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After teaching the parents of a child newly diagnosed with leukemia about the disease, which of the following descriptions given by the mother best indicates that she understands the nature of leukemia?
- A. The disease is an infection resulting in increased white blood cell production.
- B. The disease is a type of cancer caused by an increase in immature white blood cells.
- C. The disease is an inflammation associated with enlargement of the lymph nodes.
- D. The disease is an allergic disorder involving increased circulating antibodies in the blood.
Correct Answer: B
Rationale: Leukemia is a cancer characterized by excessive immature white blood cells. Other descriptions are incorrect.
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The nurse is preparing to administer the last dose of ceftriaxone (Rocephin) before discharge to a 1-year-old but finds the I.V. has occluded. The nurse should:
- A. Restart the I.V.
- B. Administer the medication intramuscularly.
- C. Arrange for early discharge.
- D. Ask the provider to request an order change.
Correct Answer: B
Rationale: Administering ceftriaxone intramuscularly is appropriate when the I.V. is occluded, ensuring the child receives the final dose before discharge.
The health care team has noticed an increase in I.V. infiltrations on the pediatric floor. As part of a Plan, Do, Study, Act quality improvement plan the team should do the following in which order?
- A. Analyze the data.
- B. Decide to monitor I.V. gauges.
- C. Perform chart audits.
- D. Write a new I.V. insertion policy.
Correct Answer: B,C,A,D
Rationale: The PDSA cycle involves planning (deciding to monitor), doing (chart audits), studying (analyzing data), and acting (writing a new policy).
The parents of a child tell the nurse that they feel guilty because their child almost drowned. Which of the following remarks by the nurse would be most appropriate?
- A. I can understand why you feel guilty, but these things happen.'
- B. Tell me a little bit more about your feelings of guilt.'
- C. You should not have taken your eyes off of your child.'
- D. You really shouldn't feel guilty; you're lucky because your child will be all right.'
Correct Answer: B
Rationale: Encouraging parents to express their feelings facilitates therapeutic communication and supports emotional processing.
An adolescent complains of chest pain and goes to the school nurse. The nurse determines that the teenager has a history of asthma but has had no problems for years. Which of the following should the nurse do next?
- A. Call the adolescent's parent.
- B. Have the adolescent lie down for 30 minutes.
- C. Obtain a peak flow reading.
- D. Give two puffs of a short-acting bronchodilator.
Correct Answer: C
Rationale: Obtaining a peak flow reading is the next step to objectively assess the adolescent's respiratory status, given the history of asthma and new chest pain, which could indicate an asthma exacerbation.
A 17-year-old female with severe nodular acne is considering treatment with isotretinoin (Accutane). Prior to beginning the medication, the nurse explains that the client will be required to:
- A. Enroll in a risk management plan.
- B. Egypt in a risk management plan.
- C. Begin an effective form of birth control.
- D. Temporarily give up sports.
Correct Answer: C
Rationale: Isotretinoin has a high risk of teratogenicity, requiring strict contraception to prevent pregnancy during treatment. A risk management plan (e.g., iPLEDGE) is also required, but the most critical initial step emphasized is effective birth control.