Question 1

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?

Accepted Answer

The normal platelet count is 150,000 to 400,000/mm³.This finding is very low,indicating an increased bleeding potential.

Question 2

On admission,a child with leukemia has widespread purpura and a platelet count of 19,000/mm³.What is the priority nursing intervention?

Accepted Answer

When platelets are low,the greatest danger is spontaneous intracranial bleeding.Neurological assessments are therefore a priority of care.

Question 3

What will the nurse teach the parents of a child with a low platelet count to avoid?

Accepted Answer

Aspirin interferes with platelet function and should be avoided to prevent the risk of prolonged bleeding.

Question 4

A 6-year-old with leukemia asks,"Who will take care of me in heaven?" What is the best response by the nurse?

Accepted Answer

This response gives the child an opportunity to verbalize his or her feelings and concerns,whereas closed responses shut off communication.The asking of a "why" question is not therapeutic as it calls for justification.

Question 5

The child receiving a transfusion complains of back pain and itching.What is the best initial action by the nurse?

Accepted Answer

If a blood transfusion reaction occurs,the first action is to stop the blood infusion,keep the line open with normal saline,and notify the charge nurse.

Question 6

What would the nurse include in a teaching plan about mouth care of a child receiving chemotherapy?

Accepted Answer

A soft toothbrush reduces capillary damage and mucous membrane breakdown and prevents bleeding and infection.Commercial mouthwashes may kill oral flora that combat infection.Water-Pik is useful for toughening gums.

Question 7

What should the nurse closely assess in a child receiving a transfusion?

Accepted Answer

The child receiving a blood transfusion is observed for signs of a transfusion reaction including chills,itching,fever,rash,headache,and back pain.

Question 8

A child with thalassemia major receives blood transfusions frequently.What is a complication of repeated blood transfusions?

Accepted Answer

As a result of repeated blood transfusions,excessive deposits of iron (hemosiderosis)are stored in tissues.

Question 9

An adolescent is diagnosed with Hodgkin's disease.Lymph nodes on both sides of her diaphragm have been found to be involved,including cervical and inguinal nodes.Which disease stage is this?

Accepted Answer

Lymph node regions on both sides of the diaphragm are consistent with a diagnosis of stage III Hodgkin's disease.

Question 10

A 3-year-old child with sickle cell disease is admitted to the hospital in sickle cell crisis with severe abdominal pain.Which type of crisis is the child most likely experiencing?

Accepted Answer

Vaso-occlusive crisis,or painful crisis,is caused by obstruction of blood flow by sickle cells,infarctions,and some degrees of vasospasm.

Question 11

A 2-year-old child has been diagnosed with hemophilia A.What information should the nurse include in a teaching plan about home care?

Accepted Answer

When bleeding occurs,the traditional approach is to follow RICE-rest,ice,compression,and elevation.

Question 12

A newly married couple is seeking genetic counseling because they are both carriers of the sickle cell trait.How can the nurse best explain the children's risk of inheriting this disease?

Accepted Answer

The sickle cell gene is inherited from both parents; therefore each offspring has a one in four chance of inheriting the disease.

Question 13

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?

Accepted Answer

Peripheral neuropathy may be signaled by severe constipation resulting from decreased nerve sensations in the bowel.

Question 14

Which statement made by a parent indicates an understanding of health maintenance of a child with sickle cell disease?

Accepted Answer

Prevention of dehydration,which can trigger the sickling process,is a priority goal in the care of a child with sickle cell disease.

Question 15

The nurse is teaching the parents of a young child with iron deficiency anemia about nutrition. What food would the nurse emphasize as being a rich source of iron?

Accepted Answer

Good nutritional sources of iron include boiled egg yolk,liver,green leafy vegetables,Cream of Wheat,dried fruits,beans,nuts,and whole-grain breads.

Question 16

What will the nurse administer with ferrous sulfate drops when providing them to a child on the pediatric unit?

Accepted Answer

Vitamin C aids in the absorption of iron,whereas food and milk interfere with the absorption of iron.

Question 17

Which statement by a mother may indicate a cause for her 9-month-old's iron deficiency anemia?

Accepted Answer

Because cow's milk contains very little iron,infants should drink iron-fortified formula for the first year of life.

Question 18

What is the result of a deficiency of factor IX?

Accepted Answer

Christmas disease,or hemophilia B,is caused by the deficiency of factor IX.

Question 19

A child has just been diagnosed with acute lymphoblastic leukemia.What is the result of an overproduction of immature white blood cells in the bone marrow?

Accepted Answer

An overproduction of immature white blood cells increases the child's susceptibility to infection.

Question 20

The nurse is dealing with a preschool-age child with a life-threatening illness.What should the nurse remember the child's concept of death is at this age?

Accepted Answer

The preschooler views death as reversible and temporary.

Quiz 27: The Child with a Condition of the Blood, Blood-Forming Organs, or Lymphatic System