Question 1

An adolescent has been taught to administer replacement factors for bleeding episodes related to hemophilia.What action by the teen indicates that further instruction is needed?

Accepted Answer

A)  Disposes of sharps in an approved container
B)  Reconstitutes the medication with sterile water
C)  Selects the appropriate needle for an IM injection
D)  Washes hands prior to working with the drugE) None of the above
F) A) and B) C

Question 2

The pediatric nurse knows that which of the following might be included in the collaborative care of children with mild to moderate anemia? (Select all that apply.)

Accepted Answer

A)  Administration of epopoietin alfa (Epogen) 
B)  Blood product transfusions
C)  Bone marrow transplantation
D)  Routine laboratory analysis
E)  Supplements and iron-rich dietF) B) and D)
G) B) and C)

Question 3

A child with chronic immune thrombocytopenia presents to the emergency department,where the parents report a 3-day history of severe headache and recent change in mental status.What diagnostic test does the nurse prepare to facilitate as the priority?

Accepted Answer

A)  CT of the head
B)  Lumbar puncture
C)  Platelet count
D)  White blood cell countE) A) and D)
F) A) and B)

Question 4

A child with pancytopenia is getting a blood transfusion and it is time to administer her IV antibiotic.The child has only one IV line.What action by the nurse is most appropriate?

Accepted Answer

A)  Administer the antibiotic with the blood.
B)  Obtain an order for an oral antibiotic.
C)  Start a new peripheral IV in another site.
D)  Stop the blood to give the antibiotic.E) A) and B)
F) A) and D)

Question 5

A child who weighs 32 kg (74.4 lb)is hospitalized with a sickle cell crisis.By your calculation,this child's 24-hour fluid requirement would be ____________________ mL/24 hours.

Accepted Answer

2,610
1500 + (20 mg/kg for eac...

Question 6

A nurse is assessing an infant for the most common type of anemia worldwide.What action by the nurse is most helpful?

Accepted Answer

A)  Assess if formula is iron-fortified.
B)  Determine family history of anemia.
C)  Look at mucous membranes for pallor.
D)  Perform range of motion on the hips.E) B) and D)
F) C) and D)

Question 7

The nurse has educated parents on administration of iron to their child.What statement by the parents indicates a need for further instruction?

Accepted Answer

A)  "I will call the doctor right away if my child has black,tarry stools."
B)  "It is best if the iron is taken on an empty stomach or with orange juice."
C)  "Rinsing the mouth after taking iron will prevent staining the teeth."
D)  "We will have our child drink the iron preparation through a straw."E) A) and C)
F) B) and C)

Question 8

In preparing a patient to receive an autologous bone marrow transplantation,which action by the nurse is best?

Accepted Answer

A)  Ensure HLA typing has been done.
B)  Limit visitors to one per shift.
C)  Place the child in protective isolation.
D)  Teach about long-term complications.E) C) and D)
F) B) and D)

Question 9

A child has mild anemia and the parent asks why this makes the child have difficulty concentrating.What response by the nurse is best?

Accepted Answer

A)  "All sick children have trouble concentrating."
B)  "Her anemia makes her too tired to think."
C)  "She may have another problem with her brain."
D)  "The brain isn't getting enough oxygen."E) A) and D)
F) A) and B)

Question 10

A child is on IV heparin.Which laboratory value does the nurse analyze to determine if the dose is therapeutic?

Accepted Answer

A)  Platelet count
B)  PT
C)  PTT
D)  Red blood cell countE) A) and C)
F) B) and C)

Question 11

A child is receiving a blood transfusion.On assessment,the nurse finds the child short of breath,febrile,and hypotensive.After stopping the transfusion,what action by the nurse takes priority?

Accepted Answer

A)  Document the findings.
B)  Obtain oxygen saturation.
C)  Prepare fluid resuscitation.
D)  Sit the child upright in bed.E) A) and B)
F) None of the above

Question 12

A teenager is hospitalized with sickle cell disease and vaso-occlusive crisis.What pain medication regimen does the nurse assist the patient with?

Accepted Answer

A)  Acetaminophen (children's Tylenol) 
B)  Ketorolac (Toradol) orally
C)  Meperidine (Demerol) ,given intravenously
D)  PCA pump with morphine (Duramorph) E) B) and C)
F) B) and D) D

Question 13

A child has mild anemia.Parents learn to assess for signs of worsening anemia,including which of the following? (Select all that apply.)

Accepted Answer

A)  Decreased activity
B)  Irritability
C)  Listlessness
D)  Pale skin
E)  Rapid heart rateF) A) and B)
G) A) and C)

Question 14

A child is taking desmopressin acetate (DDAVP) for von Willebrand's disease.What teaching about this medication does the nurse provide?

Accepted Answer

A)  Avoid products with aspirin (salicylate) in them.
B)  Get a new needle for each injection.
C)  Monitor your child's weight and report a gain.
D)  Use ice packs and pressure for epistaxis.E) None of the above
F) A) and B)

Question 15

The nurse administering a blood transfusion is aware that which of the following is the most important nursing action to prevent a transfusion reaction?

Accepted Answer

A)  Checking the provider's orders for transfusion
B)  Identifying the patient with two unique identifiers
C)  Monitoring vital signs per protocol
D)  Staying with patient for the first 15 minutesE) B) and D)
F) C) and D)

Question 16

A couple who recently married and want to have children ask the nurse what the chances are that their children will inherit thalassemia from them,as they both are carriers.What information from the nurse is most accurate?

Accepted Answer

A)  All of your children will inherit it.
B)  Each child has a 25% chance of inheriting it.
C)  None of your children will inherit it.
D)  Only the boys will inherit it.E) None of the above
F) B) and D)

Question 17

The student studying pediatric hematological disorders learns that anemia can occur in several ways,including which of the following? (Select all that apply.)

Accepted Answer

A)  Acute or chronic blood loss
B)  Altered shape of RBCs
C)  Decreased RBC production
D)  Increased RBC destruction
E)  Lack of functional RBCsF) A) and B)
G) All of the above

Question 18

A school-age child is scheduled to have a bone marrow biopsy.What action by the nurse takes priority?

Accepted Answer

A)  Ensure informed consent is on the chart.
B)  Help position the child to facilitate the sample.
C)  Provide developmentally appropriate teaching.
D)  Use distraction techniques during the procedure.E) A) and D)
F) B) and C) A

Question 19

A child has an order for ketorolac (Toradol)IV push once.The child weighs 78 lb.According to your calculation,the one-time dose would be ____________________mg.

Accepted Answer

15
The child weighs 35.45 kg.T...

Question 20

An acutely ill,anemic child's peripheral blood smear shows small,dense,spherical RBCs.What action by the nurse takes priority?

Accepted Answer

A)  Assess and treat the child's pain adequately.
B)  Discuss the option of a bone marrow transplant.
C)  Obtain informed consent for blood transfusions.
D)  Prepare the family for chelation therapy.E) A) and D)
F) None of the above

Exam 32: Caring for the Child With a Hematological Condition

An adolescent has been taught to administer replacement factors for bleeding episodes related to hemophilia.What action by the teen indicates that further instruction is needed?

Correct AnswerverifiedC

The pediatric nurse knows that which of the following might be included in the collaborative care of children with mild to moderate anemia? (Select all that apply.)

Correct AnswerverifiedShow Answer

A child with chronic immune thrombocytopenia presents to the emergency department,where the parents report a 3-day history of severe headache and recent change in mental status.What diagnostic test does the nurse prepare to facilitate as the priority?

Correct AnswerverifiedShow Answer

A child with pancytopenia is getting a blood transfusion and it is time to administer her IV antibiotic.The child has only one IV line.What action by the nurse is most appropriate?

Correct AnswerverifiedShow Answer

A child who weighs 32 kg (74.4 lb)is hospitalized with a sickle cell crisis.By your calculation,this child's 24-hour fluid requirement would be ____________________ mL/24 hours.

Correct Answerverified2,6101500 + (20 mg/kg for eac...View AnswerShow Answer

A nurse is assessing an infant for the most common type of anemia worldwide.What action by the nurse is most helpful?

Correct AnswerverifiedShow Answer

The nurse has educated parents on administration of iron to their child.What statement by the parents indicates a need for further instruction?

Correct AnswerverifiedShow Answer

In preparing a patient to receive an autologous bone marrow transplantation,which action by the nurse is best?

Correct AnswerverifiedShow Answer

A child has mild anemia and the parent asks why this makes the child have difficulty concentrating.What response by the nurse is best?

Correct AnswerverifiedShow Answer

A child is on IV heparin.Which laboratory value does the nurse analyze to determine if the dose is therapeutic?

Correct AnswerverifiedShow Answer

A child is receiving a blood transfusion.On assessment,the nurse finds the child short of breath,febrile,and hypotensive.After stopping the transfusion,what action by the nurse takes priority?

Correct AnswerverifiedShow Answer

A teenager is hospitalized with sickle cell disease and vaso-occlusive crisis.What pain medication regimen does the nurse assist the patient with?

Correct AnswerverifiedD

A child has mild anemia.Parents learn to assess for signs of worsening anemia,including which of the following? (Select all that apply.)

Correct AnswerverifiedShow Answer

A child is taking desmopressin acetate (DDAVP) for von Willebrand's disease.What teaching about this medication does the nurse provide?

Correct AnswerverifiedShow Answer

The nurse administering a blood transfusion is aware that which of the following is the most important nursing action to prevent a transfusion reaction?

Correct AnswerverifiedShow Answer

A couple who recently married and want to have children ask the nurse what the chances are that their children will inherit thalassemia from them,as they both are carriers.What information from the nurse is most accurate?

Correct AnswerverifiedShow Answer

The student studying pediatric hematological disorders learns that anemia can occur in several ways,including which of the following? (Select all that apply.)

Correct AnswerverifiedShow Answer

A school-age child is scheduled to have a bone marrow biopsy.What action by the nurse takes priority?

Correct AnswerverifiedA

A child has an order for ketorolac (Toradol)IV push once.The child weighs 78 lb.According to your calculation,the one-time dose would be ____________________mg.

Correct Answerverified15The child weighs 35.45 kg.T...View AnswerShow Answer

An acutely ill,anemic child's peripheral blood smear shows small,dense,spherical RBCs.What action by the nurse takes priority?

Correct AnswerverifiedShow Answer

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1500 + (20 mg/kg for eac...
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The child weighs 35.45 kg.T...
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