Nokea
The nurse finds an adolescent with Hodgkin's disease crying. The adolescent says, 'I am so scared.' What is the most appropriate nursing response to this comment?
- A. I understand how you must feel.'
- B. You shouldn't feel that way.'
- C. Is this the strongest feeling you've had today?'
- D. Tell me what's got you scared.'
Correct Answer: D
Rationale: The nurse should encourage the adolescent to express her feelings and concerns.
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Which statement made by a parent indicates an understanding of health maintenance of a child with sickle cell disease?
- A. I should give my child a daily iron supplement.'
- B. It is important for my child to drink plenty of fluids.'
- C. He needs to wear protective equipment if he plays contact sports.'
- D. He shouldn't receive any immunizations until he is older.'
Correct Answer: B
Rationale: Prevention of dehydration, which can trigger the sickling process, is a priority goal in the care of a child with sickle cell disease.
The most recent blood count for a child who received chemotherapy last week shows neutropenia. What is the priority nursing diagnosis for this child?
- A. Risk for infection
- B. Risk for hemorrhage
- C. Altered skin integrity
- D. Disturbance in body image
Correct Answer: A
Rationale: The child with neutropenia is at risk for infection.
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.
The nurse is caring for a child with a low platelet count. What skin assessments would alert the nurse to bleeding? (Select all that apply.)
- A. Petechiae
- B. Purpura
- C. Ecchymosis
- D. Hematoma
- E. Lymphadenopathy
Correct Answer: A,B,C,D
Rationale: The reduction or destruction of platelets in the body interferes with the clotting mechanism, leading to skin lesions such as petechiae, purpura, ecchymosis, and hematoma.
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.