Peds Ch 46 PrepU

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? 1. Football 2. Wrestling 3. Baseball 4. Soccer

3

The nurse is caring for a pediatric client who is scheduled for the surgical removal of a Wilms tumor. Which action is contraindicated in the client's care? 1. Supine positioning 2. Intravenous fluids 3. Abdominal palpation 4. Foley catheter placement

3

A school nurse is teaching a group of parents about signs and symptoms of cancer in children. Which symptom is an early sign of a brain tumor? 1. headache, epistaxis, and dizziness 2. projectile vomiting, lethargy, and coma 3. nystagmus, ataxia, and seizures 4. headache, vision changes, and vomiting

4

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? 1. Factor VIII 2. Factor V 3. Factor XIII 4. Factor X

1

The health care provider has just informed the parents of a 3-year-old that their child has leukemia. The mother begins crying and tells the nurse she does not want her baby to die. What is the nurse's best response? 1. "I know this is scary, but leukemia has a high cure rate in children these days." 2. "Don't worry, the health care provider is very good at treating leukemia." 3. "You are very lucky to have caught it so early; that makes the treatments easier." 4. "I don't blame you for being upset; any parent would be scared too."

1

The nurse is planning care for a school-aged child recovering from being hit by a motor vehicle while riding a bicycle. For what will the nurse assess to determine the onset of disseminated intravascular coagulation in this child? 1. Bleeding from intravenous sites 2. Blurred vision 3. Nausea and vomiting 4. Sudden onset of knee pain

1

The nurse is teaching an in-service program to a group of nurses on the topic of children diagnosed with sickle cell disease. The nurses in the group make the following statements. Which statement is most accurate regarding this condition? 1. "If the trait is inherited from both parents the child will have the disease." 2. "The disease is most often seen in individuals of Asian decent." 3. "The trait or the disease is seen in one generation and skips the next generation." 4. "Males are much more likely to have the disease than females."

1

When providing care for a child immediately after a bone marrow aspiration, which nursing action is priority? 1. Monitor the site dressing and vital signs. 2. Educate the family on proper handwashing. 3. Evaluate pain and administer medication. 4. Allow the child to play with a doll and syringe.

1

A high school football player has been diagnosed as having osteosarcoma of the femur. The parents are angry because they told their son not to play football. Which health teaching points would the nurse include in the teaching plan for the adolescent and his parents? 1. Tumor growth is related to your dislike of milk. 2. Football injuries do not contribute to the development of a tumor. 3. Osteosarcoma often follows trauma, such as a football injury. 4. You can expect some discoloration of the leg following chemotherapy.

2

A nurse is providing dietary interventions for a 5-year-old with an iron deficiency. Which response indicates a need for further teaching? 1. "I must encourage a variety of iron-rich foods that he likes." 2. "Red meat is a good option; he loves the hamburgers from the drive-thru." 3. "There are many iron fortified cereals that he likes." 4. "He will enjoy tuna casserole and eggs."

2

The nurse is caring for a child with aplastic anemia. The nurse is reviewing the child's blood work and notes the granulocyte count is about 500, platelet count is over 20,000, and the reticulocyte count is over 1%. The parents ask if these values have any significance. Which response by the nurse is appropriate? 1. "The doctor will discuss these findings with you when he comes to the hospital." 2. "These values will help us monitor the disease." 3. "I'm really not allowed to discuss these findings with you." 4. "These labs are just common labs for children with this disease."

2

What is the priority action the nurse should take when caring for a child newly diagnosed with Wilms tumor (nephroblastoma)? 1. Assess for constipation. 2. Protect the abdomen from manipulation. 3. Control acute pain. 4. Obtain a catheterized urine specimen.

2

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? 1. Risk for delayed growth and development 2. Risk for infection 3. Impaired skin integrity 4. Deficient fluid volume

2

The nurse identifies that the client is at risk for an infection related to chemotherapy-induced immunosuppression. What would the nurse include in the teaching plan for the child and parents about reducing the child's risk? Select all that apply. 1. Encouraging frequent close contact with numerous visitors 2. Having the child sleep in a single bed and room 3. Cheering up the environment with fresh flowers and plants 4. Providing a low-carbohydrate, low-protein diet 5. Encouraging frequent, thorough handwashing

2, 5

A 3-year-old child presents with bruising and mucous membrane bleeding from the nose and mouth. The nurse knows that these symptoms are indicative of: 1. hemophilia. 2. chronic iron-deficiency anemia. 3. von Willebrand disease. 4. disseminated intravascular coagulation (DIC).

3

The nurse develops a meal plan for a child with iron-deficiency anemia. Which meal would the nurse teach the parent has the highest amount of iron? 1. chicken, corn, brown rice, and oranges 2. tuna salad with eggs, whole wheat crackers, and blueberries 3. red meat, eggs, oatmeal, and dried fruit 4. pork, broccoli, white rice, and strawberries

3

The nurse is assessing a 3-year-old boy whose mother reports that he is listless and has been having trouble swallowing. Which finding suggests the child may have a brain tumor? 1. Vital signs show blood pressure measures 120/80 mm Hg. 2. Examination shows temperature of 101.4° F (38.6°C) and headache. 3. Observation reveals nystagmus and head tilt. 4. Observation reveals a cough and labored breathing.

3

The nurse is caring for a 2-year-old girl who is receiving chemotherapy using antitumor antibiotics. Which intervention would the nurse question? 1. Maintaining meticulous handwashing procedures 2. Assessing for tachypnea and adventitious breath sounds 3 Assessing the mouth for redness, lesions, or ulcers 4. Administering antiemetics prior to chemotherapy

3

The nurse is caring for a child with leukemia. Which nursing intervention would be the highest priority for this child? 1. grouping nursing care 2. encouraging the child to share feelings 3. following guidelines for reverse isolation 4. providing age-appropriate activities

3

The nurse is evaluating the complete blood count of a 7-year-old child with a suspected hematological disorder. Which finding is associated with an elevated mean corpuscular volume (MCV)? 1. hemoglobin (Hgb) of 11.2 g/dl (112 g/L) 2. platelet count of 250,000 3. macrocytic red blood cells (RBCs) 4. decreased white blood cells (WBCs)

3

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? 1. "I always give the ferrous sulfate with meals." 2. "We watch closely for any diarrhea since that usually happens when he takes ferrous sulfate." 3. "My husband gives our daughter orange juice when she takes her ferrous sulfate, so she gets Vitamin C." 4. "When I give my son ferrous sulfate I know he also needs potassium supplements."

3

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 10,000/mm3, hemoglobin 7.9 g/dl (79 g/L), hematocrit 28%, platelets 151,000/mm3. Which nursing action is priority? 1. Administer antibiotics intravenously stat. 2. Provide the family with preoperative instructions. 3. Ask the child to rate pain on a scale 0 to 10. 4. Transfuse 1 unit of packed red blood cells.

4

A 9-month-old infant with iron-deficiency anemia is given ferrous sulfate therapy. Which assessment would best help the nurse determine that the infant is actually taking it daily? 1. The stools will appear black. 2. The infant will be more irritable than at the last visit. 3. The infant will develop diarrhea. 4. The reticulocyte count will have decreased.

1

A child with cancer has developed neutropenia and is in isolation with neutropenic precautions. What nursing assessment takes priority for this child? 1. infection symptoms 2. mucositis 3. bleeding 4. vital signs

1

A client with cancer is diagnosed with typhlitis. Which emergency intervention would the nurse perform? 1. Administer broad-spectrum antibiotics intravenously. 2. Administer diuretics. 3. Maintain fluid restriction to below maintenance levels. 4. Monitor serum sodium levels.

1

A nurse is providing teaching to the parents of a child diagnosed with sickle cell anemia. The discussion is focused on precipitating factors for sickle cell crisis. Which statement by the parents requires the nurse to reinforce the teaching? 1. "Our family is taking a fun hiking trip up in the mountains next week." 2. "I make sure our child is up to date on all immunizations." 3. "I make sure my child wears a good warm coat and gloves during winter." 4. "We always take water along when we are on an outing."

1

The nurse is preparing to send a child with cancer for a radiation treatment. Which medication should the nurse provide to premedicate the child for this procedure? 1. Analgesic 2. Antipyretic 3. Antineoplastic 4. Antiemetic

4

A 5-year-old child is at the pediatric clinic for a well-child visit. Which symptom alerts the health care provider that this child might have acute lymphoblastic leukemia (ALL)? 1. joint pain and swelling 2. lethargy, bruises, and lymphadenopathy 3. anorexia and weight loss 4. abdominal pain, nausea, and vomiting

2

A group of nursing students are studying information about childhood cancers in preparation for a class examination. They are reviewing how childhood cancers differ from adult cancers. The group demonstrates understanding of the information when they identify what location as an unlikely site for childhood cancer? 1. Blood 2. Bladder 3. Kidney 4. Brain

2

How can the nurse most simply describe for distressed parents a rhabdomyosarcoma that has been found in their 5-year-old? 1. Indicate that the more commonly used name is Hodgkin lymphoma 2. Describe it as a bone tumor 3. Call it a tumor of muscle tissue 4. Explain that it develops in nerves outside the brain and spinal cord

3

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? 1. "Caregivers sometimes don't understand the importance of iron and proper nutrition." 2. "A family's economic problems are often a cause of malnutrition." 3. "Milk is a perfect food, and babies should be able to have all the milk they want." 4. "Children have a hard time getting enough iron from food during their first few years."

3

The nurse caring for a 14-year-old scheduled for magnetic resonance imaging (MRI) explains to a family how the test works. Which response accurately describes this test? 1. "The MRI is a nuclear scanning test to rule out cancer involving the bones or determine extent of bone involvement." 2. "The MRI uses radiation to examine soft tissue and bony structures of the body." 3. "The MRI uses radio waves and magnets to produce a computerized image of the body." 4. "The MRI uses sound waves to create images that visualize body structures and locate masses."

3

A 15-year-old boy has been diagnosed with an osteogenic sarcoma of the distal femur. He also demonstrates a chronic cough, dyspnea, and chest pain, along with chronic leg pain. Based on these findings, the nurse should suspect metastasis to which body area? 1. Brain 2. Heart 3. Rib cage 4. Lungs

4

A 15-year-old client diagnosed with von Willebrand disease has reached menarche. Based on this fact, what information is most important for the nurse to convey to the client? 1. Bruising may occur in the perineal area. 2. Occasional skipped periods can be expected. 3. The duration of each period will be short. 4. Expect menstrual bleeding to be heavy.

4

A child with cancer is dying and in hospice care. When developing the plan of care, which intervention should the nurse include as the primary focus? 1. managing the symptoms of dyspnea 2. delivering appropriate developmental care 3. providing emotional support 4. keeping the child pain-free

4

A nurse is preparing a 7-year-old girl for bone marrow aspiration. Which site should she prepare? 1. Anterior tibia 2. Sternum 3. Femur 4. Iliac crest

4

Which nursing diagnosis would be most appropriate for a child with idiopathic thrombocytopenic purpura? 1. Ineffective breathing pattern related to decreased white blood count 2. Risk for altered urinary elimination related to kidney impairment 3. Risk for infection related to abnormal immune system 4. Ineffective tissue perfusion related to poor platelet formation

4