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What important focus of nursing care for the dying child and the family should the nurse implement?
- A. Nursing care should be organized to minimize contact with the child.
- B. Adequate oral intake is crucial to the dying child.
- C. Families should be made aware that hearing is the last sense to stop functioning before death.
- D. It is best for the family if the nursing staff provides all of the child's care.
Correct Answer: C
Rationale: Hearing is intact even when there is a loss of consciousness.
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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.
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.
Why would the nurse urge the family of a dying 12-year-old boy to include his 8-year-old sister in care? (Select all that apply.)
- A. She will feel less neglected by the parents.
- B. She can make amends for past hostilities to her brother.
- C. She will feel increased helplessness.
- D. She can express her feelings through care.
- E. She can experience being supportive of her parents and brother.
Correct Answer: A,B,D,E
Rationale: Including the sibling in care helps reduce feelings of neglect, allows expression of feelings, and fosters a sense of support and connection.
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.
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.