chp 23-26 +32
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. Administering oxygen Administering analgesics Maintaining fluid intake Promoting exercise and activity Administering platelets
1,2,3
A nurse is preparing to administer a blood transfusion to a child diagnosed with beta-thalassemia. What action should the nurse take first? Prime the infusion tubing. Take the child's vital signs. Match the unit of blood to the child's identification. Set the infusion pump to the appropriate transfusion rate.
c
An 11-year-old child is being prepared for discharge after experiencing a vasoocclusive crisis secondary to sickle cell disease. The child has been prescribed hydroxyurea. After teaching the child and parents about this medication, the nurse determines that the teaching was successful when the parents identify that they will notify the health care provider about which condition? gastric upset infection constipation headache
b
Children with acute lymphoblastic leukemia (ALL) may need periodic lumbar punctures. The nurse would teach the parent that this is done to assess for: platelets. leukemic cells. early meningitis. early development of septicemia.
b
The nurse is educating a parent of a toddler with Down syndrome. Which statement by the parent indicates teaching was effective? "I will continue to offer my child low fiber foods for meal and snacks." "I am aware my child needs to be immunized on a delayed schedule." "I hope my child does well with the various therapies we have arranged." "I know my child will meet developmental milestones earlier than my other children."
c
The nurse is assessing a 3-year-old boy whose parents brought him to the clinic when they noticed that the right side of his abdomen was swollen. What finding would suggest this child has a neuroblastoma? The child has a maculopapular rash on his palms. The parents report that their son is vomiting and not eating well. The parents report that their son is irritable and not gaining weight. Auscultation reveals wheezing with diminished lung sounds.
b
The nurse is educating the parents of a child requiring renal replacement therapy The parents express concern because they live in a remote, rural area with no access to pediatric specialty dialysis units. Which would the nurse recommend to the parents? Hemodialysis Peritoneal dialysis In-home hemodialysis Renal transplant
b
The nurse is teaching an in-service program to a group of nurses on the topic of gastrointestinal disorders. The nurses in the group make the following statements. Which statement is most accurately related to the diagnosis of colic? A partial or complete intestinal obstruction occurs. A thickened, elongated muscle causes an obstruction at the end of the stomach. There are recurrent paroxysmal bouts of abdominal pain. In this disorder the sphincter that leads into the stomach is relaxed.
c
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? "Don't worry, the health care provider is very good at treating leukemia." "I don't blame you for being upset; any parent would be scared too." "I know this is scary, but leukemia has a high cure rate in children these days." "You are very lucky to have caught it so early; that makes the treatments easier."
c
The nurse admits a 7-year-old child who reports pain in the lower right quadrant of the abdomen, nausea, and constipation. An assessment shows that the child has a fever of 101°F (38.3℃). Which nursing intervention should the nurse implement to safely address the child's reported pain? Request a prescription for a laxative. Place a heating pad or hot water bottle on the abdomen. Help the child find a comfortable position. Give the child an analgesic such as acetaminophen.
c
A child is diagnosed with gastroesophageal reflux disease and is prescribed drug therapy. The primary health care provider prescribes medication that suppresses acid secretion. The nurse would anticipate administering which drug? esomeprazole famotidine metoclopramide cimetidine
a
The parents of a child with a developmental disability express feeling guilty because they sometimes find themselves wondering how their child would be without the disability. Which response by the nurse best shows empathy and encourages the parents to vent their feelings? "I'm sure it must be difficult to have a child developmentally delayed." "There are lots of parents that are experiencing the difficulty and feelings of hopelessness and grief you are having. Maybe if you talk to someone it might help you both." "I can only imagine how hard it is for you. You should know that it is common for parents to have these feelings when having a child with special needs." "It is important to focus on the positives that can come from the experience of being the parents of a child that has these issues."
c
A nurse is caring for a newborn whose screening test result indicates the possibility of sickle cell anemia (SCA) or sickle cell trait. The nurse would expect the test result to be confirmed by which lab tests? reticulocyte count peripheral blood smear erythrocyte sedimentation rate hemoglobin electrophoresis
d
A nurse is preparing discharge instructions for the family of a child diagnosed with fragile X syndrome. Then nurse will include referral to which health professional in the discharge instructions? nutritionist ophthalmologist cardiologist behavioral therapist
d
The nurse is teaching manifestations of nephrotic syndrome to the parents of a child with the disorder. What should the nurse instruct the parents to monitor to determine if edema is increasing? appetite breathing rate tightness of shoes abdominal circumference
d
Which nursing concern(s) is common when caring for an infant with exstrophy? Select all that apply. oliguria skin irritation urinary tract infections pelvic bone defects cognitive deficits
2,3,4
After teaching the parents of a child diagnosed with celiac disease about nutrition, the nurse determines that the teaching was effective when the parents identify which food(s) as appropriate for their child? Select all that apply. graham crackers peanut butter carbonated drinks shellfish jelly frozen yogurt
2,3,4,5
The nurse observes the interactions of parents with their infant who was born with a cleft lip. The mother is attempting to feed the baby, but does not make eye contact. The father is watching television with his back turned to the mother and baby. What psychosocial nursing intervention would be most helpful to this family? Ask the parents if they have any questions regarding the care of their child. Explain to the parents that surgical intervention will fix the defect in the baby's lip. Teach the mother the appropriate technique for breastfeeding an infant with cleft lip. Refer the family to a social worker or mental health practitioner.
a
When providing care to a dying child and his family, which would be most important? Focusing on the family as the unit of care. Teaching the family appropriate care measures. Offering the child support and encouragement. Assisting the parents in decision making.
a
A 7-year-old boy has experienced repeated urinary tract infections (UTIs). His older sister also experienced repeated UTIs and was diagnosed with vesicoureteral reflux, a condition that tends to appear in families. Therefore, the nurse suspects this same condition in this client. Which diagnostic tests would confirm this suspicion? Cystoscopy Urinalysis Urine culture Blood urea nitrogen test
a
A child is scheduled for chemotherapy as treatment for leukemia. As the nurse is collaborating with another colleague, the discussion turns to the client's first phase of chemotherapy. This phase is known as: induction. sanctuary. delayed intensive therapy. maintenance.
a
A child presents with intermittent abdominal pain, severe anorexia, and diarrhea. The child's height and weight are significantly behind standards for age. There is skin breakdown in the anal region. The nurse explains that this presentation is consistent with which diagnosis? Crohn disease ulcerative colitis food poisoning Hirschsprung disease
a
A child with Turner syndrome is being seen in the clinic for an annual examination. What assessment would be most important for the nurse to complete? measure the height obtain blood pressure auscultate heart sounds conduct an eye screening examination
a
A child with acute lymphoblastic leukemia (ALL) is starting treatment with methotrexate in an attempt to eradicate the leukemic cells. Which stage of therapy is the child undergoing? induction stage sanctuary stage consolidation stage delayed intensive-therapy stage
a
A nurse is teaching the parents of a child receiving hemodialysis about caring for the arteriovenous graft. Which of the following would the nurse include? palpating daily for a thrill checking for a blood return using sterile technique for connecting maintaining an occlusive dressing at all times
a
An adolescent receiving chemotherapy has lost all hair and is sad about self-image. Which action should the nurse take to support this adolescent and involve the client in decision making? Encourage the adolescent to select hats or wigs to fit one's personality. Refer the adolescent to a peer support group. Have a Child Life specialist work with the adolescent. Support the adolescent's choice of comfortable clothing.
a
The nurse is administering an IV infusion of albumin to a child with nephrotic syndrome. What is the primary concern for the nurse when administering this medication to the child? fluid overload electrolyte imbalance increased blood pressure urine output
a
The nurse is assessing a toddler and palpates a sausage-shaped mass in the upper mid abdomen. When taking the toddler's history, what question would the nurse ask the parent first? "Has your toddler been having different colored stools?" "Can you describe any pain your toddler is having?" "How is your toddler's appetite?" "Has your toddler been around anyone who has been sick?"
a
The nurse is assisting a couple wishing to conceive who just received the results from genetic testing. Which intervention takes priority? psychosocial support discussion of treatment options education on prenatal care referral for gene therapy
a
The nurse is caring for a pregnant client who received prenatal testing. The results showed phenylketonuria (PKU). The client is concerned and asks the nurse about PKU. Which statement made by the nurse is most accurate? "It can lead to brain damage without treatment." "Symptoms can be controlled with hormone therapy." "PKU is the leading cause of intellectual disability in children." "A diet high in phenylalanine will be needed for the child's life."
a
The nurse is discussing nutritional requirements to the parents of a child diagnosed with phenylketonuria (PKU). Which food item would be appropriate to recommend? orange slices egg whites fat-free milk lean chicken
a
The nurse is preparing clients for diagnostic testing for cancer. Which test is used to differentiate a neuroblastoma from other tumors? Urine catecholamine metabolites, homovanillic acid (HVA), and vanillylmandelic acid (VMA) Urinalysis Serum chemistries Complete blood count (CBC) with differential
a
A child is undergoing a series of diagnostic tests for a suspected malignancy. Which diagnostic test result is only present in Hodgkin disease? elevated lymphocytes Reed-Sternberg cells T-lymphocyte surface markers megakaryocyte cells
b
A nurse is teaching the parents of an infant diagnosed with phenylketonuria (PKU) home management of the disorder. Which statement made by the parent indicates the teaching was effective? "As my infant gets older, my infant will be able to tolerate protein better." "Phenylalanine levels will need to be checked at least once a week." "I am glad I can continue to exclusively breastfeed my infant." "It is good to know I can substitute soy formula for my breast milk."
b
The nurse is reinforcing dietary teaching with the caregiver of a child diagnosed with celiac disease. The caregivers make the following statements. Which statement indicates a need for further teaching regarding the dietary restrictions for the child with celiac disease? "The soup we eat at our house is all made from scratch." "She loves hot dogs, and we always cut hers up into small pieces." "I have learned to make my own bread with no gluten." "Even though milk and pudding are good for her, we don't give her those foods."
b
The nurse on the postpartum unit is educating the parents of an newborn diagnosed with an genetic disease. What statement by the parent would indicate to the nurse that family is receptive to additional teaching? "I feel like we have learned so much today already and it is a lot to learn at one time." "I am so glad we have this time of quiet to learn what we need to learn before we go home." "I think we would understand better if you just wrote down the information and sent it home with us." "Once we get our baby home and settled, everything will be just fine. We aren't concerned."
b
Which intervention is best to use with the 6-year-old who has developed stomatitis as a side effect of chemotherapy? Limit foods to cool, clear liquids Practice frequent, gentle oral hygiene Use lidocaine rinses Have the child freely choose desired foods and beverages
b
Which symptom would lead the nurse to suspect that a child is developing a common side effect of vincristine? The cheeks are turning bright red. The child says the fingertips feel numb. The child says the teeth "ache." The child's hearing seems to be altered.
b
A nurse is caring for a teenager who is in the end stage of cancer. Which of the following nursing interventions provides self-esteem and self-worth to the teen? listening to the adolescent's fears about death encouraging the teenager to talk about feelings allowing the teenager to completely participate in decisions answering all of the teenager's questions
c
The nurse is caring for a 10-year-old girl presenting with fever, dysuria, flank pain, urgency, and hematuria. The nurse would expect to help obtain which test first? total protein, globulin, and albumin creatinine clearance urinalysis urine culture and sensitivity
c
The toddler with a cancer diagnosis is seen for a well-child checkup. Which health maintenance activity will the nurse exclude? Plotting height and weight on a growth chart Assessing dietary intake by addressing "picky eating" and "food jags" Administering the measles, mumps, rubella (MMR) vaccine Teaching the importance of taking water safety measures
c
What is the best response by the nurse to the parents of a child with leukemia who express guilt because they did not take immediate action when their child seemed to develop one respiratory infection after another? "Don't feel bad. Children get lots of colds." "Young children develop minor illness easily and often. Stop being hard on yourselves." "Keep in mind that the signs of leukemia are often subtle and difficult to recognize." "You need to focus on the present treatment now and not worry about the past."
c
Which finding would lead the nurse to suspect that a child is experiencing moderate dehydration? dusky extremities tenting of skin sunken fontantels (fontanelles) hypotension
c
Which is a priority for the nurse caring for a client with bladder exstrophy? increasing fluid intake encouraging voiding preventing skin breakdown placing the child in prone position
c
