Nokea
A child has just been diagnosed with acute lymphoblastic leukemia. What is the result of an overproduction of immature white blood cells in the bone marrow?
- A. Decreased T-cell production
- B. Decreased hemoglobin
- C. Increased blood clotting
- D. Increased susceptibility to infection
Correct Answer: D
Rationale: An overproduction of immature white blood cells increases the child's susceptibility to infection.
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What would the nurse include in a teaching plan about mouth care of a child receiving chemotherapy?
- A. Use commercial mouthwash.
- B. Clean teeth with a soft toothbrush.
- C. Avoid use of a Water-Pik.
- D. Inspect the mouth weekly for ulcerations.
Correct Answer: B
Rationale: A soft toothbrush reduces capillary damage and mucous membrane breakdown and prevents bleeding and infection.
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.
The child receiving a transfusion complains of back pain and itching. What is the best initial action by the nurse?
- A. Notify the charge nurse.
- B. Disconnect intravenous lines immediately.
- C. Give diphenhydramine (Benadryl).
- D. Clamp off blood and keep line open with normal saline.
Correct Answer: D
Rationale: If a blood transfusion reaction occurs, the first action is to stop the blood infusion, keep the line open with normal saline, and notify the charge nurse.
What are the classic symptoms of thalassemia major (Cooley's anemia)? (Select all that apply.)
- A. Hepatomegaly
- B. Jaundice
- C. Protruding teeth
- D. Pathological fractures
- E. Renal failure
Correct Answer: A,B,C,D
Rationale: Classic symptoms of thalassemia major include hepatomegaly, jaundice, protruding teeth, and pathological fractures due to bone marrow expansion.
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.