Nokea
A 6-year-old child with leukemia asks, 'Who will take care of me in heaven?' What is the best response by the nurse?
- A. Who do you think will take care of you?'
- B. Your grandparents and God will take care of you.'
- C. Your mom will know more about that than I do.'
- D. Why are you asking me that?'
Correct Answer: A
Rationale: This response gives the child an opportunity to verbalize his or her feelings and concerns, whereas closed responses shut off communication.
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Why would the nurse urge the family of a dying 12-year-old boy to include his 8-year-old sister in care? (Select all that apply.)
- A. She will feel less neglected by the parents.
- B. She can make amends for past hostilities to her brother.
- C. She will feel increased helplessness.
- D. She can express her feelings through care.
- E. She can experience being supportive of her parents and brother.
Correct Answer: A,B,D,E
Rationale: Including the sibling in care helps reduce feelings of neglect, allows expression of feelings, and fosters a sense of support and connection.
The nurse notes that a 4-year-old child's gums bleed easily and he has bruising and petechiae on his extremities. Which lab value is consistent with these symptoms?
- A. Platelet count of 25,000/mm?³
- B. Hemoglobin level of 8 g/dL
- C. Hematocrit level of 36%
- D. Leukocyte count of 14,000/mm?³
Correct Answer: A
Rationale: The normal platelet count is 150,000 to 400,000/mm?³. This finding is very low, indicating an increased bleeding potential.
How has synthetic recombinant antihemophilic factor improved the management of hemophilia? (Select all that apply.)
- A. Eliminates the need for frequent transfusions.
- B. Can be administered by family at home.
- C. Prevents hemorrhage.
- D. Reduces cost of care of the hemophiliac.
- E. Reduces risk of HIV and hepatitis A and B transmission.
Correct Answer: A,B,D,E
Rationale: Synthetic recombinant antihemophilic factor reduces transfusion needs, allows home administration, lowers costs, and minimizes infection risks.
A child with thalassemia major receives blood transfusions frequently. What is a complication of repeated blood transfusions?
- A. Hemarthrosis
- B. Hematuria
- C. Hemoptysis
- D. Hemosiderosis
Correct Answer: D
Rationale: As a result of repeated blood transfusions, excessive deposits of iron (hemosiderosis) are stored in tissues.
The nurse is caring for a child with a low platelet count. What skin assessments would alert the nurse to bleeding? (Select all that apply.)
- A. Petechiae
- B. Purpura
- C. Ecchymosis
- D. Hematoma
- E. Lymphadenopathy
Correct Answer: A,B,C,D
Rationale: The reduction or destruction of platelets in the body interferes with the clotting mechanism, leading to skin lesions such as petechiae, purpura, ecchymosis, and hematoma.