Hemo Peds NCLEX

A dx of Hodgkin's disease is suspected in a 12-year-old child. Several diagnostic studies are performed to determine the presence of the disease. Which diagnostic test result will confirm the diagnosis of Hodgkin's disease?

The presence of Reed-Sternberg cells in the lymph nodes

Which statements by the mother of a toddler should lead the nurse to suspect that the child is at risk for iron deficiency anemia? Select all that apply.

"He drinks over three cups of milk per day." "I can't keep enough apple juice in the house; he must drink over 10 oz per day."

The nurse provides home care instructions to the parent of a child with AIDS. Which statement by the parent indicates the need for further teaching?

"I can send my child to day care if he has a fever, as long as it is a low-grade fever."

The nurse is caring for a 4-year-old child with HIV infection. The nurse should expect which statement that is aligned with the psychosocial expectations of this age?

"I know it hurts to die."

A 6-year-old child with HIV infection has been admitted to the hospital for pain management. The child asks the nurse if the pain will ever go away. The nurse should make which best response to the child?

"I know it must hurt, but if you tell me when it does, I will try to make it hurt a little less."

The home care nurse provides instructions regarding basic infection control to the parent of an infant with HIV infection. Which statement, if made by the parent, indicates the need for further instruction?

"I will clean up any spills form the diaper with diluted alcohol."

Palliative care

"I will listen and respond as the family talks about their child's life."

Which of the following statements should the nurse use to describe to the parents why their child with leukemia is at risk for infections?

"Immature white blood cells are incapable of handling an infectious process."

The mother with HIV infection brings her 10-month-old infant to the clinic for a routine checkup. The HCP has documented that the infant is asymptomatic for HIV infection. After the checkup, the mother tells the nurse that she is so pleased that the infant will not get HIV infection. The nurse should make which most appropriate response to the mother?

"Most children infected with HIV develop symptoms within the first 9 months of life, and some become symptomatic sometimes before they are 3 years old."

The nurse provides a teaching session to the nursing staff regarding osteosarcoma. Which statement by a member of the nursing staff indicates a need for information?

"The child does not experience pain at the primary tumor site."

After teaching the parents of a child newly diagnosed with leukemia about the disease, which of the following descriptions given by the mother best indicates that she understands the nature of leukemia?

"The disease is a type of cancer characterized by an increase in immature white blood cells."

A 6-year-old child with leukemia is hospitalized and is receiving combination chemotherapy. Laboratory results indicate that the child is neutropenic, and protective isolation procedures are initiated. The grandmother of the child visits and brings a fresh bouquet of flowers picked from her garden, and asks the nurse for a vase for the flowers. Which response should the nurse provide to the grandmother?

"The flowers from your garden are beautiful, but should not be placed in the child's room at this time."

The mother asks the nurse why her child's hemoglobin was normal at birth but now the child has S hemoglobin. Which of the following responses by the nurse is appropriate?

"The newborn has a high concentration of fetal hemoglobin in the blood for some time after birth."

A pregnant woman with a family history of hemophilia B and who has been seen by a genetic counselor makes the following statements. The nurse must clarify the information in which of the statements? 1. "Because the disease is X-linked, only my daughters can be born with hemophilia B." 2. "Prenatal testing can be performed to determine whether my fetus has hemophilia B." 3. "Some children with hemophilia B have worse bleeding problems than other children with the same genetics." 4. "Children with hemophilia B are lacking one of the important factors needed to clot blood."

1. "Because the disease is X-linked, only my daughters can be born with hemophilia B."

Thee maximum safe dosage of elemental iron for a child 6 months to 2 years of age is 6 mg/kg/day in divided doses tid or qid. Which of the following prescriptions is safe for an 18-month-old child weighing 22 pounds? 1. 15mg qid 2. 20mg qid 3. 25mg tid 4. 30mg tid

1. 15mg qid

A child has been diagnosed with acute lymphoblastic leukemia (ALL). With which of the following signs/symptoms did the child likely present to the primary health-care provider? Select all that apply. 1. Bruising 2. Lethargy 3. Jaundice 4. Leukopenia 5. Erythema

1. Bruising 2. Lethargy

The pediatric nurse educator is conducting an in-service for novice nurses who will begin working on the pediatric oncology unit. The educator wants to include the common clinical manifestations of cancer. Which manifestation will the educator include in the presentation? Select all that apply.

1. Cachexia 2. Anemia 4. Palpable mass

The nurse is providing HIV education to a group of individuals. During the session, the nurse discusses actions that have been shown to reduce the transmission of HIV. Which of the following information did the nurse include in her discussion? 1. Circumcised men are less likely to contract and transmit HIV than are uncircumcised men. 2. HIV is eradicated from the body when 2 to 3 di erent antiretroviral medications are taken for at least one year. 3. e HIV vaccination has been approved for men and women between the ages of 16 and 26 years of age. 4. Babies born to HIV positive mothers are less likely to contract HIV if they are exclusively breastfed.

1. Circumcised men are less likely to contract and transmit HIV than are uncircumcised men.

A hospitalized child is experiencing sickle cell vaso- occlusive crisis. The child is currently receiving an intra- venous (IV) fluid bolus, pain medication every 4 hours, and warm compresses to the extremities per physician orders. During the midday assessment, the child reports no pain. Which action should a nurse take? 1. Continue to apply warm compresses per physician order. 2. Hold the next dosage of pain medication. 3. Hold the next round of warm compresses. 4. Contact the physician for a change in orders.

1. Continue to apply warm compresses per physician order.

The nurse is providing care to an adolescent client who is dying. Which assessment findings indicate the client is experiencing a decrease in peripheral circulation? Select all that apply.

1. Cool skin 2. Mottled appearance

The pediatric nurse is providing care to a school-age child receiving chemotherapy to treat cancer. Which interventions are appropriate to include in the plan of care in order to monitor for oncologic emergencies? Select all that apply.

1. Developing other cancers 2. Recommending regular office visits 5. Providing educational and psychosocial support

The nurse is teaching parents how to prevent a sickle cell crisis in the child with sickle cell disease. Which precipitating factors to a sickle cell crisis will the nurse include in the explanation? Select all that apply.

1. Fever 2. Dehydration 4. Altitude

The nurse is providing care to a school-age client with neutropenia. Which clinical manifestations does the nurse anticipate when assessing this client? Select all that apply. 1. Fever 2. Fatigue 3. Tachycardia 4. Hypertension 5. Tachypnea

1. Fever 2. Fatigue 3. Tachycardia 5. Tachypnea

A young school-age child is in the pediatric intensive-care unit (PICU) with a fractured femur and head trauma. The child was not wearing a helmet while riding his new bicycle on the highway and collided with a car. Which nursing diagnoses may be appropriate for this family? Select all that apply. 1. Guilt Related to Lack of Child Supervision and Safety Precautions 2. Family Coping: Compromised, Related to the Critical Injury of the Child 3. Parental Role Conflict Related to Childs Injuries and PICU Policies 4. Knowledge Deficit Related to Home Care of Fractured Femur 5. Anger Related to Feelings of Helplessness

1. Guilt Related to Lack of Child Supervision and Safety Precautions 2. Family Coping: Compromised, Related to the Critical Injury of the Child 3. Parental Role Conflict Related to Childs Injuries and PICU Policies 5. Anger Related to Feelings of Helplessness

A child is receiving chemotherapy for a diagnosis of acute lymphoblastic leukemia (ALL). The nurse monitors the child for which of the following common side effects? Select all that apply. 1. Malaise 2. Alopecia 3. Priapism 4. Anorexia 5. Epistaxis

1. Malaise 2. Alopecia 4. Anorexia 5. Epistaxis

The nurse is taking a health history from a young adult with hemophilia. The nurse should ask the client whether he is experiencing any signs and symptoms of which of the following chronic illnesses? 1. Osteoarthritis 2. Diabetes mellitus 3. Asthma 4. Hypothyroidism

1. Osteoarthritis

The emergency-room nurse receives a preschool-age child who was hit by a car. Which nursing interventions are a priority for this child? Select all that apply.

1. Performing a rapid head-to-toe assessment 3. Assessing airway, breathing, and circulation

A 12-year-old boy with a history of sickle cell anemia and a diagnosis of vaso-occlusive crisis is being assessed by the admitting nurse in the emergency department. Which of the following signs/symptoms would the nurse expect to see? Select all that apply. 1. Priapism 2. Pain level of 2/10 3. Hematuria 4. Elevated liver enzymes 5. Hematocrit 39%

1. Priapism 3. Hematuria 4. Elevated liver enzymes

A child who has undergone a hematopoietic stem cell transplantation (HSCT) is ready for discharge. Which items will the nurse include in the discharge teaching for this child and family? Select all that apply.

1. Recognize the signs of graft-versus-host disease. 3. Practice good hand washing. 5. Avoid live plants and fresh vegetables.

The nurse is providing an educational session for parents with children diagnosed with iron deficiency anemia. Which statements will the nurse include educate about the normal functions of red blood cells? Select all that apply.

1. Red blood cells transport oxygen from the lungs to the tissue. 2. Red blood cells carbon dioxide to the lungs.

A 13-year-old client diagnosed with beta-thalassemia is hospitalized for blood transfusion. What are the priority nursing diagnoses related to this child's care? Select all that apply. 1. Risk for infection. 2. Impaired elimination. 3. Risk for injury. 4. Disturbed body image. 5. Chronic pain. 6. Activity intolerance.

1. Risk for infection. 3. Risk for injury. 4. Disturbed body image. 6. Activity intolerance.

A preschool-age child has just had a moderate reaction to latex. When teaching the parents about latex allergy, the nurse should inform the parents of what common household items that contain latex? Select all that apply. 1. Rubber bands 2. Sneakers 3. Toothbrushes 4. Big Wheel tricycle 5. Water toys

1. Rubber bands 2. Sneakers 3. Toothbrushes 5. Water toys

A novice nurse in the newborn intensive care unit (NICU) has just performed post-mortem care on a premature infant who passed away. The novice nurse asks to be excused near the end of the shift. Which interventions can be implemented to support this nurse? Select all that apply.

1. Schedule additional education on bereavement care 2. Ask a seasoned nurse to talk with the novice nurse 3. Tell the nurse it is ok to grieve with the family

When providing client teaching to the caregivers of a young child with sickle cell disease, a nurse should stress that: 1. The child's diet should include whole grains and leafy green vegetables. 2. Immunizations should be delayed until the child enters school. 3. There is a 50% chance that the child's future offspring will have sickle cell anemia. 4. The parents should request IV Demerol if the child is hospitalized with pain crisis.

1. The child's diet should include whole grains and leafy green vegetables.

A child with human immunodeficiency virus is started on sulfamethoxazole and trimethoprim (Bactrim) for Pneumocystis cariniipneumonia (PCP) prophylaxis. The recommended dose is based on the trimethoprim (TMP) component and is 1520 mg TMP/kg/day in divided doses every 68 hours. The child weighs 6.8 kg. The highest dose of TMP the child can receive a day is ____. (Round your answer to the nearest whole number.)

136

A child with sickle cell anemia weighs 68 lb. How many mL of fluid should this child consume per day (i.e., what are this child's daily maintenance fluid needs)? (If rounding is needed, please calculate to the nearest tenth.)

1718 mL

A child undergoing chemotherapeutic treatment for cancer is being admitted to the hospital for fever of 102 degrees F and possible sepsis. Cultures, antibiotics, and acetaminophen (Tylenol) along with bed rest have been ordered for this child. Place the following steps in order from first to last. Standard Text: Click on the down arrow for each response in the right column and select the correct choice from the list. 1. Administer the antibiotics. 2. Administer the acetaminophen (Tylenol). Response 3. Obtain the cultures. 4. Ensure the child has bed rest.

2. Administer the acetaminophen (Tylenol). Response 3. Obtain the cultures. 1. Administer the antibiotics. 4. Ensure the child has bed rest.

3. A nurse is coordinating an educational session for middle school students regarding human immunodeciency virus (HIV). The nurse should advise students that which of the following behaviors place them at high risk of contracting HIV? Select all that apply. 1. Eating food prepared by an individual with HIV. 2. Engaging in oral intercourse with an individual with HIV. 3. Sharing marijuana cigarettes with an individual with HIV. 4. Using natural skin condoms while having sex with an individual with HIV. 5. Drinking alcoholic beverages out of the same container as an individual with HIV.

2. Engaging in oral intercourse with an individual with HIV. 4. Using natural skin condoms while having sex with an individual with HIV.

A nurse is providing education to parents of young children regarding the children's potential for developing allergies. e nurse informs the parents that which are the most common allergies of childhood? 1. Medicines 2. Foods 3. Pets 4. Plants

2. Foods

A toddler has been diagnosed with iron-de ciency anemia. Which of the following information should the nurse educate the parents regarding medication administration? 1. Add the iron elixir to his morning bottle. 2. Have the child drink orange juice right after he takes his medicine. 3. Administer the medicine right before his meals. 4. Crush the tablets and mix the medicine with his applesauce.

2. Have the child drink orange juice right after he takes his medicine.

Which assessment findings would cause a nurse to withhold scheduled immunizations in a child? Select all that apply. 1. Current cold symptoms (e.g., runny nose, cough). 2. History of recent blood transfusion. 3. Currently taking corticosteroids. 4. Mild diarrhea without symptoms of dehydration. 5. Family history of penicillin allergy. 6. Positive for HIV.

2. History of recent blood transfusion. 3. Currently taking corticosteroids. 6. Positive for HIV.

A young child is admitted to the emergency department in vaso-occlusive crisis. Which of the following orders is the highest priority for the nurse to perform? 1. Morphine 1 mg subcut STAT 2. IV D5W 1⁄4NS at 90mL/hr 3. Oxygen 2 L/min 4. Arterial blood gases STAT

2. IV D5W 1⁄4NS at 90mL/hr

A nurse admits a teenager in sickle cell crisis to a pediatric unit. The child has an elevated heart rate but nor- mal blood pressure, respiratory rate, and temperature. The child has an oxygen saturation of 98% on room air and rates pain in the extremities at an 8 on a 1-to-10 numeric pain rating scale. Which actions should the nurse perform at this time? Prioritize the nurse's actions by placing each correct intervention in priority order. 1. Administer oxygen. 2. Obtain the child's weight. 3. Administer IV fluids as ordered. 4. Monitor I&O. 5. Obtain an order for pain medication via PCA. 6. Apply cool, moist compresses to extremities.

2. Obtain the child's weight. 3. Administer IV fluids as ordered. 5. Obtain an order for pain medication via PCA. 6. Apply cool, moist compresses to extremities. 4. Monitor I&O.

The nurse is providing care to a school-age client with a documented immunodeficiency who is admitted to the general pediatric unit for intravenous medication administration. Which interventions are appropriate for this client? Select all that apply.

2. Place in a positive-pressure room. 3. Avoid live vaccines. 4. Perform frequent hand washing.

Which nursing interventions would be best for the nursing diagnosis of Powerlessness Related to Relinquishing Control to the Healthcare Team? Select all that apply.

2. Prepare the child in advance for procedures. 4. Explain procedures in developmentally appropriate terms. 5. Incorporate home rituals when possible.

A school nurse is called to a third grade classroom because a child, with no previous history, is in anaphylaxis. Which of the following actions should the nurse perform? 1. Notify the parents to pick up their child as soon as possible. 2. Take the AED to the classroom, and begin emergency intervention. 3. Have the child lie quietly in the nurse's o ce for the next 30 minutes. 4. Inform the health department that the child has a reportable illness.

2. Take the AED to the classroom, and begin emergency intervention.

A nurse is providing a teaching session for adolescents and their parents regarding HIV. Which of the following information should the nurse include in the teaching session? Select all that apply. 1. It is recommended that all individuals aged 18 and older be tested for HIV. 2. The potential for contracting HIV increases when a person has intercourse with multiple partners. 3. A person can contract more than one strain of HIV, increasing the likelihood of the disease progressing to AIDS. 4. Although HAART helps to delay the onset of AIDS, all patients with HIV will die within approximately 20 years of the time of the initial infection. 5. Anyone who is diagnosed with hepatitis B or hepatitis C is at high risk for also being infected with HIV.

2. The potential for contracting HIV increases when a person has intercourse with multiple partners. 3. A person can contract more than one strain of HIV, increasing the likelihood of the disease progressing to AIDS. 5. Anyone who is diagnosed with hepatitis B or hepatitis C is at high risk for also being infected with HIV.

A 16-year-old male has hemophilia A. The nurse is assessing the actions performed by the family when administering the teen's medications. Which of the following actions would the nurse expect to see? 1. His mother draws up the factor replacement into a syringe. 2. The young man washes his hands carefully and puts on sterile gloves. 3. The missing factor is infused every night while the teen sleeps. 4. Anti-fibrinolytic medication is taken before each factor infusion.

2. The young man washes his hands carefully and puts on sterile gloves.

A 10-month-old infant has been exposed to chickenpox. e nurse would expect the baby's primary health-care provider to order which of the following interventions to prevent the baby from contracting the illness? 1. Intravenous antibiotics 2. Varicella zoster immune globulin 3. Varicella immunization 4. Nothing because the baby is protected by the mother's antibodies

2. Varicella zoster immune globulin

A young woman is being seen in the women's health clinic. She states that she had unprotected intercourse about one month earlier, and she is worried that she may have contracted HIV. Which of the following signs/symptoms would indicate that her worries may be correct? 1. Macular papular rash covering her thorax 2. Severe abdominal cramps accompanied by diarrhea 3. Exhaustion accompanied by muscle aches and pains 4. Abnormally heavy menstrual period

3. Exhaustion accompanied by muscle aches and pains

A child has been exposed to a viral illness. e child's B cells have been activated. e nurse determines that the child's body has undergone which of the following physiological responses? 1. Red blood cells have increased in number. 2. Platelets are migrating to the respiratory tract. 3. Lymphocytes have begun to produce antibodies. 4. Interferon and enzyme production is inhibited.

3. Lymphocytes have begun to produce antibodies.

A 10-year-old child, diagnosed with hemophilia A, is in the emergency department a er experiencing a fall on the school playground. Which of the following laboratory data would the nurse expect to see? 1. Leukocyte count 15,000 cells/mm3 2. Platelet count 75,000 cells/mm3 3. Partial prothrombin time (PTT) 90 sec (normal 60-70 sec) 4. Prothrombin time (PT) 9 sec (normal 11-12.5 sec)

3. Partial prothrombin time (PTT) 90 sec (normal 60-70 sec)

A 12-week-gestation African American woman asks her obstetrician's nurse whether her baby could be born with sickle cell disease. Which of the following replies is appropriate for the nurse to give? 1. It is possible because one out of every 500 African Americans is diagnosed with sickle cell anemia. 2. If either you or the baby's father has sickle cell anemia, your child may be born with the disease. 3. The baby could only have sickle cell anemia if both you and the baby's father carry a sickle cell gene. 4. If the child is a boy, he could have sickle cell anemia, but if the child is a girl, she will definitely be healthy.

3. The baby could only have sickle cell anemia if both you and the baby's father carry a sickle cell gene.

A 12-year-old girl has just been diagnosed with systemic lupus erythematosus (SLE). Which of the following information should the nurse include when educating her and her parents regarding the disease? 1. The cure rate for SLE is between 90% and 95%. 2. SLE is caused by a virus that permeates 100% of the cells of the kidneys and liver. 3. The pain of SLE arthritis will likely be controlled with non-steroidal anti-inflammatories. 4. SLE antibodies were triggered by pubertal changes.

3. The pain of SLE arthritis will likely be controlled with non-steroidal anti-inflammatories.

A child is receiving chemotherapy for the treatment of osteosarcoma. Which morning laboratory result must a nurse report immediately to the physician? 1. Absolute neutrophil count of 1200. 2. Platelet count of 150,000. 3. Urine dipstick positive for heme. 4. WBC count of 4500.

3. Urine dipstick positive for heme.

Which of the following actions indicates that the parents of a 12-month-old with iron deficiency anemia understand how to administer iron supple- ments? Select all that apply.

They administer iron supplements in combination with fruit juice. They brush the child's teeth after administering the iron supplements.

Teaching about iron supplements for iron deficiency.

They have dark stools

An 18-year-old man reports to a nurse that he had unprotected anal intercourse with a man 3 years earlier. When the nurse suggests that the patient have an HIV test, he states, "Why, I'm ne. I don't have any symptoms at all." Which of the following responses by the nurse would be appropriate to make? 1. "You are probably correct because unless you had gastrointestinal symptoms a er you had intercourse, you are probably not infected." 2. "You are probably correct because having intercourse with an infected woman is much more dangerous than with a man." 3. "I understand that there is virtually no chance that you are infected, but it is recommended that all who are 13 and older be tested." 4. "You should be tested anyway because it can take up to 10 years before any symptoms of the disease are detected."

4. "You should be tested anyway because it can take up to 10 years before any symptoms of the disease are detected."

When providing anticipatory guidance to the parents of a child with hemophilia, a nurse should stress that: 1. Active range-of-motion exercise should be used to treat sore joints. 2. Aspirin should be given for minor bumps and bruises. 3. Warm compresses should be applied to wounds to promote circulation. 4. A soft toothbrush should be used to promote oral health.

4. A soft toothbrush should be used to promote oral health.

A clinic nurse has a follow-up appointment with an adolescent with juvenile idiopathic arthritis (JIA). What topic should be the nurse's top priority? 1. Sleep patterns. 2. Participation in daily exercise. 3. Information regarding JIA support groups. 4. Avoidance of alcohol use.

4. Avoidance of alcohol use.

A child, weighing 80 lb, has been prescribed an EpiPen. Which of the following information should the nurse include in the medication teaching for the parents and the child? 1. To keep the medication in a refrigerator at all times. 2. Inject the medication at a 45 degree angle to the body surface. 3. Administer the medication into the dorsogluteal muscle. 4. Continue to inject the medication for at least 10 seconds duration.

4. Continue to inject the medication for at least 10 seconds duration.

The mother of a child with acute lymphoblastic leukemia (ALL) states that their family is employing complementary therapies to improve the child's chances of survival. The child is also receiving chemotherapy. The nurse should discuss with the mother that which of the following therapies may actually be in conflict with the child's medical care? 1. Therapeutic touch 2. Healing meals 3. Pet therapy 4. Folic acid supplements

4. Folic acid supplements

A 12-month-old child with infantile eczema is seen at the clinic for several open lesions on the arms and legs. What should a nurse caution the child's parents against? 1. Initiating a diet free of milk products. 2. The use of topical hydrocortisone cream. 3. Adding cornstarch to bath water. 4. Immunization during eczema exacerbations.

4. Immunization during eczema exacerbations.

A school-age child has sickle cell anemia. The child's parents ask the school nurse regarding the high-risk nature of 4 activities the child is requesting to participate in. Which of the following activities should the nurse advise the parents is most high risk for the child to perform? 1. Perform the lead role in the school play. 2. Play the violin in the school orchestra. 3. Create an oil painting in art class. 4. Join the after-school wrestling team.

4. Join the after-school wrestling team.

The nurse is caring for a child with stomatitis a er receiving chemotherapy. Which of the following food items would be appropriate for the nurse to provide the child? 1. Orange juice 2. Whole-grain crackers 3. Dried apple chips 4. Milkshake

4. Milkshake

An 11-month-old child is receiving chemotherapy for a diagnosis of acute lymphoblastic leukemia (ALL). Which of the following vaccinations is safe for the nurse to administer to the child? 1. Var (varicella) 2. MMR (measles, mumps, rubella) 3. LAIV (live attenuated influenza vaccine) 4. PCV (pneumococcal)

4. PCV (pneumococcal)

A young child diagnosed with iron-deficiency anemia is prescribed a liquid iron supplement. A nurse provides the parents with instructions on administration and should be certain to advise them that: 1. The medication should be given along with the child's morning cereal breakfast. 2. The child may experience some pale-colored stools. 3. The child should be permitted to sip the medication from a medicine cup. 4. The medication can be mixed with a small amount of fruit juice.

4. The medication can be mixed with a small amount of fruit juice, especially orange juice.

The nurse is providing education to pregnant women who have a family history of severe allergies. Which of the following information should the nurse convey regarding actions the women should take to minimize their children's potential for developing allergies? 1. Remove high-allergy foods from their diet during their pregnancy and while breastfeeding. 2. If they decide not to breastfeed their baby, to feed the baby a soy-based rather than a cow's milk-based formula. 3. Delay feeding their infant any solid foods until the infant is seven to eight months of age. 4. When they begin to feed their infant solid foods, to begin serving high-allergy foods shortly a er low-allergy foods have been introduced.

4. When they begin to feed their infant solid foods, to begin serving high-allergy foods shortly a er low-allergy foods have been introduced.

A nurse, caring for a client in the emergency department, is stuck by a contaminated needle. Which of the following actions should the nurse perform? e nurse should: 1. advise the client that a law requires that an HIV test be performed on the client as soon as possible. 2. wait at least 7 days before having HIV baseline testing performed. 3. be prepared to receive an intravenous infusion of HIV immune globulin in the emergency department. 4. begin postexposure prophylactic treatment within 72 hours of the HIV exposure.

4. begin postexposure prophylactic treatment within 72 hours of the HIV exposure.

A child has been prescribed 20 mg of elemental iron tid. e nurse has determined that the dosage is safe for the child. Ferrous sulfate elixir is available as: 44 mg/5 mL. How many mL of medication will the child consume each day? (If rounding is needed, please calculate to the nearest tenth.)

6.8 mL

Which of the following beverages should the nurse plan to give a child with leukemia to relieve nausea?

A carbonated beverage.

The nursing student is presenting a clinical conference and discusses the cause of beta-thalassemia. The nursing student informs the group that a child at greatest risk of developing this disorder is which of these?

A child of Mediterranean descent.

Which client in the pediatric intensive care unit (PICU) would most benefit from palliative care?

A child with burn injuries to the legs.

The child is admitted to the hospital after being diagnosed with retinoblastoma. Which assessment finding does the nurse anticipate for this child?

A white pupil

The nurse is performing an assessment on a 10-year-old child suspected to have Hodgkin's disease. Which assessment findings are specifically characteristic of the disease? Select all that apply.

Abdominal pain. Painless, firm, and moveable adenopathy in the cervical area.

When should a child be put on NPO status?

Absent bowel sounds

A child diagnosed with a Wilms tumor is prescribed chemotherapy. Which laboratory test will the nurse monitor prior to administering the chemotherapy to determine the childs infection-fighting capability?

Absolute neutrophil count (ANC)

Immunity from a vaccine

Acquired from

A child is diagnosed with thrombocytopenia secondary to chemotherapy treatments. Which action by the nurse is the most appropriate?

Administer intramuscular injections (IM).

The nurse is instructing the parents of a child with iron deficiency anemia regarding the administration of a liquid oral iron supplement. What instruction should the nurse tell the parents?

Administer the iron through a straw.

The nurse is caring for a child who is in a sickle cell crisis and has severe pain. Which nursing intervention is the most appropriate for this child?

Administering pain medication

A 24-hour urine collection for vanillylmandelic acid (VMA) has been ordered on a child suspected of having neuroblastoma. When is the most appropriate time for the nurse to begin the collection?

After the next time the child voids

Which intervention is considered supportive care for a family whose infant has died from sudden infant death syndrome (SIDS)?

Allowing parents to hold, touch, and rock the infant

Early manifestations of leukemia

Anorexia Petechiae Unsteady gait

A school-age child with hemophilia falls on the playground and goes to the nurses office with superficial bleeding above the knee. Which action by the nurse is the most appropriate?

Apply pressure to the area for at least 15 minutes.

A school-age child with congenital heart block codes in the emergency department (ED). The parents witness this and stare at the resuscitation scene unfolding before them. Which nursing intervention is most appropriate in this situation?

Ask the parents to sit near the child's face and hold her hand.

After teaching a child with leukemia scheduled for a bone marrow aspiration about the procedure, the nurse determines that the teaching has been successful when the child identifies which of the following as the site for the aspiration?

Back of the hipbone.

The antiemetic drug ondansetron (Zofran) is administered to a child receiving chemotherapy. When should the nurse administer this medication?

Before chemotherapy administration as a prophylactic measure

A nurse is teaching the family of an 8-year- old boy with acute lymphocytic leukemia about appropriate activities. Which of the following activities should the nurse recommend?

Being treated as "normal" as much as possible.

A nurse is administering an intramuscular vaccination to an infant diagnosed with WiskottAldrich syndrome (WAS). Which reaction is the infant more at risk for due to the diagnosis of WAS?

Bleeding at injection site

A 4-year-old child is admitted to the hospital for abdominal pain. The mother reports that the child has been pale and excessively tired and is bruising easily. On physical examination, lymphadenopathy and hepatosplenomegaly are noted. Diagnostic studies are being performed because acute lymphocytic leukemia is suspected. The nurse determines that which laboratory result confirms the dx?

Bone marrow biopsy showing blast cells

S/s of metastasis from primary site

Bone pain Periorbital ecchymoses Proptosis Ill appearance

A child is diagnosed with sickle cell disease. The parents are unsure how their child contracted the disease. Which explanation by the nurse is the most appropriate?

Both the mother and the father have the sickle cell trait.

A school bus carrying children in grades K12 crashed into a ravine. The critically injured children were transported by ambulance and admitted to the pediatric intensive-care unit (PICU). The nurse is concerned about calming the frightened children. Which nursing intervention is most appropriate to achieve the goal of calming the frightened children?

Call the children's parents to come into the PICU.

A child is diagnosed with a Wilms tumor. Which nursing action is most appropriate prior to surgery?

Careful bathing and handling

The nurse is providing discharge teaching to a school-age client who was recently diagnosed with a latex allergy. Which product will the nurse educate the client and family to avoid?

Chewing gum

A mother asks the nurse if her child's iron deficiency anemia is related to the child's frequent infections. The nurse responds based on the under- standing of which of the following?

Children with iron deficiency anemia are more susceptible to infection than are other children.

S/s of neuropathy d/t chemo

Constipation Foot drop Jaw pain

An infant of a mother infected with HIV is seen in the clinic each month and is being monitored for symptoms indicative of HIV infection. With knowledge of the most common opportunistic infection of children infect with HIV, the nurse assesses the infant for which sign?

Cough

A 12-year-old with leukemia is receiving cyclophosphamide (Cytoxan). The nurse should assess for the adverse effect of:

Cystitis.

Laboratory findings indicate that a child with leukemia is also anemic. The nurse interprets this finding as most likely resulting from which of the following?

Decreased red blood cell production.

A child with beta-thalassemia is receiving long-term blood transfusion therapy for the tx of the disorder. Chelation therapy is prescribed as a result of too much iron from the transfusions. Which medication should the nurse anticipate to be prescribed?

Deferoxamine

Mild symptoms of HIV

Dermatitis Hepatomegaly Lymphadenopathy

Impending death s/s?

Difficulty swallowing and Cheyenne strokes respirations

Klinefeltor sydrom

Doing well in school

The nurse is teaching the parents of a child with sickle cell disease. To instruct them on how to prevent sickle cell crisis, she should include which instruction?

Drink at least 2 quarts of fluids per day.

The nurse is conducting staff in-service training on von Willebrand's disease. Which should the nurse include as characteristics of von Willebrand's disease? Select all that apply.

Easy bruising occurs. Gum bleeding occurs. It is a hereditary bleeding disorder. Tx and care are similar to that for hemophilia. The disorder causes platelets to adhere to damaged endothelium.

Sickle cell crisis

Emotional stress included in select all

The nurse and parents are planning for the discharge of a child with leukemia who is receiv- ing dactinomycin (actinomycin D) and vincristine (Oncovin). The nurse should teach the parents to:

Encourage increased fluid intake.

Rhabdomyosarcoma of nasopharynx

Enlarged neck lymph Pain Epistaxis

A 14-year-old girl with sickle cell disease has her fourth hospitalization for sickle cell crisis. Her family is planning a ski vacation in the mountains. What should the nurse tell the parents?

Explain that the high altitude may cause a crisis.

Siblings of a client in pediatric intensive care unit (PICU) are preparing to visit their brother, who was hit by a car while riding his bike. Which intervention by the nurse will assist the siblings in preparing for the visit?

Explain what the siblings will hear and see when they visit.

S/s of rhabdomyosarcoma

Eye drooping Swelling Uncoordinated movements

The parents of a toddler-age child who sustained severe head trauma from falling out a second-story window are arguing in the pediatric intensive-care unit (PICU) and blaming each other for the childs accident. Which nursing diagnosis is most appropriate for this family?

Family Coping: Compromised, Related to the Childs Critical Injury

S/s needing intervention for ALL

Fever Petechiae

A 15-year-old has been admitted to the hospi- tal with the diagnosis of acute lymphocytic leuke- mia. Which of the following signs and symptoms require the most immediate nursing intervention?

Fever and petechiae.

A child diagnosed with cancer is prescribed chemotherapy. The latest lab value indicates the white-blood-cell count is very low. Which medication order does the nurse anticipate?

Filgrastim (Neupogen)

The clinic nurse instructs parents of a child with sickle cell anemia about the precipitating factors related to sickle cell crisis. Which, if identified by the parents as a precipitating factor indicated the need for further instructions?

Fluid-overload

School child having anaphylaxis

Grab AED

Neuroblastoma

Half the children have a metastatic disease Child will need a bone biopsy Surgery to resect tumor

What can cause osteoarthritis?

Hemophilia

What test is used to distinguish if a child has a disease?

Hgb electrophoresis

The nurse analyzes the laboratory results of a child with hemophilia. The nurse understands that which results will most likely be abnormal in this child?

Hgb level

A 12-year-old with leukemia will be taking vincristine. The nurse should encourage the child to eat what kind of diet?

High-residue.

An adolescent is receiving methotrexate chemotherapy after undergoing limb-salvage surgery for osteogenic sarcoma. Which statement by the adolescent indicates understanding of the purpose of leucovorin therapy after the methotrexate?

I know I will be taking the leucovorin every 6 hours for about the next 3 days.

Parents of a child who experienced a moderately severe allergic reaction after eating peanuts ask the nurse what they can do to help if it happens again. Which response by the nurse is the most appropriate?

I will teach you how to use an EpiPen.

A 10 year old child with hemophilia A has slipped on the ice and bumped his knee. The nurse should prepare to administer which prescription?

IV infusion of factor VIII

How can HIV can be transmitted?

IV substance use

Which of the following medication orders to help relieve discomfort in a child with leukemia should the nurse question?

Ibuprofen (Motrin).

The nurse analyzes the laboratory values of a child with leukemia who is receiving chemotherapy. The nurse notes that the platelet count is 19,500 mm3 (19.5x10^9/L). On the basis of this laboratory result, which intervention should the nurse include in the plan of care?

Initiate bleeding precautions.

A child with hemophilia presents with a burning sensation in the knee and reluctance to move the body part. The nurse collaborates with the care team to provide factor replacement and:

Institute Rest, Ice, Compression, and Elevation (RICE).

A child comes to the clinic for an assessment 20 days postbone marrow transplant. Which system should receive the highest priority during the nursing assessment?

Integumentary

A child who has beta-thalassemia is receiving numerous blood transfusions. The child is also receiving deferoxamine (Desferal) therapy. The parents ask how the deferoxamine will help their child. Which rationale does the nurse use when responding to the parents?

It prevents iron overload.

Severely symptomatic HIV

Kaposi's sarcoma Wasting syndrome Pulmonary candidiasis

A preschool-age child is brought to the clinic by the mother, who says the child has been lethargic and anorexic lately and complains of bone pain. On exam, the nurse notes petechiae, joint pain, and an enlarged liver. Which diagnosis does the nurse anticipate for this child?

Leukemia

A school-age client is admitted to the pediatric intensive care unit (PICU) in critical condition after a motor vehicle accident. Which intervention should be implemented at this time?

Maintain consistent caregivers.

Which specific nursing interventions are implemented in the care of a child with leukemia who is at risk for infection? Select all that apply.

Maintain the child in a semiprivate room. Reduce exposure to environmental organisms. Use strict aseptic technique for all procedures. Ensure that anyone entering the child's room wears a mask.

A toddler-age client is in end-stage renal failure. Which nursing intervention will assist this child most?

Maintain the child's normal routines.

The nurse is caring for a child with disseminated intravascular coagulation (DIC). Which nursing intervention is a priority for this child?

Maintenance of skin integrity

The nurse is caring for an adolescent client diagnosed with rheumatoid arthritis. Which non-pharmacological measure to reduce joint pain is most appropriate for the nurse to recommend to this client?

Moist heat

A child is diagnosed with rhabdomyosarcoma. Which nursing intervention is most appropriate for this child?

Monitor for hematuria

Teaching for chemo

Monitor for infection Bleeding precautions Hand hygiene

Precautions for those with thrombocytopenia

Monitor signs for bleeding Avoid venipunctures

Which home care instruction should the nurse provide to the parent of a child with AIDS? Select all that apply.

Monitor the child's weight. Frequent hand washing is important. The child should avoid exposure to other illnesses. Clean up body fluid spills with bleach solution (10:1 ratio of water to bleach).

The nurse is assisting with conscious sedation for a 6-year-old undergoing a bone marrow biopsy. The nurse's most important responsibility during the procedure is to:

Monitor the client.

The nurse is providing care for an adolescent client who is experiencing pain related to a sickle cell crisis. Which medication does the nurse prepare to administer to this client?

Morphine sulfate

The nurse is evaluating the activity tolerance of a 9-month-old with iron deficiency anemia. Which finding indicates that the infant is not tolerating activity?

Muscle weakness

A child with human immunodeficiency virus (HIV) also has oral candidiasis. Which type of mouth care solution will the nurse teach the child to use?

Normal saline

A child who is diagnosed with leukemia has a sibling who is expressing feelings of anger and guilt. How would the nurse characterize this reaction by the sibling?

Normal; the sibling is affected too, and anger and guilt are expected feelings.

A 10-year-old with leukemia is taking immunosuppressive drugs. To maintain health the nurse should instruct the child and parents to:

Not receive any live attenuated vaccines.

A child undergoes surgical removal of a brain tumor. During the postoperative period, the nurse notes that the child is restless, the pulse rate is elevated, and the BP has decreased significantly from the baseline values. The nurse suspects that the child is in shock. Which is the most appropriate nursing action?

Notify the health care provider (HCP).

The nurse is monitoring a child for bleeding after surgery for removal of a brain tumor. The nurse checks the head dressing for the presence of blood and notes a colorless drainage on the back of the dressing. Which intervention should the nurse perform immediately?

Notify the health care provider (HCP).

The nurse explains to the parents of a 1-year- old child admitted to the hospital in sickle cell crisis that the local tissue damage the child has on admission is caused by which of the following?

Obstruction to circulation.

HIV

Obtain yearly vaccine Avoid individuals who have colds Provide nutritional supplements

Interventions for those with mucositis

Offer soft foods Use soft disposable toothbrush Encourage saline gargle

Rhabdomyosarcoma of upper arm

Pain Lymph node enlargement Palpable mass

Which of the following is the priority nursing diagnosis during a toddler's vasoocclusive sickle cell crisis?

Pain related to tissue anoxia.

The mother of a 4-year-old child tells the pediatric nurse that the child's abdomen seems to be swollen. During further assessment, the mother tells the nurse that the child is eating well and that the activity level of the child is unchanged. The nurse, suspecting the possibility of Wilms' tumor, should avoid which during the physical assessment?

Palpating the abdomen for a mass

A child is admitted to the neonatal intensive care unit (NICU). The parents are concerned because they cannot stay for long hours to visit. Which statement made by the nurse is most appropriate?

Parents often feel this way; would you be interested in talking with others who have experienced having a child in the NICU?

Complicated grief

Personal activities are affected

Which of the following foods should the nurse encourage the mother to offer to her child with iron deficiency anemia?

Potato, peas, and chicken.

Foods rich in Fe

Potatoes Peas Chicken

Amputation

Prepare the child for a prosthesis fitting

Managing epistaxis

Press nares together for 10 min. Pack cotton into bleeding nares

The charge nurse on a pediatric unit is making a room assignment for a school-age child diagnosed with sickle cell disease, who is in splenic sequestration crisis. Which room assignment is most appropriate for this client?

Private room

A child with meningococcemia is being admitted to the pediatric intensive-care unit. Which room assignment is the most appropriate for this child?

Private room, in respiratory isolation

A child is prescribed Didanosine (Videx), a nucleoside reverse transcriptase inhibitor, for human immunodeficiency virus (HIV). Which lab value will the nurse monitor closely for this child?

Red blood cell count

Laboratory studies are performed for a child suspected to have iron deficiency anemia. The nurse reviews the laboratory results, knowing that which result indicates this type of anemia?

Red blood cells that are microcytic and hypochromic

A child recently diagnosed with aplastic anemia is being prepared for discharge. When planning support for the family, which service should the nurse plan to include in the discharge plan?

Referrals to support groups and social services

After doing well for a period of time, a child with leukemia develops an overwhelming infection. The child's death is imminent. Which of the following statements offers the nurse the best guide in making plans to assist the parents in dealing with their child's imminent death?

Relatives are especially grieved when a child does well at first but then declines rapidly.

Dying children and their family

Remain in contact Develop professional support system Take time for work

Lumbar puncture

Restrain infant

The nurse is reviewing a health care provider's prescriptions for a child with sickle cell anemia who was admitted to the hospital for the tx of vasoocclusive crisis. Which prescriptions documented in the child's record should the nurse question? Select all that apply.

Restrict fluid intake. Give meperidine, 25 mg IV, every 4 hours for pain.

A nurse is planning care for a child with human immunodeficiency virus (HIV). Which nursing diagnosis is the highest priority for this child?

Risk for Infection

SLE nursing dx

Risk for impaired skin integrity Risk for activity intolerance Disturbed body image Risk for infection Acute pain Ineffective family health management

The nurse is providing care to a school-age client diagnosed with idiopathic thrombocytopenic purpura (ITP). Which nursing diagnosis is the priority for this client?

Risk for injury

What is the most appropriate method to use when drawing blood from a child with hemophilia?

Schedule all labs to be drawn at one time.

An adolescent client has a stiff neck, a headache, a fever of 103 degrees Fahrenheit, and purpuric lesions noted on the legs. Although the adolescents physical needs take priority at the present time, the nurse can expect which to be the most significant psychological stressor forthis adolescent?

Separation from friends and permanent changes in appearance

A nurse begins an infusion of intravenous immune globulin (IVIG) to a child who has combined immunodeficiency disease. Which assessment finding indicates that the nurse should stop the infusion?

Severe shaking, chills, and fever

A diagnosis of hemophilia A is confirmed in an infant. Which of the following instructions should the nurse provide the parents as the infant becomes more mobile and starts to crawl?

Sew thick padding into the elbows and knees of the child's clothing.

The nurse is providing care to an adolescent client diagnosed with systemic lupus erythematosus (SLE). Which action by the client indicates acceptance of body changes associated with SLE?

She discusses the body changes with a peer.

Epistaxis

Sit up and lean forward

A child with a brain tumor is admitted to the pediatric intensive care unit (PICU) after brain surgery to remove the tumor. Which postoperative order would the nurse question?

Sodium levels every 24 hours

The nurse is monitoring the urine specific gravity and pH on a child receiving chemotherapy. Which urinalysis result is the goal for this child?

Spec gravity 1.005; pH 7.5

Osteosarcoma

Spend time with adolescent to answer any questions he may have

AIDS precautions

Standard precautions

Which action by the parents demonstrates an understanding of the nurses teaching with regard to prevention of iron-deficient anemia?

Starting iron-fortified infant cereal at 4 to 6 months of age

Teaching about Wilms' tumors

Surgery done within 48 hours Palpating could lead to spread of tumor Further treatments start immediately after

A school-age child diagnosed with rheumatoid arthritis asks the nurse to recommend an exercise activity. Which activity is most appropriate for this child?

Swimming

The mother tells the nurse she will be afraid to allow her child with hemophilia to participate in sports because of the danger of injury and bleeding. After explaining that physical fitness is important for children with hemophilia, which of the following activities should the nurse suggest as ideal?

Swimming

The nurse is providing home care instructions to the parents of a 10-year-old child with hemophilia. Which post activity should the nurse suggest for this child?

Swimming

An HIV-positive mother states she is relieved after the birth of her child to hear that the child is HIV-negative. Which response by the nurse is the most appropriate?

Symptoms could still appear over the next 2 years

Preschool children's perception of death

Temporary

The clinic nurse is assessing a child who is scheduled to receive a live virus vaccine (immunization). What are the general contraindications associated with receiving a live virus vaccine? Select all that apply.

The child has a previous anaphylactic reaction to the vaccine. The child has a disorder that caused a severely deficient immune system.

The clinic nurse is instructing the parent of a child with HIV infection regard immunizations. The nurse should provide which instruction to the parent?

The inactivated influenza vaccine will be given yearly.

A preschool child is seen in the clinic, and the nurse anticipates a diagnosis of leukemia. Which reaction does the nurse anticipate this child will exhibit upon diagnosis?

Thoughts that they caused their illness and are being punished

Best way to take liquid Fe supplements

Through a straw

A child is on a ventilator in the pediatric intensive care unit (PICU). Which nursing intervention would best meet the psychosocial needs of this child?

Touch and talk to the child often.

Method to inject Fe

Use Z-track method

A transfusion of packed red blood cells has been ordered for a 1-year-old with a sickle cell ane- mia. The infant has a 25 gauge I.V. infusing dextrose with sodium and potassium. Using the Situation, Background, Assessment, Recommendation (SBAR) method of communication, the nurse contacts the physician and recommends:

Using the existing IV, but changing the fluids to normal saline for the transfusion.

The nurse is providing care to a preschool-age client who is diagnosed with acquired immune deficiency syndrome (AIDS). In planning the clients care, which vaccine is inappropriate for the client to receive?

Varicella vaccine

The nurse is monitoring a 3-year-old child for s/s of increased ICP after a craniotomy. The nurse plans to monitor for which early s/s of increased ICP?

Vomiting

A child diagnosed with hemophilia plans on participating in a bicycling club. Which recommendation by the nurse is the most appropriate?

Wear kneepads, elbow pads, and a helmet while bicycling.

Parents of a child in the pediatric intensive care unit (PICU) have been experiencing shock and disbelief regarding their situation. Which statement by the parents indicates they are moving forward into the next stage of coping?

Why not me instead of my child?

The nurse is administering packed red blood cells to a child with sickle cell disease (SCD). The nurse is monitoring for a transfusion reaction and knows it is most likely to occur during which time frame?

Within the first 20 minutes of administration of the transfusion

Because of the risks associated with admin- istration of factor VIII concentrate, the nurse should teach the child's family to recognize and report which of the following?

Yellowing of the skin.

The nurse must prepare parents to see their adolescent daughter in the pediatric intensive- care unit (PICU). The child arrived by life flight after experiencing multiple traumas in a car accident involving a suspected drunk driver. At this time, which statement by the nurse to the family is the most appropriate?

Your child's condition is very critical; her face is swollen, and she may not look like herself.

A HCP prescribes laboratory studies for an infant of a woman positive for HIV. The nurse anticipates that which laboratory study will be prescribe for the infant?

p24 antigen assay