COURSEHERO pt. 2

Playing in the woods about a week ago

A mother brings her 8-year-old son for evaluation because of a rash on his lower leg. Which finding would support the suspicion that the child has Lyme disease?

Ineffective protection related to impaired humoral defenses

A nurse is preparing a plan of care for a child with a primary immunodeficiency. Which nursing diagnosis is the priority?

• Eggs • Shrimp • Peanuts

A nurse is preparing a presentation for a group of new parents and is planning to discuss nutrition during the first year. As part of the presentation, the nurse is planning to address foods that should be avoided to reduce the risk of possible food allergies. Which foods would the nurse most likely include? Select all that apply.

Epstein-Barr virus

Infectious mononucleosis ("mono") is caused by which of the following?

Widely fluctuating blood pressure

A nurse is providing care for a child with disseminated intravascular coagulation (DIC). What would alert the nurse to possible neurologic compromise?

• Cancer • Immunosuppressive drugs • Malnutrition

After teaching a class of nursing students about acquired immunodeficiency, the instructor determines that the teaching was effective when the students identify what as a contributing factor? Select all that apply.

Zidovudine

A nurse is providing care to a child with HIV who is prescribed therapy with a nucleoside reverse transcriptase inhibitor. What would the nurse expect to administer?

• headache • vomiting • lethargy

The nurse is caring for a child with idiopathic thrombocytopenic purpura. Which assessment finding requires immediate notification of the health care provider? Select all that apply.

Iliac crest

A nurse is preparing a 7-year-old girl for bone marrow aspiration. Which site should she prepare?

Intravenous immune globulin

A nurse is providing care to a child with idiopathic thrombocytopenic purpura with a platelet count of 18,000/mm3. Which medication would the nurse most likely expect to be ordered?

11.0 to 13.0 seconds

The nurse is reviewing the results of a clotting study for a healthy 6-year-old. What would the nurse document as a normal prothrombin finding?

Vancomycin

Which of the following is the drug of choice for multidrug-resistant strains of infection?

"Will you show me how you walk across the room?"

A nurse is conducting a physical examination of a 5-year-old with suspected iron-deficiency anemia. How would the nurse evaluate for changes in neurologic functioning?

The child develops an active immunity.

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?

Development of toxic iron overload

A client with severe chronic anemia is receiving ongoing transfusion therapy. The nurse frequently assesses the client for what major complication of this therapy:

β-Thalassemia major.

A 10-month-old has been admitted to the hospital with severe hemolytic anemia and chronic hypoxia. The nurse notes icteral sclerae, jaundice of the skin, and frontal and maxillary bossing. The nurse interprets these findings as most likely indicating:

Vitamin B12 deficiency

A 14-year-old girl who is a vegetarian has recently developed anemia. Blood smear results show large, fragile, immature erythrocytes. She claims to take an iron supplement regularly and is surprised to learn that she is anemic, as she is otherwise healthy. The nurse recognizes that this is the likely cause of this type of anemia:

Inadequate intake of dietary iron in the mother during late gestation

A 4-month-old infant is found to be anemic. Which is the most likely cause of anemia in this child?

• Pallor • Fatigue • Easy bruising • Cyanosis

A 5-year-old boy is diagnosed with congenital aplastic anemia. Which symptoms should be considered when developing the plan of care? Select all that apply.

Treatment for 1 to 3 months and the child will be cured

A child abruptly develops miniature petechiae over his legs, along with epistaxis and bleeding into the joints. Laboratory results reveal a platelet count of 20,000/mm3 and idiopathic thrombocytopenic purpura (ITP) is diagnosed. The parent of the child is distraught and asks the nurse what should be expected. What prognosis is most accurate?

• Applying pressure to a puncture site for a full 5 minutes • Limiting the use of adhesive tape on the child's skin • Administering medications orally or intravenously

A child develops treatment-related thrombocytopenia. When preparing the plan of care for the child, which would the nurse include? Select all that apply.

T cells

A group of nursing students are reviewing information about humoral and cellular immunity. The students demonstrate understanding of this material when they identify what as being involved in cellular immunity?

High urine specific gravity

A group of students are reviewing the effects of sickle cell anemia on the various parts of the body. The students demonstrate a need for additional study when they identify what as an effect?

Mononucleosis

A high school football player comes to the clinic with malaise, fever, headache, and anorexia that have been present for the last few days. Upon physical examination, the nurse notes that the cervical lymph nodes are firm and tender. Tonsils are red and enlarged and appear to have a white covering. What should the nurse suspect the diagnosis to be for this patient?

placental spread during pregnancy

A mother, who is HIV positive, is distraught when she learns that her 6-month-old baby is also human immunodeficiency virus (HIV) positive. The child had undergone open heart surgery as a newborn and had received numerous blood transfusions. The nurse recognizes that the most likely means of transmission of the disease to this child was:

T-lymphocyte deficiency

A newborn is found to have Di George syndrome and has misshaped ears, a small mandible, and an absent thymus. The nurse recognizes that this condition is associated with which of the following types of immunodeficiency disorders?

Disseminated intravascular coagulation

A nurse caring for an 8-year-old with a bleeding disorder documents the following nursing diagnosis: ineffective tissue perfusion related to intravascular thrombosis and hemorrhage. This diagnosis is most appropriate for a client with:

Discontinue the transfusion.

A nurse is administering a blood transfusion to a child. About 35 minutes after beginning the transfusion, the child develops pruritus and urticaria. Some wheezing is noted. Which action would the nurse take first?

• Iron-binding capacity 390 ug/100 mL • Serum ferritin 8 ug/100mL • Hematocrit 30%

A nurse is reviewing laboratory test results of a child with iron-deficiency anemia. Which laboratory results would be communicated with the next shift during shift hand-off? Select all that apply.

Red, strawberry tongue

A nurse practitioner suspects that a child has scarlet fever based on which assessment finding?

Herpes zoster

A nursing student learning about childhood infectious diseases correctly identifies which of the following as the disease related to chickenpox, which tends to occur in older children or young adults?

Social isolation related to infectivity and inability to go to the playroom

A school-aged child with an infectious disease is placed on transmission-based precautions. Which nursing diagnosis would be the priority?

hemarthrosis

A symptom often seen in the child diagnosed with hemophilia is that the child has bleeding into the joints. This symptom is referred to as:

Factor VIII

A toddler who is beginning to walk has fallen and hit his head on the corner of a low table. The caregiver has been unable to stop the bleeding and brings the child to the pediatric clinic. The nurse is gathering data during the admission process and notes several bruises and swollen joints. A diagnosis of hemophilia is confirmed. This child most likely has a deficiency of which blood factor?

Neutrophils

After teaching a class on the role of white blood cells in infection, the instructor determines that the teaching was successful when the class identifies which type of white blood cells as important in combating bacterial infections?

Factor VIII

After teaching a group of students about hemophilia, the instructor determines that the students have understood the information when they identify hemophilia A as involving a problem with:

An enlarged spleen

An 8-month-old girl appears pale, irritable, and anorexic. On blood testing, the red blood cells are hypochromic and microcytic. The hemoglobin level is less than 5 g/100 mL, and the serum iron level is high. Which symptom should the nurse most expect as a result of excessive iron deposits?

Polymerase chain reaction (PCR) test

An infant born to a mother who was HIV positive was tested at birth and found to be negative. The infant is scheduled for follow-up testing. Which test would the nurse expect to be performed?

• The child is irritable. • The lesions are found on the extensor surfaces. • The child is 9 months old.

An infant presents with a rash and signs of secondary infection on the face. The nurse suspects infantile eczema based on which assessment findings? Select all that apply.

• Eggs • Peanuts • Milk

Food allergies have become more and more common in the last few decades. What are some common food allergies of childhood? Select all that apply.

Christmas factor

Individuals with hemophilia B have a deficiency in factor IX, which can cause excessive blood loss. What is another name for this clotting factor?

Using a friend's comb

Parents of a child who has been diagnosed with tinea capitis ask how the child got the infection. Which of the following would the nurse explain as the most likely cause?

Decreased hemoglobin level

In a child diagnosed with sickle cell disease, which clinical manifestation would the nurse most likely see?

The child's fluid intake will improve.

In caring for a child with sickle cell disease, the highest priority goal is:

"Milk is a perfect food, and babies should be able to have all the milk they want."

In discussing the causes of iron-deficiency anemia in children with a group of nurses, the following statements are made. Which of these statements is a misconception related to iron-deficiency anemia?

True

Iron-deficiency anemia could be virtually eliminated if all infants were breastfed and those infants who are formula-fed were fed iron-fortified formula for the full first year.

Drain any standing water in the yard

It is summer time, and the mother of a 6-year-old boy tells the nurse that the mosquitoes in their neighborhood are terrible this year. She says she has heard of cases of West Nile virus in the area and asks the nurse what she can do to protect her son from it. Which of the following should the nurse recommend to the mother?

Incubation period

Nursing students are learning about the infectious process. They correctly identify the first stage of an infectious disease to be the:

Screening for HIV

The nurse is instructing a group of women of childbearing age about human immunodeficiency virus (HIV) during pregnancy. What would be a priority recommendation in this setting?

1,500 to 2,000 mL of fluid per day.

The caregiver of a child with sickle cell disease asks the nurse how much fluid her child should have each day after the child goes home. In response to the caregiver's question, the nurse would explain that for the child with sickle cell disease, it is best that the child have:

30

The health care provider has prescribed diphenhydramine 5 mg/kg/dose for a child with urticaria weighing 33 lb (15 kg). The medication is supplied as 12.5 mg/5 ml. How many milliliters will the nurse administer to the child for one dose? Record your answer using a whole number.

0.6

The health care provider has prescribed ferrous sulfate 4 mg/kg/day in three divided doses for a child weighing 15 lb (6.8 kg). The ferrous sulfate is supplied as 15 mg/ml. How many milliliters will the nurse administer to the child for one dose? Record your answer using one decimal place.

PCR

The most accurate screening test for the presence of HIV antigen in young children is

Spooned nails

The mother of a 5-year-old girl brings the child to the clinic for an evaluation. The mother tells the nurse, "She seems to be so tired and irritable lately. And she looks so pale." Further assessment reveals pale conjunctiva and oral mucous membranes. The nurse suspects iron-deficiency anemia. Which additional finding would help provide additional evidence for this suspicion?

The best way is to eliminate the food from the diet and then look for improvement."

The mother of a child with a possible food allergy asks the nurse for information about how to test for it. Which response by the nurse would be most appropriate?

Griseofulvin

The nurse caring for children with fungal infections most often administers which of the following medications?

intramuscular

The nurse is administering iron-dextran to a child diagnosed with iron-deficiency anemia. The most appropriate method of administration of this drug would be:

petechiae

The nurse is assessing a child and notices pinpoint hemorrhages appearing on several different areas of the body. The hemorrhages do not blanch on pressure. The nurse documents this finding as:

humoral; bacterial

The nurse is explaining to a parent some of the basic aspects of the immune system and its functions. She informs them that B cells, also known as _________ cells, will attack __________ antigens.

Baseball

The nurse is caring for a 10-year-old boy with hemophilia. He asks the nurse for suggestions about appropriate physical activities. Which activity would the nurse most likely recommend?

Deferasirox

The nurse is caring for a 10-year-old girl with iron toxicity. What would the nurse expect the physician to order?

"He can resume participation in football in 2 weeks."

The nurse is caring for a 12-year-old boy with idiopathic thrombocytopenia. The nurse is providing discharge instructions about home care and safety recommendations to the boy and his parents. Which response indicates a need for further teaching?

"We should administer desmopressin as often as needed."

The nurse is caring for a 13-year-old girl with von Willebrand disease. After teaching the adolescent and her parents about this disorder and care, which response by the parents indicates a need for additional teaching?

Trimethoprim-sulfamethoxazole (TMP-SMZ)

The nurse is caring for a 6-month-old infant whose mother tested positive for HIV during her pregnancy. The infant had a positive polymerase chain reaction (PCR) for HIV at birth. Which medication would be prescribed for the prevention of pneumocystis pneumonia (PCP)?

urine output of 10 ml over 3 hours

The nurse is caring for a child admitted to the hospital for sepsis. Which assessment finding is the most concerning?

Gastrointestinal

The nurse is caring for a child diagnosed with Hepatitis B. Which system is most likely to have complications from this diagnosis?

The nurse will administer oxygen.

The nurse is caring for a child hospitalized with pertussis. Which nursing intervention would be the highest priority for this child?

"My son can never take penicillin for an infection."

The nurse is caring for a child recently diagnosed with glucose-6-phosphate dehydrogenase (G6PD) deficiency. The nurse is teaching the parents about triggers that may result in oxidative stress. Which response indicates a need for further teaching?

2

The nurse is caring for a child who weighs 44 lb (20 kg) experiencing an anaphylactic reaction. The health care provider has prescribed epinephrine 0.01 mg/kg injection. Epinephrine is supplied at 1mg in 10 ml. How many milliliters will the nurse administer? Record your answer using a whole number.

Zidovudine

The nurse is caring for a newborn whose mother is HIV positive. The nurse would expect to administer a 6-week course of which medication?

"I mix ferrous sulfate with milk in a bottle."

The nurse is caring for a toddler taking ferrous sulfate for severe iron-deficiency anemia. Which report by the parent is most concerning?

a child with erythema infectiosum experiencing fatigue and confusion

The nurse is caring for multiple clients on the pediatric unit. Which child will the nurse see first?

Thalassemia

The nurse is collecting data from the caregivers of a child brought to the clinic setting. The parents tell the nurse that the child's skin seems to be an unusual color. The nurse notes that the child's skin appears bronze-colored and jaundiced. This observation alerts the nurse to the likelihood that this child has which disorder?

Packed red blood cells

The nurse is developing a plan of care for a child who is to have a transfusion. Which would the nurse expect to administer because it is the most common form of transfusion?

an elimination diet.

The nurse is discussing food allergies with parents of a young child. She explains that a very effective way to determine which foods a child may be allergic to is to implement:

Nystatin

The nurse is discussing medications to be given to a child who has been diagnosed with candidiasis. Which of the following medications would most likely be prescribed for the child?

Bull's-eye rash around the bite

The nurse is performing a physical examination for a 7-year-old girl who was bitten by a tick. What would alert the nurse to the possibility of early localized Lyme disease?

Swollen lymph nodes

The nurse is performing a physical examination of an 8-year-old girl who was bitten by her kitten. Which assessment would lead the nurse to suspect cat-scratch disease?

Ring-like rash on lower leg

The nurse is performing a physical examination on a 9-year-old boy who has experienced a tick bite on his lower leg and is suspected of having Lyme disease. Which assessment finding would the nurse expect to find?

Provide education to sexually active females about proper condom usage.

The nurse is providing education regarding 2020 Health Goals to reduce the incidence of acquired immunodeficiency syndrome (AIDS) within the community. Which goal will the nurse choose as a primary prevention strategy?

Place the child in a supine position.

The nurse is providing postoperative care to a school-age child after a splenectomy and notes the following: temperature 102.1ºF (39ºC), heart rate 120 bpm, respiratory rate 28 breaths/minute, blood pressure 78/36 mm Hg, and oxygen saturation 90%. Which nursing action is priority?

• Acute otitis media, one episode every 3 to 4 weeks over the past year. • Recurrent deep abscess of the thigh • Oral thrush, persistent over the past 6 to 7 months

The nurse is reviewing the medical history of a 4-year-old child. What would the nurse identify as potentially indicative of a primary immunodeficiency? Select all that apply.

"If the trait is inherited from both parents the child will have the disease."

The nurse is teaching an in-service program to a group of nurses on the topic of children diagnosed with sickle cell anemia. The nurses in the group make the following statements. Which statement is most accurate regarding sickle cell anemia?

• Administering oxygen • Administering analgesics • Maintaining fluid intake

The nurse is working with a child who is in sickle cell crisis. Treatment and nursing care for this child include which actions? Select all that apply.

cheeseburger, broccoli, and fresh strawberries

The nurse will select which meal as the best choice for a child with iron-deficiency anemia?

• Nausea, vomiting, diarrhea • Urticaria, angioedema • Bronchospasm • Hypoxia • Seizures

The nursing instructor is describing the events of anaphylaxis. Place the assessment findings in the order that they would occur from first to last.

"Side effects, such as drowsiness and dryness, do not indicate an allergy."

The parents are concerned their child with atopic dermatitis is having an allergic reaction to diphenhydramine because the child became "sleepy and has a dry throat" after receiving the medication. Which education provided to the parents by the nurse is most important?

Contact the health care provider to request treatment.

The parents of a 3-month-old infant report concerns the infant is irritable, feeds poorly, and has a rash. The nurse notes weeping, crusty lesions on the infant's cheeks and neck. Which action by the nurse is most appropriate?

"Maternal antibodies crossed the placenta preventing infections until now."

The parents of a 5-month-old infant diagnosed with humoral IgA deficiency question the nurse about why the infant was not diagnosed sooner. Which response by the nurse most appropriate?

"ITP is primarily an autoimmune disease in that the immune system attacks and destroys the body's own platelets, for an unknown reason."

The parents of a 6-year-old male with idiopathic thrombocytopenic purpura (ITP) ask the nurse conducting an assessment of the child what causes the disease. What is the nurse's best response?

Hemoglobin A

When evaluating the hemogram of an 8-month-old infant, the nurse would identify which type of hemoglobin as being the predominant type?

Herpes zoster is a reactivation of a previous varicella zoster infection."

When providing care for a child with herpes zoster (shingles), the parents ask the nurse how the child contracted this infectious disorder. Which response by the nurse is most appropriate?

Risk for injury

When providing care to a child with aplastic anemia, which nursing diagnosis would be the priority?

Fever

Which of the following would the nurse be least likely to assess in a child with a hematologic disorder?

Iliac crest

Which site is most frequently used to perform a bone marrow aspiration?

Sickle cell disease is genetically inherited.

Which statement is most accurate related to sickle cell disease?

IgG

A nursing instructor is preparing a teaching plan for a class about the immune response. When discussing the immune response, which of the following would the instructor describe as being primarily involved in a secondary immune response?

Papilloma virus

A nursing instructor is teaching students about childhood infectious diseases. Which of the following would the instructor identify as the cause of warts in children?

Contact precautions

A nursing instructor is teaching the students about the standard and transmission-based precautions. What type of precautions require placing a client in an isolated room with limited access, wearing gloves during contact with the client and all body fluids or contaminated items, wearing two layers of protective clothing, and avoiding sharing equipment between clients?

Increased concentration of IgG

A child is scheduled to undergo hyposensitization. Which result confirms progress?

• liver • spleen • thymus • bone marrow

The nurse is educating an immunocompromised child about the organs that assist in the immune process. The nurse recognizes teaching was effective when the child identifies which organs? Select all that apply.

• Incubation • Prodrome • Illness • Convalescence

A nursing instructor has presented a class on the stages of an infectious disease to a group of students and asks the students to place the stages in their proper sequence from beginning to end. Place the stages in their proper sequence.

0.4 mg

A child is undergoing skin testing for allergies. About 10 minutes after a scratch test with an allergen, the child develops signs and symptoms of anaphylaxis. The nurse prepares to administer epinephrine subcutaneously. The child weighs 88 pounds. The nurse would administer which dosage of epinephrine?

The child has mild to moderate iron deficiency.

A child with iron-deficiency anemia is prescribed ferrous fumarate, 3 mg/kg/day in two divided doses. What does this prescription indicate to the nurse?

"Antibiotics are needed to help our child recover from rubella."

The nurse is educating parents of a child admitted to the hospital with rubella (German measles). Which statement by the parents indicates the further education is needed?

"This will cause increased urine production."

The nurse is educating parents of a child with acute renal disease about expected outcomes for erythropoietin treatment. Which statement by the parents indicates that further education is needed?

Macrophages

The immune system works to destroy pathogens by helping the body get rid of or resist the invasion of foreign materials The blood cells that surround, ingest and neutralize the pathogens are which of the following?

Virus

When the nurse is instructing on disease transmission, which is noted as the smallest infectious agent known?

Antihistamines

When treating allergies in a child, the nurse is aware that the classification for the drug of choice to control itching, sneezing, and rhinorrhea is:

an 8-month-old bottle-fed female with HIV

Which child will the nurse identify as at greatest risk for developing a urinary tract infection?

Administer prescribed medications.

Which nursing intervention is priority when caring for a child with HIV?

IgG

Which immunoglobin occurs most frequently in plasma and is the major immunoglobulin synthesized during secondary response?

"We will place the liquid in the front of her gums, just below her teeth."

A 5-year-old girl is diagnosed with iron-deficiency anemia and is to receive iron supplements. The child has difficulty swallowing tablets, so a liquid formulation is prescribed. After teaching the parents about administering the iron supplement, which statement by the parents indicates the need for additional teaching?

Allogenic

A 9-year-old boy will be undergoing a hematopoietic stem cell transplantation, with donor cells being provided by his 12-year-old sister. The nurse recognizes that this type of transplantation is:

Mumps

A child in the clinic has a fever and reports a sore neck. Upon assessment the nurse finds a swollen parotid gland. The nurse suspects which infectious disease?

scarlet fever.

A child is diagnosed with group A streptococcal pharyngitis. The nurse would teach the parents to be alert for signs and symptoms of:

Penicillin V

A child is diagnosed with scarlet fever. The nurse is reviewing the child's medical record, expecting which medication to be prescribed for this child?

Hemoglobin

A child is diagnosed with sickle cell anemia. Which component of the blood, the one responsible for the transport of oxygen, is defective in this disorder?

Transfuse 1 unit of packed red blood cells.

The nurse is caring for a child admitted to the hospital for an open fracture of the femur following a motor vehicle accident. The nurse notes the following lab values: white blood cells 10,000mm3, hemoglobin 7.9 g/dL (79 g/L), hematocrit 28%, platelets 151,000 mm3. Which nursing action is priority?

"We need to make sure that he washes his hands frequently."

The nurse is providing teaching to the parents of a child with varicella. Which statement indicates that the parents have understood the instructions?

Identical twin

The nurse is reviewing the chart of a child scheduled for a stem cell transplant. The child will be receiving a syngeneic transplant. The nurse understands that which of the following would be the donor?

• Assess intake and output. • Provide popsicles and ice. • Administer acetaminophen. • Initiate contact precautions. • Give an oral dose of acyclovir.

Which collaborative interventions will the nurse implement for a child with acute herpetic gingivostomatitis? Select all that apply.

False

In hemophilia A, the classic form, only females manifest a bleeding disorder.

"My husband gives our daughter orange juice when she takes her ferrous sulfate, so she gets Vitamin C."

The nurse is reinforcing teaching with a group of caregivers of children diagnosed with iron-deficiency anemia. One of the caregivers tells the group, "I give my child ferrous sulfate." Which statement made by the caregivers is correct regarding giving ferrous sulfate?

False

The primary intervention for beta-thalassemia is a chronic transfusion program of packed white blood cells with iron chelation.

constipation

The nurse is educating a child with a peanut allergy about the signs and symptoms of an anaphylactic reaction. The nurse realizes additional teaching is needed when the child identifies which sign/symptom?

Upper respiratory excretion

A 5-year-old girl catches the flu from a friend at day care after the friend sneezed and wiped mucus on a toy that the girl played then with. In this case, what is the portal of exit in the chain of infection?

Scarlet fever

A 6-year-old child is brought to the clinic by his parents. The parents state, "He had a sore throat for a couple of days and now his temperature is over 102°F (38.9°C). He has this rash on his face and chest that looks like sunburn but feels really rough." What would the nurse suspect?

• Cancer • Radiation therapy • Severe stress • Malnutrition

A 7-year-old girl has been battling leukemia and receiving radiation therapy. She is highly susceptible to infections, and the nurse recognizes that this is because she is experiencing secondary immunodeficiency. What factors cause secondary immunodeficiency? Select all that apply.

Pernicious anemia

A child is prescribed monthly injections of vitamin B12. When developing the teaching plan for the family, the nurse would focus on which type of anemia?

"Because the baby grows rapidly during the first months, he uses up what you gave him."

A nurse is leading a discussion with a group of new mothers about newborn nutrition and its importance for growth and development. One of the mothers asks, "Doesn't the baby get iron from me before birth?" Which response by the nurse would be most appropriate?

• During the prodromal period • When specific symptoms develop • During the illness stage

A nurse is presenting a class to parents about the infectious process in children. The nurse would describe that infections are contagious during which time? Select all that apply.

Infection

A nurse is teaching the parents of a child with sickle cell disease about factors that predispose the child to a sickle cell crisis. The nurse determines that the teaching was successful when the parents identify what as a factor?

fifth disease.

A young client arrives at the clinic with a rash on the trunk and flexor surfaces of the extremities. The mother informs the nurse that the rash started a day before on the exterior surfaces of the extremities; 2 days before, the child had a really bad rash on the face. The physician diagnoses the child with erythema infectiosum. The nurse tells the mother that this is also known as:

"She has been down, but playing in soccer camp will cheer her up."

The nurse is preparing a child for discharge following a sickle cell crisis. Which statement by the mother indicates a need for further teaching?

Determining if her throat itches

The school nurse is walking through the lunchroom when one of the children says she started to feel strange after trading lunches with a friend. Which assessment would be most important?

an 18-month-old child receiving chemotherapy over 5 days

Which child will the nurse identify as being at greatest risk for developing a hospital-acquired infection (HAI)?

• T cells • B cells • Phagocytes

Which immune cells are disrupted when a child is infected with human immunodeficiency virus (HIV)? Select all that apply.

Pregnancy will accelerate the progression of the disease.

A nursing is providing education to pregnant women diagnosed with HIV. Which statement indicates the need for further teaching?

• Handwashing • Contact precautions • Gloves

A teenage patient active on the high school football team comes to the clinic with a cut on his leg that looks infected. The culture report returns information that leads to a diagnosis of MRSA. What should the nurse use as preventive measures in this case?

"He'll need to have those vitamin shots for the rest of his life."

After teaching the parents of a child diagnosed with pernicious anemia about the disorder and treatment, the nurse determines that the teaching was successful when the parents state:

After the lesions have crusted

After teaching the parents of a child with varicella zoster, the nurse determines that the parents have understood the teaching when they state that their child can return to school at which time?

• skin • cilia • mucous membranes

Nursing students demonstrate an understanding of how the body protects itself from invasion of bacteria when they identify which of the following as physical protective barriers? (Select all that apply.)

• Wearing protective clothing when playing in wooded areas. • Inspecting the skin closely for ticks after the child plays in wooded areas. • Contacting the health care provider if there is any area of inflammation that might be a bite.

Parents bring their 9-year-old child to the clinic for a well-child visit. They are concerned because several children in the neighborhood have developed Lyme disease and ask for suggestions on what to do to reduce their child's risk. What would be appropriate for the nurse to suggest? Select all that apply

• Monitoring of heart rate and rhythm during the infusion • Need for strict handwashing to reduce the risk for infection • Daily measurements of white blood cell counts

A nurse is preparing a teaching plan for the parents of a child scheduled to have a stem cell transplant. Which would the nurse expect to include in the teaching plan? Select all that apply.

• Wearing appropriate footwear when going outside • Having a readily available fast-acting insecticide when outdoors • Not drinking from open soda cans when outside

An older school-aged child is allergic to wasp stings. The nurse is teaching the child and her parents about ways to minimize her risk. Which of the following would the nurse include in the teaching plan? Select all that apply.

• Lyme disease • Rocky Mountain spotted fever

A nurse is preparing a presentation for parents about common childhood infectious diseases. What conditions would the nurse include as being caused by a tick bite? Select all that apply.

Apply heat to the site of bleeding.

A nurse is preparing a teaching plan for a child with hemophilia and his parents. Which information would the nurse be least likely to include to manage a bleeding episode?

Ensure neutropenic precautions are in place.

The nurse is caring for a child who had a stem cell transplant and is being monitored for engraftment. Which nursing action is

"Preterm infants are at risk for iron-deficiency anemia."

A mother asks the nurse why her infant who was born at 34 weeks' gestation is being prescribed ferrous sulfate. Which response by the nurse is most appropriate?

• "Keep the lesions dry." • "Try applying ointment to them."

A mother brings her child who frequently gets cold sores to the clinic. The mother is concerned and asks the nurse what she can do to prevent occurence. Which response by the nurse provides appropriate guidance? Select all that apply.

• Plan the vacation at a time when the pollen count is lowest.

A mother tells the clinic nurse that her family wants to go on vacation this year, but that they are afraid to go to their usual spot because their young daughter has problems with pollen-related allergies. What should the nurse recommend to this mother?

• Exposure to blood and body fluids through sexual contact • Sharing contaminated needles • Transfusion of contaminated blood • Perinatally from mother to fetus • Through breastfeeding

A nurse is giving a talk to high school students about preventing the spread of human immunodeficiency virus (HIV). What does the nurse identify as ways in which HIV is spread? Select all that apply.

Initiate pain assessment with a standardized pain scale.

The nurse is caring for a child who has been admitted for a sickle cell crisis. What would the nurse do first to provide adequate pain management?

IgE

The nurse is caring for a child who is receiving a skin test to determine the presence of allergies. A positive skin test for one particular allergen shows the mediation of which type of immune globulin?

A complication of this infection includes secondary bacterial infections of the skin.

What is a true statement regarding varicella zoster virus infection?

Inspect the child's anus with a flashlight 2 to 3 hours after he is asleep.

A nurse is instructing the parents of a child who is suspected of having pinworms how to check the child. Which of the following instructions would be most appropriate?

Brush his or her teeth

The child is prescribed liquid ferrous sulfate. The nurse should encourage the child to take which action immediately after each dose to best eliminate possible side effects?

Iron-chelating drugs

The child with thalassemia may be given which classification of medication to prevent one of the complications frequently seen with the treatment of this disorder?

• Chemotaxis • Phagocytosis • Lysis of the foreign antigen

What occurs with complement activation? Select all that apply.

Multiple body sites can be affected.

When assessing a child for a possible hematologic disorder, which would the nurse need to keep in mind as most important?

• Congenital problems • Secondary complication from a viral invasion • Exposure to a toxic substance

A nurse is talking to parents whose children have immune disorders. What does the nurse identify as causing dysfunction of the immune system? (Select all that apply.)

• Eggs • Fortified cereal • Green leafy vegetables

A nurse is teaching a school-aged child with iron-deficiency anemia and her parents about dietary measures to increase iron intake. The nurse determines that the teaching was successful when they state which food is high in iron? Select all that apply.

Measles

A young client in the clinic has a rash, cough, and fever that the mother says spiked on day 5 of the rash. The client also had conjunctivitis. What would the nurse expect the physician to tell the family that the child has?

Ensure neutropenic precautions are in place.

The nurse is caring for a child who had a stem cell transplant and is being monitored for engraftment. Which nursing action is priority?

Ask parents which immunizations have been given.

The nurse is caring for a child whose family recently immigrated from a developing country. While completing the admission history, the parents report all the child's immunizations are up to date. Which nursing action is most appropriate?

Kaposi sarcomas observed on the skin

The nurse is caring for a child with HIV admitted to the pediatric unit. Which assessment finding would alert the nurse that the child has most likely progressed from HIV to AIDS?

IgE

When describing anaphylaxis to a group of parents whose children have experienced anaphylaxis from insect stings, the nurse integrates knowledge that this response is related to which immunoglobulin?

Risk for infection

When developing the postoperative plan of care for a child with sickle cell anemia who has undergone a splenectomy, which would the nurse identify as the priority?

Encourage the child to wear a medical alert bracelet for penicillin.

When providing discharge instructions to a child who was admitted to the hospital following stridor, wheezing, and urticaria after taking penicillin, which nursing action is priority?

IgG

When teaching a group of new parents about newborn care and development, which immunoglobulin would the nurse explain as being primarily responsible for the passive immunity exhibited by newborns?

• Standard precautions • Contact precautions

A hospitalized child develops herpangina. Which of the following infection control precautions would the nurse expect to institute? Select all that apply.

Protease inhibitors

The nurse is caring for a child undergoing highly active antiretroviral therapy (HAART) for HIV infection. The nurse is preparing to administer the prescribed medication. In addition to the nucleoside analog reverse transcriptase inhibitors (NRTIs) and the nonnucleoside analog reverse transcriptase inhibitors (NNRTIs), the nurse is cognizant that the child will be taking which additional medication as part of the three-drug regimen?

vitamin B12 injections

While assessing an adolescent, the nurse notes pallor and a beefy red tongue. Upon questioning, the adolescent reports eating a vegetarian diet to help with weight loss. Which health care provider prescription will the nurse anticipate?