NURSING NUR 254 Exam 4 Study Material

  1. The nurse is caring for a child who has leukemia with a white blood cell (WBC) count of <
    1000 mm. Which of the following should the nurse include in the child’s plan of care?
    a. Administer prescribed influenza vaccination
    b. Assign the child to a room with other children
    c. Allow the child to play with other children who do not have a fever
    d. Use sterile techniquesfor any procedures
  2. The nurse is providing a teaching session to the health care staff regarding
    osteosarcoma. Which of the following statements by an attendee indicates a need for
    additional teaching?
    a. “A common clinical manifestation islimping if a weight-bearing limb is affected.”
    b. “The sternum is the most common site of this sarcoma.”
    c. “Children typically experience pain at the primary tumorsite.”
    d. “In the early stage, the symptoms of this disease are usually attributed to normal
    growing pains.”
  3. The nurse is caring for a child who is suspected of having a Wilm’s tumor. Which of the
    following actions by the nurse indicates the need for additional training?
    a. Instructing the parents that the child needs to remain in bed.
    b. Preventing a child from playing tag in the playroom.
    c. Requesting a bland soft diet for the child.
    d. Palpating the child’s abdomen.
  4. The nurse is caring for a 5-year-old child who has sickle cell disease (SCD). An assessment
    of the child includes the following: respirations 10 and unarousable. The child is
    currently on intravenous (IV) fluids and continuous IV morphine sulfate Based on the
    assessment information, which of the following actions should the nurse take first?
    a. Increase the IV fluids to decrease vaso-occlusion.
    b. Obtain a complete metabolic laboratory blood sample.
    c. Elevate the head of the bed (HOB) to increase oxygen saturation.
    d. Administer naloxone to reverse the effect of the morphine.
  5. The nurse is admitting a child who has a vaso-occlusive sickle cell crisis. Which of the
    following interventions should the nurse anticipate to be prescribed for the child?
    a. Correction of alkalosis and reduction of energy expenditure.
    b. Globulins and factor VIII replacement.
    c. Hydration and pain management.
    d. Electrolyte replacement and administration of heparin.
  6. The nurse working in the emergency department (ED) is caring for a child who has
    hemophilia and developed a swollen knee after falling off a bicycle. The nurse is teaching
    the child’s parents about care when similar incidents occur at home in the future. Which
    of the following actions should the nurse teach the parents?
    a. Take the child to the nearest emergency department (ED).
    b. Keep the child’s affected knee below the level of the heart.
    c. Apply an ice pack and compression dressings to the knee.
    d. Administer recommended dose of aspirin.
  1. The newly hired nurse is talking with the nurse preceptor about the prevention of irondeficiency anemia in infants. Which of the following statements by the newly hired nurse
    is correct regarding prevention of this condition?
    a. “Whole cow’s milk should not be given until 1 year of age with limited daily
    intake.”
    b. “Ferroussulfate drops are contraindicated in infantslessthan 6 months of age.”
    c. “Iron-fortified commercial formula should be given for the first 6 months of life.”
    d. “Iron-fortified infant cerealshould be introduced to infants at 10 months.”
  2. The nurse is assessing a child who has severe iron deficiency anemia. Which of the
    following assessment finds should the nurse expect to observe?
    a. Pallor.
    b. Painfulswelling of the hands.
    c. An enlarged abdomen.
    d. Visual disturbances.
  3. The nurse is caring for 4-year-old child who is 36 hours postoperative following a
    removal of a Wilm’stumor. Which of the following requires immediate follow up by the
    nurse?
    a. White blood cell (WBC) count of 15.0 mm³.
    b. Bowelsounds present in all 4 quadrants.
    c. Temperature of 100.4˚ F that occurs 1 time in a 24-hour period.
    d. Incision site is pink at the edges.
  4. The nurse is providing discharge instructions to the parents of a child who had surgical
    resection of a neuroblastoma 4 days ago. Which of the following statements by the
    parents indicates teaching has been effective?
    a. “I will need to begin slowly reintroducing my child into social interaction.”
    b. “We will provide pain relief using pain medication and rest.”
    c. “A protective helmet will need to be worn until the incision is healed.”
    d. “An increase in temperature is expected aftersurgery.”
  5. The nurse is caring for a child who has increased intracranial pressure (ICP) and is in
    stable condition. Which of the following interventionsshould the nurse implement to
    decrease ICP in the child?
    a. Limit number of visitors inside the child’s room.
    b. Keep the child positioned on the left side.
    c. Administer opioids for pain control.
    d. Administer hypertonic intravenous(IV) fluids.
  6. The nurse is caring for a child who has Reye’s syndrome. Which of the following should
    the nurse include in the child’s plan of care?
    a. Change the child’s body position every 2 hours.
    b. Provide the child a quiet atmosphere with dimmed lighting.
    c. Administer salicylates for increased temperature every 4 hours as needed (PRN).
    d. Assess for diplopia in both of the child’s eyes.

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