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T5 hematology
| Question | Answer |
|---|---|
| Which child should the nurse document as being anemic | 1-year-old child with a hemoglobin of 13 g/dl |
| Several blood tests are ordered for a preschool child with severe anemia. The child is crying and upset because of memories of the venipuncture done at the clinic 2 days ago. The nurse should explain | topical application of local anesthetic can eliminate venipuncture pain. The nurse is planning activity for a 4-year-old child with anemia. Which activity should the nurse plan for this child |
| The nurse is teaching parents about the importance of iron in a toddler’s diet. Which explains why iron deficiency anemia is common during toddlerhood | Milk is a poor source of iron. |
| The nurse is teaching parents of an infant about the causes of iron deficiency anemia. Which statement best describes iron deficiency anemia in infants | Clinical manifestations are similar regardless of the cause of the anemia. |
| Which should the nurse include when teaching the mother of a 9-month-old infant about administering liquid iron preparation | Adequate dosage will turn the stools a tarry green color. |
| Iron dextran is ordered for a young child with severe iron deficiency anemia. Nursing considerations include to | inject deeply into a large muscle. |
| The nurse is recommending how to prevent iron deficiency anemia in a healthy, term, breast-fed infant. Which should be suggested | Iron-fortified infant cereal by age 4 to 6 months |
| Parents of a child with sickle cell anemia ask the nurse, “What happens to the hemoglobin in sickle cell anemia?” Which statement by the nurse explains the disease process | Normal adult hemoglobin is replaced by abnormal hemoglobin. |
| When both parents have sickle cell trait, which is the chance their children will have sickle cell anemia | 25% |
| The nurse is conducting a staff in-service on sickle cell anemia. Which describes the pathologic changes of sickle cell anemia | Increased red blood cell destruction occurs. |
| Which clinical manifestation should the nurse expect when a child with sickle cell anemia experiences an acute vasoocclusive crisis | Painful swelling of hands and feet; painful joints |
| Meperidine (Demerol) is not recommended for children in sickle cell crisis because it | may induce seizures. |
| A school-age child is admitted in vasoocclusive sickle cell crisis. The child’s care should include | adequate hydration and pain management. |
| The parents of a child hospitalized with sickle cell anemia tell the nurse that they are concerned about narcotic analgesics causing addiction. Which is appropriate for the nurse to explain about narcotic analgesics | Rarely cause addiction because they are medically indicated |
| Which statement best describes β-thalassemia major (Cooley anemia) | Increased incidence occurs in families of Mediterranean extraction. |
| Chelation therapy is begun on a child with β-thalassemia major. The purpose of this therapy is to | eliminate excess iron. |
| In which of the conditions are all the formed elements of the blood simultaneously depressed | Aplastic anemia |
| A possible cause of acquired aplastic anemia in children is | drugs. |
| Parents of a hemophiliac child ask the nurse, “Can you describe hemophilia to us?” Which response by the nurse is descriptive of most cases of hemophilia | X-linked recessive inherited disorder in which a blood-clotting factor is deficient |
| The nurse is conducting a staff in-service on childhood blood disorders. Which describes the pathology of idiopathic thrombocytopenic purpura | An excessive destruction of platelets |
| Which is most descriptive of the pathophysiology of leukemia | Unrestricted proliferation of immature white blood cells (WBCs) occurs. |
| A boy with leukemia screams whenever he needs to be turned or moved. Which is the most probable cause of this pain | Bone involvement |
| Myelosuppression, associated with chemotherapeutic agents or some malignancies such as leukemia, can cause bleeding tendencies because of a(n) | decrease in blood platelets. |
| A child with leukemia is receiving triple intrathecal chemotherapy consisting of methotrexate, cytarabine, and hydrocortisone. The purpose of this is to prevent | central nervous system (CNS) disease. |
| A young boy will receive a bone marrow transplant (BMT). This is possible because one of his older siblings is a histocompatible donor. Which is this type of BMT called | Allogeneic |
| Which is the most effective pain-management approach for a child who is having a bone marrow aspiration | Conscious or unconscious sedation |
| Which immunization should not be given to a child receiving chemotherapy for cancer | Measles, rubella, mumps |
| Which is often administered to prevent or control hemorrhage in a child with cancer | Platelets |
| The nurse is administering an IV chemotherapeutic agent to a child with leukemia. The child suddenly begins to wheeze and have severe urticaria. Which is the most appropriate nursing action | Stop drug infusion immediately. |
| A school-age child with leukemia experienced severe nausea and vomiting when receiving chemotherapy for the first time. Which is the most appropriate nursing action to prevent or minimize these reactions with subsequent treatments | Administer an antiemetic before chemotherapy begins. |
| A young child with leukemia has anorexia and severe stomatitis. The nurse should suggest that the parents try which intervention | Relax any eating pressures. |
| The nurse is preparing a child for possible alopecia from chemotherapy. Which should be included | Explain to child that when hair regrows, it may have a slightly different color or texture. |
| Which is a common clinical manifestation of Hodgkin disease | Enlarged, firm, nontender lymph node |
| Which is caused by a virus that primarily infects a specific subset of T lymphocytes, the CD4+ T cells | Acquired immunodeficiency syndrome (AIDS) |
| A young child with human immunodeficiency virus (HIV) is receiving several antiretroviral drugs. The purpose of these drugs is to | delay disease progression. |
| Which immunization should be given with caution to children infected with human immunodeficiency virus (HIV) | Varicella |
| The nurse is planning care for an adolescent with AIDS. Which is the priority nursing goal | Preventing infection |
| The school nurse is informed that a child with human immunodeficiency virus (HIV) will be attending school soon. Which is an important nursing intervention | Carefully follow universal precautions. |
| The nurse is conducting a staff in-service on inherited childhood blood disorders. Which statement describes severe combined immunodeficiency syndrome (SCIDS) | There is a deficit in both the humoral and cellular immunity with this disease. |
| Several complications can occur when a child receives a blood transfusion. Which is an immediate sign or symptom of an air embolus | Sudden difficulty in breathing |
| An 8-year-old girl is receiving a blood transfusion when the nurse notes that she has developed precordial pain, dyspnea, distended neck veins, slight cyanosis, and a dry cough. These manifestations are most suggestive of | circulatory overload. |
| An adolescent will receive a bone marrow transplant (BMT). The nurse should explain that the bone marrow will be administered by which route | IV infusion |
| The nurse is reviewing first aid with a group of school nurses. Which statement made by a participant indicates a correct understanding of the information | “If a child has a nosebleed, I should have the child sit up and lean forward.” |
| The nurse is planning care for a school-age child admitted to the hospital with hemophilia. Which interventions should the nurse plan to implement for this child | Avoidance of IM injections ,Acetaminophen (Tylenol) for mild pain control ,Soft tooth brush for dental hygiene |
| Parents of a school-age child with hemophilia ask the nurse, “Which sports are recommended for children with hemophilia?” Which sports should the nurse recommend | Swimming, Golf, Bowling |
| Which should the nurse teach about prevention of sickle cell crises to parents of a preschool child with sickle cell disease | Notify the health care provider if a fever of 38.5° C (101.3° F) or greater occurs ,Give penicillin as prescribed, Notify the health care provider if your child begins to develop symptoms of a cold. |
| The nurse is preparing to give oral care to a school-age child with mucositis secondary to chemotherapy administered to treat leukemia. Which preparations should the nurse use for oral care on this child | Chlorhexidine gluconate (Peridex), Antifungal troches (lozenges), Lip balm (Aquaphor) |
| A toddler with leukemia is on IV chemo tx The toddler’s lab results are WBC: 1000; neutrophils: 7%; nonsegmented neutrophils (bands): 7%. What is this child’s absolute neutrophil count (ANC) | 140 |
| The nurse has initiated a blood transfusion on a preschool child. The child begins to exhibit signs of a transfusion reaction what interventions are done | stop fusion, vitals, maintain patent IV w/ NS, notify MD |
Created by:
marcil21