CH27
What would the nurse include in a teaching plan about mouth care of a child receiving chemotherapy? a. Use commercial mouthwash. b. Clean teeth with a soft toothbrush. c. Avoid use of a Water-Pik. d. Inspect the mouth weekly for ulcerations.
B
Which statement made by a parent indicates an understanding of health maintenance of a child with sickle cell disease? a. "I should give my child a daily iron supplement." b. "It is important for my child to drink plenty of fluids." c. "He needs to wear protective equipment if he plays contact sports." d. "He shouldn't receive any immunizations until he is older."
B
A 3-year-old child with sickle cell disease is admitted to the hospital in sickle cell crisis with severe abdominal pain. Which type of crisis is the child most likely experiencing? a. Aplastic b. Hyperhemolytic c. Vaso-occlusive d. Splenic sequestration
C
A newly married couple is seeking genetic counseling because they are both carriers of the sickle cell trait. How can the nurse best explain the children's risk of inheriting this disease? a. Every fourth child will have the disease; two others will be carriers. b. All of their children will be carriers, just as they are. c. Each child has a one in four chance of having the disease and a two in four chance of being a carrier. d. The risk levels of their children cannot be determined by this information.
C
An adolescent is diagnosed with Hodgkin's disease. Lymph nodes on both sides of her diaphragm have been found to be involved, including cervical and inguinal nodes. Which disease stage is this? a. I b. II c. III d. IV
C
The nurse is dealing with a preschool-age child with a life-threatening illness. What should the nurse remember the child's concept of death is at this age? a. That it is final b. Only a fear of separation from her parents c. That a person becomes alive again soon after death d. An understanding based on simple logic
C
What important focus of nursing care for the dying child and the family should the nurse implement? a. Nursing care should be organized to minimize contact with the child. b. Adequate oral intake is crucial to the dying child. c. Families should be made aware that hearing is the last sense to stop functioning before death. d. It is best for the family if the nursing staff provides all of the child's care
C
A school-aged child is living with a chronic disease process. How would the nurse anticipate chronic illness will effect growth and development? (Select all that apply.) a. Delayed bonding with parents b. Delayed toilet training c. Impaired sense of belonging d. Decreased feelings of independence e. Impaired speech development
C,D
Place the stages of dying in the usual order as detailed by Kübler-Ross (1975). Put a comma and space between each answer choice (a, b, c, d, etc.) a. Bargaining b. Acceptance c. Denial d. Anger e. Reaching out to help others f. Depression
C,D,A,F,B,E
A child has just been diagnosed with acute lymphoblastic leukemia. What is the result of an overproduction of immature white blood cells in the bone marrow? a. Decreased T-cell production b. Decreased hemoglobin c. Increased blood clotting d. Increased susceptibility to infection
D
A child with thalassemia major receives blood transfusions frequently. What is a complication of repeated blood transfusions? a. Hemarthrosis b. Hematuria c. Hemoptysis d. Hemosiderosis
D
To prevent ________________ ________________, the nurse warms the blood that is to be given as a transfusion through a central line.
cardiac arrhythmias
The rate of RBC production is regulated by _________________.
erythropoietin
Which statement by a mother may indicate a cause for her 9-month-old's iron deficiency anemia? a. "Formula is so expensive. We switched to regular milk right away." b. "She almost never drinks water." c. "She doesn't really like peaches or pears, so we stick to bananas for fruit." d. "I give her a piece of bread now and then. She likes to chew on it."
A
The nurse, caring for a child receiving chemotherapy, notes that the child's abdomen is firm and slightly distended. There is no record of a bowel movement for the last 2 days. What do these assessment findings suggest? a. Peripheral neuropathy b. Stomatitis c. Myelosuppression d. Hemorrhage
A
A 2-year-old child has been diagnosed with hemophilia A. The information the nurse would include in a teaching plan about home care would be: a. if bleeding occurs, apply pressure, ice, elevate, and rest the extremity. b. children's aspirin in lowered doses may be given for joint discomfort. c. a firm, dry toothbrush should be used to clean teeth at least twice a day. d. do not permit interactive play with other children.
A
A 6-year-old with leukemia asks, "Who will take care of me in heaven?" What is the best response by the nurse? a. "Who do you think will take care of you?" b. "Your grandparents and God will take care of you." c. "Your mom will know more about that than I do." d. "Why are you asking me that?"
A
A child who is receiving a transfusion should be closely assessed for: a. fever. b. lethargy. c. jaundice. d. bradycardia.
A
AThe nurse notes that a 4-year-old child's gums bleed easily and he has bruising and petechiae on his extremities. Which lab value is consistent with these symptoms? a. Platelet count of 25,000/mm3 b. Hemoglobin level of 8 g/dL c. Hematocrit level of 36% d. Leukocyte count of 14,000/mm3
A
On admission, a child with leukemia has widespread purpura and a platelet count of 19,000/mm3. What is the priority nursing intervention? a. Assessing neurological status b. Inserting an intravenous line c. Monitoring vital signs during platelet transfusions d. Providing family education about how to prevent bleeding
A
The most recent blood count for a child who received chemotherapy last week shows neutropenia. What is the priority nursing diagnosis for this child? a. Risk for infection b. Risk for hemorrhage c. Altered skin integrity d. Disturbance in body image
A
The nurse is teaching the parents of a young child with iron deficiency anemia about nutrition. What food would the nurse emphasize as being a rich source of iron? a. An egg white b. Cream of Wheat c. A banana d. A carrot
B
The nurse is caring for a child with a low platelet count. What skin assessments would alert the nurse to bleeding? (Select all that apply.) a. Petichiae b. Purpura c. Ecchymosis d. Hematoma e. Lymphadenopathy
A,B,C,D
What are the classic symptoms of thalassemia major (Cooley's anemia)? (Select all that apply.) a. Hepatomegaly b. Jaundice c. Protruding teeth d. Pathological fractures e. Renal failure
A,B,C,D
What should be included in the nursing care of a 12-year-old child receiving radiation therapy for Hodgkin's disease? (Select all that apply.) a. Application of sunblock b. Appetite stimulation c. Conservation of energy d. Provision for expressions of anger
A,B,C,D
The family of a child receiving chemotherapy for leukemia should be taught to focus on which aspect(s) of the child's care? (Select all that apply.) a. Using a support group b. Stimulating appetite c. Maintaining adequate hydration d. Continuing with scheduled immunizations e. Reporting exposure to infectious diseases
A,B,C,E
How has synthetic recombinant antihemophilic factor improved the management of hemophilia? (Select all that apply.) a. Eliminates the need for frequent transfusions b. Can be administered by family at home c. Prevents hemorrhage d. Reduces cost of care of the hemophiliac e. Reduces risk of HIV and hepatitis A and B transmission
A,B,D,E
The nurse explains that the COPP medical regimen for the treatment of Hodgkin's disease uses a combination of which drugs? (Select all that apply.) a. Vincristine b. Cyclophosphamide c. Methotrexate d. Prednisone e. Procarbazine hydrochloride
A,B,D,E
Why would the nurse urge the family of a dying 12-year-old boy to include his 8-year-old sister in care? (Select all that apply.) a. She will feel less neglected by the parents. b. She can make amends for past hostilities to her brother. c. She will feel increased helplessness. d. She can express her feelings through care. e. She can experience being supportive of her parents and brother.
A,B,D,E
The nurse would instruct the parent to give ferrous sulfate drops to the child: a. with milk. b. with orange juice. c. with water. d. on a full stomach.
B
What will the nurse teach the parents of a child with a low platelet count to avoid? a. Ibuprofen b. Aspirin c. Caffeine d. Prednisone
B
A child is diagnosed with iron deficiency anemia. What will the nurse explain can occur if this disorder goes untreated? a. Hemorrhage b. Heart failure c. Infection d. Pulmonary embolism
B
The nurse is presenting information on the congentital disorder of hemophilia A. What fact will the nurse include? a. It is seen in males and females equally. b. It is transmitted by symptom-free females. c. It is a sex-linked dominant trait. d. It is a defective gene located on the Y chromosome.
B
The child receiving a transfusion complains of back pain and itching. What is the best initial action by the nurse? a. Notify the charge nurse. b. Disconnect intravenous lines immediately. c. Give diphenhydramine (Benadryl). d. Clamp off blood and keep line open with normal saline.
D
The nurse clarifies that the deficiency of factor IX results in: a. thalassemia. b. idiopathic thrombocytopenic purpura. c. hemophilia A. d. Christmas disease.
D
The nurse finds an adolescent with Hodgkin's disease crying. The adolescent says, "I am so scared." What is the most appropriate nursing response to this comment? a. "I understand how you must feel." b. "You shouldn't feel that way." c. "Is this the strongest feeling you've had today?" d. "Tell me what's got you scared."
D
The nurse confirms that sickle cell trait can be distinguished from sickle cell disease by a lab test called ________________.
Electrophoresis
The nurse shows slides of red blood cells from a child with sickle cell disease, noting that in addition to their sickle shape, the cells contain the abnormal element of ______________ _____.
HEMOGLOBIN s
