NCLEX - Pediatrics - Oncology 2024 Review
Questions With Correct Answers 100% Pass
The nurse analyzes the laboratory values of a child with leukemia who is receiving
chemotherapy. The nurse notes that the platelet count is 19,500 mm3 (19.5 × 109/L). On the
basis of this laboratory result, whic...
EXAM STUDY MATERIALS July 30, 2024 11:26 AM NCLEX - Pediatrics - Oncology 2024 Review Questions With Correct Answers 100% Pass The nurse analyzes the laboratory values of a child with leukemia who is receiving chemotherapy. The nurse notes that the platelet count is 19,500 mm3 (19.5 × 109/L). On the basis of this laboratory result, which intervention should the nurse include in th e plan of care? 1.Initiate bleeding precautions. 2.Monitor closely for signs of infection. 3.Monitor the temperature every 4 hours. 4.Initiate protective isolation precautions. - answer✔✔Correct Answer: 1 Rationale: Leukemia is a malignant increase in the number of leukocytes, usually at an immature stage, in the bone marrow. It affects the bone marrow, causing anemia from decreased erythrocytes, infection from neutropenia, and bleeding from decreased plate let production (thrombocytopenia). If a child is severely thrombocytopenic and has a platelet count less than 20,000 mm3 (20.0 × 109/L), bleeding precautions need to be initiated because of the increased risk of bleeding or hemorrhage. Precautions include limiting activity that could result in head injury, using soft toothbrushes, checking urine and stools for blood, and administering stool softeners to prevent straining with constipation. In addition, suppositories, enemas, and rectal temperatures are avoi ded. Options 2, 3, and 4 are related to the prevention of infection rather than bleeding. The nurse is monitoring a 3 -year-old child for signs and symptoms of increased intracranial pressure (ICP) after a craniotomy. The nurse plans to monitor for which ea rly sign or symptom of increased ICP? 1.Vomiting 2.Bulging anterior fontanel 3.Increasing head circumference 4.Complaints of a frontal headache - answer✔✔Correct Answer: 1 EXAM STUDY MATERIALS July 30, 2024 11:26 AM Rationale: The brain, although well protected by the solid bony cranium, is highly susceptible to pressure that may accumulate within the enclosure. Volume and pressure must remain constant within the brain. A change in the size of the brain, such as occurs with edema or increased volume of intracranial blood or cerebrospinal fluid witho ut a compensatory change, leads to an increase in ICP, which may be life -threatening. Vomiting, an early sign of increased ICP, can become excessive as pressure builds up and stimulates the medulla in the brainstem, which houses the vomiting center. Childr en with open fontanels (posterior fontanel closes at 2 to 3 months; anterior fontanel closes at 12 to 18 months) compensate for ICP changes by skull expansion and subsequent bulging fontanels. When the fontanels have closed, nausea, excessive vomiting, dip lopia, and headaches become pronounced, with headaches becoming more prevalent in older children. To get more questions with correct answers email jamesdickson3161@gmail.com. We also provide Test banks and other E books to students - answer✔✔ A 4-year-old child is admitted to the hospital for abdominal pain. The mother reports that the child has been pale and excessively tired and is bruising easily. On physical examination, lymphadenopathy and hepatosplenomegaly are noted. Diagnostic studies are being perf ormed because acute lymphocytic leukemia is suspected. The nurse determines that which laboratory result confirms the diagnosis? 1.Lumbar puncture showing no blast cells 2.Bone marrow biopsy showing blast cells 3.Platelet count of 350,000 mm3 (350 × 109/L) 4.White blood cell count 4,500 mm3 (4.5 × 109/L) - answer✔✔Correct Answer: 2 Rationale: Leukemia is a malignant increase in the number of leukocytes, usually at an immature stage, in the bone marrow. The confirmatory test for leukemia is microscopic exam ination of bone marrow obtained by bone marrow aspirate and biopsy, which is considered positive if blast cells are present. An altered platelet count occurs as a result of the disease, but also may occur as a result of chemotherapy and does not confirm th e diagnosis. The white blood cell count may be normal, high, or low in leukemia. A lumbar puncture may be done to look for blast cells in the spinal fluid that indicate central nervous system disease. The nurse is monitoring a child for bleeding after surg ery for removal of a brain tumor. The nurse checks the head dressing for the presence of blood and notes a colorless drainage on the back of the dressing. Which intervention should the nurse perform immediately? 1.Reinforce the dressing. 2.Notify the healt h care provider (HCP). 3.Document the findings and continue to monitor.
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