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Which is the most definitive diagnosis of leukemia?
- A. A detailed history that includes bone pain and recurrent infections
- B. A lumbar puncture to ascertain if leukemic cells are in the cerebral spinal fluid
- C. A CBC with differential to check the morphology of all the blood cells
- D. A bone marrow biopsy will show an infiltrate of blast cells
Correct Answer: D
Rationale: The correct answer is D: A bone marrow biopsy will show an infiltrate of blast cells. A bone marrow biopsy is the gold standard for diagnosing leukemia as it provides direct visualization of the bone marrow cells. In leukemia, there is an abnormal proliferation of immature cells called blast cells. Therefore, the presence of blast cells in the bone marrow biopsy confirms the diagnosis.
A: A detailed history may provide valuable information, but it is not definitive for diagnosing leukemia.
B: A lumbar puncture is more relevant for diagnosing central nervous system involvement in leukemia, not for confirming the diagnosis itself.
C: A CBC with differential can show abnormalities in blood cell counts, but it does not provide direct visualization of blast cells in the bone marrow.
E, F, G: No additional options provided.
In summary, the most definitive diagnosis of leukemia is confirmed through a bone marrow biopsy, which directly shows the presence of blast cells, distinguishing it from the other choices.
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A 36 pound almost 3-year-old arrives to the ED with dehydration. The provider orders an IV fluid bolus, 15 ml/kg over 30 minutes. How many ml will the nurse administer?
- A. 164 ml
- B. 246 ml
- C. 460 ml
- D. 640 ml
Correct Answer: B
Rationale: The correct answer is B: 246 ml. To calculate the IV fluid bolus amount, first, we need to determine the child's weight in kilograms: 36 lbs ÷ 2.2 = 16.36 kg. Next, multiply the weight in kg by the ordered dose of 15 ml/kg: 16.36 kg x 15 ml/kg = 245.4 ml. Since it is recommended to round up in pediatric dosing, the nurse will administer 246 ml. Choice A is incorrect as it underestimates the dose. Choices C and D are incorrect as they overestimate the dose.
Which is an effective strategy to reduce the stress of burn dressing procedures for a 6-year-old child?
- A. Give the child as many choices as possible
- B. Reassure the child that dressing changes are not painful
- C. Explain to the child why analgesics cannot be used
- D. Encourage the child to master stress with controlled passivity
Correct Answer: A
Rationale: The correct answer is A: Give the child as many choices as possible. By providing the child with choices, you empower them and give them a sense of control over the situation, reducing feelings of helplessness and stress. This strategy helps the child feel more involved and less anxious during the burn dressing procedure. Choices B, C, and D are incorrect because reassuring the child about pain, explaining why analgesics cannot be used, or encouraging controlled passivity may not directly address the child's emotional distress and lack of control in the situation. It is essential to prioritize the child's emotional well-being and sense of autonomy in managing stress during medical procedures.
Signs of digoxin toxicity include of the following (Select all that apply):
- A. Vomiting
- B. Poor feeding
- C. Constipation
- D. Bradycardia
Correct Answer: A,B,D
Rationale: The correct signs of digoxin toxicity are vomiting, poor feeding, and bradycardia. Vomiting is a common early sign due to the drug's effect on the gastrointestinal system. Poor feeding can occur as a result of nausea and anorexia. Bradycardia is a classic sign of digoxin toxicity due to its effect on cardiac function. Constipation is not typically associated with digoxin toxicity. In summary, A, B, and D are correct as they align with the expected symptoms of digoxin toxicity, whereas C is incorrect as constipation is not a common sign.
What is the purpose of pediatric hospice?
- A. Provide pain relief so the child doesn't know they are dying
- B. Extend the dying process so the child and family can say goodbye
- C. Hasten the dying process to stop the suffering
- D. Support the highest quality of life possible for whatever time remains
Correct Answer: D
Rationale: The correct answer is D: Support the highest quality of life possible for whatever time remains. Pediatric hospice aims to provide comprehensive care to children with life-limiting illnesses, focusing on enhancing their quality of life through physical, emotional, and spiritual support. This approach prioritizes symptom management, comfort, and dignity for the child, ensuring they live as fully as possible until the end. Other choices are incorrect because A does not acknowledge the child's awareness, B may not align with the child's wishes, and C goes against the ethical principles of hospice care.
The nurse is educating parents of a sickle cell patient regarding infection prevention. Which statement best indicates the parent understands the child's risk for infection?
- A. If the child has a fever, they need to stay home from school
- B. Antibiotics should be administered sparingly to prevent resistant infections in this population
- C. Children with sickle cell disease are at risk for infection due to impaired splenic function
- D. If the child is showing signs of crisis, a cup of hot tea can prevent the red blood cells from clumping rapidly
Correct Answer: C
Rationale: The correct answer is C. Children with sickle cell disease are at risk for infection due to impaired splenic function. This is because the spleen plays a crucial role in fighting infections, and individuals with sickle cell disease often have impaired splenic function, making them more susceptible to infections.
Explanation for other choices:
A: If the child has a fever, they need to stay home from school - While it is important for sickle cell patients to avoid exposure to infections, staying home from school only when the child has a fever does not address the overall risk of infection in these patients.
B: Antibiotics should be administered sparingly to prevent resistant infections in this population - While antibiotic resistance is a concern, the statement does not specifically address the child's risk for infection due to impaired splenic function.
D: If the child is showing signs of crisis, a cup of hot tea can prevent the red blood cells from clumping rapidly - This statement is incorrect as hot tea does not prevent