Nokea
What pain management approach is most effective for a child who is having a bone marrow test?
- A. Relaxation techniques
- B. Administration of an opioid
- C. EMLA cream applied over site
- D. Conscious or unconscious sedation
Correct Answer: D
Rationale: Conscious or unconscious sedation is most effective for managing pain during bone marrow tests, with relaxation, opioids, and EMLA as adjuncts. Sedation ensures comfort and minimizes distress during this invasive procedure.
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In teaching parents how to minimize or prevent bleeding episodes when the child is myelosuppressed, the nurse includes what information?
- A. Meticulous mouth care is essential to avoid mucositis.
- B. Rectal temperatures are necessary to monitor for infection.
- C. Intramuscular injections are preferred to intravenous ones.
- D. Platelet transfusions are given to maintain a count greater than 50,000/mm3.
Correct Answer: A
Rationale: Meticulous mouth care prevents gingival bleeding and mucositis in myelosuppressed children with low platelets. Rectal temperatures and intramuscular injections risk bleeding and infection, and platelet transfusions are typically given below 10,000/mm3 or with active bleeding.
Total-body irradiation is indicated for what reason?
- A. Palliative care
- B. Lymphoma therapy
- C. Definitive therapy for leukemia
- D. Preparation for bone marrow transplant
Correct Answer: D
Rationale: Total-body irradiation destroys the immune system to prepare for bone marrow transplant, increasing complication risks until engraftment. It?s not used for palliative care, lymphoma, or leukemia as a primary treatment, which rely on other modalities.
A young child with leukemia has anorexia and severe stomatitis. What approach should the nurse suggest that the parents try?
- A. Relax any eating pressures.
- B. Firmly insist that the child eat normally.
- C. Serve foods that are either hot or cold.
- D. Provide only liquids because chewing is painful.
Correct Answer: A
Rationale: Relaxing eating pressures and offering soft, bland foods with mouthwashes and anesthetics support nutrition in children with stomatitis and anorexia. Insisting on normal eating creates conflict, hot/cold foods may irritate mucosa, and liquids alone are insufficient.
A school-age child with leukemia experienced severe nausea and vomiting when receiving chemotherapy for the first time. What is the most appropriate nursing action to prevent or minimize these reactions with subsequent treatments?
- A. Administer the chemotherapy between meals.
- B. Give an antiemetic before chemotherapy begins.
- C. Have the child bring favorite foods for snacks.
- D. Keep the child NPO (nothing by mouth) until nausea and vomiting subside.
Correct Answer: B
Rationale: Administering an antiemetic like ondansetron before chemotherapy prevents anticipatory nausea and vomiting. Giving chemotherapy between meals doesn?t prevent nausea, favorite foods may cause aversions, and NPO status risks dehydration and discomfort.
Nursing care of the child with myelosuppression from leukemia or chemotherapeutic agents should include which therapeutic intervention?
- A. Restrict oral fluids.
- B. Institute strict isolation.
- C. Use good hand-washing technique.
- D. Give immunizations appropriate for age.
Correct Answer: C
Rationale: Good hand-washing reduces infection risk in myelosuppressed children by minimizing exposure to pathogens. Oral fluids are encouraged, strict isolation isn?t needed, and immunizations are ineffective or risky during immunosuppression.