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When developing the discharge plan for a child who had a nephrectomy for a Wilms' tumor, the nurse identifies outcomes to prevent damage to the child's remaining kidney and accomplish which of the following?
- A. Minimize pain.
- B. Prevent dependent edema.
- C. Prevent urinary tract infection.
- D. Minimize sodium intake.
Correct Answer: C
Rationale: Preventing UTIs protects kidney function.
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A 12-year-old with leukemia will be taking vincristine. The nurse should encourage the child to eat what kind of diet?
- A. High-residue.
- B. Low-residue.
- C. Low-fat.
- D. High-calorie.
Correct Answer: D
Rationale: A high-calorie diet supports energy needs during leukemia treatment, especially with vincristine, which doesn't require dietary restrictions.
A nurse is teaching the parents of a child newly diagnosed with celiac disease. Which food should the nurse instruct them to avoid?
- A. Rice.
- B. Wheat.
- C. Corn.
- D. Potatoes.
Correct Answer: B
Rationale: Celiac disease requires a gluten-free diet, avoiding wheat, barley, and rye. Rice, corn, and potatoes are gluten-free and safe.
Laboratory findings indicate that a child with leukemia is also anemic. The nurse interprets this finding as most likely resulting from which of the following?
- A. Inadequate dietary folic acid intake.
- B. Decreased red blood cell production.
- C. Increased destruction of red blood cells by lymphocytes.
- D. Progressive replacement of bone marrow with scar tissue.
Correct Answer: B
Rationale: Leukemia crowds out bone marrow, reducing red blood cell production, causing anemia. Other causes are less likely.
The nurse is preparing to administer furosemide (Lasix) to a 3-year-old with a heart defect. The nurse verifies the child's identity by checking the arm band and:
- A. Asking the child to state her name.
- B. Checking the room number.
- C. Asking the child to tell her birth date.
- D. Asking the parent the child's name.
Correct Answer: D
Rationale: Asking the parent is appropriate for a 3-year-old, who may not reliably state their name or birth date. Room numbers are not reliable identifiers.
A parent of a child with a moderate head injury asks the nurse, 'How will you know if my child is getting worse?' The nurse should tell the parents that the best indicator of the child's brain function is:
- A. The vital signs.
- B. Level of consciousness.
- C. Reactions of the pupils.
- D. Motor strength.
Correct Answer: B
Rationale: Level of consciousness is the most sensitive indicator of brain function, reflecting changes in neurological status.