Nokea
The nurse notes that a 4-year-old child's gums bleed easily and he has bruising and petechiae on his extremities. Which lab value is consistent with these symptoms?
- A. Platelet count of 25,000/mm?³
- B. Hemoglobin level of 8 g/dL
- C. Hematocrit level of 36%
- D. Leukocyte count of 14,000/mm?³
Correct Answer: A
Rationale: The normal platelet count is 150,000 to 400,000/mm?³. This finding is very low, indicating an increased bleeding potential.
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The nurse, caring for a child receiving chemotherapy, notes that the child's abdomen is firm and slightly distended. There is no record of a bowel movement for the last 2 days. What do these assessment findings suggest?
- A. Peripheral neuropathy
- B. Stomatitis
- C. Myelosuppression
- D. Hemorrhage
Correct Answer: A
Rationale: Peripheral neuropathy may be signaled by severe constipation resulting from decreased nerve sensations in the bowel.
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.
What will the nurse teach the parents of a child with a low platelet count to avoid?
- A. Benadryl
- B. Aspirin
- C. Caffeine
- D. Prednisone
Correct Answer: B
Rationale: Aspirin interferes with platelet function and should be avoided to prevent the risk of prolonged bleeding.
What should the nurse closely assess in a child receiving a transfusion?
- A. Fever
- B. Lethargy
- C. Jaundice
- D. Bradycardia
Correct Answer: A
Rationale: The child receiving a blood transfusion is observed for signs of a transfusion reaction including chills, itching, fever, rash, headache, and back pain.
The nurse explains that the COPP medical regimen for the treatment of Hodgkin's disease uses a combination of which drugs? (Select all that apply.)
- A. Vincristine
- B. Cyclophosphamide
- C. Methotrexate
- D. Prednisone
- E. Procarbazine hydrochloride
Correct Answer: A,B,D,E
Rationale: The COPP regimen includes cyclophosphamide, vincristine, prednisone, and procarbazine hydrochloride for treating Hodgkin's disease.