Exam 4 questions

what is the primary treatment for hemophilia? exercise corticosteroids pain management replacement of missing clotting factor

replacement of missing clot factor

what is the leading cause of death in children with sickle-cell disease? a. acute chest syndrome b. cerebral vascular accident c. sepsis d. splenic sequestration

sepsis

14) 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? 1. Antibiotics 2. Sodium levels every 24 hours 3. Anticonvulsants 4. Hourly intake and output

sodium levels every 24 hours

4) The nurse is monitoring the urine specific gravity and pH on a child receiving chemotherapy. Which urinalysis result is the goal for this child? 1. Spec gravity 1.030; pH 6 2. Spec gravity 1.030; pH 7.5 3. Spec gravity 1.005; pH 6 4. Spec gravity 1.005; pH 7.5

spec gravity 1.005; pH 7.5

an adolescent with a history of surgical repair for undescended testes comes to the clinic for a sport physical. anticipatory guidance for the parents and adolescent would focus on which of the following as most important? a. adolescent sterility b. asolescent future plans c. technique for monthly testicular self-exam d. need for a lot of psychosocial support

technique for montly testicular self-examinations

the RN is planning a client education program for sickle cell disease; what topics should be included in the plan of care? aerobic exercise to improve ocygenation fluid restraint to 1 L/day high iron, high protein diet proper hand washing and infection avoidance

proper hand washing and infection avoidance

8) 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? 1. At 0700 2. After the next time the child voids 3. At bedtime 4. When the order is noted

after the next time the child voids

4) 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? 1. Semiprivate room 2. Reverse-isolation room 3. Contact-isolation room 4. Private room

private room

16) 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? 1. Giving comfort measures, such as back rubs 2. Suggesting diversional activities, such as coloring 3. Administering pain medication 4. Preparing the child for painful procedures

administer pain medication

19) The child has just been diagnosed with osteosarcoma, and the nurse is teaching the family regarding this type of cancer. The nurse knows that instruction has been successful when the family states that osteosarcoma is common in which age group? 1. Infants 2. Toddlers 3. Preschool-age children 4. School-age children 5. adolescents

adolescents

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

2, 3, 1, 4

the nurse is monitoring the lab velues of a child with leukemia who is receiving chemotherapy. the nurse prepares to implement bleeding precautions if the child become thrombocytopenia and the platelet count is less than which value? a. 90,000 b. 150,000 c. 350,000 d. 400,000

90,000

the nurse is conducting staff in-service training on von willebrand disease. which should the nurse include as characteristics of von willebrand disease? select all that apply a. easy bruising occurs b. gum bleeding occurs c. it is hereditary bleeding disorder d. treatment and care are similar to that for hemophilia e. it is characterized by extremely high creatnine levels

a b c d e

12) The child is admitted to the hospital after being diagnosed with retinoblastoma. Which assessment finding does the nurse anticipate for this child? 1. A red reflex 2. Yellow sclera 3. A white pupil 4. Blue-tinged sclera

a white pupil

1) 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 child's infection-fighting capability? 1. Hemoglobin 2. RBC count 3. Absolute neutrophil count (ANC) 4. Platelets

absolute neutrophil count

a preschool age child undergoing chemotherapy experiences nause and vomiting. which of the following would be the best intervention to include in the child's plan of care? a. administer tube feedings b. offer small, frequent meals c. offer fluids only between meals d. allow child to choose what to eat for meals

allow child to choose what to eat for meals

a 2 year old female has recently been diagnosed with Wilms Tumor. her presenting S/S most likely included a. a soft mass in the left lower quadrant, pain, dysuira, peri-umbilical petechiae b. an abdominal mass, hematuria, hypertension, and fever c. enlarged abdomen detected by her parents, decreased ambulation, fatigue and hyperglycemia d. firm, left lower quadrant mass, hyponatremia, constipation, and polyuria

an abdominal mass, hematuria, HTN, fever

wilms tumor has been recognized with a number of congenital malformations including: a. aniridia b. tetralogy of fallot c. club foot d. cataracts

aniridia

10) A school-age child with hemophilia falls on the playground and goes to the nurse's office with superficial bleeding above the knee. Which action by the nurse is the most appropriate? 1. Apply a warm, moist pack to the area. 2. Perform some passive range of motion to the affected leg. 3. Apply pressure to the area for at least 15 minutes. 4. Keep the affected extremity in a dependent position.

apply pressure to the area for at least 15 mins

5) The antiemetic drug ondansetron (Zofran) is administered to a child receiving chemotherapy. When should the nurse administer this medication? 1. Only if the child experiences nausea 2. After the chemotherapy has been administered 3. Before chemotherapy administration as a prophylactic measure 4. Never; this antiemetic is not effective for controlling nausea and vomiting associated with chemotherapy

before chemotherapy, administertation as a prophylactic measure

3) 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? 1. "Both the mother and the father have the sickle cell trait." 2. "The mother has the trait, but the father doesn't." 3. "The father has the trait, but the mother doesn't." 4. "The mother has sickle cell disease, but the father doesn't have the disease or the trait."

both the mother and the father have the sickle cell trait

16) 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 3. Gene abnormalities 4. Palpable mass 5. Chromosomal abnormalities

cachexia anemia palpable mass

9) A child is diagnosed with a Wilms tumor. Which nursing action is most appropriate prior to surgery? 1. Careful bathing and handling 2. Monitoring of behavioral status 3. Maintenance of strict isolation 4. Administration of packed RBCs

careful bathing and handling

the nurse who is caring for a client with recently diagnosed Hodgkin's lymphoma understands that which lymph nodes are usually affected first? a. cervical b. inguinal c. axillary d. submandibular

cervical

a child being treated for acute lymphocytic leukemia has a WBC of 7,000. the nurse care plan lists risk for infection as a priority nursing diagnosis, and measures are being taken to reduce the child's exposure to infection, the nurse determines that the plan has been successful when which outcome has been met? a. child's WBC count goes up b. child's WBC count goes down c. child's temp remains within normal range d. parents demonstrate good hand washing technique

child's temp remains normal range

18) A seasoned nurse is precepting a novice nurse on a pediatric oncology unit. The seasoned nurse would like to review the ongoing physiologic and psychosocial care of the children who survive cancer. Which topics will the seasoned nurse include in the discussion with the novice nurse? Select all that apply. 1. Developing other cancers 2. Recommending regular office visits 3. Encouraging school-age clients to manage their own care 4. Needing weekly laboratory tests 5. Providing educational and psychosocial support

developing other cancers recommending regular office visits providing educational and psychosocial support

the nurse is collecting data on a 9 year old who is suspected of having a brain tumor. which question should the nurse ask to elicit data related to a hallmark symptoms of a brain tumor? a. do you have trouble seeing? b. do you feel tired all the time? c. do you throw up in the morning? d. do you have headaches late in the day?

do you throw up in the morning

the nurse is monitoring a 3 month old for signs of increased ICP. on palpatation of the fontanelles, the nurse notes that the anterior fontanel is soft and flat. on the basis of this finding, which action should the nurse take? a. increase oral fluids b. document the findings c. notify HCP d. inform the parents that this finding is abnormal

document the findings

an adolescent with Ewing sarcoma requires leg amputation. after the amputation, the child becomes very frightened because of aching and cramping felt in the missing limb. the nurse should perform which action to assist alleviating the childs fear? a. elevate residual limb on pillow b. explain to the child that this is a temporary condition c. teach the child ways to deal with aching and cramping d. ask the HCP to increase pain medication

explain to the child that is a temporary condition

6) 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 3. Regular exercise 4. Altitude 5. Increased fluid intake

fever dehydration altitude

18) 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

fever fatigue tachycardia tachypnea

2) A child diagnosed with cancer is prescribed chemotherapy. The latest lab value indicates the WBC count is very low. Which medication order does the nurse anticipate? 1. Filgrastim (Neupogen) 2. Ondansetron (Zofran) 3. Oprelvekin (Neumega) 4. Epoetin alfa (human recombinant erythropoietin)

filgrastim (neupogen)

the clinic nurse instructs parents of a child with sickle cell anemia about the precipitating factors related to sickle cell crisis. which is identified by the parents as a precipiating factor indicates the need for further instruction? a. fluid overload b. stress c. infection d. trauma

fluid overload

6) A child is diagnosed with thrombocytopenia secondary to chemotherapy treatments. Which action by the nurse is the most appropriate? 1. Refrain from administering any intramuscular injections (IM). 2. Perform oral hygiene. 3. Monitor intake and output. 4. Use palpation as a component of assessment.

refrain from administering any IM injections

20) The nurse is caring for the 5-year-old just diagnosed with von Willebrand disease after a tooth extraction with increased bleeding. The family asks the nurse how the signs and symptoms of von Willebrand disease are manifested. What will the nurse tell the family? Select all that apply. 1. Decreased partial thromboplastin time 2. Factor VI deficiency 3. Frequent nosebleeds 4. Bleeding from mucous membranes 5. Frequent bruising

frequent nosebleeds bleeding from mucous membranes frequent bruising

the RN is planning a client education program for sickle cell disease in children, which of the following interventions would be included in the care plan? a. health teaching to help reduce sickling crisis b. avoidance of the use of opioids c. administration of an anticoagulant to prevent sickling d. observation of imposed fluid restriction

health teaching to help reduce sickling crisis

10) 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? 1. "I'm glad I only need one dose of the leucovorin." 2. "I don't have any pain so I won't need to take the leucovorin this time." 3. "I know I will be taking the leucovorin every 6 hours for about the next 3 days." 4. "I don't have any nausea so I won't need the leucovorin."

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

the nurse is providing instructions to the mother of a patient with sickle cell disease. which statement by the mother indicates a need for further intervention? a. i need to be sure that my child has adequate rest periods b. i need to take my child's temperature and watch for fever c. i need to encourage my child to drink large amounts of fluids d. i need to make sure that my child spends some time in the sun to prevent a crisis

i need to make sure that my child spends some time in the sun to prevent a crisis

8) 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? 1. It prevents blood transfusion reactions. 2. It stimulates RBC production. 3. It provides vitamin supplementation. 4. It prevents iron overload.

it prevents iron overload

13) 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? 1. Hodgkin disease 2. Leukemia 3. Rhabdomyosarcoma 4. Ewing sarcoma

leukemia

what is the most common form of childhood cancer? sarcoma epistaxis leukemia retinoblastoma

leukemia

in children diagnosed with sickle cell disease, tissue damage results form which of the following a. air hunger and respiratory alkalosis due to deoxygenated RBC b. hypersensitivity of the CNS due to elevated serum bilirubin c. general inflammatory response due to autoimmune reaction from hypoxia d. local tissue damage with ischemia and necrosis due to obstructed circulation

local tissues damage with ischemia and necrosis due to obstructed circulation

the RN is instructing the family of a child recently diagnosed with hemophilia, which of the following actions would the RN instrust them to avoid? a. immobilizing the joint b. lowering the injured area c. applying cold to the area d. applying pressure

loweing the injured area

17) 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. Monitor complete blood count (CBC). 2. Document intake and output. 3. Observe for behavioral changes. 4. Refer for psychosocial support. 5. Implement neutropenic precautions.

monitor CBC document intake/output observe for behavioral changes

5) 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? 1. Morphine sulfate 2. Meperidine 3. Acetaminophen 4. Ibuprofen

morphine sulfate

11) 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? 1. Abnormal; the sibling should be referred to a psychologist. 2. Normal; the illness doesn't affect the sibling. 3. Unexpected; the cancer is easily treated. 4. Normal; the sibling is affected too, and anger and guilt are expected feelings.

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

when assessing a child with wilms tumor, the nurse should keep in mind that it is most important to avoid which of the following? a. measuring child's chest circumference b. palpating child's abdomen c. placing the child in an upright position d. measuring child's occipitofrontal circumference

palpating child's abdomen

a 4 year old has a right nephrectomy to remove a wilms tumor. the nurse knows that is is essential to a. request low salt diet b. restrict fluis c. educate the family regarding renal transplants d. prevent UTI

prevent UTI

after a client is admitted to the pediatric unit with a diagnosis of acute lymphocytic leukemia, the labratory test indicates that the client is neutropenic. the nurse should perform which of following? a. advise the client to rest and avoid exertion b. prevent client exposure to infections c. monitor blood pressure frequently d. observe for increased bruising

prevent client exposure to infections

3) 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? 1. Acceptance, especially if able to discuss the disease with children their own age 2. Thoughts that they caused their illness and are being punished 3. Understanding of what cancer is and how it is treated 4. Unawareness of the illness and its severity

thoughts that they caused their illness and are being punished

the nurse is analyzing the lab values of a child with leukemia who is receiving chemotherapy. the nurse notes that the platelet count is 20,000. on the basis of the laboratory result, which interventions should the nurse document in plant of care? select all that apply a. use of soft toothbrush for mouth care b. monitor closely for signs of infection c. monitor temperature every 4 hours d. initiate protective isolation precautions e. check urine and stools for signs of bleeding

use of soft toothbrush for mouth care check urine and stools for signs of bleeding

11) A child diagnosed with hemophilia plans on participating in a bicycling club. Which recommendation by the nurse is the most appropriate? 1. Consider a swim club instead of the bicycling club. 2. Wear kneepads, elbow pads, and a helmet while bicycling. 3. Participate only in the social activities of the club. 4. Not join the club.

wear kneepads, elbow pads, and a helmet while bicycling

7) The nurse is administering packed RBCs 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? 1. Six hours after the transfusion is given 2. Within the first 20 minutes of administration of the transfusion 3. At the end of the administration of the transfusion 4. Never; children with SCD do not have reactions.

within the first 20 mins of administration of the transfusion