,1. The nurse is caring for a child who has leukemia with a white blood cell (WBC) count of <
1000 mm³. Which of the following should the nurse include in the child's plan of care?
A) Administer prescribed influenza vaccination
B) Place the child in reverse isolation
C) Restrict all visitors to prevent infection
D) Administer prophylactic antibiotics daily
Correct Answer: Administer prescribed influenza vaccination
Rationale: A child with leukemia and a WBC count <1000 mm³ is severely immunocompromised
and at high risk for infection. The influenza vaccination is recommended to prevent serious
respiratory illness in these patients. Reverse isolation and visitor restrictions are appropriate,
but vaccination is a specific intervention.
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) "Osteosarcoma most commonly affects the metaphysis of long bones."
B) "The most common site for osteosarcoma is the distal femur."
C) "In the early stage, the symptoms of this disease are usually attributed to normal growing
pains."
D) "Osteosarcoma is a type of bone cancer that can metastasize to the lungs."
Correct Answer: "In the early stage, the symptoms of this disease are usually attributed to
normal growing pains."
Rationale: Osteosarcoma symptoms are not typically dismissed as growing pains; this statement
indicates a need for further teaching. The other statements are accurate. The most common
sites are the distal femur, proximal tibia, and proximal humerus, with metastasis to the lungs
being a significant concern.
,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) Assessing the child's blood pressure
B) Monitoring for hematuria
C) Palpating the child's abdomen
D) Obtaining a urine specimen
Correct Answer: Palpating the child's abdomen
Rationale: Palpating the abdomen of a child with a suspected Wilm's tumor is contraindicated
because it can cause tumor rupture and metastasis. The nurse should avoid deep palpation.
Assessing blood pressure, monitoring for hematuria, and obtaining urine specimens are
appropriate interventions.
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) Discontinue the IV fluids
B) Administer naloxone to reverse the effect of the morphine
C) Place the child in a high Fowler's position
D) Notify the healthcare provider
Correct Answer: Administer naloxone to reverse the effect of the morphine
Rationale: The child is experiencing respiratory depression (respirations 10) and is unarousable,
which are signs of opioid toxicity from the continuous morphine infusion. Naloxone is the
antidote and should be administered immediately to reverse these life-threatening effects.
, 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) Hydration and pain management
B) Blood transfusion and antibiotics
C) Oxygen therapy and respiratory treatments
D) Corticosteroids and antiemetics
Correct Answer: Hydration and pain management
Rationale: The priority interventions for a vaso-occlusive sickle cell crisis are hydration to reduce
blood viscosity and pain management (often with opioids) to control the severe pain caused by
tissue ischemia. These are the standard, first-line treatments.
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) Apply heat to the knee to promote healing
B) Administer aspirin for pain relief
C) Apply an ice pack and compression dressings to the knee
D) Elevate the knee above the level of the heart
Correct Answer: Apply an ice pack and compression dressings to the knee
Rationale: The immediate care for a joint bleed in a child with hemophilia includes rest, ice,
compression, and elevation (RICE). Aspirin is contraindicated due to bleeding risk. Ice and
compression will help reduce swelling and pain.
1000 mm³. Which of the following should the nurse include in the child's plan of care?
A) Administer prescribed influenza vaccination
B) Place the child in reverse isolation
C) Restrict all visitors to prevent infection
D) Administer prophylactic antibiotics daily
Correct Answer: Administer prescribed influenza vaccination
Rationale: A child with leukemia and a WBC count <1000 mm³ is severely immunocompromised
and at high risk for infection. The influenza vaccination is recommended to prevent serious
respiratory illness in these patients. Reverse isolation and visitor restrictions are appropriate,
but vaccination is a specific intervention.
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) "Osteosarcoma most commonly affects the metaphysis of long bones."
B) "The most common site for osteosarcoma is the distal femur."
C) "In the early stage, the symptoms of this disease are usually attributed to normal growing
pains."
D) "Osteosarcoma is a type of bone cancer that can metastasize to the lungs."
Correct Answer: "In the early stage, the symptoms of this disease are usually attributed to
normal growing pains."
Rationale: Osteosarcoma symptoms are not typically dismissed as growing pains; this statement
indicates a need for further teaching. The other statements are accurate. The most common
sites are the distal femur, proximal tibia, and proximal humerus, with metastasis to the lungs
being a significant concern.
,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) Assessing the child's blood pressure
B) Monitoring for hematuria
C) Palpating the child's abdomen
D) Obtaining a urine specimen
Correct Answer: Palpating the child's abdomen
Rationale: Palpating the abdomen of a child with a suspected Wilm's tumor is contraindicated
because it can cause tumor rupture and metastasis. The nurse should avoid deep palpation.
Assessing blood pressure, monitoring for hematuria, and obtaining urine specimens are
appropriate interventions.
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) Discontinue the IV fluids
B) Administer naloxone to reverse the effect of the morphine
C) Place the child in a high Fowler's position
D) Notify the healthcare provider
Correct Answer: Administer naloxone to reverse the effect of the morphine
Rationale: The child is experiencing respiratory depression (respirations 10) and is unarousable,
which are signs of opioid toxicity from the continuous morphine infusion. Naloxone is the
antidote and should be administered immediately to reverse these life-threatening effects.
, 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) Hydration and pain management
B) Blood transfusion and antibiotics
C) Oxygen therapy and respiratory treatments
D) Corticosteroids and antiemetics
Correct Answer: Hydration and pain management
Rationale: The priority interventions for a vaso-occlusive sickle cell crisis are hydration to reduce
blood viscosity and pain management (often with opioids) to control the severe pain caused by
tissue ischemia. These are the standard, first-line treatments.
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) Apply heat to the knee to promote healing
B) Administer aspirin for pain relief
C) Apply an ice pack and compression dressings to the knee
D) Elevate the knee above the level of the heart
Correct Answer: Apply an ice pack and compression dressings to the knee
Rationale: The immediate care for a joint bleed in a child with hemophilia includes rest, ice,
compression, and elevation (RICE). Aspirin is contraindicated due to bleeding risk. Ice and
compression will help reduce swelling and pain.
