Nokea
The 9-year-old child with leukemia who is on palliative care has drawn a picture of a boy under a huge black cloud that has lightning coming out of it. Which would be an appropriate intervention for the nurse?
- A. What is this picture about?'
- B. Are you afraid of lightning?'
- C. I bet this is a picture of you, isn't it?'
- D. Is it about to rain in your picture?'
Correct Answer: A
Rationale: Asking what the child has drawn is a neutral and nonthreatening question. Drawings can give a clue to perceptions and emotions that a young child may not be able to verbalize. The nurse should not try to interpret the drawing.
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In caring for a patient with multiple myeloma, which should the nurse prioritize from the plan of care?
- A. Limit fluid intake to less than 1000 mL/day
- B. Closely supervise and assist when ambulating
- C. Strain all urine for kidney crystals
- D. Limit the use of an analgesic
Correct Answer: B
Rationale: Because of the constant threat of pathologic fractures, ambulation should be carefully supervised and assisted. Fluids are not restricted. Uric acid is increased and may crystalize in the kidney, but straining is not necessary. Analgesia is necessary for relief of bone pain.
A child with hemophilia is hospitalized with hemarthrosis. Which should the nurse caring for that child expect to implement when following the plan of care?
- A. Use analgesia sparingly.
- B. Apply warm compresses to reduce hemorrhages in the joint.
- C. Encourage vigorous joint movement exercises to keep the joints flexible.
- D. Reinforce instructions to receive factor VIII infusions prophylactically
Correct Answer: D
Rationale: Prophylactic infusions of factor VIII reduce episodes of hemarthrosis.
The typical medical treatment of polycythemia vera involves repeated phlebotomies for which intended benefit?
- A. stimulate bone marrow.
- B. Reduce blood viscosity
- C. increase hemoglobin.
- D. reduce symptoms of gout.
Correct Answer: B
Rationale: Repeated phlebotomy decreases blood viscosity and prevent blood clots.
Erythropoiesis is the term referring to which process?
- A. Destruction of older red blood cells
- B. Lack of folic acid to create new red blood cells
- C. Releasing white blood cells in response to infection
- D. Production of new red blood cells in the bone marrow
Correct Answer: D
Rationale: Erythropoiesis is the term used to describe the production of new red blood cells in the bone marrow.
The peripheral smear is a diagnostic test performed for which reason?
- A. assesses the level of hemoglobin.
- B. measures antibody production.
- C. examines the shape and structure of cells.
- D. identifies possible sources of infection
Correct Answer: C
Rationale: The peripheral smear allows the study of the size, structure, and shape of cells.