Question 1

The nurse is conducting a physical examination of a toddler with suspected lead poisoning. Lab results indicate blood lead level 52 m g/dL. Which action would the nurse expect to happen next?

Accepted Answer

Blood lead levels of 45 mcg/dL or higher in children require immediate action, including confirmation of the test results within 48 hours and preparation for chelation therapy to remove the lead from the body.

Question 2

A nurse is conducting a physical examination of a 5-year-old with suspected iron- deficiency anemia. How would the nurse evaluate for changes in neurologic functioning?

Accepted Answer

Evaluating changes in neurologic functioning in a child suspected of iron-deficiency anemia can involve assessing their gait or how they walk. This can reveal coordination and balance issues that might be related to neurologic effects of anemia.

Question 3

The nurse is caring for a 12-year-old boy with idiopathic thrombocytopenia. The nurse is providing discharge instructions about home care and safety recommendations to the boy and his parents. Which response indicates a need for further teaching?

Accepted Answer

Participation in contact sports like football is not recommended for someone with idiopathic thrombocytopenia due to the increased risk of bleeding and injury. Swimming is considered a safer activity because it poses less risk of injury. Avoiding aspirin and drugs like ibuprofen is correct because they can further inhibit platelet function, increasing the risk of bleeding. The statement about antihistamines is incorrect, as they are not generally contraindicated in patients with idiopathic thrombocytopenia, but it does not indicate a need for further teaching related to safety and bleeding risks.

Question 4

The nurse is assessing a child with suspected thalassemia. Which of the following would the nurse expect to assess?

Accepted Answer

Frontal bossing is a common finding in children with thalassemia due to the expansion of the bone marrow as the body tries to compensate for the anemia. This leads to characteristic facial bone deformities.

Question 5

The nurse is caring for a child recently diagnosed with glucose-6-phosphate dehydrogenase (G6PD) deficiency. The nurse is teaching the parents about triggers that may result in oxidative stress. Which of the following responses indicates a need for further teaching?

Accepted Answer

Penicillin is generally considered safe for individuals with G6PD deficiency. The need for further teaching is indicated by the incorrect belief that penicillin must be avoided.

Question 6

The nurse is caring for a 13-year-old girl with von Willebrand disease. After teaching the adolescent and her parents about this disorder and care, which response by the parents indicates a need for additional teaching?

Accepted Answer

Desmopressin should not be administered "as often as needed" without specific guidance from a healthcare provider, as overuse can lead to water retention and hyponatremia. Proper dosing and timing are crucial for safety and efficacy.

Question 7

The nurse is caring for a child who has been admitted for a sickle cell crisis. Which of the following would the nurse do first to provide adequate pain management?

Accepted Answer

Initiating pain assessment with a standardized pain scale is the first step in providing adequate pain management for a child in sickle cell crisis. This allows the nurse to objectively assess the child's pain level, which is crucial for determining the most appropriate and effective pain management strategies.

Question 8

The nurse is caring for a 2-year-old boy with hemophilia. His parents are upset by the possibility that he will become infected with hepatitis or HIV from the clotting factor replacement therapy. Which response by the nurse would be most appropriate?

Accepted Answer

The correct response is D because it directly addresses the parents' concern about the risk of virus transmission from clotting factor replacement therapy. Since 1986, the treatment of clotting factor with dry heat has significantly reduced the risk of transmitting viruses such as hepatitis and HIV, making it a safer option for individuals with hemophilia.

Question 9

A child with iron-deficiency anemia is prescribed ferrous fumarate, 3 mg/kg/day in two divided doses. The nurse interprets this order as indicating which of the following?

Accepted Answer

The dosage of ferrous fumarate, 3 mg/kg/day in two divided doses, is typically prescribed for children with mild to moderate iron deficiency anemia to replenish iron stores and correct the anemia.

Question 10

The nurse is caring for a child with thalassemia who is receiving chelation therapy at home using a battery-operated pump. After teaching the parents about this treatment, which statement by the mother indicates a need for additional teaching?

Accepted Answer

The statement "I can have the nurse administer the chelation therapy if I am uncomfortable" indicates a need for additional teaching because chelation therapy at home, especially with a battery-operated pump, is designed for parents or caregivers to administer. It emphasizes the importance of the caregiver being comfortable and capable of managing the therapy to ensure consistency and effectiveness.

Question 11

The nurse is teaching the parents of a child with a hematologic disorder about the functions of the various blood cells. The nurse determines that the teaching was successful when the parents state which blood cell as being primarily responsible for blood clotting?

Accepted Answer

Thrombocytes, also known as platelets, are primarily responsible for blood clotting. They aggregate at the site of a blood vessel injury to form a plug that helps stop bleeding.

Question 12

When evaluating the hemogram of an 8-month-old infant, the nurse would identify which type of hemoglobin as being the predominant type?

Accepted Answer

At around 6 months of age, hemoglobin A becomes the predominant type of hemoglobin, replacing hemoglobin F, which is the primary hemoglobin type in fetal life.

Question 13

The nurse is evaluating the laboratory test results of a 7-year-old child with a suspected hematologic disorder. Which finding would cause the nurse to be concerned?

Accepted Answer

A low RBC count (2.8 × 10^12/L) indicates anemia, which is concerning and warrants further investigation.

Question 14

When providing care to a child with aplastic anemia, which nursing diagnosis most likely would be the priority?

Accepted Answer

Aplastic anemia involves a decrease in the production of blood cells, increasing the risk of bleeding and infection, making "Risk for injury" a priority to prevent complications.

Question 15

The nurse is reviewing the laboratory test results of a child diagnosed with disseminated intravascular coagulation (DIC). Which of the following would the nurse interpret as indicative of this disorder?

Accepted Answer

Positive fibrin split products are indicative of disseminated intravascular coagulation (DIC) because they are a byproduct of the breakdown of fibrin, which occurs during the extensive clotting process seen in DIC.

Question 16

A nurse is providing care to a child with idiopathic thrombocytopenic purpura with a platelet count of 18,000/mm³. Which medication would the nurse most likely expect to be ordered?

Accepted Answer

Intravenous immune globulin (IVIG) is commonly used in the treatment of idiopathic thrombocytopenic purpura (ITP) to increase the platelet count by modifying the immune system's response that is causing the platelet destruction.

Question 17

The nurse is reviewing the white blood cell differential of a 4-year-old girl. Which value would lead the nurse to be concerned?

Accepted Answer

Eosinophils at 10% are elevated, indicating a possible allergic reaction or parasitic infection, which is concerning and warrants further investigation. Normal eosinophil levels are typically 1-4%.

Question 18

A child with suspected sickle cell disease is scheduled for a hemoglobin electrophoresis. When reviewing the child's history, which of the following would the nurse identify as potentially interfering with the accuracy of the results?

Accepted Answer

A blood transfusion can interfere with the accuracy of hemoglobin electrophoresis results by introducing normal hemoglobin into the bloodstream, which can mask the presence of abnormal hemoglobins associated with sickle cell disease.

Question 19

The mother of a 5-year-old girl brings the child to the clinic for an evaluation. The mother tells the nurse, "She seems to be so tired and irritable lately. And she looks so pale." Further assessment reveals pale conjunctiva and oral mucous membranes. The nurse suspects iron- deficiency anemia. Which additional finding would help provide additional evidence for this suspicion?

Accepted Answer

Spooned nails (koilonychia) are a classic sign of iron-deficiency anemia, especially in advanced cases. This symptom, combined with the child's fatigue, irritability, and pallor, supports the suspicion of iron-deficiency anemia.

Question 20

The nurse is teaching the parents of a child diagnosed with iron-deficiency anemia about ways to increase their child's intake of iron. The parents demonstrate understanding of the teaching when they identify which foods as good choices for the child? Select all that apply.

Accepted Answer

Tuna, salmon, tofu, and dried fruits are good sources of iron. Cow's milk is not a good source of iron and can actually inhibit iron absorption.

Quiz 46: Nursing Care of the Child With an Alteration in Cellular Regulation/Hematologic or Neoplastic Disorder

The nurse is conducting a physical examination of a toddler with suspected lead poisoning. Lab results indicate blood lead level 52 m g/dL. Which action would the nurse expect to happen next?

A nurse is conducting a physical examination of a 5-year-old with suspected iron- deficiency anemia. How would the nurse evaluate for changes in neurologic functioning?

The nurse is caring for a 12-year-old boy with idiopathic thrombocytopenia. The nurse is providing discharge instructions about home care and safety recommendations to the boy and his parents. Which response indicates a need for further teaching?

The nurse is assessing a child with suspected thalassemia. Which of the following would the nurse expect to assess?

The nurse is caring for a child recently diagnosed with glucose-6-phosphate dehydrogenase (G6PD) deficiency. The nurse is teaching the parents about triggers that may result in oxidative stress. Which of the following responses indicates a need for further teaching?

The nurse is caring for a 13-year-old girl with von Willebrand disease. After teaching the adolescent and her parents about this disorder and care, which response by the parents indicates a need for additional teaching?

The nurse is caring for a child who has been admitted for a sickle cell crisis. Which of the following would the nurse do first to provide adequate pain management?

The nurse is caring for a 2-year-old boy with hemophilia. His parents are upset by the possibility that he will become infected with hepatitis or HIV from the clotting factor replacement therapy. Which response by the nurse would be most appropriate?

A child with iron-deficiency anemia is prescribed ferrous fumarate, 3 mg/kg/day in two divided doses. The nurse interprets this order as indicating which of the following?

The nurse is caring for a child with thalassemia who is receiving chelation therapy at home using a battery-operated pump. After teaching the parents about this treatment, which statement by the mother indicates a need for additional teaching?

The nurse is teaching the parents of a child with a hematologic disorder about the functions of the various blood cells. The nurse determines that the teaching was successful when the parents state which blood cell as being primarily responsible for blood clotting?

When evaluating the hemogram of an 8-month-old infant, the nurse would identify which type of hemoglobin as being the predominant type?

The nurse is evaluating the laboratory test results of a 7-year-old child with a suspected hematologic disorder. Which finding would cause the nurse to be concerned?

When providing care to a child with aplastic anemia, which nursing diagnosis most likely would be the priority?

The nurse is reviewing the laboratory test results of a child diagnosed with disseminated intravascular coagulation (DIC) . Which of the following would the nurse interpret as indicative of this disorder?

A nurse is providing care to a child with idiopathic thrombocytopenic purpura with a platelet count of 18,000/mm³. Which medication would the nurse most likely expect to be ordered?

The nurse is reviewing the white blood cell differential of a 4-year-old girl. Which value would lead the nurse to be concerned?

A child with suspected sickle cell disease is scheduled for a hemoglobin electrophoresis. When reviewing the child's history, which of the following would the nurse identify as potentially interfering with the accuracy of the results?

The nurse is teaching the parents of a child diagnosed with iron-deficiency anemia about ways to increase their child's intake of iron. The parents demonstrate understanding of the teaching when they identify which foods as good choices for the child? Select all that apply.

Quiz 46: Nursing Care of the Child With an Alteration in Cellular Regulation/Hematologic or Neoplastic Disorder

The nurse is conducting a physical examination of a toddler with suspected lead poisoning. Lab results indicate blood lead level 52 m g/dL. Which action would the nurse expect to happen next?

A nurse is conducting a physical examination of a 5-year-old with suspected iron- deficiency anemia. How would the nurse evaluate for changes in neurologic functioning?

The nurse is caring for a 12-year-old boy with idiopathic thrombocytopenia. The nurse is providing discharge instructions about home care and safety recommendations to the boy and his parents. Which response indicates a need for further teaching?

The nurse is assessing a child with suspected thalassemia. Which of the following would the nurse expect to assess?

The nurse is caring for a child recently diagnosed with glucose-6-phosphate dehydrogenase (G6PD) deficiency. The nurse is teaching the parents about triggers that may result in oxidative stress. Which of the following responses indicates a need for further teaching?

The nurse is caring for a 13-year-old girl with von Willebrand disease. After teaching the adolescent and her parents about this disorder and care, which response by the parents indicates a need for additional teaching?

The nurse is caring for a child who has been admitted for a sickle cell crisis. Which of the following would the nurse do first to provide adequate pain management?

The nurse is caring for a 2-year-old boy with hemophilia. His parents are upset by the possibility that he will become infected with hepatitis or HIV from the clotting factor replacement therapy. Which response by the nurse would be most appropriate?

A child with iron-deficiency anemia is prescribed ferrous fumarate, 3 mg/kg/day in two divided doses. The nurse interprets this order as indicating which of the following?

The nurse is caring for a child with thalassemia who is receiving chelation therapy at home using a battery-operated pump. After teaching the parents about this treatment, which statement by the mother indicates a need for additional teaching?

The nurse is teaching the parents of a child with a hematologic disorder about the functions of the various blood cells. The nurse determines that the teaching was successful when the parents state which blood cell as being primarily responsible for blood clotting?

When evaluating the hemogram of an 8-month-old infant, the nurse would identify which type of hemoglobin as being the predominant type?

The nurse is evaluating the laboratory test results of a 7-year-old child with a suspected hematologic disorder. Which finding would cause the nurse to be concerned?

When providing care to a child with aplastic anemia, which nursing diagnosis most likely would be the priority?

The nurse is reviewing the laboratory test results of a child diagnosed with disseminated intravascular coagulation (DIC) . Which of the following would the nurse interpret as indicative of this disorder?

A nurse is providing care to a child with idiopathic thrombocytopenic purpura with a platelet count of 18,000/mm3. Which medication would the nurse most likely expect to be ordered?

The nurse is reviewing the white blood cell differential of a 4-year-old girl. Which value would lead the nurse to be concerned?

A child with suspected sickle cell disease is scheduled for a hemoglobin electrophoresis. When reviewing the child's history, which of the following would the nurse identify as potentially interfering with the accuracy of the results?

The nurse is teaching the parents of a child diagnosed with iron-deficiency anemia about ways to increase their child's intake of iron. The parents demonstrate understanding of the teaching when they identify which foods as good choices for the child? Select all that apply.

A nurse is providing care to a child with idiopathic thrombocytopenic purpura with a platelet count of 18,000/mm³. Which medication would the nurse most likely expect to be ordered?