go to the prom because I have this stupid disease.' 4. 'I know I got sick because I've been causing a lot of problems at home.' 5. 'this illness is serious, but with treatment I think I have a chance to get better.'

Correct: 2, 3, & 5

Which signs and symptoms would the nurse expect when assessing a 4-year-old child with newly diagnosed acute lymphocytic leukemia (ALL)? SATA 1. edema 2. alopecia 3. anorexia 4. insomnia 5. petechiae

Correct: 3 & 5 Rationale: catabolic alterations of metabolism caused by cancer; bone marrow depression will reduce the platelet count, which results in bleeding tendencies, petechiae, and ecchymoses

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. Which age-appropriate behavior would the nurse expect from the child regarding the life-threatening diagnosis? a. expressing anger by being insolent b. saying that when people die they go to heaven c. being afraid to go to sleep for fear of not awakening d. telling the nurse that death is punishment for not being good

Correct: a. expressing anger by being insolent Rationale: anger is an appropriate response of an 11 yo who sees dying as a loss of control over every aspect of living; the child may convey this emotion by physically attempting to run away or by pushing others away through rude behavior

Which education about cranial radiation would the nurse provide to the parents of a child with leukemia? a. reduces the risk of systemic infection b. intensifies the effects of chemotherapy c. helps prevent metastasis to the lymphatic system d. helps prevent central nervous system involvement

Correct: d. helps prevent central nervous system involvement Rationale: cranial radiation destroys leukemic cells in the brain; it is necessary because chemotherapeutic agents are inadequately absorbed across the blood-brain therapy