PEDS Final Exam

Which finding, noted during the newborn admission assessment, would lead the nurse to suspect unilateral congenital hip dysplasia?

1. Lordosis

2. Trendelenburg sign

3. Asymmetry of the gluteal and thigh fat folds

4. Telescoping of the affected limb

3. Asymmetry of the gluteal and thigh fat folds

Which clinical manifestations should the nurse monitor for when conducting a scoliosis screening for a school-age child? Select all that apply.

1. Lordosis

2. Prominent scapula

3. Pain

4. A one-sided rib hump

5. Uneven shoulders and hips

2, 4, 5

Which parental statement would cause the nurse to include further education related to the care required for a child who is diagnosed with congenital clubfoot?

1. "We're getting a special car seat to accommodate the casts."

2. "We'll watch for any swelling of the feet while the casts are on."

3. "We'll keep the casts dry."

4. "We're happy this is the only cast our baby will need."

4. "We're happy this is the only cast our baby will need."

Which is the priority nursing diagnosis for nurse to use when planning care for a school-age child who must wear a brace for correction of scoliosis?

1. Impaired Gas Exchange, Risk for

2. Altered Growth and Development, Risk for

3. Impaired Skin Integrity, Risk for

4. Impaired Mobility, Risk for

3. Impaired Skin Integrity, Risk for

Which assessment finding would require an immediate nursing action when providing care to an adolescent who is postoperative for spinal fusion surgery?

1. Sleeps when not bothered but arouses easily with stimuli

2. Impaired color, sensitivity, and movement to lower extremities

3. Nausea relieved by antiemetics

4. Pain relieved by analgesics

2. Impaired color, sensitivity, and movement to lower extremities

The nurse is providing care to a child who is diagnosed with Legg-Calvé-Perthes disease. Which parental statement regarding the child's care required further teaching from the nurse?

1. "We're glad this will only take about 6 weeks to correct."

2. "We understand abduction of the affected leg is important."

3. "We know to watch for areas on the skin that the brace might rub."

4. "We understand swimming is a good sport for Legg-Calvé-Perthes."

1. "We're glad this will only take about 6 weeks to correct."

Which teaching topic is the priority for the nurse who is teaching the family of an infant diagnosed with osteogenesis imperfecta?

1. Cast care

2. Trunk and extremity support during everyday care

3. Postoperative spinal surgery care

4. Traction care

2. Trunk and extremity support during everyday care

An infant returns to the unit following surgical correction of bilateral congenital clubfeet. The infant has bilateral long-leg casts. The nurse notes that the toes on both feet are edematous, but there is color, sensitivity, and movement to them. Which action by the nurse is the priority?

1. Apply a warm, moist pack to the feet.

2. Elevate the legs on pillows.

3. Encourage movement of the toes.

4. Call the surgical provider to report the edema.

2. Elevate the legs on pillows.

Which should the nurse include in a teaching session for the parents of an infant who will be placed in a Pavlik harness for the treatment of congenital developmental dysplasia?

1. Apply lotion or powder to minimize skin irritation.

2. Check at least 2 or 3 times a day for red areas under the straps.

3. Put clothing over the harness for maximum effectiveness of the device.

4. Place a diaper over the harness, preferably using a thin, superabsorbent, disposable

2. Check at least 2 or 3 times a day for red areas under the straps.

Which action by the nurse is appropriate for a child who presents in the emergency department with an ankle injury?

1. Avoid compressing the area to allow tissue swelling as necessary.

2. Perform passive range-of-motion to the extremity.

3. Lower the extremity below the level of the heart.

4. Apply ice to the extremity.

4. Apply ice to the extremity.

Which clinical data noted by the nurse during the shift assessment indicate the pediatric client may be experiencing compartment syndrome? Select all that apply.

1. Pink, warm extremity

2. Dorsalis pedis pulse present

3. Prolonged capillary refill time

4. Pain not relieved by pain medication

5. Paresthesia of the leg

3, 4, 5

The father of a school-age child who requires hospital admission for intravenous antibiotics to treat osteomyelitis states, "I don't understand why normal antibiotics can't be used." Which should the nurse include in the response to the father?

1. The antibiotic of choice is not available in oral form.

2. Blood flow to bones is limited, and parenteral administration is necessary to get appropriate blood levels.

3. Because the child is older now, it is harder to get the child to cooperate with oral antibiotics.

4. Because 2 weeks of therapy is necessary, the intravenous route will produce fewer side effects.

2. Blood flow to bones is limited, and parenteral administration is necessary to get appropriate blood levels.

Which assessment finding for a toddler-age child in balanced Bryant traction for a fractured right femur would require immediate action by the nurse?

1. The child keeps trying to turn and lie on his belly.

2. The ropes are unequal in length.

3. The child's buttocks are resting on the bed.

4. The Ace bandage wrapping the legs is wrinkled.

3. The child's buttocks are resting on the bed.

Which interventions should the nurse include in the plan of care for an adolescent client who is on complete bed rest after spinal fusion surgery secondary to scoliosis to prevent complications associated with immobility? Select all that apply.

1. Encouraging use of the spirometer every 2 hours while the child is awake

2. Log-rolling the client every 2 hours while awake

3. Increasing intake of milk to maintain bone calcium

4. Increasing fruit and grains in the diet

5. Limiting fluid intake to reduce the need to void

1, 2, 4

A school nurse suspects that a child who fell at recess has a fractured arm. Which should the nurse consider when applying a splint to transport the child to the hospital?

1. The splint is applied firmly enough to prevent swelling.

2. The arm is fully extended in the splint.

3. The splint is fully padded to prevent skin damage.

4. The joints above and below the suspected fracture are immobilized by the splint.

4. The joints above and below the suspected fracture are immobilized by the splint.

Which assessment data obtained by the nurse during the health history portion of the assessment process support the current diagnosis of Duchenne muscular dystrophy (MD) for an 18-month-old child?

1. Infant was postmature by almost 2 weeks.

2. The child seems very muscular.

3. The child walked early and without support at 10 months.

4. The child's older sister developed scoliosis in the fourth grade.

2. The child seems very muscular.

Which should the nurse include in the neurovascular assessment for an infant following casting of the leg for talipes equinovarus?

1. Warmth

2. Capillary refill

3. Pedal pulse

4. Sensation

5. Movement of the toes

1, 2, 4, 5

Which clinical manifestations should the nurse expect when assessing a pediatric client who is diagnosed with congenital hip dysplasia (CHD)? Select all that apply.

1. Limited adduction of the affected hip

2. Asymmetry of thigh fat folds

3. Telescoping of the thigh

4. Muscle weakness

5. Atrophy of the muscles

2, 3

Which clinical manifestations should the nurse expect when assessing a pediatric client who is diagnosed with Legg-Calvé-Perthes disease? Select all that apply.

1. Limited abduction of the affected hip

2. Asymmetry of thigh fat folds

3. Telescoping of the thigh

4. Muscle weakness

5. Atrophy of the muscles

4, 5

Which are appropriate interventions for the nurse to include in the plan of care for a child who is receiving traction? Select all that apply.

1. Monitoring breath sounds

2. Assessing neurovascular status every 2 hours

3. Repositioning every 2 to 3 hours

4. Using moleskin to protect the skin from rough edges

5. Encouraging the parents cuddle with their child

1, 2, 5

Which are appropriate interventions for the nurse to include in the plan of care for a child who is casted? Select all that apply.

1. Monitoring breath sounds

2. Assessing neurovascular status every 4 hours

3. Repositioning every 2 to 3 hours

4. Using moleskin to protect the skin from rough edges

5. Encouraging the parents cuddle with their child

1, 3, 4, 5

Which injury prevention strategies should the nurse include in the plan of care for a pediatric client who is diagnosed with muscular dystrophy?

1. Develop a home fire evacuation plan.

2. Provide information regarding oxygen safety.

3. Recommend the use of portable generator.

4. Teach safe transfer methods.

5. Perform neurovascular checks every 2 hours.

1, 2, 3, 4

The nurse prepares to administer a vitamin K injection during the admission assessment for a newborn. The father asks, "Why does my baby need a shot?" Which rationale for administering this injection should the nurse include in the response?

1. Activates clotting factors

2. Dissolves blood clots

3. Promotes gas exchange

4. Promotes the production of hemoglobin

1. Activates clotting factors

Which parental statement indicates correct understanding of information presented regarding the treatment for infant anemia?

1. "We will add green leafy vegetables to our child's low-iron formula."

2. "We will discontinue the use of vitamin C supplements by 6 months of age."

3. "We will begin an iron-fortified infant cereal at 4 to 6 months of age."

4. "We will introduce cow's milk by 6 months of age."

3. "We will begin an iron-fortified infant cereal at 4 to 6 months of age."

The parents of an infant diagnosed with sickle-cell disease ask, "How did our child get this disease? Neither one of us has it." Which should the nurse consider when responding to the parents?

1. The father is not the biologic father of the infant.

2. The mother of the child has the trait, but the father does not.

3. The father of the child has the trait, but the mother does not.

4. The mother and the father of the child have the sickle-cell trait.

4. The mother and the father of the child have the sickle-cell trait.

Which parental statements regarding precipitating factors for sickle-cell disease indicate correct understanding of the discharge information presented by the nurse? Select all that apply.

1. "My child should avoid regular exercise."

2. "We should provide acetaminophen or ibuprofen to treat fever."

3. "Our child needs to drink lots of fluid to avoid dehydration when playing sports."

4. "High altitudes can cause exacerbation and should be avoided."

5. "Fluid restriction is necessary to avoid exacerbations from occurring."

2, 3, 4

The nurse is administering packed red blood cells to a child with sickle-cell disease (SCD). When should the nurse monitor the child closely due to the risk of reaction?

1. Six 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.

3. The first 20 mL of blood administered.

A child who has beta-thalassemia is receiving numerous blood transfusions and deferoxamine (Desferal) therapy. The parents ask how the deferoxamine will help their child. Which response by the nurse is accurate?

1. "It stimulates red blood cell production."

2. "It prevents iron overload."

3. "It provides vitamin supplementation."

4. "It decreases the risk of transfusion reactions."

2. "It prevents iron overload."

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 the bone marrow producing inadequate cells."

4. "Aplastic anemia is a disorder that occurs after a viral illness."

3. "Aplastic anemia is caused the bone marrow producing inadequate cells."

Which symptoms should the nurse include in the teaching plan for the family of a recently child diagnosed with aplastic anemia?

1. Fatigue and fever

2. Runny nose and cough

3. Nausea and vomiting

4. Cyanosis and bradycardia

1. Fatigue and fever

A child diagnosed with hemophilia presents to the emergency department (ED) with multiple injuries following a motor vehicle crash. Which injury is the priority when conducting the nursing assessment?

1. Occipital hematoma

2. Radial fracture

3. Dislocated shoulder

4. Abdominal abrasions

1. Occipital hematoma

Which nursing action is appropriate when treating a school-age 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

1. Applying pressure to the area

The nurse is providing care to a child diagnosed with hemophilia who states, "I am going to join a bike club at school." Which recommendation should the nurse give to the child?

1. Wear knee pads, elbow pads, and a helmet while bicycling.

2. Consider a swim club instead of the bicycling club.

3. Do not join the club.

4. Participate only in the social activities of the club.

1. Wear knee pads, elbow pads, and a helmet while bicycling.

Which is the priority nursing intervention when providing care to a pediatric client who is experiencing disseminated intravascular coagulation (DIC)?

1. Preparing the child for radiographic procedures

2. Implementing the prescribed fluid restriction for the child

3. Encouraging the child to frequently ambulate

4. Monitoring the child's oxygen saturation and vital signs

4. Monitoring the child's oxygen saturation and vital signs

Which is the priority nursing diagnosis for the child diagnosed with idiopathic thrombocytopenic purpura (ITP)?

1. Ineffective Breathing Pattern

2. Nausea

3. Fluid Volume Deficit

4. Risk for Injury

4. Risk for Injury

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

3. Adequate hydration

Which teaching topic should the nurse include in the discharge instructions for the family of child diagnoses with sickle-cell disease to prevent crisis?

1. Respiratory infection and dehydration

2. Mid-range altitudes

3. Weight loss without dehydration

4. Overhydration

1. Respiratory infection and dehydration

Which risks should the nurse closely assess a pediatric client for during the posttransplant phase of hematopoietic stem cell transplantation (HSCT)?

1. Hemorrhage

2. Thrombosis

3. Pancytopenia

4. Infection

5. Fluid volume overload

1, 3, 4

Which concepts should the nurse include in the discharge instructions for a child who has undergone a hematopoietic stem cell transplantation (HSCT)? Select all that apply.

1. Keeping the child on a high-calcium diet

2. Practicing good hand washing

3. Avoiding live plants and fresh vegetables

4. Avoiding influenza vaccinations

5. Returning the child to school within 6 weeks

1, 2, 3

During a natural disaster, a child diagnosed with hemophilia is injured and bleeding internally. Which blood product should the nurse plan to administer if the appropriate factor is not available?

1. Platelets

2. Whole blood

3. Packed cells

4. Fresh or fresh frozen plasma

4. Fresh or fresh frozen plasma

A school-age child diagnosed with classic hemophilia is admitted to the hospital for hemorrhage into the knee joint. Which nursing diagnosis should the nurse use to plan care for this child?

1. Risk for Impaired Physical Mobility related to joint stiffness and contractures

2. Risk for Impaired Tissue Perfusion (cerebral) related to blood loss.

3. Activity Intolerance related to bleeding

4. Disturbed Body Image related to swollen knee

1. Risk for Impaired Physical Mobility related to joint stiffness and contractures

Which rationale should the nurse include in the teaching session, related to infant iron deficiency anemia, when a parent asks why it is inappropriate to switch from formula to cow's milk prior to 1 year of age? Select all that apply.

1. Cow's milk is a poor source of iron.

2. The child may be exposed to an antibiotic in processed milk.

3. Cow's milk has a high fat content.

4. In young children, cow's milk can lead to bleeding from the gastrointestinal tract.

5. Cow's milk contains no vitamin C, which is necessary for iron absorption.

1, 4

The nurse is preparing to administer a blood transfusion to a child with a severe anemia. Which type of transfusion reaction can be avoided by the nurse's assessment?

1. Allergic

2. Hemolytic

3. Febrile

4. Septic

2. Hemolytic

The heatlthcare provider prescribes a unit of packed red blood cells for a pediatric client. Which intravenous fluid should the nurse hang during the blood transfusion?

1. D5W

2. D5LR

3. D5 1/4NS

4. NS

4. NS

A school-age child is admitted to the hospital in a sickle-cell crisis. Which actions should the nurse include in the plan of care to address the child's pain?

1. Administering opioid analgesics, per order

2. Administering nonsteroidal anti-inflammatory drugs (NSAIDs), per order

3. Applying cold packs to affected joints, prn

4. Encouraging oral fluid intake

5. Maintaining bed rest

1, 2, 4, 5

The healthcare provider orders laboratory tests following the initiation of treatment for a child diagnosed with iron deficiency anemia. Which laboratory result should the nurse share with the child's family as an indication of improvement?

1. Low hemoglobin

2. Normal platelet count

3. High reticulocyte count

4. Low hematocrit

3. High reticulocyte count

Which topic should the nurse include in the discharge instructions for the family of a child who has undergone hematopoietic stem cell transplantation (HSCT)?

1. Avoiding influenza vaccination

2. Returning to school within 6 weeks

3. Maintaining a low-calcium diet

4. Practicing diligent hand hygiene

4. Practicing diligent hand hygiene

Which functions of red blood cells (RBCs) should the nurse include in a teaching session for the family of a pediatric client who is diagnosed with anemia? Select all that apply.

1. Carry oxygen from the lungs to the tissues

2. Return carbon dioxide from the tissues to the lungs

3. Assist the body to fight infection

4. Assist the body to fight allergens

5. Form hemostatic plugs to stop bleeding

1, 2

Which functions of white blood cells (WBCs) should the nurse include in a teaching session for the family of a pediatric client who is diagnosed with human immunodeficiency virus (HIV)? Select all that apply.

1. Carry oxygen from the lungs to the tissues

2. Return carbon dioxide from the tissues to the lungs

3. Assist the body to fight infection

4. Assist the body to fight allergens

5. Form hemostatic plugs to stop bleeding

3, 4

A child is diagnosed with lymphocytopenia. Which parental statements indicate understanding of this diagnosis? Select all that apply.

1. "My child may be prone to allergic reactions."

2. "My child may have trouble initiating an inflammatory response."

3. "My child may require iron supplements to treat this disorder."

4. "My child may require further testing for leukemia."

5. "My child may have been exposed to tuberculosis."

4, 5

The nurse is providing care to a pediatric client who is diagnosed with leukopenia. Which disorders should the nurse suspect based on this information? Select all that apply.

1. Cardiovascular

2. Immune

3. Bone marrow

4. Respiratory

5. Neurologic

2, 3

Which injury prevention topics should the nurse include in the plan of care for a pediatric client who has received hematopoietic stem cell transplantation (HSCT)? Select all that apply.

1. Medication storage strategies

2. Needle and syringe disposal

3. Immunization schedule

4. Yearly influenza vaccination

5. Routine dental appointments

1, 2

A parent of a newborn asks the nurse why young children seem to become ill so often when compared with older children and adults. Which is the best response by the nurse?

1. "Newborns have lower numbers of natural killer cells."

2. "Newborns have high levels of IgA in their systems."

3. "Newborns are lacking lymphoid tissue."

4. "Newborns have an immature thymus gland."

1. "Newborns have lower numbers of natural killer cells."

A premature neonate is at greater risk for infection than a full-term newborn because of a reduced number of which immunoglobulin?

1. IgE

2. IgG

3. IgA

4. IgM

2. IgG

The nurse is planning care for a child with acquired immune deficiency syndrome (AIDS). Which vaccines should be avoided in the child with AIDS?

1. Inactivated polio vaccine

2. Tetanus toxoid vaccination

3. Varicella vaccine

4. Acellular pertussis vaccine

3. Varicella vaccine

An adolescent female client is diagnosed with systemic lupus erythematosus (SLE). Which action by the client indicates acceptance of the body changes that occur because of SLE?

1. Attends school but does not stay for after-school activities

2. Discusses the body changes with healthcare providers only

3. Discusses the body changes with her best friend

4. Only attends small parties at friends' homes

3. Discusses the body changes with her best friend

A school-age client diagnosed with rheumatoid arthritis (RA) wants to participate in the school sports programs. The client asks the nurse to recommend a sporting activity that is appropriate. Which activity would be the most appropriate for the nurse to recommend?

1. Baseball

2. Basketball

3. Football

4. Swimming

4. Swimming

The nurse is caring for a child with rheumatoid arthritis. Which nonpharmacologic intervention should the nurse include in the plan of care for joint pain?

1. Elevation of the extremity

2. Immobilization

3. Massage

4. Application of moist heat

4. Application of moist heat

In which position should the nurse place a child who is experiencing an anaphylactic shock reaction?

1. Trendelenburg position

2. Flat, with legs slightly elevated

3. High Fowler position

4. Reverse Trendelenburg position

2. Flat, with legs slightly elevated

A child is prescribed oral corticosteroid for a rash caused by graft-versus-host disease. Which should the nurse monitor the child for after administering the drug?

1. Hyperglycemia

2. Hepatic toxicity

3. Seizures

4. Renal toxicity

1. Hyperglycemia

After a severe allergic reaction, an EpiPen is prescribed for the school-age child. Which instructions should the nurse provide to this child's parents based on the current data? Select all that apply.

1. "It is important that your child always has access to this medication."

2. "Your child is too young to self-administer this medication."

3. "If you are able to administer the medication, there is no need for follow-up care."

4. "It is important to check the expiration date on the medication and replace if expired."

5. "Your child should wear a Medic Alert bracelet at all times."

1, 4, 5

An adolescent female client is diagnosed with systemic lupus erythematosus (SLE). Which should the nurse include in the teaching session regarding an activity that should be avoided?

1. Receiving a manicure and a pedicure

2. Washing the hair with shampoo daily

3. Using a tanning bed

4. Attending late night parties and dances

3. Using a tanning bed

Which is the priority nursing action when providing care to a pediatric client who has documented allergies to cow's milk, peanuts, and latex?

1. Evaluating the hospital room for equipment containing latex

2. Ordering an EpiPen for the child

3. Notifying dietary of the milk and peanut allergy

4. Placing a sign on the door which identifies all allergies

1. Evaluating the hospital room for equipment containing latex

Which is the rationale for ensuring the irrigation of blood products and ensuring that they are cytomegalovirus (CMV)-negative prior to administering a blood transfusion for a pediatric client diagnosed with severe combined immune deficiency (SCID)?

1. Transfusion reaction from lymphocytes and platelets in the donor blood.

2. Transfusion reaction and infection from lymphocytes in the donor blood.

3. Infection and graft-versus-host disease from lymphocytes in the donor blood.

4. Infection and graft-versus-host disease from erythrocytes in the donor blood.

3. Infection and graft-versus-host disease from lymphocytes in the donor blood.

A nurse is planning care for a child with human immunodeficiency virus (HIV). Which is the priority nursing diagnosis for this child?

1. Ineffective Peripheral Tissue Perfusion

2. Ineffective Thermoregulation

3. Risk for Fluid Volume Deficit

4. Risk for Infection

4. Risk for Infection

A child is receiving a nucleoside reverse transcriptase inhibitor for human immunodeficiency virus (HIV). Which laboratory value should the nurse include in the plan of care as needing to monitor?

1. Glucose

2. Sodium

3. Potassium

4. Red blood cell count

4. Red blood cell count

A child with human immunodeficiency virus (HIV) is diagnosed with oral candidiasis. Which should the nurse include in the plan of care related to oral care based on this information?

1. Listerine

2. Normal saline

3. Viscous lidocaine

4. Scope

2. Normal saline

The nurse is providing care for the family of a child who is diagnosed with acquired immunodeficiency syndrome (AIDS). Which priority nursing diagnosis should the nurse include in the plan of care?

1. Anticipatory Grieving

2. Risk for Impaired Parenting

3. Compromised Family Coping

4. Parental Role Conflict

1. Anticipatory Grieving

The nurse is providing discharge instructions to the family of a child who experienced an anaphylactic reaction. Which parental statements indicate accurate understanding of the action that histamine plays during this type of reaction? Select all that apply.

1. "Histamine releases IgE antibodies, which help to stop the reaction."

2. "Histamine causes smooth muscle contraction, which causes the wheezing."

3. "Histamine causes increased capillary permeability, which is what causes difficulty breathing."

4. "Histamine causes vasoconstriction leading to respiratory issues."

5. "Histamine causes the destruction of red blood cells, which is why we administer the EpiPen."

2, 3

When teaching a pregnant client about antibodies that are passed from mother to newborn, which antibody should the nurse include?

1. IgM

2. IgA

3. IgD

4. IgG

4. IgG

Which infection control measures should the nurse include in the discharge instructions for the family of a child who is immunodeficient? Select all that apply.

1. "It is important that your child does not share cups with other members of the family."

2. "You should avoid washing your child's utensils in the dishwasher."

3. "You should allow your child to eat fresh fruit with the skin intact."

4. "It is important that everyone practices hand hygiene before touching your child."

5. "You should use alcohol wipes to cleanse your child's diaper area."

1, 4

Which interventions should the nurse include in the plan of care to address nutrition for a child who is diagnosed with acquired immunodeficiency syndrome (AIDS)? Select all that apply.

1. Encourage three large meals each day.

2. Eliminate unpleasant odors from the environment during meals.

3. Weigh the child each day, using the same scale.

4. Assess skin turgor every 4 hours.

5. Include favorite foods in the meal plan.

2, 3, 5

Which interventions should the nurse include in the plan of care for a hospitalized child who is diagnosed with rheumatoid arthritis (RA)? Select all that apply.

1. Performing passive range-of-motion (ROM) exercises with the child

2. Discouraging the child from completing activities of daily living (ADLs)

3. Encouraging periods of rest for the child

4. Placing cool compresses on the child's joints

5. Performing daily weights

1, 3, 5

The nurse is providing education to a family whose child experiences anaphylaxis when exposed to any amount of latex. Which items, often found in the home or school environment, should the nurse include in the teaching session? Select all that apply.

1. Art supplies

2. Toothpaste

3. Balloons

4. Perfumes

5. Chewing gum

1, 3, 5

The nurse is providing care to a child who experienced an anaphylactic reaction to an unknown allergen. Which high-risk foods should the nurse question the family about regarding recent consumption?

1. Peanut butter

2. Shrimp

3. Eggs

4. Milk

5. Soda

1, 2, 3

The nurse is providing care for a pediatric client who is diagnosed with a Wilms tumor. Which laboratory test result should the nurse monitor prior to administering the prescribed chemotherapy dose?

1. Hemoglobin

2. Red blood cell count

3. Platelets

4. Absolute neutrophil count (ANC)

4. Absolute neutrophil count (ANC)

Which general manifestations should the nurse monitor for when conducting a physical assessment for a pediatric client who is diagnosed with cancer? Select all that apply.

1. Infection

2. Polycythemia

3. Petechiae

4. Pain

5. Cachexia

1, 3, 4, 5

Which is a therapeutic nursing response when the mother of a pediatric client diagnosed with cancer states, "I regret not seeking medical attention earlier for my child."?

1. "You may feel guilty, but you should not blame yourself."

2. "Most cancers can be treated easily."

3. "Many types of cancer are difficult to diagnose and might not show early symptoms."

4. "Early diagnosis is not significant in the diagnosis and management of cancer."

3. "Many types of cancer are difficult to diagnose and might not show early symptoms."

A child diagnosed with cancer is prescribed chemotherapy. Recent laboratory data show a low white blood cell (WBC) count. Which prescription should the nurse anticipate based on the current data?

1. Epoetin alfa (Epogen)

2. Ondansetron (Zofran)

3. Oprelvekin (Neumega)

4. Filgrastim (Neupogen)

4. Filgrastim (Neupogen)

Which urine specific gravity, and corresponding pH, should the nurse include in a goal statement for a pediatric client receiving chemotherapy in the treatment of cancer?

1. Specific gravity 1.030 and pH 7.5

2. Specific gravity 1.005 and pH 6

3. Specific gravity 1.030 and pH 6

4. Specific gravity 1.005 and pH 7.5

4. Specific gravity 1.005 and pH 7.5

The nurse is preparing to administer a prescribed, as needed, antiemetic drug for a child who is diagnosed with cancer. Which action by the nurse is most appropriate?

1. Administering the drug only if the child is nauseated

2. Administering the drug prophylactically prior to the next dose of chemotherapy

3. Administering the drug after the next dose of chemotherapy

4. Administering the drug only if the child is experiencing diarrhea

2. Administering the drug prophylactically prior to the next dose of chemotherapy

Which nursing intervention is contraindicated for a pediatric client who is experiencing thrombocytopenia secondary to chemotherapy treatments?

1. Administering intramuscular injections

2. Monitoring intake and output

3. Palpating during the assessment

4. Providing oral hygiene

1. Administering intramuscular injections

The child is receiving chemotherapy for acute lymphocytic leukemia (ALL). Which assessment data should the nurse immediately report to the healthcare provider due to a metabolic emergency?

1. Thrombocytopenia

2. Leukocytosis

3. Oliguria

4. Edema

3. Oliguria

The adolescent client is receiving methotrexate chemotherapy after undergoing limb-salvage surgery for osteogenic sarcoma. The healthcare provider also prescribes leucovorin therapy. Which adolescent statement indicates correct understanding for the administration schedule for this newly prescribed drug?

1. "I do not have any pain, so I will not need to take the leucovorin this time."

2. "I do not have any nausea, so I .will not need the leucovorin."

3. "I am glad I only need one dose of the leucovorin."

4. "It is important that I receive my leucovorin on time, as it protects my body from the methotrexate."

4. "It is important that I receive my leucovorin on time, as it protects my body from the methotrexate."

The sibling of a pediatric client diagnosed with leukemia expresses feelings of anger and guilt to the nurse. Which explanation should the nurse provide to the client's parents regarding the reaction of the sibling?

1. Abnormal; the sibling should be referred to a psychologist.

2. Unexpected; the cancer is easily treated.

3. Unusual; the illness does not affect the sibling.

4. Normal; the sibling is affected, too, and anger and guilt are expected feelings.

4. Normal; the sibling is affected, too, and anger and guilt are expected feelings.

The nurse is providing care to a pediatric client who is receiving chemotherapy to treat acute lymphocytic leukemia (ALL). Which nursing diagnoses should the nurse include in the plan of are based on the side effects associated with the treatment? Select all that apply.

1. Risk for Injury

2. Impaired Skin Integrity

3. Risk for Electrolyte Imbalance

4. Risk for Infection

5. Sleep Deprivation

1, 2, 3, 4

Which is the priority nursing intervention for a pediatric client, diagnosed with leukemia, who has a granulocyte count of 250/mm3

and a platelet count of 150,000/mm3?

1. Fluid restriction

2. Mouth care

3. Neutropenic precautions

4. Hand hygiene

4. Hand hygiene

A child with rhabdomyosarcoma is prescribed radiation therapy after surgical removal of the tumor. Which intervention should the nurse include in the child's plan of care?

1. Apply lotion to the area before radiation therapy.

2. Apply sunscreen to the area when the child is exposed to sunlight.

3. Remove any markings left after each radiation treatment.

4. Vigorously scrub the area when bathing the child.

2. Apply sunscreen to the area when the child is exposed to sunlight.

The child is admitted to the hospital unit newly diagnosed with retinoblastoma. Which clinical manifestation does the nurse anticipate upon assessment?

1. A white reflex

2. Blue-tinged sclerae

3. A red reflex

4. Yellow-tinged sclerae

1. A white reflex

A preschool-age child is being seen in the oncology clinic. Which reaction should the nurse anticipate based on the child's stage of development?

1. Unawareness of the illness and its severity

2. Acceptance, especially if able to discuss the disease with children their own age

3. Understanding of what cancer is and how it is treated

4. Thoughts that they caused their illness and are being punished

4. Thoughts that they caused their illness and are being punished

A pediatric client diagnosed with cancer is to receive 2 months of chemotherapy that is separated by a 6-week period. The mother asks why the child cannot receive the medication for 2 months straight. Which rationale should the nurse include when responding to the

client's mother?

1. Prevention of nausea and vomiting from the drugs

2. Schedule requirement of the infusion center

3. Decrease incidence of heart failure

4. Allows normal cells to repair themselves while the cancer cells die

4. Allows normal cells to repair themselves while the cancer cells die

The parent of a child diagnosed with Ewing sarcoma asks why multiple drugs are needed to treat this cancer. Which rationale should the nurse use when responding to the client's mother?

1. The prescribed drug protocol is needed due to the aggressive nature of the cancer.

2. The prescribed drug protocol decreases side effects.

3. The prescribed drug protocol is used in specifically in children.

4. The prescribed drug protocol involves a group of drugs that work in different modes.

4. The prescribed drug protocol involves a group of drugs that work in different modes.

An adolescent female client, diagnosed with osteosarcoma, has a below-the-knee amputation as part of the treatment regimen. Which behavior, assessed by the nurse, indicates the client is beginning to accept the amputation?

1. Complaints of pain in the missing leg

2. Insists that a prosthetic be applied prior to participating in physical therapy.

3. Insists on covering the lower portion of the body prior to peer visitation.

4. Watches the dressing change

4. Watches the dressing change

A school-age child, diagnosed with rhabdomyosarcoma, is experiencing nausea and vomiting related to the prescribed chemotherapy in spite of the use of antiemetics. The mother is pushing the child to eat the food. Which statement by the nurse is appropriate to address this situation?

1. "Since your child is receiving IV fluids, it is not important to push oral intake of food."

2. "A food aversion may occur if you continue to force your child to eat."

3. "Emesis that is caused by your child being force-fed can damage the stomach."

4. "A psychologic conflict could occur between you and your child if you continue to push

eating."

2. "A food aversion may occur if you continue to force your child to eat."

The school-age child, diagnosed with a medulloblastoma, will receive intrathecal chemotherapy injections after surgery. Which rationale for this type of chemotherapy administration should the nurse include in the medication teaching?

1. It reduces side effects.

2. It does not require the child being "stuck."

3. Many chemotherapy drugs do not cross the blood-brain barrier.

4. Intrathecal administration is less expensive than intravenous administration.

3. Many chemotherapy drugs do not cross the blood-brain barrier.

The school-age child is admitted to the pediatric neurologic unit with a suspected craniopharyngioma. Which assessment data collected by the nurse supports the suspected diagnosis? Select all that apply.

1. Evening nausea

2. Excessive urination

3. Nystagmus

4. Headaches

5. Orbital ecchymosis

2, 3, 4

Which nursing actions will decrease the risk of extravasation when administering chemotherapy to a pediatric client through a peripheral line? Select all that apply.

1. Ensuring that the intravenous line is a free flowing line

2. Administering the medication by infusion pump

3. Checking for blood return before and during chemotherapy administration

4. Diluting the medication with normal saline

5. Administering the vesicant drug last

1, 3

The nurse is preparing to assist with a lumbar puncture for a pediatric client who is diagnosed with cancer. Which statements should the nurse include in the teaching session for the client and family? Select all that apply.

1. "This procedure assesses the bone marrow."

2. "This procedure assesses cerebrospinal fluid."

3. "This procedure confirms the diagnosis of acute lympoblastic leukemia."

4. "The procedure determines if malignant cells are affecting the nervous system."

5. "This procedure assesses cellular components of the blood."

2, 4

Which assessment findings, indicative of a hematologic emergency, should the nurse report to the healthcare provider due to the need for immediate intervention? Select all that apply.

1. Anemia

2. Thrombocytopenia

3. Disseminated intravascular coagulation

4. Cardiac arrhythmias

5. Tetany

1, 2, 3

Which pediatric cancer diagnoses necessitate priority assessment by the nurses for clinical manifestations associated with emergencies related to space-occupying lesions? Select all that apply.

1. Hodgkin disease

2. Leukemia

3. Neuroblastoma

4. Melanoma

5. Lymphoma

1, 3, 5