Question 1

A child with thalassemia major receives blood transfusions frequently.The nurse is aware that a complication of repeated blood transfusions is:
A) hemarthrosis.
B) hematuria.
C) hemoptysis.
D) hemosiderosis.

Accepted Answer

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

Question 2

The nurse,caring for a child receiving chemotherapy,notes that the child's abdomen is firm and slightly distended.Also,there is no record of a bowel movement for the last 2 days.These assessment findings suggest the possibility of:
A) peripheral neuropathy.
B) stomatitis.
C) myelosuppression.
D) hemorrhage.

Accepted Answer

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

Question 3

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.The disease is in stage:
A) I.
B) II.
C) III.
D) IV.

Accepted Answer

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

Question 4

The nurse would include in a teaching plan about mouth care of a child receiving chemotherapy to:
A) use commercial mouthwash.
B) clean teeth with a soft toothbrush.
C) avoid use of a Water-Pik.
D) inspect the mouth weekly for ulcerations.

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 5

When dealing with a preschool-age child with a life-threatening illness,the nurse should remember that at this age the child's concept of death includes:
A) that it is final.
B) only a fear of separation from her parents.
C) that a person becomes alive again soon after death.
D) an understanding based on simple logic.

Accepted Answer

The preschooler views death as reversible and temporary.

Question 6

On admission,a child with leukemia has widespread purpura and a platelet count of 19,000/mm³.The priority nursing intervention is:
A) assessing neurological status.
B) inserting an intravenous line.
C) monitoring vital signs during platelet transfusions.
D) providing family education about how to prevent bleeding.

Accepted Answer

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

Question 7

A 3-year-old child with sickle cell disease is admitted to the hospital in sickle cell crisis with severe abdominal pain.The nurse recognizes that the type of crisis the child is most likely experiencing is:
A) aplastic.
B) hyperhemolytic.
C) vaso-occlusive.
D) splenic sequestration.

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 8

When teaching the parents of a young child about iron deficiency anemia,the nurse would tell them that a rich source of iron is:
A) an egg white.
B) cream of Wheat.
C) a banana.
D) a carrot.

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 9

The nurse would teach the parents of a child with a low platelet count to avoid:
A) ibuprofen.
B) aspirin.
C) caffeine.
D) prednisone.

Accepted Answer

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

Question 10

A child who is receiving a transfusion should be closely assessed for:
A) fever.
B) lethargy.
C) jaundice.
D) bradycardia.

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 11

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?
A) Every fourth child will have the disease; two others will be carriers.
B) All of their children will be carriers, just as they are.
C) Each child has a one in four chance of having the disease and a two in four chance of being a carrier.
D) The risk levels of their children cannot be determined by this information.

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 12

The statement made by a parent indicating understanding of health maintenance of a child with sickle cell disease is:
A) "I should give my child a daily iron supplement. "
B) "It is important for my child to drink plenty of fluids. "
C) "He needs to wear protective equipment if he plays contact sports. "
D) "He shouldn't receive any immunizations until he is older. "

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 13

A 2-year-old child has been diagnosed with hemophilia A.The information the nurse would include in a teaching plan about home care would be:
A) if bleeding occurs, apply pressure, ice, elevate, and rest the extremity.
B) children's aspirin in lowered doses may be given for joint discomfort.
C) a firm, dry toothbrush should be used to clean teeth at least twice a day.
D) do not permit interactive play with other children.

Accepted Answer

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

Question 14

A 6-year-old with leukemia asks,"Who will take care of me in heaven?" The best response for the nurse to make is:
A) "Who do you think will take care of you?"
B) "Your grandparents and God will take care of you. "
C) "Your mom will know more about that than I do. "
D) "Why are you asking me that?"

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 15

The nurse would instruct the parent to give ferrous sulfate drops to the child:
A) with milk.
B) with orange juice.
C) with water.
D) on a full stomach.

Accepted Answer

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

Question 16

A child has just been diagnosed with acute lymphoblastic leukemia.The nurse is aware that the result of an overproduction of immature white blood cells in the bone marrow is:
A) decreased T-cell production.
B) decreased hemoglobin.
C) increased blood clotting.
D) increased susceptibility to infection.

Accepted Answer

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

Question 17

The nurse notes that a 4-year-old child's gums bleed easily and he has bruising and petechiae on his extremities.The lab value that would be consistent with these symptoms is:
A) platelet count of 25,000/mm³.
B) hemoglobin level of 8 g/dL.
C) hematocrit level of 36%.
D) leukocyte count of 14,000/mm³.

Accepted Answer

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

Question 18

The nurse clarifies that the deficiency of factor IX results in:
A) thalassemia.
B) idiopathic thrombocytopenic purpura.
C) hemophilia A.
D) Christmas disease.

Accepted Answer

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

Question 19

The statement by a mother that may indicate a cause for her 9-month-old having iron deficiency anemia is:
A) "Formula is so expensive. We switched to regular milk right away. "
B) "She almost never drinks water. "
C) "She doesn't really like peaches or pears, so we stick to bananas for fruit. "
D) "I give her a piece of bread now and then. She likes to chew on it. "

Accepted Answer

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

Question 20

When the child receiving a transfusion complains of back pain and itching,the nurse's initial action would be to:
A) notify the charge nurse.
B) disconnect intravenous lines immediately.
C) give diphenhydramine (Benadryl).
D) clamp off blood and keep line open with normal saline.

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.

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

A child with thalassemia major receives blood transfusions frequently.The nurse is aware that a complication of repeated blood transfusions is:

The nurse,caring for a child receiving chemotherapy,notes that the child's abdomen is firm and slightly distended.Also,there is no record of a bowel movement for the last 2 days.These assessment findings suggest the possibility of:

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.The disease is in stage:

The nurse would include in a teaching plan about mouth care of a child receiving chemotherapy to:

When dealing with a preschool-age child with a life-threatening illness,the nurse should remember that at this age the child's concept of death includes:

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

A 3-year-old child with sickle cell disease is admitted to the hospital in sickle cell crisis with severe abdominal pain.The nurse recognizes that the type of crisis the child is most likely experiencing is:

When teaching the parents of a young child about iron deficiency anemia,the nurse would tell them that a rich source of iron is:

The nurse would teach the parents of a child with a low platelet count to avoid:

A child who is receiving a transfusion should be closely assessed for:

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?

The statement made by a parent indicating understanding of health maintenance of a child with sickle cell disease is:

A 2-year-old child has been diagnosed with hemophilia A.The information the nurse would include in a teaching plan about home care would be:

A 6-year-old with leukemia asks,"Who will take care of me in heaven?" The best response for the nurse to make is:

The nurse would instruct the parent to give ferrous sulfate drops to the child:

A child has just been diagnosed with acute lymphoblastic leukemia.The nurse is aware that the result of an overproduction of immature white blood cells in the bone marrow is:

The nurse notes that a 4-year-old child's gums bleed easily and he has bruising and petechiae on his extremities.The lab value that would be consistent with these symptoms is:

The nurse clarifies that the deficiency of factor IX results in:

The statement by a mother that may indicate a cause for her 9-month-old having iron deficiency anemia is:

When the child receiving a transfusion complains of back pain and itching,the nurse's initial action would be to: