peds week 5

List the steps of RBC production in the proper order. Decrease in circulating oxygen Rapid maturation leads to development of RBCs Kidneys produce erythropoietin RBC precursors produced in the bone marrow

1. Decrease in circulating oxygen 2. Kidneys produce erythropoietin 3. RBC precursors produced in the bone marrow 4. Rapid maturation leads to development of RBCs

The nurse is preparing a 3-year-old patient for a positron emission tomography (PET) scan to diagnose a neck mass. The child's caregiver asks what will be done to prevent potential discomfort and restlessness of the child during the procedure. What should the nurse respond? a. "Your child will be sedated prior to the procedure." b. "We will administer opioid analgesia 2 hours prior to the procedure." c. "You will be allowed to remain in the room at all times with your child." d. "Soft wrist restraints during the procedure will help the procedure go faster."

a. "Your child will be sedated prior to the procedure."

The mother of a 5-year-old patient reports unexplained weight loss in the child over the past month, frequent epistaxis, and persistent diarrhea. Which other findings support a possible diagnosis of cancer? (Select all that apply.) a. Anemia b. Frequent sneezing c. Poor concentration d. Ulcers of the mouth e. Mass in the child's neck

a. Anemia e. Mass in the child's neck

The nurse is educating the parents of a child with leukemia about necessary homecare. During the teaching session, the mother states, "We plan to let him return to baseball practice next week." Which information is most important for the nurse to include in the response? a. Avoid physically exhausting activities. b. Apply ample amounts of sunscreen on child's skin while outside. c. Assess the child's mucus membranes for signs of dehydration frequently while playing. d. Notify the health care provider immediately if the child has shortness of breath while playing.

a. Avoid physically exhausting activities.

A patient's chest x-ray reveals inflammation of the bronchi and a sputum culture is positive for streptococcus. Which white blood cells may be active? (Select all that apply.) a. B cells b. T cells c. Monocytes d. Lymphocytes e. Megakaryocyte f. Natural killer cells

a. B cells b. T cells c. Monocytes d. Lymphocytes f. Natural killer cells

Match the term with its definition. a. Erythrocyte b. Erythropoietin c. Polycythemia d. Hematopoiesis reduction in blood cells red blood cell production increased production of red blood cells white blood cell hormone that stimulates red blood cell production and maturation red blood cell

a. Erythrocyte - red blood cell b. Erythropoietin - hormone that stimulates red blood cell production and maturation c. Polycythemia - increased production of red blood cells d. Hematopoiesis - red blood cell production

Match each term with its definition. a. Hemostasis b. Fibrinogen c. Thrombocyte d. Megakaryocyte e. Vasoconstriction - Protein necessary for clotting - Precursor to platelets - Prevention of blood loss - Blood vessels increase in diameter - Blood vessels decrease in diameter - Small, irregular shaped, non-nucleated fragments

a. Hemostasis - Prevention of blood loss b. Fibrinogen - Protein necessary for clotting c. Thrombocyte - Small, irregular shaped, non-nucleated fragments d. Megakaryocyte - Precursor to platelets e. Vasoconstriction - Blood vessels decrease in diameter

A six-year-old child with leukemia presents with altered level of consciousness (LOC) and sluggish pupils but no cardiac compromise after falling from a bike. The nurse notes a platelet count of 10,000, WBC of four, and hemoglobin of seven. After the patient's airway is stabilized, which priority order should the nurse anticipate? a. Obtain a head CT b. Assess serum glucose c. Administer IV fluid bolus d. Administer pain medication

a. Obtain a head CT

Which mechanism immediately follows tissue injury? a. Vessel spasm b. Fibrin mesh forms c. Release of clotting factor d. Increased platelet formation

a. Vessel spasm

Match the white blood cell with its function. a. T-cell b. B-cell c. Basophil d. Monocyte - humoral immunity (antibody production) - activate inflammatory response - adaptive immunity - reduce inflammatory response - fight chronic infection - cell-mediated immunity

answers are wrong - unknown a. T-cell - fight chronic infection b. B-cell - humoral immunity (antibody production) c. Basophil -activate inflammatory response d. Monocyte - adaptive immunity

A child is admitted to the hospital with Non-Hodgkin lymphoma, and reports having lower abdominal pain of 6/10. The nurse notes a temperature of 102.3° F, heart rate 107 and respiratory rate 14. Which actions are most important for the nurse to take? (Select all that apply.) a. Assess lung sounds b. Obtain urine culture c. Obtain blood culture d. Obtain uric acid level e. Administer pain medication

b. Obtain urine culture c. Obtain blood culture

Which patient findings would have an associated effect on the white blood cell function? (Select all that apply.) a. Low iron b. Osteosarcoma c. Bacterial pneumonia d. Prolonged bleeding time e. Enlarged cervical lymph nodes

b. Osteosarcoma c. Bacterial pneumonia e. Enlarged cervical lymph nodes

When preparing a child to receive chemotherapy, the nurse can expect to see which values in the patient's electronic health record? a. ABG levels b. WBC levels c. Serum glucose level d. Resting metabolic rate

b. WBC levels

A two-year-old child diagnosed with Hodgkin Lymphoma presents with enlarged neck lymph nodes, and an x-ray reveals widening of the mediastinum. Which action should the nurse take first? a. Prepare for surgical excision b. Auscultate for bowel sounds c. Assess the child's airway for patency d. Educate parents or caregiver on chemotherapy

c. Assess the child's airway for patency

Which patients are at risk for impaired clotting? (Select all that apply.) a. Acute kidney failure b. Impaired lung function c. Diagnosis of osteosarcoma d. Diagnosis of liver failure cirrhosis e. A patient with Von Willebrand disease

c. Diagnosis of osteosarcoma d. Diagnosis of liver failure cirrhosis e. A patient with Von Willebrand disease

The nurse is evaluating a child who was admitted for persistent cough, dyspnea, swelling, and discomfort in the neck and axilla. Lymph node biopsy confirmed that the child has Non-Hodgkin Lymphoma. Which question would best determine the effectiveness of nursing care to this patient? a. Is the child's core body temperature stable? b. Is the child's urine output sufficient for age? c. Has the child's respiratory status remained stable? d. Are the parents knowledgeable about the disease process?

c. Has the child's respiratory status remained stable?

The function of the RBC is to carry oxygen to the tissues. Which factor is essential for the RBC to complete this task? a. Glycogen b. Leukocytes c. Hemoglobin d. Erythropoietin

c. Hemoglobin

The nurse is caring for a 17-year-old with single-node Hodgkin lymphoma who reports right upper quadrant pain, nausea and vomiting. The nurse notes icteric skin and sclera, and abdominal distention. Which prescription would the nurse anticipate? a. Administer IV pain medicine b. Assess serum potassium level c. Obtain serum AST and ALT levels d. Administer oral antiemetic medication

c. Obtain serum AST and ALT levels

The nurse is caring for a child receiving chemotherapy and notes bruising on the arms and legs. Which test will help identify the cause for bruising? a. Biopsy b. Albumin level c. Platelet levels d. Head computed tomography (CT)

c. Platelet levels

The nurse conducts an assessment on a child who presents with swelling and discomfort in the axilla, persistent cough, and dyspnea. Which assessment is a priority? a. Temperature b. Lung sounds c. Tracheal position d. Breathing pattern

c. Tracheal position

The mother of a 10-year-old questions the nurse regarding the method of chemotherapy administration and is concerned the child will require frequent IV insertions. With which statement should the nurse respond? a. "The injections will not hurt." b. "The peripheral IV will remain in place for up to 3 months." c. "Eventually, the child will get accustomed to the frequent injections." d. "A central venous catheter (CVC) may be implanted for long-term chemotherapy administration."

d. "A central venous catheter (CVC) may be implanted for long-term chemotherapy administration."

The nurse is caring for a four-year-old child with leukemia who is receiving chemotherapy. The parent reports that the child has abdominal pain, nausea, and vomiting. Upon exam, the nurse notes poor skin turgor, pallor, dry mucus membranes, and poor appetite. Which action should the nurse take first? a. Administer pain medicine b. Assess hourly urine output c. Administer oral antiemetic d. Administer normal saline IV bolus

d. Administer normal saline IV bolus

A child diagnosed with leukemia reports nausea, vomiting, and anorexia related to chemotherapy treatment. The nurse notes a hemoglobin count of 10, WBC count of 8, platelet count of 103,000, and an albumin level of 2.1. Which prescription would the nurse anticipate? a. Decrease dietary protein b. Administer PO allopurinol c. Administer platelet transfusion d. Administer total parenteral nutrition

d. Administer total parenteral nutrition

Which situation identifies an environment in which a child may be at increased risk of developing cancer? a. Residing in low-income housing b. Making frequent trips to a foreign country c. Visiting at private school near a clothing factory d. Exposure to radiation from repeated computed tomography (CT) scans

d. Exposure to radiation from repeated computed tomography (CT) scans

The nurse is caring for a 16-year-old child diagnosed with Hodgkin Lymphoma who reports shortness of breath, and chest pain. The nurse notes hoarseness of patient's voice when speaking. Which prescription would the nurse take first? a. Obtain sputum culture b. Administer pain medication c. Administer albuterol nebulizer d. Obtain an emergency chest radiograph

d. Obtain an emergency chest radiograph

The structure of red blood cells supports ease of flow through the blood vessels. Which patient condition is most likely to inhibit blood flow? a. Diabetes b. Leukemia c. Pneumonia d. Sickle cell anemia

d. Sickle cell anemia