Question 1

How has synthetic recombinant antihemophilic factor improved the management of hemophilia? (Select all that apply. )
A) Eliminates the need for frequent transfusions.
B) Can be administered by family at home.
C) Prevents hemorrhage.
D) Reduces cost of care of the hemophiliac.
E) Reduces risk of HIV and hepatitis A and B transmission.

Accepted Answer

The drug can be given at home by the family.Because it supplies the missing factor,transfusions are not necessary and consequently the exposure to HIV and hepatitis A and B is reduced.Cost of care is greatly reduced because hospitalizations and transfusions are not as frequently required.The drug does not prevent hemorrhage;it makes hemorrhage manageable.

Question 2

The most recent blood count for a child who received chemotherapy last week shows neutropenia.What is the priority nursing diagnosis for this child?
A) Risk for infection
B) Risk for hemorrhage
C) Altered skin integrity
D) Disturbance in body image

Accepted Answer

The child with neutropenia is at risk for infection.

Question 3

The nurse explains that the COPP medical regimen for the treatment of Hodgkin's disease uses a combination of which drugs? (Select all that apply. )
A) Vincristine
B) Cyclophosphamide
C) Methotrexate
D) Prednisone
E) Procarbazine hydrochloride

Accepted Answer

The COPP medical regimen includes the combination of cyclophosphamide,vincristine (Oncovin),prednisone,and procarbazine hydrochloride.

Question 4

Why would the nurse urge the family of a dying 12-year-old boy to include his 8-year-old sister in care? (Select all that apply. )
A) She will feel less neglected by the parents.
B) She can make amends for past hostilities to her brother.
C) She will feel increased helplessness.
D) She can express her feelings through care.
E) She can experience being supportive of her parents and brother.

Accepted Answer

All options are potential benefits to including the sibling in the care of a dying child except increased helplessness.She would feel less helpless.

Question 5

The family of a child receiving chemotherapy for leukemia should be taught to focus on which aspect(s)of the child's care? (Select all that apply. )
A) Using a support group
B) Stimulating appetite
C) Maintaining adequate hydration
D) Continuing with scheduled immunizations
E) Reporting exposure to infectious diseases

Accepted Answer

Support groups are helpful for emotional support and realistic tips on care.The child on chemotherapy is anorexic and has no appetite.Maintenance of hydration is essential for the adequate therapeutic effect of the drugs.Because the drugs suppress the bone marrow,children are at risk for infection,and the suppression will not allow the antibody response needed for immunization.

Question 6

The nurse finds an adolescent with Hodgkin's disease crying.The adolescent says,"I am so scared." What is the most appropriate nursing response to this comment?
A) "I understand how you must feel."
B) "You shouldn't feel that way."
C) "Is this the strongest feeling you've had today?"
D) "Tell me what's got you scared."

Accepted Answer

The nurse should encourage the adolescent to express her feelings and concerns.

Question 7

The nurse is presenting information on the congenital disorder of hemophilia A.What fact will the nurse include?
A) It is seen in males and females equally.
B) It is transmitted by symptom-free females.
C) It is a sex-linked dominant trait.
D) It is a defective gene located on the Y chromosome.

Accepted Answer

Hemophilia A affects mostly males who received the sex-linked recessive trait from a symptom-free female.The defective gene is on the X chromosome.

Question 8

What are the classic symptoms of thalassemia major (Cooley's anemia)? (Select all that apply. )
A) Hepatomegaly
B) Jaundice
C) Protruding teeth
D) Pathological fractures
E) Renal failure

Accepted Answer

All of the options are classic signs of thalassemia major except renal failure.

Question 9

The nurse is caring for a child with a low platelet count.What skin assessments would alert the nurse to bleeding? (Select all that apply. )
A) Petechiae
B) Purpura
C) Ecchymosis
D) Hematoma
E) Lymphadenopathy

Accepted Answer

The reduction or destruction of platelets in the body interferes with the clotting mechanism.Skin lesions that are common to these disorders include petechiae,a bluish,nonblanching,pinpoint-sized lesion;purpura,groups of adjoining petechiae;ecchymosis,an isolated bluish lesion larger than a petechia;and hematoma,a raised ecchymosis.Lymphadenopathy is an enlargement of lymph nodes that is indicative of infection or disease.

Question 10

A school-aged child is living with a chronic disease process.How would the nurse anticipate chronic illness will effect growth and development? (Select all that apply. )
A) Delayed bonding with parents
B) Delayed toilet training
C) Impaired sense of belonging
D) Decreased feelings of independence
E) Impaired speech development

Accepted Answer

A school-age child is in the stage of industry versus inferiority.A chronic illness might experience loss of grade level in school because of illness and inability to participate or compete can lead to sense of inferiority.Sense of independence and accomplishment can be lost.Being different from peers may impede child's sense of belonging.

Question 11

A child is diagnosed with iron deficiency anemia.What will the nurse explain can occur if this disorder goes untreated?
A) Hemorrhage
B) Heart failure
C) Infection
D) Pulmonary embolism

Accepted Answer

Untreated iron deficiency anemias progress slowly,and in severe cases the heart muscle becomes too weak to function.If this happens,heart failure follows.

Question 12

What important focus of nursing care for the dying child and the family should the nurse implement?
A) Nursing care should be organized to minimize contact with the child.
B) Adequate oral intake is crucial to the dying child.
C) Families should be made aware that hearing is the last sense to stop functioning before death.
D) It is best for the family if the nursing staff provides all of the child's care.

Accepted Answer

Hearing is intact even when there is a loss of consciousness.

Question 13

What should be included in the nursing care of a 12-year-old child receiving radiation therapy for Hodgkin's disease? (Select all that apply. )
A) Application of sunblock
B) Appetite stimulation
C) Conservation of energy
D) Provision for expressions of anger
E) Preparation for premature sexual development

Accepted Answer

Sun block should be applied to skin after radiation to prevent burning.Low energy levels produce anorexia and anger in many young patients.Radiation delays the development of secondary sex characteristics and menses.

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

How has synthetic recombinant antihemophilic factor improved the management of hemophilia? (Select all that apply. )

The most recent blood count for a child who received chemotherapy last week shows neutropenia.What is the priority nursing diagnosis for this child?

The nurse explains that the COPP medical regimen for the treatment of Hodgkin's disease uses a combination of which drugs? (Select all that apply. )

Why would the nurse urge the family of a dying 12-year-old boy to include his 8-year-old sister in care? (Select all that apply. )

The family of a child receiving chemotherapy for leukemia should be taught to focus on which aspect(s) of the child's care? (Select all that apply. )

The nurse finds an adolescent with Hodgkin's disease crying.The adolescent says,"I am so scared." What is the most appropriate nursing response to this comment?

The nurse is presenting information on the congenital disorder of hemophilia A.What fact will the nurse include?

What are the classic symptoms of thalassemia major (Cooley's anemia) ? (Select all that apply. )

The nurse is caring for a child with a low platelet count.What skin assessments would alert the nurse to bleeding? (Select all that apply. )

A school-aged child is living with a chronic disease process.How would the nurse anticipate chronic illness will effect growth and development? (Select all that apply. )

A child is diagnosed with iron deficiency anemia.What will the nurse explain can occur if this disorder goes untreated?

What important focus of nursing care for the dying child and the family should the nurse implement?

What should be included in the nursing care of a 12-year-old child receiving radiation therapy for Hodgkin's disease? (Select all that apply. )