Exam (elaborations)

Chapter 24: NURS 340 Preparation For The Nclex Questions and Answers ,100% CORRECT

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Chapter 24: NURS 340

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Chapter 24: NURS 340

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Contains Questions & answers

chapter 24 nurs 340 preparation for the nclex questions and answers
1 the nurse is caring for a 16 year old boy with acute myelogenous leukemia who is having chemotherapy and who has incomplete reco

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Chapter 24: NURS 340 Preparation For The Nclex Questions
and Answers
Origin: Chapter 24, 1
1. The nurse is caring for a 16-year-old boy with acute myelogenous leukemia
who is having chemotherapy and who has incomplete records for varicella
zoster immunization. Which is the priority nursing diagnosis?
A) Pain related to adverse effects of treatment verbalized by the child
B) Nausea related to side effects of chemotherapy verbalized by the child
C) Constipation related to the use of opioid analgesics for pain
D) Risk for infection related to neutropenia and
immunosuppression Ans: D
Feedback:
The priority nursing diagnosis is risk for infection related to neutropenia
and immunosuppression. The incomplete records for varicella zoster
immunization can cause a problem since exposure to chickenpox could
cause sepsis, so the nurse should contact the oncologist for approval to
administer the vaccine. Certain vaccines are not administered when the
child is immunosuppressed, so timing is crucial. Diagnoses for pain and
nausea are valid for this child because he is undergoing chemotherapy, but
they are not a priority. Likewise, the need for constipation management
would not be necessary unless opioid use begins.

Origin: Chapter 24, 2
2. The nurse is caring for an 8-year-old girl who has been diagnosed with
leukemia and will have a variety of tests, including a lumbar puncture,
before beginning chemotherapy.
What action would be the priority?
A) Applying EMLA to the lumbar puncture site
B) Educating the child and family about the testing procedures
C) Administering promethazine as ordered for nausea
D) Educating the family about chemotherapy and its
side effects Ans: B
Feedback:
The priority would be educating the child and family about the testing
procedures so they know what to expect and understand why the tests are
being performed. Applying EMLA to the lumbar puncture site will be done
prior to the procedure. The family will be educated about chemotherapy
Page 1

, and its side effects prior to the therapy beginning, and promethazine or
other antiemetics will be administered once chemotherapy has begun.

Origin: Chapter 24, 3
3. The nurse is caring for a 13-year-old boy with acute myelogenous
leukemia who is experiencing feelings of powerlessness due to the
effects of chemotherapy. What intervention will best help the teen's
sense of control?
A) Involving the boy in decisions whenever possible
B) Acknowledging the boy's feelings of anger with the disease
C) Providing realistic expectations of treatments and outcomes
D) Recognizing abilities that are unaffected by
the disease Ans: A

Page 2

, Feedback:
Involving the boy in the decision-making process will best help his sense of
control. Whether he is included in important decisions about therapy or
minor decisions like menus or dress, it will give him a sense of control over
his situation. Acknowledging feelings of anger, recognizing his abilities, and
providing realistic expectations will reduce body image disturbance and
build self-esteem.

Origin: Chapter 24, 4
4. The nurse is caring for a 5-year-old girl with a disseminated
medulloblastoma. What intervention would be most appropriate for
this situation?
A) Providing emotional support to the parents and siblings of the child
B) Recommending support groups for people whose children have cancer
C) Encouraging the family to cry and express feelings away from the child
D) Educating the family about the disease, its treatments, and
side effects Ans: C
Feedback:
The outcome of this highly malignant medulloblastoma is often not
positive. Helping the family through anticipatory grieving by encouraging
the family to cry and express feelings away from the child would be unique
to this child's situation. Educating the family about the disease, its
treatments, and side effects; recommending support groups; and providing
emotional support to the parents and siblings would be appropriate for
any child with cancer.

Origin: Chapter 24, 5
5. The nurse is assessing a 3-year-old boy whose parents brought him to the
clinic when they noticed that the right side of his abdomen was swollen.
What finding would suggest this child has a neuroblastoma?
A) The child has a maculopapular rash on his palms.
B) The parents report that their son is vomiting and not eating well.
C) The parents report that their son is irritable and not gaining weight.
D) Auscultation reveals wheezing with diminished
lung sounds. Ans: B
Feedback:
Along with the swollen abdomen on one side, the parents reporting that
Page 3

, the child is vomiting and anorexic points to the possibility of a
neuroblastoma. Observing a maculopapular rash on the child's palms is a
sign of graft-versus-host disease. The parents reporting that the child is
irritable and not gaining weight suggests a possible brain tumor as well as
malabsorption problems. Auscultation revealing wheezing with diminished
lung sounds would suggest other problems, not a neuroblastoma.

Origin: Chapter 24, 6
6. The nurse is educating the parents of a 4-year-old boy with a Wilms tumor
who is about to have chemotherapy prior to surgery. Which statement by
the parents indicates that the

Page 4

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Chapter 24: NURS 340 Preparation For The Nclex Questions and Answers ,100% CORRECT

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