NCLEX Child Health - Hematologic

A 9-year-old child with sickle cell anemia is being discharged after treatment for a crisis. Which instructions for avoiding future crisis should the nurse provide to the client and the child's family? Select all that apply.

1. Drink plenty of fluids 2. Wash hands before meals and after playing 3. Report a sore throat to an adult immediately

A child is admitted to the hospital with a suspected diagnosis of idiopathic thrombocytopenic purpura (ITP) and diagnostic studies are performed. Which diagnostic result is indicative of this disorder?

A bone marrow examination showing an increased number of megakaryocytes

A child diagnosed with hemophilia is brought into the emergency department after being hit on the neck with a baseball. What is the focus of the nurse's immediate assessment?

Airway obstruction

A 3-year-old is admitted to the hospital with a diagnosis of acute lymphocytic leukemia (ALL). The nurse assigned to care for the child is concerned because the child is crying and stating, "My knees hurt." Which intervention should the nurse provide for the child?

Apply cold packs to the knees

The nurse is providing instructions to a parent of a 10-year-old child with hemophilia regarding appropriate activities. The nurse tells the mother that which activity should be safe for the child to participate in?

Archery

A child who was admitted to the hospital for sickle cell crisis is preparing for discharge. The nurse provides instructions to the parents on measures to prevent a crisis. Which statement by the parents indicates a need for further instructions?

We need to increase the dose of analgesic as soon as the pain begins

Oral iron is prescribed for a child with an iron deficiency anemia. The nurse provides instructions to the mother regarding the administration of the iron. How should the nurse instruct the mother to administer the iron?

Between meals

A child is admitted to the hospital with a suspected diagnosis of von Willebrand's disease. On assessment of the child, which symptom would most likely be noted?

Bleeding from the mucous membranes

The nurse is caring for an adolescent with sickle cell anemia hospitalized for the treatment of vaso-occlusive crisis. The nurse should determine that what problem should receive priority in the client's plan of care?

Compromised tissue perfusion

The nurse is assessing for the presence of bleeding in a child with leukemia. Which laboratory result will assist the nurse in planning appropriate care?

Decreased platelets

The nurse is caring for an infant who is admitted to the hospital with a diagnosis of hemolytic disease. Which finding should the nurse expect to note in this infant when reviewing the laboratory results?

Decreased red blood cell count

The nurse is reviewing the health care provider's prescriptions for a child admitted to the hospital with a diagnosis of sickle cell crisis. The nurse should contact the health care provider if what is prescribed?

Demerol

The nurse is providing instructions to the mother of a child with a diagnosis of megaloblastic anemia. Which dietary sources of vitamin B12 should the nurse instruct the mother to include in the diet?

Eggs

The nurse is providing instructions to the mother of a preschool child with hemophilia. What instruction should the nurse give to the mother to promote a safe environment while allowing for normalcy?

Examine toys and the play area for sharp objects

Desmopressin (DDAVP) is prescribed via intranasal route for a child with von Willebrand's disease, and the nurse instructs the parents regarding the administration of this medication. Which statement by a parent indicates a need for further teaching?

I need to restrict my child's fluid intake to prevent over hydration

The home care nurse is instructing the mother of a child with iron deficiency anemia regarding the administration of a liquid oral iron supplement. Which statement, if made by the mother, indicates an understanding of the administration of this medication?

I should use a medicine dropper and place the iron near the back of the throat

The nurse is preparing a plan of care for the child with beta thalassemia. Which problem should the nurse identify as a priority for this client?

Inadequate tissue perfusion

Intravenous immunoglobulin (Gammagard) therapy is prescribed for a child with immune thrombocytopenic purpura (ITP). The nurse reviews the health care provider's prescription and determines that this medication is prescribed for the child for what reason?

Increase the number of circulating platelets

The nurse receives a telephone call from the parent of a toddler who has acute lymphocytic leukemia (ALL). The parent tells the nurse that the child has developed epistaxis. The nurse advises the parent to immediately take which action?

Keep the child calm and quiet, and place the child in an upright and leaning forward position

The nurse is reviewing the health care provider's prescriptions for a child who was admitted to the hospital with vaso-occlusive pain crisis from sickle cell anemia. Which health care provider prescription should the nurse question?

Meperidine Hydrochloride (Demerol)

The nurse provides instructions regarding home care to a parent of a 3-year-old child who has been hospitalized with hemophilia. Which statement by the parent indicates the need for further teaching?

My child should not have any immunizations

The nurse is providing instructions regarding home care to the parents of a 3-year-old child hospitalized with hemophilia. Which statement by a parent indicates a need for further instructions?

My child should not receive dental hygiene care from a dentist

The nurse is preparing to discharge a hospitalized child newly diagnosed with hemophilia. What should be included in the teaching plan for home care for this child?

Padding crib rails and table corners

The nurse is assigned to care for a child diagnosed with hemophilia. The nurse reviews the results of the prescribed laboratory tests. Which test should the nurse anticipate to be abnormal?

Partial Thromboplastin Time (PTT)

The nurse is preparing to teach the parents of a child with anemia about the dietary sources of iron that are easy for the body to absorb. Which food item should the nurse include in the teaching plan?

Poultry

A 5-year-old child has a deficiency in factor VIII. An important goal is to relieve pain caused by bleeding into the joints. Which intervention should the nurse expect to be prescribed to achieve this goal?

Provide for joint immobilization

The nurse is performing an assessment of a 12-month-old child with iron deficiency anemia. Which assessment finding should the nurse expect to note in this child?

Tachycardia

The nurse is developing a plan of care for a child with hemophilia. Which evaluative statement developed by the nurse indicates a positive outcome for this child?

The child experiences no long-term complications for injury or bleeding

Intravenous immune globulin (IVIG) therapy is prescribed for a child with idiopathic thrombocytopenic purpura (ITP). What is the expected result of this medication?

White blood cell count 18,000 and platelets 355,000