Exam 6 Peds

A child has just been diagnosed with acute lymphoblastic leukemia, and the mother is expressing guilt about not taking the child to the doctor right away. What response by the nurse is best?

"It is common for parents not to notice subtle changes in their children's health."

Hematopoietic stem cell transplantation (HSCT) is the standard treatment for a child in his or her first remission with what cancer?

Acute myeloblastic leukemia (AML).

Which of the following medications is NOT typically used for the treatment of Haemophilus influenzae type b (Hib)?

Acyclovir.

A hospitalized child has developed a methicillin-resistant Staphylococcus aureus (MRSA) infection. The nurse plans which interventions when caring for this child? (Select all that apply)

Administration of vancomycin. Administration of mupirocin ointment to the nares if colonized. Contact isolation only.

When an adolescent with a new diagnosis of Ewing sarcoma asks the nurse about treatment, the nurse's response is based on the knowledge that:

Affected bones such as ribs and proximal fibula may be removed to excise the tumor.

A parent brings a child to the emergency department and reports fever, foul smell coming from the throat, and a gray covering over the tonsils. What action by the nurse takes priority?

Assess respiratory status immediately.

A child with acute myeloblastic leukemia is scheduled to have a bone marrow transplant (BMT). The donor is the child's own umbilical cord blood that had been previously harvested and banked. This type of BMT is termed:

Autologous.

Which of the following instructions should the nurse include in the teaching plan for the parents of a child with recurrent otitis media?

Avoiding contact with people who have upper respiratory tract infections.

A nurse is assessing a client who has a history of HIV with phagocytic dysfunction. The nurse should monitor this client for which of the following conditions?

Bacterial infection.

Which STD should the nurse suspect when an adolescent girl comes to the clinic because she has a vaginal discharge that is white with a fishy smell?

Bacterial vaginosis.

A nurse has taught parents about diagnostic testing for their child who is suspected of having leukemia. What test described by the parents shows good understanding of this information?

Bone marrow

The nurse understands that the types of precautions needed for children receiving chemotherapy are based on which action of chemotherapeutic agents?

Bone marrow suppression.

A parent asks the nurse how she will know whether her child has fifth disease. The nurse should advise the parent to be alert for which manifestation?

Bright red rash on the cheeks that looks like slapped cheeks.

Which of the following clinical features is most indicative of orbital rhabdomyosarcoma in an infant?

Bulging of the eye with vision changes.

A nurse is reviewing the laboratory data of a client who has acute leukemia and received aggressive chemotherapy treatment 10 days ago. Which of the following abnormalities should the nurse expect to see? (Select all that apply)

Decreased WBC count Decreased platelet count.

What is an expected physical assessment finding for an adolescent with a diagnosis of Hodgkin disease?

Enlarged, painless, firm cervical lymph nodes.

Which STD should the nurse suspect when an adolescent male comes to the clinic experiencing thick yellowish-green penile discharge along with dysuria and itching?

Gonorrhea.

An adolescent has been diagnosed with the Epstein-Barr virus. What discharge information should the nurse give to the parents?

He will need to avoid mountain biking, skateboarding, and other sports for a few months.

While completing an assessment on a 6-month-old infant, which finding should the nurse recognize as a symptom of a brain tumor?

Increased head circumference.

A nurse is assisting with the admission of a child who has pertussis. Which of the following actions should the nurse take?

Initiate droplet precautions.

After insertion of bilateral tympanostomy tubes in a toddler, which instructions should the nurse include in the child's discharge plan for the parents?

Insert ear plugs into the canals when the child bathes.

What should the nurse teach parents about oral hygiene for the child receiving chemotherapy?

Inspect the child's mouth daily for ulcers.

A nurse is caring for a toddler whose parent states that the child has a mass in his abdominal area and his urine is a pink color. Which of the following actions is the nurse's priority?

Instruct the parent to avoid pressing on the abdominal area.

What should the nurse recognize as symptoms of a brain tumor in a school-age child? (Select all that apply)

Intermittent headache. Declining academic performance. Blurred vision. Vomiting when getting out of bed.

A child with a history of fever of unknown origin, excessive bruising, lymphadenopathy, anemia, and fatigue is exhibiting symptoms most suggestive of which of the following?

Leukemia.

Match the following vaccine to the corresponding type of vaccine.

MMR-Attenuated Vaccine Polio (shot)-Inactivated Vaccine Flumist-Attenuated Vaccine Rotavirus-Attenuated Vaccine Meningococcal-Inactivated Vaccine Smallpox-Attenuated Vaccine Influenza (flu shot)-Inactivated Vaccine Rabies-Inactivated Vaccine Oral Polio-Attenuated Vaccine DTaP-Inactivated Vaccine

Which of the following statements is not true regarding vaccines?

Multiple vaccines should not be given on the same day

The nurse is aware that an abdominal mass found in a 10-month-old infant corresponds with which childhood cancer?

Neuroblastoma.

The nurse assigned to care for a child with mumps is monitoring the child for the signs and symptoms associated with the common complication of mumps. The nurse monitors for which sign/symptom that is most indicative of this common complication?

Nuchal rigidity.

A nurse is collecting data from a client who has herpes zoster (shingles). Which of the following is an expected finding?

Painful vesicles following a nerve pathway.

What should the nurse expect to observe in the prodromal phase of rubeola?

Petechiae on the soft palate.

Which intervention is appropriate for a hospitalized child who has crops of lesions on the trunk that appear as a macular rash and vesicles?

Place the child in strict isolation with airborne and contact precautions.

A child with a brain tumor is undergoing radiation therapy. What should the nurse include in the discharge instructions to the child's parents? (Select all that apply)

Plan for adequate rest periods for the child. Avoid excessive skin exposure to the sun. A darkening of the skin receiving radiation is expected.

The nurse is caring for a 16-year-old child with a diagnosis of acquired immunodeficiency syndrome (AIDS). What treatment goal has the highest priority for this child?

Preventing spread of infection.

What is a priority nursing diagnosis for the 4-year-old child newly diagnosed with leukemia?

Risk for Infection related to immunosuppressed state.

The mother of an infant with multiple anomalies tells the nurse that she had a viral infection in the beginning of her pregnancy. Which viral infection is associated with fetal anomalies?

Rubella

A nurse is conducting a health education class for a group of school-age children. Which statement made by the nurse is correct about the body's first line of defense against infection in the innate immune system?

Skin integrity.

A 2-year-old child with chronic otitis media with effusion is at greatest risk for which of the following?

Speech delays.

Which intervention is appropriate for a child receiving high doses of steroids?

Substitute a killed virus vaccine for live virus vaccines.

A nurse is promoting vaccine administration. When instructing on the physiological changes, which statement best explains what occurs in the child when vaccines are administered?

The child develops an active immunity.

A nurse in a well-child clinic is teaching parents about their child's immune system. Which statement by the nurse is correct?

The immune system distinguishes and actively protects the body's own cells from foreign substances.

The nursing student learns how infants acquire immunity. Which statement about this process is correct?

The infant acquires humoral and cell-mediated immunity in response to infections and immunizations.

A nurse is assessing a toddler suspected to have Hand, Foot, and Mouth Disease (HFMD). Which clinical manifestation should the nurse expect to find?

Vesicular rash on the trunk and extremities.

A nurse is assisting with developing the plan of care for a client who requires airborne precautions. Which of the following actions should the nurse suggest?

Wear an N95 mask.

Which clinical finding is an overt sign of retinoblastoma in children?

Whitish reflex in the eye.

Children with non-Hodgkin lymphoma are at risk for complications resulting from tumor lysis syndrome (TLS). What findings would the nurse assess for to identify this complication early?

elevated BUN and creatinine.