Peds Question-FINAL

A school-age child is being seen in the oncology clinic for possible Hodgkin disease (HD). During the course of the nursing assessment, which findings would be expected? (Select all that apply.) a. Poor appetite b. Complaints of night sweats c. Fever d. Painless cervical nodes e. Painful cervical nodes

"Answers: b and d (complaints of night sweats, painless cervical nodes.) Painless cervical nodes are a hallmark sign of HD. In addition to this, night sweats also are characteristic. Fever, poor appetite, and painful cervical nodes are more characteristic of infection."

A mother of a child diagnosed with a potentially life-threatening form of cancer says to the nurse, "I don't understand how this could happen to us. We have been so careful to make sure our child is healthy." Which response by the nurse is most appropriate? a. "This must be a difficult time for you and your family. Would you like to talk about how you are feeling?" b. "Why do you say that? Do you think that you could have prevented this?" c. "Many children are diagnosed with cancer. It is not always life-threatening." d. "You shouldn't feel that you could have prevented the cancer. It is not your fault."

"Correct Answer: A Parents of children diagnosed with cancer require major emotional support, and should be allowed to express their feelings. Prevention and blaming oneself is not supportive, nor is telling the parents that there are many other children with cancer."

The medication ketoconazole (Nizoral) is ordered for a child with a fungal infection. The child weighs 22 pounds. The dose is 4 mg/kg per day. The daily dose for this child would be ____ mg.

40

The child post-stem cell transfusion tells a nurse that she has a rash, diarrhea, and abdominal pain. Which condition does the nurse suspect? a. Graft-versus-host disease b. Severe combined immunodeficiency disease c. Anaphylaxis d. Systemic lupus erythematosus

A

A child is diagnosed with lupus and is placed on steroid therapy. Which diet should be included in the child's plan of care? a. Increased calcium b. Increased protein c. Increased carbohydrates d. Increased iron

A. Increased calcium

A 3-year-old diagnosed with a brain tumor is discharged from the hospital following brain surgery. Which response by the parents indicates discharge teaching was successful? a. "My child can begin radiation treatments now that he's discharged." b. "We have to make sure to watch for a decrease in urine." c. "Children with brain tumors have an increased rate of development." d. "The American Medical Association (AMA) is a resource for assistance."

Answer: a. "My child can begin radiation treatments now that he's discharged." Feedback: The child diagnosed with a brain tumor does not begin chemotherapy or radiation until after discharge from the hospital. Signs and symptoms of diabetes insipidus may occur following brain surgery, so the parents need to watch for an increase in urine production. Children with brain tumors may have slowed development, incoordination, learning disabilities, or other effects. The American Cancer Society is a potential resource for assistance, not the AMA.Evaluation; Physiological Integrity; Analyzing

A parent questions the nurse regarding why her child requires assessment with the Denver Developmental Screening Test prior to surgery for a brain tumor. What would be the most appropriate response by the nurse? a. "The results will provide a baseline to compare with after surgery." b. "The Denver Developmental Screening Test assesses cognitive development." c. "The Denver Developmental Screening Test assesses the growth of the child." d. "A Denver Developmental Screening Test is conducted on every child."

Answer: a. "The results will provide a baseline to compare with after surgery. "Feedback: Having a baseline assessment is important so that deficits postsurgery can be monitored. The Denver Developmental Screening Test is not an assessment of growth or cognitive abilities. Also, not every child is given the Denver Developmental Screening Test.Assessment; Health Promotion and Maintenance; Applying

Which nursing diagnosis is the highest priority for a child undergoing chemotherapy, experiencing nausea, and vomiting? a. Fluid and Electrolyte Imbalance b. Body Image Disturbances c. Alterations in Skin Integrity d. Alterations in Nutrition

Answer: a. Fluid and Electrolyte Imbalance Feedback: Although all of the nursing diagnoses are important, dehydration and electrolyte alteration secondary to vomiting may be life-threatening and are the priority for this client.Diagnosis; Physiological Integrity; Applying

Which condition is a special consideration the nurse keeps in mind when taking care of a child with a brain tumor? a. Increased urination b. Headache and night sweats c. Seizures d. Nausea and vomiting

Answer: a. Increased urination Feedback: Diabetes insipidus is a special consideration in children with brain tumors, so the nurse needs to watch for an increase in urine production. Headaches may be a sign of brain tumor, but night sweats are not. Seizures, nausea, and vomiting may all occur with brain tumor, but are not the priority consideration.Assessment; Physiological Integrity; Applying

The parent of a child undergoing chemotherapy asks the nurse why the child must wear a mask when in public places. Which response by the nurse would be most appropriate? a. "Chemotherapy causes dry mouth, and the mask will help contain moisture." b. "Chemotherapy decreases immune system function, increasing the risk of acquiring an infection." c. "Chemotherapy kills cancer cells, and your child might spread those cells to others." d. "Chemotherapy makes the oral mucous membranes deteriorate and makes them susceptible to infection."

Answer: b. "Chemotherapy decreases immune system function, increasing the risk of acquiring an infection." Feedback: Chemotherapeutic agents decrease the immunity of the child. Proper use of the mask will decrease the chance of acquiring an infection. Cancer is not spread; a mask cannot help contain moisture; and unsightly mouth sores are not a medical reason to wear a mask.Implementation; Physiological Integrity; Applying

A child was just diagnosed with Wilms' tumor. In planning teaching interventions, what key point should the nurse emphasize to the parents? a. Appropriate protective equipment should be worn for contact sports. b. Do not put pressure on the abdomen. c. Encourage the child to remain active. d. Frequent visits from friends and family will improve morale.

Answer: b. Do not put pressure on the abdomen. Feedback: Palpation of Wilms' tumor can cause rupture and spread of cancerous cells. Frequent visitation might allow the child to be exposed to more infections, and activity and sports are discouraged because of the risk of rupture of the encapsulated tumor.Planning; Physiological Integrity; Applying

A preschool-age child is to undergo several painful procedures. Which technique is the most appropriate for the nurse to use in preparing the child? a. Allow a family member to explain the procedure to the child. b. Explain the procedure in simple terms. c. Allow the child to practice injections on a favorite doll. d. Allow the child to watch an educational video.

Answer: b. Explain the procedure in simple terms. Feedback: Preschoolers have the cognitive ability to understand simple terms. Use of the favorite doll is contraindicated because it is part of that child, and the child might perceive that the doll is experiencing pain.Implementation; Psychosocial Integrity; Applying

A child with cancer has the following lab result: WBC 10,000 mcg/L, RBC 5 mcg/L, and platelets 20,000 mcg/L. Which risk should the nurse consider most significant, when planning this child's care? a. Pain b. Hemorrhage c. Infection d. Anemia

Answer: b. Hemorrhage Feedback: The lab values presented are within normal range, except for the platelet count. Decrease in platelet count places the child at greatest risk for hemorrhage.Planning; Physiological Integrity; Analyzing

A preschool-age child undergoing chemotherapy experiences nausea and vomiting. Which action would best encourage the child to eat? a. Offer fluids only between meals. b. Administer tube feedings. c. Offer small, frequent meals. d. Allow the child to choose what to eat for meals.

Answer: d. Allow the child to choose what to eat for meals. Feedback: Although all options can be utilized to promote nutrition, allowing the preschooler choices meets two issues: nutrition and developmental tasks.Planning; Physiological Integrity; Analyzing

A mother of a 5-year-old child asks the nurse questions regarding the importance of vigilant use of sunscreen. Which information is most important for the nurse to convey to the mother? a. A child's skin is delicate and burns easily. b. In addition to causing skin cancer, repeated sun exposure predisposes the child to other forms of cancer. c. Repeated exposure to the sun causes premature aging of the skin. d. Appropriate use of sunscreen decreases the risk of skin cancer.

Answer: d. Appropriate use of sunscreen decreases the risk of skin cancer.Feedback: Although all of the answers may be correct, recommending the use of sunscreen to decrease the incidence of skin cancer is the best response.Implementation; Safe, Effective Care Environment; Applying

A child is diagnosed with severe combined immunodeficiency. The nurse considers that dietary instruction to the parents is effective if which food is included in the child's diet? a. Grilled cheese b. Chicken fingers and milkshakes c. Tuna salad and whole wheat bread d. Hamburger and skim milk

B. Chicken fingers and milkshakes

A child is diagnosed with lupus and is experiencing a skin exacerbation. What should the nurse encourage the parents to do when providing care in order to decrease the risk factors associated with exacerbation in skin? a. Provide oral rehydration products. b. Use sunscreen products of 30 SPF. c. Use antimicrobial soap. d. Provide a high-protein diet.

B. Use sunscreen products of 30 SPF.

A child is recently diagnosed with juvenile rheumatoid arthritis (JRA). What is of priority for this child and family? a. Anxiety reduction b. Optimum nutrition c. Growth and development d. Education

C. Growth and development

A preschool-age child diagnosed with AIDS has developed respiratory compromise. Which technique would the nurse utilize to encourage effective lung expansion? a. Incentive spirometry b. Chest physiotherapy c. Coughing and deep breathing d. Bubble blowing

D. Bubble Blowing

A mother of a child with juvenile rheumatoid arthritis (JRA) asks the nurse what activities the child can enjoy. Which would be the most appropriate response based on knowledge of the physiologic aspects of JRA? a. Bicycling b. Running c. Skiing d. Swimming

D. Swimming

A child is diagnosed with the HIV. The child's mother expresses concern about transmission at the daycare setting. What should the nurse teach the family regarding handling soiled diapers? a. Use gowns, gloves, and masks. b. Use gowns and gloves. c. Use gowns and goggles. d. Use standard precautions.

D. Use standard precautions

A child is diagnosed with severe combined immunodeficiency deficiency syndrome. The nurse's priority interventions are directed toward which objective? a. Prevention of infection b. Maintenance of skin integrity c. Management of body image concerns d. Maintenance of cardiac function

a. Prevention of infection