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Ch. 30, 31, 6, & ... not on here last chapter (integumentary)
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A mother states that she brought her child to the clinic because the 3-year-old girl was not
keeping up with her siblings. During physical assessment, the nurse notes that the child
has pale skin and conjunctiva and has muscle weakness. The hemoglobin on admission is
6.4 g/dl. After notifying the practitioner of the results, what nursing priority intervention
should occur next?
a. Reduce environmental stimulation to prevent seizures.
b. Have the laboratory repeat the analysis with a new specimen.
c. Minimize energy expenditure to decrease cardiac workload.
d. Administer intravenous fluids to correct the dehydration.
keeping up with her siblings. During physical assessment, the nurse notes that the child
has pale skin and conjunctiva and has muscle weakness. The hemoglobin on admission is
6.4 g/dl. After notifying the practitioner of the results, what nursing priority intervention
should occur next?
a. Reduce environmental stimulation to prevent seizures.
b. Have the laboratory repeat the analysis with a new specimen.
c. Minimize energy expenditure to decrease cardiac workload.
d. Administer intravenous fluids to correct the dehydration.
A child with severe anemia requires a unit of red blood cells (RBCs). The nurse explains
to the child that the transfusion is necessary for which reason?
a. Allow her parents to come visit her.
b. Fight the infection that she now has.
c. Increase her energy so she will not be so tired.
d. Help her body stop bleeding by forming a clot (scab).
to the child that the transfusion is necessary for which reason?
a. Allow her parents to come visit her.
b. Fight the infection that she now has.
c. Increase her energy so she will not be so tired.
d. Help her body stop bleeding by forming a clot (scab).
An 8-year-old girl is receiving a blood transfusion when the nurse notes that she has
developed precordial pain, dyspnea, distended neck veins, slight cyanosis, and a dry
cough. These manifestations are most suggestive of what complication?
a. Air embolism
b. Allergic reaction
c. Hemolytic reaction
d. Circulatory overload
developed precordial pain, dyspnea, distended neck veins, slight cyanosis, and a dry
cough. These manifestations are most suggestive of what complication?
a. Air embolism
b. Allergic reaction
c. Hemolytic reaction
d. Circulatory overload
What statement best describes iron deficiency anemia in infants?
a. It is caused by depression of the hematopoietic system.
b. Diagnosis is easily made because of the infant's emaciated appearance.
c. It results from a decreased intake of milk and the premature addition of solid
foods.
d. Clinical manifestations are related to a reduction in the amount of oxygen available
to tissues.
a. It is caused by depression of the hematopoietic system.
b. Diagnosis is easily made because of the infant's emaciated appearance.
c. It results from a decreased intake of milk and the premature addition of solid
foods.
d. Clinical manifestations are related to a reduction in the amount of oxygen available
to tissues.
What information should the nurse include when teaching the mother of a 9-month-old
infant about administering liquid iron preparations?
a. Give with meals.
b. Stop immediately if nausea and vomiting occur.
c. Adequate dosage will turn the stools a tarry green color.
d. Allow preparation to mix with saliva and bathe the teeth before swallowing.
infant about administering liquid iron preparations?
a. Give with meals.
b. Stop immediately if nausea and vomiting occur.
c. Adequate dosage will turn the stools a tarry green color.
d. Allow preparation to mix with saliva and bathe the teeth before swallowing.
The parents of a child with sickle cell anemia (SCA) are concerned about subsequent
children having the disease. What statement most accurately reflects inheritance of SCA?
a. SCA is not inherited.
b. All siblings will have SCA.
c. Each sibling has a 25% chance of having SCA.
d. There is a 50% chance of siblings having SCA.cThe clinical manifestations of sickle cell anemia (SCA) are primarily the result of which
physiologic alteration?
a. Decreased blood viscosity
b. Deficiency in coagulation
c. Increased red blood cell (RBC) destruction
d. Greater affinity for oxygencA school-age child is admitted in vasoocclusive sickle cell crisis (pain episode). The
child's care should include which therapeutic interventions?
a. Hydration and pain management
b. Oxygenation and factor VIII replacement
c. Electrolyte replacement and administration of heparin
d. Correction of alkalosis and reduction of energy expenditureaA child with sickle cell anemia (SCA) develops severe chest and back pain, fever, a cough,
and dyspnea. What should be the first action by the nurse?
a. Administer 100% oxygen to relieve hypoxia.
b. Notify the practitioner because chest syndrome is suspected.
c. Infuse intravenous antibiotics as soon as cultures are obtained.
d. Give ordered pain medication to relieve symptoms of pain episode.bIn a child with sickle cell anemia (SCA), adequate hydration is essential to minimize
sickling and delay the vasoocclusion and hypoxia-ischemia cycle. What information
should the nurse share with parents in a teaching plan?
a. Encourage drinking.
b. Keep accurate records of output.
c. Check for moist mucous membranes.
d. Monitor the concentration of the child's urine.cWhat statement best describes -thalassemia major (Cooley anemia)?
a. It is an acquired hemolytic anemia.
b. Inadequate numbers of red blood cells (RBCs) are present.
c. Increased incidence occurs in families of Mediterranean extraction.
d. It commonly occurs in individuals from West Africa.cWhat therapeutic intervention is most appropriate for a child with -thalassemia major?
a. Oxygen therapy
b. Supplemental iron
c. Adequate hydration
d. Frequent blood transfusionsdIron overload is a side effect of chronic transfusion therapy. What treatment assists in
minimizing this complication?
a. Magnetic therapy
b. Infusion of deferoxamine
c. Hemoglobin electrophoresis
d. Washing red blood cells (RBCs) to reduce ironbIn which condition are all the formed elements of the blood simultaneously depressed?
a. Aplastic anemia
b. Sickle cell anemia
c. Thalassemia major
d. Iron deficiency anemiaaFor children who do not have a matched sibling bone marrow donor, the therapeutic
management of aplastic anemia includes what intervention?
a. Antibiotics
b. Antiretroviral drugs
c. Iron supplementation
d. Immunosuppressive therapydWhat statement is descriptive of most cases of hemophilia?
a. X-linked recessive deficiency of platelets causing prolonged bleeding
b. X-linked recessive inherited disorder in which a blood clotting factor is deficient
c. Autosomal dominant deficiency of a factor involved in the blood-clotting reaction
d. Y-linked recessive inherited disorder in which the red blood cells become moon
shapedbThe nurse is teaching the family of a child, age 8 years, with moderate hemophilia about
home care. What should the nurse tell the family to do to minimize joint injury?
a. Administer nonsteroidal anti-inflammatory drugs (NSAIDs).
b. Administer DDAVP (synthetic vasopressin).
c. Provide intravenous (IV) infusion of factor VIII concentrates.
d. Encourage elevation and application of ice to the involved joint.cWhat condition is an acquired hemorrhagic disorder that is characterized by excessive
destruction of platelets?
a. Aplastic anemia
b. Thalassemia major
c. Idiopathic thrombocytopenic purpura
d. Disseminated intravascular coagulationcCare for the child with acute idiopathic thrombocytopenic purpura (ITP) includes which
therapeutic intervention?
a. Splenectomy
b. Intravenous administration of anti-D antibody
c. Use of nonsteroidal anti-inflammatory drugs (NSAIDs)
d. Helping child participate in sportsbA toddler is diagnosed with chronic benign neutropenia. The parents are being taught
about caring for their child. What information is important to include?
a. Avoid large indoor crowds and people who are ill.
b. Parenteral antibiotics are necessary to control disease.
c. Frequent rest periods are needed during the daytime.
d. List the side effects of corticosteroids used to decrease inflammation.aThe majority of children in the United States with human immunodeficiency virus (HIV)
infection acquired the disease by which means?
a. Through sexual contact
b. From a blood transfusion
c. By using intravenous (IV) drugs
d. Perinatally from their mothersdA young child with human immunodeficiency virus (HIV) is receiving several
antiretroviral drugs. What is the purpose of these drugs?
a. Cure the disease.
b. Delay disease progression.
c. Prevent spread of infection.
d. Treat Pneumocystis carinii pneumonia.bThe nurse is planning care for an adolescent with acquired immunodeficiency syndrome.
What is the priority nursing goal?
a. Prevent infection.
b. Prevent secondary cancers.
c. Identify source of infection.
d. Restore immunologic defenses.aThe school nurse is informed that a child with human immunodeficiency virus (HIV)
infection will be attending school soon. What is an important nursing intervention to
include in the plan of care?
a. Carefully follow universal precautions.
b. Inform the parents of the other children.
c. Determine how the child became infected.
d. Reassure other children that they will not become infected.aWhat condition is an inherited immunodeficiency disorder characterized by absence of
both humoral and cell-mediated immunity?
a. Fanconi syndrome
b. Wiskott-Aldrich syndrome
c. Acquired immunodeficiency syndrome (AIDS)
d. Severe combined immunodeficiency syndrome (SCIDS)dThe nurse is preparing a community outreach program about the prevention of
iron-deficiency anemia in infants. What statement should the nurse include in the
program?
a. Whole milk can be introduced into the infant's diet in small amounts at 6 months.
b. Iron supplements cannot be given until the infant is older than 1 year of age.
c. Iron-fortified cereal should be introduced to the infant at 2 months of age.
d. Breast milk or iron-fortified formula should be used for the first 12 months.dA 5-year-old child is admitted to the hospital in a sickle cell crisis. The child has been alert
and oriented but in severe pain. The nurse notes that the child is complaining of a
headache and is having unilateral hemiplegia. What action should the nurse implement?
a. Notify the health care provider.
b. Place the child on bed rest.
c. Administer a dose of hydrocodone (Vicodin).
d. Start O2 per the hospital's protocol.aWhat pain medication is contraindicated in children with sickle cell disease (SCD)?
a. Meperidine (Demerol)
b. Hydrocodone (Vicodin)
c. Morphine sulfate
d. Ketorolac (Toradol)aIn anticipation of the admission of a child with hereditary spherocytosis (HS) who is
experiencing an aplastic crisis, what action should the nurse plan?
a. Secure an isolation room.
b. Prepare for a transfusion of packed red blood cells.
c. Anticipate preoperative preparation for a splenectomy.
d. Gather equipment and medication for treatment of shock.bA child with hemophilia A will have which abnormal laboratory result?
a. PT (ProTime)
b. Platelet count
c. Fibrinogen level
d. PTT (partial thromboplastin time)dA child with hemophilia A is scheduled for surgery. What precautions should the nurse
institute with this child?
a. Handle the child gently when transferring to a cart.
b. Caution the child not to brush his teeth before surgery.
c. Use tape sparingly on postoperative dressings.
d. Do not administer analgesics before surgery.aNursing strategies to improve the growth and development of the child with human
immunodeficiency virus (HIV) infection should include what?
a. Provide only those foods that the child feels like eating.
b. Fortify foods with nutritional supplements to maximize quality of intake.
c. Weigh the child and measure height and muscle mass on a daily basis.
d. Provide high-fat and high-calorie meals and snacks to meet body requirements for
growth.bWhat medication is classified as an antiretroviral?
a. Dapsone (Aczone)
b. Pentamidine (Pentam)
c. Didanosine (Videx)
d. Trimethoprim-sulfamethoxazole (Bactrim)cThe nurse is caring for a child with hemophilia A. The child's activity is as tolerated. What
activity is contraindicated for this child?
a. Ambulating to the cafeteria
b. Active range of motion
c. Ambulating to the playroom
d. Passive range of motion exercisesdWhat condition precipitates polycythemia?
a. Dehydration
b. Severe infections
c. Immunosuppression
d. Prolonged tissue hypoxiadThe clinic nurse is evaluating lab results for a child. What recorded hemoglobin (Hgb)
result is considered within the normal range?
a. 9 g/dl
b. 10 g/dl
c. 11 g/dl
d. 12 g/dldThe clinic nurse is evaluating lab results for a child. What recorded hematocrit (Hct) result
is considered within the normal range?
a. 30%
b. 40%
c. 50%
d. 60%bThe nurse is caring for a school-age child with severe anemia and activity intolerance.
What diversional activity should the nurse plan for this child?
a. Playing a musical instrument
b. Playing board or card games
c. Participating in a game of table tennis
d. Participating in decorating the hospital roombThe nurse is preparing to administer a unit of packed red blood cells to a hospitalized
child. What is an appropriate action that applies to administering blood?
a. Take the vital signs every 15 minutes while blood is infusing.
b. Use blood within 1 hour of its arrival from the blood bank.
c. Administer the blood with 5% glucose in a piggyback setup.
d. Administer the first 50 ml of blood slowly and stay with the child.dWhat rationale explains why prolonged use of oxygen should be discouraged in a child
with anemia?
a. Prolonged use of oxygen can decrease erythropoiesis.
b. Prolonged use of oxygen can interfere with iron production.
c. Prolonged use of oxygen interferes with a child's appetite.
d. Prolonged use of oxygen can affect the synthesis of hemoglobin.aThe nurse is teaching a parent of an infant to limit the amount of formula to encourage the
intake of iron-rich food. What amount should the nurse teach to the parent?
a. 500 ml
b. 750 ml
c. 1000 ml
d. 1250 mlcA child with sickle cell disease is in a vasoocclusive crisis. What nonpharmacologic pain
intervention should the nurse plan?
a. Exercise as a distraction
b. Heat to the affected area
c. Elevation of the extremity
d. Cold compresses to the affected areabWhat immunoglobulin pattern does the nurse expect in a child recently diagnosed with
Wiskott-Aldrich syndrome?
a. Diminished levels of IgG
b. Diminished levels of IgA
c. Diminished levels of IgM
d. Diminished levels of IgEcThe nurse is caring for a 14-year-old child with disseminated intravascular coagulation
(DIC). What clinical manifestations should the nurse expect to observe? (Select all that
apply.)
a. Petechiae
b. Chronic diarrhea
c. Hepatosplenomegaly
d. Bleeding from openings in the skin
e. Hypotension
f. PurpuraadefWhat activity should the school nurse recommend for a child with hemophilia A? (Select
all that apply.)
a. Golf
b. Soccer
c. Rugby
d. Jogging
e. SwimmingadeWhat are signs and symptoms of anemia? (Select all that apply.)
a. Pallor
b. Fatigue
c. Dilute urine
d. Bradycardia
e. Muscle weaknessabeThe nurse is administering a unit of blood to a child. What are signs and symptoms of a
transfusion reaction? (Select all that apply.)
a. Chills
b. Shaking
c. Flank pain
d. Hypothermia
e. Sudden severe headacheabceThe nurse is teaching parents of a child being discharged from the hospital after a
splenectomy about the risk of infection. What should the nurse include in the teaching
session? (Select all that apply.)
a. Avoid obtaining the pneumococcal vaccination for the child.
b. Avoid obtaining the meningococcal vaccination for the child.
c. The child should receive prophylactic penicillin for certain procedures.
d. Have the child immunized with the Haemophilus influenzae type b vaccination.
e. Notify the health care provider if your child develops a fever of 38.5° C (101.3° F).cdeThe clinic nurse is evaluating causes for iron deficiency caused by inadequate supply of
iron. What should the nurse recognize as causes for iron deficiency caused by an
inadequate iron supply? (Select all that apply.)
a. Prematurity
b. Slow growth rate
c. Excessive milk intake
d. Severe iron deficiency in the mother
e. Exclusive breastfeeding of infant from birth to 3 monthsacdThe clinic nurse is evaluating causes for iron deficiency due to impaired iron absorption.
What should the nurse recognize as causes for iron deficiency due to impaired iron
absorption? (Select all that apply.)
a. Gastric acidity
b. Chronic diarrhea
c. Lactose intolerance
d. Absence of phosphates
e. Inflammatory bowel diseasebceThe nurse is preparing to admit a 1-month-old infant with severe congenital neutropenia
(Kostmann disease). What clinical features of severe congenital neutropenia should the
nurse recognize? (Select all that apply.)
a. Anemia is present.
b. Neutropenia is present.
c. The illness is severe.
d. It has a dominant inheritance pattern.
e. There are decreased eosinophils in the bone marrow.bcThe nurse is preparing to admit a 4-year-old child with chronic benign neutropenia. What
clinical features of chronic benign neutropenia should the nurse recognize? (Select all that
apply.)
a. Gingivitis is present.
b. Anemia is not present.
c. Monocytosis is present.
d. It has an autosomal recessive pattern.
e. Treatment is by bone marrow transplantation.abcThe nurse is caring for a 12-year-old child with -thalassemia. What clinical
manifestations should the nurse expect to observe? (Select all that apply.)
a. Anorexia
b. Unexplained fever
c. Enlarged spleen or liver
d. Bronzed, freckled complexion
e. Precocious sexual developmentabcdWhat childhood cancer may demonstrate patterns of inheritance that suggest a familial
basis?
a. Leukemia
b. Retinoblastoma
c. Rhabdomyosarcoma
d. Osteogenic sarcomabAs part of the diagnostic evaluation of a child with cancer, biopsies are important for
staging. What statement explains what staging means?
a. Extent of the disease at the time of diagnosis
b. Rate normal cells are being replaced by cancer cells
c. Biologic characteristics of the tumor or lymph nodes
d. Abnormal, unrestricted growth of cancer cells producing organ damageaWhat statement related to clinical trials developed for pediatric cancers is most accurate?
a. Are accessible only in major pediatric centers
b. Do not require consent for standard therapy
c. Provide the best available therapy compared with an expected improvement
d. Are standardized to provide the same treatment to all children with the diseasecChemotherapeutic agents are classified according to what feature?
a. Side effects
b. Effectiveness
c. Mechanism of action
d. Route of administrationcWhat type of chemotherapeutic agent alters the function of cells by replacing a hydrogen
atom of a molecule?
a. Plant alkaloids
b. Antimetabolites
c. Alkylating agents
d. Antitumor antibioticscWhat side effect commonly occurs with corticosteroid (prednisone) therapy?
a. Alopecia
b. Anorexia
c. Nausea and vomiting
d. Susceptibility to infectiondWhat chemotherapeutic agent is classified as an antitumor antibiotic?
a. Cisplatin (Platinol AQ)
b. Vincristine (Oncovin)
c. Methotrexate (Texall)
d. Daunorubicin (Cerubidine)dThe nurse is administering an intravenous chemotherapeutic agent to a child with
leukemia. The child suddenly begins to wheeze and have severe urticaria. What nursing
action is most appropriate to initiate?
a. Recheck the rate of drug infusion.
b. Stop the drug infusion immediately.
c. Observe the child closely for next 10 minutes.
d. Explain to the child that this is an expected side effect.bTotal-body irradiation is indicated for what reason?
a. Palliative care
b. Lymphoma therapy
c. Definitive therapy for leukemia
d. Preparation for bone marrow transplantdThe parents of a child with cancer tell the nurse that a bone marrow transplant (BMT) may
be necessary. What information should the nurse recognize as important when discussing
this with the family?
a. BMT should be done at the time of diagnosis.
b. Parents and siblings of the child have a 25% chance of being a suitable donor.
c. If BMT fails, chemotherapy or radiotherapy will need to be continued.
d. Finding a suitable donor involves matching antigens from the human leukocyte
antigen (HLA) system.dAn adolescent will receive a bone marrow transplant (BMT). The nurse should explain
that the bone marrow will be administered by which method?
a. Bone grafting
b. Intravenous infusion
c. Bone marrow injection
d. Intraabdominal infusionbAfter chemotherapy is begun for a child with acute leukemia, prophylaxis to prevent acute
tumor lysis syndrome includes which therapeutic intervention?
a. Hydration
b. Oxygenation
c. Corticosteroids
d. Pain managementaNursing care of the child with myelosuppression from leukemia or chemotherapeutic
agents should include which therapeutic intervention?
a. Restrict oral fluids.
b. Institute strict isolation.
c. Use good hand-washing technique.
d. Give immunizations appropriate for age.cIn teaching parents how to minimize or prevent bleeding episodes when the child is
myelosuppressed, the nurse includes what information?
a. Meticulous mouth care is essential to avoid mucositis.
b. Rectal temperatures are necessary to monitor for infection.
c. Intramuscular injections are preferred to intravenous ones.
d. Platelet transfusions are given to maintain a count greater than 50,000/mm3aA school-age child with leukemia experienced severe nausea and vomiting when receiving
chemotherapy for the first time. What is the most appropriate nursing action to prevent or
minimize these reactions with subsequent treatments?
a. Administer the chemotherapy between meals.
b. Give an antiemetic before chemotherapy begins.
c. Have the child bring favorite foods for snacks.
d. Keep the child NPO (nothing by mouth) until nausea and vomiting subside.bA young child with leukemia has anorexia and severe stomatitis. What approach should
the nurse suggest that the parents try?
a. Relax any eating pressures.
b. Firmly insist that the child eat normally.
c. Serve foods that are either hot or cold.
d. Provide only liquids because chewing is painful.aThe nurse is preparing a child for possible alopecia from chemotherapy. What information
should the nurse include?
a. Wearing hats or scarves is preferable to a wig.
b. Expose head to sunlight to stimulate hair regrowth.
c. Hair may have a slightly different color or texture when it regrows.
d. Regrowth of hair usually begins 12 months after chemotherapy ends.cWhat pain management approach is most effective for a child who is having a bone
marrow test?
a. Relaxation techniques
b. Administration of an opioid
c. EMLA cream applied over site
d. Conscious or unconscious sedationdThe nurse is caring for a child receiving chemotherapy for leukemia. The child's
granulocyte count is 600/mm3
and platelet count is 45,000/mm3
. What oral care should the
nurse recommend for this child?
a. Rinsing mouth with water
b. Daily toothbrushing and flossing
c. Lemon glycerin swabs for cleansing
d. Wiping teeth with moistened gauze or ToothettesbWhat immunization should not be given to a child receiving chemotherapy for cancer?
a. Tetanus vaccine
b. Inactivated poliovirus vaccine
c. Diphtheria, pertussis, tetanus (DPT)
d. Measles, mumps, rubella (MMR)dWhat description identifies the pathophysiology of leukemia?
a. Increased blood viscosity
b. Abnormal stimulation of the first stage of coagulation process
c. Unrestricted proliferation of immature white blood cells (WBCs)
d. Thrombocytopenia from an excessive destruction of plateletscA child with leukemia is receiving intrathecal chemotherapy to prevent which condition?
a. Infection
b. Brain tumor
c. Central nervous system (CNS) disease
d. Drug side effectscA parent tells the nurse that 80% of children with the same type of leukemia as his son's
have a 5-year survival. He believes that because another child on the same protocol as his
son has just died, his son now has a better chance of success. What is the best response by
the nurse?
a. "It is sad for the other family but good news for your child."
b. "Each child has an 80% likelihood of 5-year survival."
c. "The data suggest that 20% of the children in the clinic will die. There are still
many hurdles for your son."
d. "You should avoid the grieving family because you will be benefiting from their
loss."bWhat is a common clinical manifestation of Hodgkin disease?
a. Petechiae
b. Bone and joint pain
c. Painful, enlarged lymph nodes
d. Nontender enlargement of lymph nodesdWhat are the most common clinical manifestations of brain tumors in children?
a. Headaches and vomiting
b. Blurred vision and ataxia
c. Hydrocephalus and clumsy gait
d. Fever and poor fine motor controlaA 5-year-old child is being prepared for surgery to remove a brain tumor. Preparation for
surgery should be based on which information?
a. Removal of the tumor will stop the various signs and symptoms.
b. Usually the postoperative dressing covers the entire scalp.
c. He is not old enough to be concerned about his head being shaved.
d. He is not old enough to understand the significance of the brain.bEssential postoperative nursing management of a child after removal of a brain tumor
includes which nursing care?
a. Turning and positioning every 2 hours
b. Measuring all fluid intake and output
c. Changing the dressing when it becomes soiled
d. Using maximum lighting to ensure accurate observationsbAn adolescent is scheduled for a leg amputation in 2 days for treatment of osteosarcoma.
What approach should the nurse implement?
a. Answer questions with straightforward honesty.
b. Avoid discussing the seriousness of the condition.
c. Explain that although the amputation is difficult, it will cure the cancer.
d. Help the adolescent accept the amputation as better than a long course of
chemotherapy.aWhat is an important priority in dealing with the child suspected of having Wilms tumor?
a. Intervening to minimize bleeding
b. Monitoring temperature for infection
c. Ensuring the abdomen is protected from palpation
d. Teaching parents how to manage the parenteral nutritioncThe mother of an infant tells the nurse that sometimes there is a whitish "glow" in the
pupil of his eye. The nurse should suspect which condition?
a. Brain tumor
b. Retinoblastoma
c. Neuroblastoma
d. RhabdomyosarcomabThe nurse is caring for a 6-year-old child with acute lymphoblastic leukemia (ALL). The
parent states, "My child has a low platelet count, and we are being discharged this
afternoon. What do I need to do at home?" What statement is most appropriate for the
nurse to make?
a. "You should give your child aspirin instead of acetaminophen for fever or pain."
b. "Your child should avoid contact sports or activities that could cause bleeding."
c. "You should feed your child a bland, soft, moist diet for the next week."
d. "Your child should avoid large groups of people for the next week."bOne pediatric oncologic emergency is acute tumor lysis syndrome. Symptoms that this
may be occurring include what?
a. Muscle cramps and tetany
b. Respiratory distress and cyanosis
c. Thrombocytopenia and sepsis
d. Upper extremity edema and neck vein distensionaA child has an absolute neutrophil count (ANC) of 500/mm3
. The nurse should expect to
be administering which prescribed treatment?
a. Platelets
b. Packed red blood cells
c. Zofran (ondansetron)
d. G-CSF (Neupogen) dailydWhat specific gravity of the urine is desired so that hemorrhagic cystitis is prevented?
a. 1.035
b. 1.030
c. 1.025
d. 1.005dA child, age 10 years, has a neuroblastoma and is in the hospital for additional
chemotherapy treatments. What laboratory values are most likely this child's?
a. White blood cell count, 17,000/mm3
; hemoglobin, 15 g/dl
b. White blood cell count, 3,000/mm3
; hemoglobin, 11.5 g/dl
c. Platelets, 450,000/mm3
; hemoglobin, 12 g/dl
d. White blood cell count, 10,000/mm3
; platelets, 175,000/mm3bCalculate the absolute neutrophil count (ANC) for the following: WBC count of 5000
mm3
; neutrophils (segs) of 10%; and nonsegmented neutrophils (bands) of 12%.
a. 110/mm3
b. 500/mm3
c. 1100/mm3
d. 5000/mm3cA child has been diagnosed with a Wilms tumor. What should preoperative nursing care
include?
a. Careful bathing and handling
b. Monitoring of behavioral status
c. Maintenance of strict isolation
d. Administration of packed red blood cellsaWhat is appropriate mouth care for a toddler with mucosal ulceration related to
chemotherapy?
a. Mouthwashes with plain saline
b. Lemon glycerin swabs for cleansing
c. Mouthwashes with hydrogen peroxide
d. Swish and swallow with viscous lidocaineaThe nurse should expect to care for which age of child if the admitting diagnosis is
retinoblastoma?
a. Infant or toddler
b. Preschool- or school-age child
c. School-age or adolescent child
d. AdolescentaPostoperative positioning for a child who has had a medulloblastoma brain tumor
(infratentorial) removed should be which?
a. Trendelenburg
b. Head of bed elevated above heart level
c. Flat on operative side with pillows behind the head
d. Flat, on either side with pillows behind the backdA child is receiving vincristine (Oncovin). The nurse should monitor for which side effect
of this medication?
a. Diarrhea
b. Photosensitivity
c. Constipation
d. OtotoxicityaWhat chemotherapeutic agent can cause an anaphylactic reaction?
a. Prednisone (Deltasone)
b. Vincristine (Oncovin)
c. L-Asparaginase (Elspar)
d. Methotrexate (Trexall)cA child with cancer being treated with chemotherapy is receiving a platelet transfusion.
The nurse understands that the transfused platelets should survive the body for how many
days?
a. 1 to 3 days
b. 4 to 6 days
c. 7 to 9 days
d. 10 to 12 daysaDaily toothbrushing and flossing can be encouraged for the child on chemotherapy when
the platelet count is above which?
a. 10,000/mm3
b. 20,000/mm3
c. 30,000/mm3
d. 40,000/mm3dA parent of a hospitalized child on chemotherapy asks the nurse if a sibling of the
hospitalized child should receive the varicella vaccination. The nurse should give which
response?
a. The sibling can get a varicella vaccination.
b. The sibling should not get a varicella vaccination.
c. The sibling should wait until the child is finished with chemotherapy.
d. The sibling should get varicella-zoster immune globulin if exposed to chickenpox.aThe nurse is collecting a 24-hour urine sample on a child with suspected diagnosis of
neuroblastoma. What finding in the urine is expected with neuroblastomas?
a. Ketones
b. Catecholamines
c. Red blood cells
d. Excessive white blood cellsbA child with osteosarcoma is experiencing phantom limb pain after an amputation. What
prescribed medication is effective for short-term phantom pain relief?
a. Phenytoin (Dilantin)
b. Gabapentin (Neurontin)
c. Valproic Acid (Depakote)
d. Phenobarbital (Phenobarbital)bThe nurse is precepting a new graduate nurse at an ambulatory pediatric hematology and
oncology clinic. What cardinal signs of cancer in children should the nurse make the new
nurse aware of? (Select all that apply.)
a. Sudden tendency to bruise easily
b. Transitory, generalized pain
c. Frequent headaches
d. Excessive, rapid weight gain
e. Gradual, steady fever
f. Unexplained loss of energyacfA child on chemotherapy has developed rectal ulcers. What interventions should the nurse
teach to the child and parents to relieve the discomfort of rectal ulcers? (Select all that
apply.)
a. Warm sitz baths
b. Use of stool softeners
c. Record bowel movements
d. Use of an opioid for discomfort
e. Occlusive ointment applied to the areaabceWhat are favorable prognostic criteria for acute lymphoblastic leukemia? (Select all that
apply.)
a. Male gender
b. CALLA positive
c. Early pre-B cell
d. 2 to 10 years of age
e. Leukocyte count ?7?50,000/mm3bcdThe nurse should teach the family that which residual disabilities can occur for a child
being treated for a brain tumor? (Select all that apply.)
a. Ataxia
b. Anorexia
c. Dysphagia
d. Sensory deficits
e. Crania nerve palsiesacdeThe nurse is caring for a child with retinoblastoma that was treated with an enucleation.
What interventions should the nurse plan for care of an eye socket after enucleation?
(Select all that apply.)
a. Clean the prosthesis.
b. Change the eye pad daily.
c. Keep the opposite eye covered initially.
d. Irrigate the socket daily with a prescribed solution.
e. Apply a prescribed antibiotic ointment after irrigation.bdeWhat guidelines should the nurse follow when handling chemotherapeutic agents? (Select
all that apply.)
a. Use clean technique.
b. Prepare medications in a safety cabinet.
c. Wear gloves designed for handling chemotherapy.
d. Wear face and eye protection when splashing is possible.
e. Discard gloves and protective clothing in a special container.bcdeWhat strategies should the nurse implement to increase nutritional intake for the child
receiving chemotherapy? (Select all that apply.)
a. Allow the child any food tolerated.
b. Fortify foods with nutritious supplements.
c. Allow the child to be involved in food selection.
d. Encourage the parents to place pressure on the importance of eating.
e. Encourage the child to eat favorite foods during infusion of chemotherapy
medications.abcPertussis vaccination should begin at which age?
a. Birth
b. 2 months
c. 6 months
d. 12 monthsbA mother tells the nurse that she does not want her infant immunized because of the
discomfort associated with injections. What should the nurse explain?
a. This cannot be prevented.
b. Infants do not feel pain as adults do.
c. This is not a good reason for refusing immunizations.
d. A topical anesthetic can be applied before injections are given.dA 4-month-old infant comes to the clinic for a well-infant checkup. Immunizations she
should receive are DTaP (diphtheria, tetanus, acellular pertussis) and IPV (inactivated
poliovirus vaccine). She is recovering from a cold but is otherwise healthy and afebrile.
Her older sister has cancer and is receiving chemotherapy. Nursing considerations should
include which?
a. DTaP and IPV can be safely given.
b. DTaP and IPV are contraindicated because she has a cold.
c. IPV is contraindicated because her sister is immunocompromised.
d. DTaP and IPV are contraindicated because her sister is immunocompromised.aWhich serious reaction should the nurse be alert for when administering vaccines?
a. Fever
b. Skin irritation
c. Allergic reaction
d. Pain at injection sitecWhich muscle is contraindicated for the administration of immunizations in infants and
young children?
a. Deltoid
b. Dorsogluteal
c. Ventrogluteal
d. Anterolateral thighbWhich is described as an elevated, circumscribed skin lesion that is less than 1 cm in
diameter and filled with serous fluid?
a. Cyst
b. Papule
c. Pustule
d. VesicledWhich vitamin supplementation has been found to reduce both morbidity and mortality in
measles?
a. A
b. B1
c. C
d. ZincaWhat does impetigo ordinarily results in?
a. No scarring
b. Pigmented spots
c. Atrophic white scars
d. Slightly depressed scarsaWhat often causes cellulitis?
a. Herpes zoster
b. Candida albicans
c. Human papillomavirus
d. Streptococci or staphylococcidLymphangitis (streaking) is frequently seen in what?
a. Cellulitis
b. Folliculitis
c. Impetigo contagiosa
d. Staphylococcal scalded skinaWhat is most important in the management of cellulitis?
a. Burow solution compresses
b. Oral or parenteral antibiotics
c. Topical application of an antibiotic
d. Incision and drainage of severe lesionsbWhat causes warts?
a. A virus
b. A fungus
c. A parasite
d. BacteriaaWhat is the primary treatment for warts?
a. Vaccination
b. Local destruction
c. Corticosteroids
d. Specific antibiotic therapybHerpes zoster is caused by the varicella virus and has an affinity for which?
a. Sympathetic nerve fibers
b. Parasympathetic nerve fibers
c. Lateral and dorsal columns of the spinal cord
d. Posterior root ganglia and posterior horn of the spinal corddTreatment for herpes simplex virus (type 1 or 2) includes which?
a. Corticosteroids
b. Oral griseofulvin
c. Oral antiviral agent
d. Topical or systemic antibioticcWhat should the nurse explain about ringworm?
a. It is not contagious.
b. It is a sign of uncleanliness.
c. It is expected to resolve spontaneously.
d. It is spread by both direct and indirect contact.dWhen giving instructions to a parent whose child has scabies, what should the nurse
include?
a. Treat all family members if symptoms develop.
b. Be prepared for symptoms to last 2 to 3 weeks.
c. Carefully treat only areas where there is a rash.
d. Notify practitioner so an antibiotic can be prescribed.bWhich is usually the only symptom of pediculosis capitis (head lice)?
a. Itching
b. Vesicles
c. Scalp rash
d. Localized inflammatory responseaThe school reviewed the pediculosis capitis (head lice) policy and removed the "no nit"
requirement. The nurse explains that now, when a child is found to have nits, the parents
must do which before the child can return to school?
a. No treatment is necessary with the policy change.
b. Shampoo and then trim the child's hair to prevent reinfestation.
c. The child can remain in school with treatment done at home.
d. Treat the child with a shampoo to treat lice and comb with a fine-tooth comb every
day until nits are eliminated.cThe nurse should know what about Lyme disease?
a. Very difficult to prevent
b. Easily treated with oral antibiotics in stages 1, 2, and 3
c. Caused by a spirochete that enters the skin through a tick bite
d. Common in geographic areas where the soil contains the mycotic spores that cause
the diseasecThe nurse is teaching a nursing student about standard precautions. Which statement made
by the student indicates a need for further teaching?
a. "I will use precautions when I give an infant oral care."
b. "I will use precautions when I change an infant's diaper."
c. "I will use precautions when I come in contact with blood and body fluids."
d. "I will use precautions when administering oral medications to a school-age child."dThe nurse is preparing an airborne infection isolation room for a patient. Which
communicable disease does the patient likely have?
a. Varicella
b. Pertussis
c. Influenza
d. Scarlet feveraAn infant with respiratory syncytial virus (RSV) is being admitted to the hospital. The
nurse should plan to place the infant on which precaution?
a. Enteric
b. Airborne
c. Droplet
d. ContactdThe nurse is administering the first hepatitis A vaccine to an 18-month-old child. When
should the child return to the clinic for the second dose of hepatitis A vaccination?
a. After 2 months
b. After 3 months
c. After 4 months
d. After 6 monthsdThe nurse is preparing to administer a measles, mumps, rubella, and varicella (MMRV)
vaccine. Which is a contraindication associated with administering this vaccine?
a. The child has recently been exposed to an infectious disease.
b. The child has symptoms of a cold but no fever.
c. The child is having intermittent episodes of diarrhea.
d. The child has a disorder that causes a deficient immune system.dAn immunocompromised child has been exposed to chickenpox. What should the nurse
anticipate to be prescribed to the exposed child?
a. Acyclovir (Zovirax)
b. Valacyclovir (Valtrex)
c. Amantadine (Symmetrel)
d. Varicella-zoster immune globulindThe clinic nurse is instructing parents about caring for a toddler with ascariasis (common
roundworm). Which statement made by the parents indicates a need for further teaching?
a. "We will wash our hands often, especially after diaper changes."
b. "We know that roundworm can be transmitted from person to person."
c. "We will be sure to continue the nitazoxanide (Alinia) orally for 3 days."
d. "We will bring a stool sample to the clinic for examination in 2 weeks."bThe nurse is assessing a child suspected of having pinworms. Which is the most common
symptom the nurse expects to assess?
a. Restlessness
b. Distractibility
c. Rectal discharge
d. Intense perianal itchingdA child has been diagnosed with giardiasis. Which prescribed medication should the nurse
expect to administer?
a. Acyclovir (Zovirax)
b. Metronidazole (Flagyl)
c. Erythromycin (Pediazole)
d. Azithromycin (Zithromax)bA child has been diagnosed with scabies. Which statement by the parent indicates
understanding of the nurse's teaching about scabies?
a. "The itching will stop after the cream is applied."
b. "We will complete extensive aggressive housecleaning."
c. "We will apply the cream to only the affected areas as directed."
d. "Everyone who has been in close contact with my child will need to be treated."dAn 18-month-old child has been diagnosed with pediculosis capitis (head lice). Which
prescription should the nurse question if ordered for the child?
a. Malathion (Ovide)
b. Permethrin 1% (Nix)
c. Benzyl alcohol 5% lotion
d. Pyrethrin with piperonyl butoxide (RID)aA child has been diagnosed with cat scratch disease. The nurse explains which
characteristics about this disease?
a. "The disease is usually a benign, self-limiting illness."
b. "The animal that transmitted the disease will also be ill."
c. "The disease is treated with a 5-day course of oral azithromycin."
d. "Symptoms include pruritus, especially at the site of inoculation."aThe nurse is planning care for a child with chickenpox (varicella). Which prescribed
supportive measures should the nurse plan to implement? (Select all that apply.)
a. Administration of acyclovir (Zovirax)
b. Administration of azithromycin (Zithromax)
c. Administration of Vitamin A supplementation
d. Administration of acetaminophen (Tylenol) for fever
e. Administration of diphenhydramine (Benadryl) for itchingadeThe nurse is planning care for an infant with candidiasis (moniliasis) diaper dermatitis.
Which topical ointments may be prescribed for the patient? (Select all that apply.)
a. Nystatin
b. Bactroban
c. Neosporin
d. Miconazole
e. ClotrimazoleadeThe nurse is conducting discharge teaching to an adolescent with a methicillin-resistant
staphylococcus aureus (MRSA) infection. What should the nurse include in the
instructions? (Select all that apply.)
a. Avoid sharing of towels and washcloths.
b. Launder clothes and bedding in cold water.
c. Use bleach when laundering towels and washcloths.
d. Take a daily bath or shower with an antibacterial soap.
e. Apply mupirocin (Bactroban) to the nares twice a day for 2 to 4 weeks.adeThe clinic nurse is reviewing the immunization guidelines for hepatitis B. Which are true
of the guidelines for this vaccine? (Select all that apply.)
a. The hepatitis B vaccination series should be begun at birth.
b. The adolescent not vaccinated at birth does not have a need to be vaccinated.
c. Any child not vaccinated at birth should receive two doses at least 4 months apart.
d. An unimmunized 10-year-old child should receive three doses administered 4
weeks apart.adThe nurse is planning to administer immunizations to a 6-month-old infant. Which
interventions should the nurse implement to minimize local reactions from the vaccines?
(Select all that apply.)
a. Select a needle length of 1 inch.
b. Administer in the deltoid muscle.
c. Inject the vaccine into the vastus lateralis.
d. Draw the vaccine up from a vial with a filter needle.
e. Change the needle on the syringe after drawing up the vaccine and before
injecting.acThe nurse is preparing to admit a 5-year-old child who developed lesions of varicella
(chickenpox) 3 days ago. Which clinical manifestations of varicella should the nurse
expect to observe? (Select all that apply.)
a. Nonpruritic rash
b. Elevated temperature
c. Discrete rose pink rash
d. Vesicles surrounded by an erythematous base
e. Centripetal rash in all three stages (papule, vesicle, and crust)bdeThe nurse is preparing to admit a 1-year-old child with pertussis (whooping cough). Which
clinical manifestations of pertussis should the nurse expect to observe? (Select all that
apply.)
a. Earache
b. Coryza
c. Conjunctivitis
d. Low-grade fever
e. Dry hacking coughbdeThe nurse is preparing to admit a 2-year-old child with rubella (German measles). Which
clinical manifestations of rubella should the nurse expect to observe? (Select all that
apply.)
a. Sore throat
b. Conjunctivitis
c. Koplik spots
d. Lymphadenopathy
e. Discrete, pinkish red maculopapular exanthemaabdeThe clinic nurse is assessing a child with bacterial conjunctivitis (pink eye). Which
assessment findings should the nurse expect? (Select all that apply.)
a. Itching
b. Swollen eyelids
c. Inflamed conjunctiva
d. Purulent eye drainage
e. Crusting of eyelids in the morningbcdeThe clinic nurse is assessing a child with a heavy ascariasis lumbricoides (common
roundworm) infection. Which assessment findings should the nurse expect? (Select all that
apply.)
a. Anemia
b. Anorexia
c. Irritability
d. Intestinal colic
e. Enlarged abdomenbcde
Other sets by this creator
Exam 4 -- 473
154 terms
473 Exam 3
131 terms
473 -- Exam 2 cont.
122 terms
473 Exam 2 -- part 1
137 terms
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