Nokea
The nurse and parents are planning for the discharge of a child with leukemia who is receiving dactinomycin (actinomycin D) and vincristine (Oncovin). The nurse should teach the parents to:
- A. Encourage increased fluid intake.
- B. Keep the child out of the sun.
- C. Monitor the child's heart rate.
- D. Observe the child for drowsiness.
Correct Answer: A
Rationale: Increased fluid intake helps flush chemotherapy drugs, reducing toxicity. Sun protection and monitoring are less critical.
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A 16-month-old child diagnosed with Kawasaki disease (KD) is very irritable, refuses to eat, and exhibits peeling skin on the hands and feet. The nurse should do which of the following first?
- A. Apply lotion to the hands and feet.
- B. Offer foods the toddler likes.
- C. Place the toddler in a quiet environment.
- D. Encourage the parents to get some rest.
Correct Answer: C
Rationale: Irritability in Kawasaki disease is often due to discomfort and inflammation. A quiet environment reduces stimulation and promotes comfort, addressing the primary issue first.
An adolescent with chronic renal failure is scheduled to go home with a peritoneal dialysis catheter in place. When developing the discharge teaching plan for the client and family focusing on psychosocial needs, which of the following areas should be a top priority to include?
- A. Advantages of limiting social activities and contacts for the first few months.
- B. Not disclosing information about the peritoneal dialysis to people outside the family.
- C. Possible effect on body image of the presence of an abdominal catheter.
- D. Importance of relying on parents to do the dialysis and dressing changes.
Correct Answer: C
Rationale: Body image concerns are significant.
An adolescent is to receive radioactive iodine for Graves' diseases. Which statement by the client reflects the need for more teaching?
- A. I plan to talk on Facebook since I have to keep several feet from my friends for 3 days.
- B. Taking radioactive iodine will not affect my ability to have children in the future.
- C. The advantage of radioactive iodine is that I will not need future medication for my disease.
- D. I should try to use a separate bathroom from the rest of my family for several days.
Correct Answer: C
Rationale: Radioactive iodine often leads to hypothyroidism, requiring lifelong thyroid hormone replacement. Options A, B, and D reflect correct understanding of radiation precautions and fertility.
After the acute stage following an ingestion of drain cleaner by a child, the nurse should be alert for the development of which of the following as a likely complication?
- A. Tracheal stenosis.
- B. Tracheal varices.
- C. Esophageal strictures.
- D. Esophageal diverticula.
Correct Answer: C
Rationale: Corrosive ingestion can scar the esophagus, leading to strictures. Tracheal complications are less common unless the airway is directly affected, and diverticula are not typical.
A male adolescent who underwent repair of an inguinal hernia earlier today and is getting ready to go home receives instructions about resuming physical activities. Which of the following statements would indicate that he has understood the instructions?
- A. I can start riding my bike next week.
- B. I have to skip physical education classes for 2 weeks.
- C. I can start wrestling again in 3 weeks.
- D. I can return to my weight-lifting class in 2 weeks.
Correct Answer: B
Rationale: Avoiding strenuous activities like PE for 2 weeks prevents strain on the surgical site.