Question 1

The nurse is caring for a child with rheumatoid arthritis. Which nonpharmacologic intervention should the nurse include in the plan of care for joint pain?

Accepted Answer

Application of moist heat can help relieve joint pain and stiffness in children with rheumatoid arthritis by increasing blood flow and relaxing muscles.

Question 2

When teaching a pregnant client about antibodies that are passed from mother to newborn, which antibody should the nurse include?

Accepted Answer

IgG is the only class of antibody that can cross the placenta from mother to fetus. Therefore, it is the antibody that provides passive immunity to the newborn in the first few months of life. IgM is too large to cross the placenta, and IgA is found mainly in colostrum and breast milk. IgD has no known role in passive immunity.

Question 3

Which infection control measures should the nurse include in the discharge instructions for the family of a child who is immunodeficient? Select all that apply.

Accepted Answer

- Sharing cups can spread germs, which is risky for an immunodeficient child. Hand hygiene is crucial in preventing the transmission of infections, especially around immunocompromised individuals. Washing utensils in the dishwasher is generally safe and can effectively sanitize them. Fresh fruits with skin intact might harbor bacteria or viruses, posing a risk to an immunodeficient child. Alcohol wipes might be too harsh for the sensitive skin of a child's diaper area and are not specifically related to preventing infection transmission in this context.

Question 4

Which is the rationale for ensuring the irrigation of blood products and ensuring that they are cytomegalovirus (CMV)-negative prior to administering a blood transfusion for a pediatric client diagnosed with severe combined immune deficiency (SCID)?

Accepted Answer

Infection and graft-versus-host disease (GVHD) can occur from the lymphocytes present in the donor blood in patients with severe combined immune deficiency (SCID) due to their severely compromised immune systems. Irrigating blood products to remove white blood cells and ensuring they are CMV-negative helps prevent these complications.

Question 5

In which position should the nurse place a child who is experiencing an anaphylactic shock reaction?

Accepted Answer

In an anaphylactic shock, it's important to improve blood flow to the vital organs. Placing the child flat with legs slightly elevated helps achieve this by using gravity to aid venous return to the heart, enhancing perfusion to vital organs.

Question 6

A parent of a newborn asks the nurse why young children seem to become ill so often when compared with older children and adults. Which is the best response by the nurse?

Accepted Answer

Newborns have lower numbers of natural killer cells, which are part of the immune system that helps fight infections. This contributes to their increased susceptibility to illnesses.

Question 7

A premature neonate is at greater risk for infection than a full-term newborn because of a reduced number of which immunoglobulin?

Accepted Answer

The reduced number of IgG antibodies in premature neonates means that they have less protection against bacterial and viral infections, making them more susceptible to infections compared to full-term newborns. IgA antibodies protect against infections in the mucous membranes, while IgE is involved in allergic reactions. IgM antibodies provide early defense against infections, but they are not as effective as IgG in providing long-lasting immunity.

Question 8

Which interventions should the nurse include in the plan of care to address nutrition for a child who is diagnosed with acquired immunodeficiency syndrome (AIDS)? Select all that apply.

Accepted Answer

Eliminating unpleasant odors can enhance appetite. Weighing the child daily helps monitor nutritional status. Including favorite foods can encourage eating and improve nutritional intake.

Question 9

The nurse is providing discharge instructions to the family of a child who experienced an anaphylactic reaction. Which parental statements indicate accurate understanding of the action that histamine plays during this type of reaction? Select all that apply.

Accepted Answer

Histamine causes smooth muscle contraction, which can lead to bronchoconstriction and wheezing. It also causes increased capillary permeability, which can lead to edema in the airways and difficulty breathing. Histamine does not release IgE antibodies or cause the destruction of red blood cells. It can cause vasodilation, not vasoconstriction, which can lead to hypotension and cardiovascular collapse.

Question 10

A child with human immunodeficiency virus (HIV) is diagnosed with oral candidiasis. Which should the nurse include in the plan of care related to oral care based on this information?

Accepted Answer

Normal saline is a non-irritating solution that can help to soothe the oral tissues that are inflamed by candidiasis, and it can also help to remove debris from the mouth. Listerine and Scope are not recommended for children due to their alcohol content, which can cause pain and irritation. Viscous lidocaine is not used for oral care in this case as it is a local anesthetic and does not address the underlying fungal infection. However, it may be used to relieve pain associated with the infection.

Question 11

A child is prescribed oral corticosteroid for a rash caused by graft-versus-host disease. Which should the nurse monitor the child for after administering the drug?

Accepted Answer

Oral corticosteroids can cause an increase in blood glucose levels which can lead to hyperglycemia. Monitoring for signs and symptoms of hyperglycemia is important in patients receiving oral corticosteroids. Hepatic toxicity, seizures, and renal toxicity are not common side effects of oral corticosteroids used for treating graft-versus-host disease rash.

Question 12

Which is the priority nursing action when providing care to a pediatric client who has documented allergies to cow's milk, peanuts, and latex?

Accepted Answer

Evaluating the hospital room for equipment containing latex is the priority nursing action because latex allergy is a potentially life-threatening condition.

Question 13

A school-age client diagnosed with rheumatoid arthritis (RA) wants to participate in the school sports programs. The client asks the nurse to recommend a sporting activity that is appropriate. Which activity would be the most appropriate for the nurse to recommend?

Accepted Answer

Swimming is a low impact sport that will be easier on the joints for a client with RA. Baseball and basketball involve a lot of running and jumping, and football involves physical contact which can be painful and damaging for the joints.

Question 14

A nurse is planning care for a child with human immunodeficiency virus (HIV). Which is the priority nursing diagnosis for this child?

Accepted Answer

HIV puts a child at high risk for infections, which can lead to life-threatening complications. Therefore, the priority nursing diagnosis for this child is "Risk for Infection." The other options are also potential concerns for the child with HIV, but they are not the priority.

Question 15

A child is receiving a nucleoside reverse transcriptase inhibitor for human immunodeficiency virus (HIV). Which laboratory value should the nurse include in the plan of care as needing to monitor?

Accepted Answer

The laboratory value that should be monitored when a child is receiving a nucleoside reverse transcriptase inhibitor for HIV is the red blood cell count. These medications can cause bone marrow suppression, leading to anemia or thrombocytopenia, so it is important to monitor the child's red blood cell count regularly. Glucose, sodium, and potassium levels are not typically affected by this medication.

Question 16

The nurse is providing care for the family of a child who is diagnosed with acquired immunodeficiency syndrome (AIDS). Which priority nursing diagnosis should the nurse include in the plan of care?

Accepted Answer

Anticipatory Grieving is the priority nursing diagnosis because the family is facing the loss of their child to AIDS.

Question 17

An adolescent female client is diagnosed with systemic lupus erythematosus (SLE). Which should the nurse include in the teaching session regarding an activity that should be avoided?

Accepted Answer

Using a tanning bed should be avoided by clients with SLE as it can aggravate the condition and worsen the symptoms. The UV rays from tanning beds can cause photosensitivity in clients with SLE, leading to skin rashes and other symptoms. The other options listed do not specifically pose a risk to clients with SLE.

Question 18

The nurse is planning care for a child with acquired immune deficiency syndrome (AIDS). Which vaccines should be avoided in the child with AIDS?

Accepted Answer

The varicella vaccine is a live attenuated vaccine, and it is contraindicated in children with AIDS, as they are immunocompromised and may not be able to handle the live virus. The inactivated polio vaccine, tetanus toxoid vaccine, and acellular pertussis vaccine are all safe for children with AIDS.

Question 19

An adolescent female client is diagnosed with systemic lupus erythematosus (SLE). Which action by the client indicates acceptance of the body changes that occur because of SLE?

Accepted Answer

Discussing the body changes with her best friend indicates acceptance and a willingness to share and communicate about her condition with others. The other choices suggest avoidance or limited communication about her condition and its effects.

Question 20

After a severe allergic reaction, an EpiPen is prescribed for the school-age child. Which instructions should the nurse provide to this child's parents based on the current data? Select all that apply.

Accepted Answer

The child should always have access to the EpiPen in case of an allergic reaction. It's important to check the expiration date to ensure the medication is effective. Wearing a Medic Alert bracelet can provide critical information in an emergency.

Quiz 48: The Child With Alterations in Immune Function

The nurse is caring for a child with rheumatoid arthritis. Which nonpharmacologic intervention should the nurse include in the plan of care for joint pain?

When teaching a pregnant client about antibodies that are passed from mother to newborn, which antibody should the nurse include?

Which infection control measures should the nurse include in the discharge instructions for the family of a child who is immunodeficient? Select all that apply.

Which is the rationale for ensuring the irrigation of blood products and ensuring that they are cytomegalovirus (CMV) -negative prior to administering a blood transfusion for a pediatric client diagnosed with severe combined immune deficiency (SCID) ?

In which position should the nurse place a child who is experiencing an anaphylactic shock reaction?

A parent of a newborn asks the nurse why young children seem to become ill so often when compared with older children and adults. Which is the best response by the nurse?

A premature neonate is at greater risk for infection than a full-term newborn because of a reduced number of which immunoglobulin?

Which interventions should the nurse include in the plan of care to address nutrition for a child who is diagnosed with acquired immunodeficiency syndrome (AIDS) ? Select all that apply.

The nurse is providing discharge instructions to the family of a child who experienced an anaphylactic reaction. Which parental statements indicate accurate understanding of the action that histamine plays during this type of reaction? Select all that apply.

A child with human immunodeficiency virus (HIV) is diagnosed with oral candidiasis. Which should the nurse include in the plan of care related to oral care based on this information?

A child is prescribed oral corticosteroid for a rash caused by graft-versus-host disease. Which should the nurse monitor the child for after administering the drug?

Which is the priority nursing action when providing care to a pediatric client who has documented allergies to cow's milk, peanuts, and latex?

A school-age client diagnosed with rheumatoid arthritis (RA) wants to participate in the school sports programs. The client asks the nurse to recommend a sporting activity that is appropriate. Which activity would be the most appropriate for the nurse to recommend?

A nurse is planning care for a child with human immunodeficiency virus (HIV) . Which is the priority nursing diagnosis for this child?

A child is receiving a nucleoside reverse transcriptase inhibitor for human immunodeficiency virus (HIV) . Which laboratory value should the nurse include in the plan of care as needing to monitor?

The nurse is providing care for the family of a child who is diagnosed with acquired immunodeficiency syndrome (AIDS) . Which priority nursing diagnosis should the nurse include in the plan of care?

An adolescent female client is diagnosed with systemic lupus erythematosus (SLE) . Which should the nurse include in the teaching session regarding an activity that should be avoided?

The nurse is planning care for a child with acquired immune deficiency syndrome (AIDS) . Which vaccines should be avoided in the child with AIDS?

An adolescent female client is diagnosed with systemic lupus erythematosus (SLE) . Which action by the client indicates acceptance of the body changes that occur because of SLE?

After a severe allergic reaction, an EpiPen is prescribed for the school-age child. Which instructions should the nurse provide to this child's parents based on the current data? Select all that apply.