Ch38 | Child With An Oncological Or – Verified Test Bank - Safe Maternity Nursing Care 2nd Ed - Exam Resource Pack by Luanne Linnard Palmer. DOCX document preview.
Chapter 38: Child With an Oncological or Hematological Condition
Multiple Choice
Identify the choice that best completes the statement or answers the question.
____ 1. Which primary function of red blood cells (RBCs) should the nurse consider when providing care to a pediatric patient who has been diagnosed with anemia?
1) | Mediating the immune system to decrease areas of serious inflammation |
2) | Transporting hemoglobin that carries oxygen from the lungs to the tissues |
3) | Migrating and providing a rapid defense against any foreign agent |
4) | Providing hemostasis and vascular repair following injury to a vessel wall |
____ 2. The pediatric nurse teaches the parents of a preschool-aged child diagnosed with anemia that it is important to identify the cause of anemia so treatment can be tailored to their child’s specific needs. The nurse tells the parents that their child’s anemia is caused by increased destruction of red blood cells that occurs with which condition noted in the medical history?
1) | Bone marrow failure |
2) | Acute blood loss |
3) | Myelodysplastic syndrome |
4) | Sickle cell anemia |
____ 3. A hematologist diagnoses a school-aged child with thrombocytopenia. The parents ask the nurse why the patient is receiving IV immunoglobulins (IVIG). The nurse gives which reply to the parents?
1) | “It is given to decrease the number of platelets.” |
2) | “It is given to decrease the formation of antiplatelet antibodies.” |
3) | “ It will help fight off infection.” |
4) | “It will help increase the number of platelets.” |
____ 4. The nurse is providing instructions to the parents of a child with hemophilia. Which parental statement regarding the child’s care indicates a correct understanding of the information provided?
1) | “We will only take rectal temperatures.” |
2) | “Our child’s risk of exposure to infectious diseases is now increased.” |
3) | “We will need to learn how to administer factor replacement therapy.” |
4) | “Our child is cleared to play contact sports.” |
____ 5. The pediatric nurse tells the parents that this type of sickle cell anemia (SCA) crisis is caused by an increasing rate of RBC destruction, which leads to severe anemia and a state of jaundice. Which type of sickle cell crisis is this child experiencing?
1) | Sequestration crisis |
2) | Hyperhemolytic crisis |
3) | Vaso-occlusive crisis |
4) | Aplastic anemia crisis |
____ 6. When talking to the parents of a school-aged cancer patient, the pediatric nurse identifies which as the most common cancer found in children?
1) | Nasopharyngeal cancer |
2) | Acute lymphocytic leukemia |
3) | Chronic lymphocytic leukemia |
4) | Ewing sarcoma |
____ 7. The pediatric nurse plans care for a child experiencing a sickle cell crisis. Which nursing intervention is appropriate for this patient?
1) | Encouraging an increased amount of activity |
2) | Monitoring respiratory status and oxygenation |
3) | Using only nonpharmacological pain interventions to avoid an acute pulmonary event |
4) | Implementing fluid restrictions |
____ 8. A toddler presents to the clinic with several common childhood symptoms. The health-care provider thinks that the child may have a Wilms’ tumor. Which symptom does the nurse expect to see?
1) | Abdominal mass |
2) | Diarrhea |
3) | Cough and congestion |
4) | A sore throat |
____ 9. The nurse is working on the pediatric oncology floor and is speaking with the family of a child who will require chemotherapy treatment. Which statement made by the nurse accurately describes the administration of a chemotherapy drug regimen to prevent metastasizing?
1) | The induction phase focuses on combating the involvement of the central nervous system and other vital organs. |
2) | Intensification requires the administration of a single drug in low doses. |
3) | The induction phase requires the administration of multiple drugs in high doses. |
4) | The maintenance phase requires no chemotherapy treatments. |
____ 10. A 2-year-old child presents to the emergency department (ED) with bleeding of the gums and petechiae covering the lower extremities. The parents also report that there was bright red blood in the child's stool. What does the nurse suspect is causing the child’s symptoms?
1) | Idiopathic thrombocytopenia purpura |
2) | Hyperbilirubinemia |
3) | Sickle cell anemia |
4) | Iron-deficiency anemia |
____ 11. The nurse is administering packed red blood cells to a child with sickle cell disease (SCD). When should the nurse monitor the child closely because of the risk of reaction?
1) | 6 hours after the transfusion is given |
2) | At the end of the administration of the transfusion |
3) | The first 20 mL of blood administered |
4) | Never; children with SCD do not have reactions |
____ 12. A child diagnosed with aplastic anemia is admitted to the hospital. The parents ask the nurse what aplastic anemia is. Which response by the nurse is accurate?
1) | “Aplastic anemia causes a proliferation of white blood cells.” |
2) | “Aplastic anemia is characterized by abnormally shaped red blood cells.” |
3) | “Aplastic anemia is caused by the bone marrow producing inadequate cells.” |
4) | “Aplastic anemia is a disorder that occurs after a viral illness.” |
____ 13. Which nursing action is appropriate when treating a school-aged child diagnosed with hemophilia for a superficial wound above the knee?
1) | Applying pressure to the area |
2) | Applying a warm, moist pack to the area |
3) | Performing some passive range of motion to the affected leg |
4) | Keeping the affected extremity in a dependent position |
____ 14. Which is the priority teaching point for the nurse to include in the discharge instructions for the parents of a child who was admitted in a sickle cell crisis?
1) | Rapid weaning of pain medications |
2) | A diet high in protein |
3) | Adequate hydration |
4) | Restriction of activities |
____ 15. The nurse is caring for a child with severe anemia. The laboratory reports that the child's platelet count is below 18,000/mm3. Which action should the nurse take next?
1) | Let the child sleep. |
2) | Give oral iron. |
3) | Prepare for blood transfusion. |
4) | Give pain medication. |
____ 16. Which topic is the priority for the nurse who is teaching the family of a child diagnosed with idiopathic thrombocytopenia purpura (ITP)?
1) | Fluid restriction |
2) | Blood in stool is expected |
3) | Neutropenic precautions |
4) | Maintaining a safe environment |
____ 17. A patient is admitted to the pediatric floor with a suspected diagnosis of Hodgkin’s lymphoma. Which common finding does the nurse expect to see?
1) | Swollen lymph nodes |
2) | Weight loss |
3) | Fever |
4) | Hair loss |
____ 18. The nurse is assessing a young child during a sickle cell crisis. Which nursing action is appropriate in assessing the child’s pain level?
1) | Administering antianxiety medication around the clock |
2) | Using a numerical pain scale for assessment purposes |
3) | Administering antinausea medication around the clock |
4) | Using the Wong-Baker FACES scale for assessment purposes |
____ 19. Which term should the nurse use when talking with other members of the health-care team about a common side effect of chemotherapy that makes oral consumption difficult?
1) | Thrombocytopenia |
2) | Stomatitis |
3) | Petechiae |
4) | Purpura |
____ 20. Which nursing intervention is most appropriate when providing care to a child on neutropenic precautions?
1) | Provide masks for all visitors. |
2) | Maintain airborne precautions. |
3) | Use hand sanitizer only. |
4) | Avoid fresh fruits and vegetables. |
Multiple Response
Identify one or more choices that best complete the statement or answer the question.
____ 21. A school-aged African American male is brought to an emergency department (ED) by his parents with a vaso-occlusive crisis. When caring for this child, the nurse monitors for which conditions during the assessment? (Select all that apply.)
1) | Uncontrolled bleeding |
2) | Acute chest syndrome |
3) | Splenic sequestration |
4) | Leg ulcerations |
5) | Diuresis |
____ 22. The nurse is caring for an adolescent who is newly diagnosed with thalassemia major. What information should the nurse include in teaching the family about this diagnosis? (Select all that apply.)
1) | There is a cure for thalassemia major. |
2) | A bone marrow transplant would help maintain perfusion. |
3) | Regular transfusions are required to keep the hemoglobin level above 10 g/dL. |
4) | Repetitive transfusions can lead to iron overload. |
5) | This condition does not cause weakness or fatigue. |
____ 23. The nurse is providing care to a child diagnosed with cancer. Laboratory results indicate anemia. Based on the laboratory results, which clinical manifestations do(es) the nurse anticipate? (Select all that apply.)
1) | Fever |
2) | Fatigue |
3) | Bleeding |
4) | Muscle cramps |
5) | Tachycardia |
____ 24. The nurse prepares to transfuse 2 units of PRBCs to a child with severe anemia. When caring for this child, the nurse monitors for which side effects and potential complications? (Select all that apply.)
1) | Fatigue |
2) | Hypotension |
3) | Urticaria |
4) | Fever |
5) | Hypertension |
____ 25. The nurse is preparing to discharge a pediatric patient recovering from iron-deficiency anemia. Which information should the nurse include in the discharge teaching regarding management in the home environment? (Select all that apply.)
1) | Rinse the child’s mouth after taking oral iron. |
2) | Oral elemental iron should be taken with orange juice. |
3) | Oral iron should be taken with milk products. |
4) | Encourage well-balanced meals. |
5) | Supplemental oral iron can cause the child to become constipated. |
Chapter 38: Child With an Oncological or Hematological Condition
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Safe Maternity Nursing Care 2nd Ed - Exam Resource Pack
By Luanne Linnard Palmer