Nokea
Laboratory findings indicate that a child with leukemia is also anemic. The nurse interprets this finding as most likely resulting from which of the following?
- A. Inadequate dietary folic acid intake.
- B. Decreased red blood cell production.
- C. Increased destruction of red blood cells by lymphocytes.
- D. Progressive replacement of bone marrow with scar tissue.
Correct Answer: B
Rationale: Leukemia crowds out bone marrow, reducing red blood cell production, causing anemia. Other causes are less likely.
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When developing the plan of care for a child with early Duchenne's muscular dystrophy, which of the following nursing goals is the priority?
- A. Encouraging early wheelchair use.
- B. Fostering social interactions.
- C. Maintaining function of unaffected muscles.
- D. Prevent circulatory impairment.
Correct Answer: C
Rationale: Maintaining function of unaffected muscles is the priority to prolong mobility and independence in early Duchenne's muscular dystrophy.
The nurse is preparing to administer furosemide (Lasix) to a 3-year-old with a heart defect. The nurse verifies the child's identity by checking the arm band and:
- A. Asking the child to state her name.
- B. Checking the room number.
- C. Asking the child to tell her birth date.
- D. Asking the parent the child's name.
Correct Answer: D
Rationale: Asking the parent is appropriate for a 3-year-old, who may not reliably state their name or birth date. Room numbers are not reliable identifiers.
The nurse is caring for a child in Bryant's traction (see figure). The nurse should:
- A. Adjust the weights on the legs until the buttocks rest on the bed.
- B. Provide frequent skin care.
- C. Place a pillow under the buttocks.
- D. Remove the elastic leg wraps every 8 hours for 10 minutes.
Correct Answer: B
Rationale: Frequent skin care is essential in Bryant's traction to prevent pressure ulcers due to prolonged immobility.
An infant diagnosed with Hirschsprung's disease is scheduled to receive a temporary colostomy. When initially discussing the diagnosis and treatment with the parents, which of the following would be most appropriate?
- A. Assessing the adequacy of their coping skills.
- B. Reassuring them that their child will be fine.
- C. Encouraging them to ask questions.
- D. Giving them printed material on the procedure.
Correct Answer: C
Rationale: Encouraging questions promotes understanding and engagement with the treatment plan.
The nurse is caring for a child in Bryant’s traction (see fi gure). The nurse should:
- A. Adjust the weights on the legs until the buttocks rest on the bed.
- B. Provide frequent skin care.
- C. Place a pillow under the buttocks.
- D. Remove the elastic leg wraps every 8 hours for 10 minutes.
Correct Answer: B
Rationale: The traction is positioned correctly; the nurse should provide frequent skin care to the back and shoulder areas. The hips and buttocks should be lifted off the bed to provide counter traction; the nurse should not adjust the weights. The nurse should not place a pillow under the buttocks as this would prevent counter traction. The elastic wraps should remain on the legs unless permitted by the physician.