NURS 332 Exam 3 - Mallon, pediatrics

which ethnic group has the highest incidence of sickle cell disease? african americans 3 MULTIPLE CHOICE OPTIONS which procedure is appropriate when identifying the means of eliminating excess iron in a child with thalassemia major? chelation therapy 3 MULTIPLE CHOICE OPTIONS which complete blood count test value would the nurse consider outside the normal range? platelet count 70 x 10/mm3 3 MULTIPLE CHOICE OPTIONS which drug is not recommended for treating pain during sickle cell disease episodes? meperidine 3 MULTIPLE CHOICE OPTIONS which symptom would the nurse recognize as an acquired immunodeficiency syndrome (AIDS)-defining condition in an American child with HIV? cytomegalovirus 3 MULTIPLE CHOICE OPTIONS which treatment method has greatly improved the prognosis for children with HIV infection? combination antiretroviral therapy 3 MULTIPLE CHOICE OPTIONS which is the primary treatment for hemophilia? replacement of missing clotting factor 3 MULTIPLE CHOICE OPTIONS which factor is appropriate to consider when administering iron? to administer w ascorbic acid 3 MULTIPLE CHOICE OPTIONS a child w beta-thalassemia has received numerous blood transfusions and is now being started on deferoxamine. the parents want to know why the child has been started on a new medication. which is the most appropriate response? helps prevent iron overload 3 MULTIPLE CHOICE OPTIONS which statement is true regarding HIV positive children attending schools? parents or legal guardians have the right to decide whether to share HIV status w the school 3 MULTIPLE CHOICE OPTIONS what intervention is included in the mgmt of nosebleeds (epistaxis) in children? instruct child to breathe through mouth, insert cotton/wadded tissue into each nostril for persistent bleeding, apply continuous pressure to nose w thumb and forefinger for at least 10 mins characteristics of anemia caused by decreased RBC production tachycardia, SOB, pica nurse is developing a teaching plan for the family of a toddler recently diagnosed w sickle cell disease. what does the nurse include as important for the family to be aware and report to recognize signs of the major cause of death for children under age 5 w sickle cell disease? presence of fever 3 MULTIPLE CHOICE OPTIONS a nursing student caring for a patient admitted for tx of a sequestration sickle cell crisis is discussing this type of crisis w the instructor. which statement by the nursing student indicates proper understanding of this type of crisis? sequestration sickle cell crisis... which statement by the nursing student indicates proper understanding of this type of crisis? this type of crisis is characterized by pooling of large amt of blood in the spleen 3 MULTIPLE CHOICE OPTIONS common clinical manifestations of hemophilia excessive bruising, hemorrhage from any trauma, prolonged bleeding from or in the body the parent of a child receiving an iron prep tells the nurse that the child's stools are tarry and black. which would be the nurses best explanation? an expected change caused by the iron prep 3 MULTIPLE CHOICE OPTIONS which procedure does the nurse recognize as means of eliminating excess iron in a child w B-thalassemia major? chelation therapy 3 MULTIPLE CHOICE OPTIONS which intervention would b performed 1st by nurse during blood transfusion? identify donor and recipient blood types and groups 3 MULTIPLE CHOICE OPTIONS parents of child w sickle cell anemia are concerned about next kids having the dx. both parents are carriers for the sickle cell trait. which response by the nurse is most accurate? 25% chance of sibling having SCA 3 MULTIPLE CHOICE OPTIONS which would the nurse recognize as most important nursing consideration in the care of a child w sickle cell anemia? teaching parents and child how to recognize s/s of crisis 3 MULTIPLE CHOICE OPTIONS initial treatment for beta-thalassemia blood transfusions every 3-5 weeks to keep hemoglobin at acceptable lvl while performing a review of systems on a pt w hemophilia, nurse finds that the pt recently passed black tarry stools. what is suspected? pt has GI bleeding 3 MULTIPLE CHOICE OPTIONS when developing a plan of care for a child diagnosed w anemia, which activity is important for the nurse to complete to determine how to minimize tissue oxygen needs? measure childs vital signs and observe behavior during periods of rest to establish baseline for nonexertion energy expenditure 3 MULTIPLE CHOICE OPTIONS clinical definition of cure in childhood cancer completion of therapy, no evidence of any disease, a period of 5 yrs since diagnosis which type of cancer can manifest as a cat's eye reflex, or leukocoria in an infant? retinoblastoma 3 MULTIPLE CHOICE OPTIONS which is the most common brain tumor in childhood? cerebellar astrocytoma 3 MULTIPLE CHOICE OPTIONS most common form of childhood cancer? leukemia 3 MULTIPLE CHOICE OPTIONS the nurse explains that the wilms tumor is diagnosed in which part of the body? kidney which nursing consideration is correct regarding admin of IV chemo? many chemo drugs are vesicants that can cause severe cellular damage if the drug infiltrates surrounding tissue 3 MULTIPLE CHOICE OPTIONS from which body system does hodgkin originate? lymphatic 3 MULTIPLE CHOICE OPTIONS nurse recognizes which neurotoxic effect in the child who is receiving chemo with vincristine? severe constipation 3 MULTIPLE CHOICE OPTIONS education regarding possible side effects of short term steroid therapy in a child behavioral changes 3 MULTIPLE CHOICE OPTIONS which risk factor is associated w the development of tumor lysis syndrome high wbc count at diagnosis 3 MULTIPLE CHOICE OPTIONS which would nurse understand is safest and most effective way to deliver chemo to a child while minimizing discomfort? implantable infusion port 3 MULTIPLE CHOICE OPTIONS which most increases a child's risk for developing hodgkin lymphoma? AIDS 3 MULTIPLE CHOICE OPTIONS nurse is caring for a child w a wilms tumor. which is most important nursing intervention before surgery? avoiding abd palpation 3 MULTIPLE CHOICE OPTIONS which frequent complication of treatment for childhood cancer results from neutropenia? infection 3 MULTIPLE CHOICE OPTIONS child w lymphoma is undergoing extensive radiotherapy. which is most common side effect of this tx? fatigue 3 MULTIPLE CHOICE OPTIONS to keep an accurate account of drainage after a surgical removal of a tumor, which is most appropriate nursing intervention? circle the soiled area on the surgical dressing w a pen 3 MULTIPLE CHOICE OPTIONS expected physical examinations for pt w hodgkin lymphoma night sweats, fever, enlarged liver (hepatomegaly), enlarged spleen (splenomegaly) which techniques are included in a diagnostic eval of a child suspected of having cancer? lumbar puncture, chest xray, biopsy possible symptoms of cancer in children sudden eye or vision changes, excessive rapid weight loss, prolonged unexplained fever or illness, frequent headaches, unexplained decrease in energy, frequent vomiting which test is essential for the definitive diagnosis of leukemia? bone marrow aspiration 3 MULTIPLE CHOICE OPTIONS nurse is caring for a child receiving chemo IV. child begins to complain of stinging pain at IV site. most appropriate nursing action in this situation is? stopping the infusion 3 MULTIPLE CHOICE OPTIONS which are the most common s/s of leukemia related to bone marrow involvment? anemia, infection, bleeding 3 MULTIPLE CHOICE OPTIONS a nurse caring for a child w drug induced myelosuppression is preparing the family for discharge. what discharge instruction would be important? monitor closely and call oncologist for any fever > 101F 3 MULTIPLE CHOICE OPTIONS child receiving chemo develops aversion to food. which step can the nurse take to provide adequate nutrition to child? consider adding tofu to the child's diet 3 MULTIPLE CHOICE OPTIONS child receiving radiation therapy asks "can i wash these marks off of me?" nurses best response would be: do not try to wash them off 3 MULTIPLE CHOICE OPTIONS which tx strategy could be benefical for the pt who has a bp of 40mmHg at rest and is not showing any response to vasodilator testing? bosentan 3 MULTIPLE CHOICE OPTIONS which kind of drainage would nurse consider a life-threatening sign when assessing chest tube drainage of a child in post op after cardiac surgery? drainage > 3mL/kg/hr for more than 3 hrs 3 MULTIPLE CHOICE OPTIONS nurse preparing to give digoxin to a 9mo infant sees that 4 mL of the drug is prescribed. which is the most appropriate action by the nurse, drawing on knowledge of this med and safe peds dosages? don't draw up dose because there is an error in dosage. should be in mcg not ml; rarely more than 1 ml of digoxin is administered to infants while reviewing lab reports, nurse finds that pt has a total cholesterol lvl of 220mg/dL and low-density lipoprotein (ldl) lvl of 140mg/dL. which instruction would the nurse give the pt after reviewing prescription? take the statin meds in the evening 3 MULTIPLE CHOICE OPTIONS nurse is assessing cholesterol lvls of a pt and finds low-density lipoprotein (ldl) lvs of 140mg/dL. which instruction would be most appropriate for nurse to give to pt? you should include olive oil and green vegetables in your diet 3 MULTIPLE CHOICE OPTIONS pt has had a persistent fever for last 5 days, inflammation of lips and conjunctiva and reddening of the tongue. pt also has cervical lymphadenopathy and erythema in palms and soles. which dx would nurse expect to find in med record? kawasaki disease 3 MULTIPLE CHOICE OPTIONS how is patent ductus arteriosus treated? ligation through thoracotomy child w severe peanut allergy ate peanuts and is in resp distress. priority nursing intervention is: establishing airway 3 MULTIPLE CHOICE OPTIONS nurse is preparing to admin potassium supplement as prescribed to a pt w chf. which med in pts med profile would make nurse hold the dose and contact primary hcp for further guidance? spironolactione 3 MULTIPLE CHOICE OPTIONS which clinical manifestations result from pulmonary congestion in children w chf? tachypnea, exercise intolerance, cyanosis