,NUR254/NUR 254 Exam 3 | Maternal & Pediatric
Nursing | Galen College | 2026/2027 Edition (PDF)
1. The nurse is caring for a child who has leukemia with a white blood cell (WBC) count of less than
1,000/mm³. Which intervention should the nurse include in the child's plan of care?
A) Administer the 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 techniques for any procedures
Correct Answer: Use sterile techniques for any procedures
Rationale: A WBC count of less than 1,000/mm³ indicates severe neutropenia, placing the child at high
risk for infection. Implementing sterile techniques for all procedures is crucial to minimize the risk of
introducing pathogens. Live immunizations like influenza should be avoided until immune function
improves, and the child should have limited contact with others.
2. The nurse is providing a teaching session to the healthcare staff regarding osteosarcoma. Which
statement by an attendee indicates a need for additional teaching?
A) "In the early stage, the symptoms of this disease are usually attributed to normal growing pains."
B) "Limping and pain at the tumor site are common early symptoms."
C) "Misconceptions regarding location can delay diagnosis and treatment."
D) "Osteosarcoma typically requires amputation of the affected limb."
Correct Answer: "Osteosarcoma typically requires amputation of the affected limb."
Rationale: While osteosarcoma often presents with limping and pain that may be mistaken for growing
pains, treatment has evolved, and limb-salvage surgery is now common. The statement that amputation
is typically required is outdated and indicates a need for additional teaching.
3. The nurse is caring for a child who is suspected of having a Wilms' tumor. Which action by the nurse
indicates the need for additional training?
,A) Instructing the parents that the child needs to remain in bed
B) Preventing the child from playing tag in the playroom
C) Requesting a bland soft diet for the child
D) Palpating the child's abdomen
Correct Answer: Palpating the child's abdomen
Rationale: Palpation of the abdomen in a child suspected of having a Wilms' tumor is strictly
contraindicated due to the risk of rupturing the encapsulated tumor, which can disseminate cancerous
cells. This is a well-established safety precaution in pediatric oncology.
4. A 5-year-old child with sickle cell disease (SCD) is on IV fluids and continuous IV morphine sulfate. An
assessment reveals the child is unarousable with respirations of 10 per minute. Which action should the
nurse take first?
A) Increase the IV fluids to decrease vaso-occlusion
B) Obtain a complete metabolic panel
C) Elevate the head of the bed to increase oxygen saturation
D) Administer naloxone to reverse the effects of the morphine
Correct Answer: Administer naloxone to reverse the effects of the morphine
Rationale: The child is exhibiting signs of opioid overdose (unresponsiveness and bradypnea). Naloxone
is an opioid antagonist that reverses the effects of morphine, making it the priority to restore respiratory
drive. Airway and breathing take precedence over other interventions.
5. The nurse is admitting a child who has a vaso-occlusive sickle cell crisis. Which intervention should the
nurse anticipate will be prescribed?
A) Factor VIII replacement
B) Packed red blood cell transfusions
C) Hydration and pain management
D) Anticoagulant therapy
, Correct Answer: Hydration and pain management
Rationale: The primary treatments for vaso-occlusive episodes in sickle cell disease are aggressive
intravenous hydration and pain control, typically with opioids. Hydration decreases blood viscosity and
facilitates the movement of sickled cells. Factor VIII is indicated for hemophilia, and transfusions are not
first-line treatment.
6. The nurse is caring for a child with hemophilia who developed a swollen knee after falling off a
bicycle. Which action should the nurse teach the parents to take if similar incidents occur at home?
A) Take the child to the nearest emergency department immediately
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 a dose of the child's prescribed factor replacement
Correct Answer: Apply an ice pack and compression dressings to the knee
Rationale: For a joint bleed in a child with hemophilia, the RICE (Rest, Ice, Compression, Elevation)
protocol is the appropriate immediate first aid. Ice and compression help reduce swelling and bleeding.
The child should be taken to the ED if bleeding does not stop or if it is a severe injury.
7. Which statement by a newly hired nurse is correct regarding the prevention of iron deficiency anemia
in infants?
A) "Whole cow's milk should be introduced at 6 months of age."
B) "Iron-fortified commercial formula should be given for the first 12 months."
C) "Infants should be started on iron supplements at birth."
D) "Fruit juices should be given to enhance iron absorption."
Correct Answer: "Iron-fortified commercial formula should be given for the first 12 months."
Nursing | Galen College | 2026/2027 Edition (PDF)
1. The nurse is caring for a child who has leukemia with a white blood cell (WBC) count of less than
1,000/mm³. Which intervention should the nurse include in the child's plan of care?
A) Administer the 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 techniques for any procedures
Correct Answer: Use sterile techniques for any procedures
Rationale: A WBC count of less than 1,000/mm³ indicates severe neutropenia, placing the child at high
risk for infection. Implementing sterile techniques for all procedures is crucial to minimize the risk of
introducing pathogens. Live immunizations like influenza should be avoided until immune function
improves, and the child should have limited contact with others.
2. The nurse is providing a teaching session to the healthcare staff regarding osteosarcoma. Which
statement by an attendee indicates a need for additional teaching?
A) "In the early stage, the symptoms of this disease are usually attributed to normal growing pains."
B) "Limping and pain at the tumor site are common early symptoms."
C) "Misconceptions regarding location can delay diagnosis and treatment."
D) "Osteosarcoma typically requires amputation of the affected limb."
Correct Answer: "Osteosarcoma typically requires amputation of the affected limb."
Rationale: While osteosarcoma often presents with limping and pain that may be mistaken for growing
pains, treatment has evolved, and limb-salvage surgery is now common. The statement that amputation
is typically required is outdated and indicates a need for additional teaching.
3. The nurse is caring for a child who is suspected of having a Wilms' tumor. Which action by the nurse
indicates the need for additional training?
,A) Instructing the parents that the child needs to remain in bed
B) Preventing the child from playing tag in the playroom
C) Requesting a bland soft diet for the child
D) Palpating the child's abdomen
Correct Answer: Palpating the child's abdomen
Rationale: Palpation of the abdomen in a child suspected of having a Wilms' tumor is strictly
contraindicated due to the risk of rupturing the encapsulated tumor, which can disseminate cancerous
cells. This is a well-established safety precaution in pediatric oncology.
4. A 5-year-old child with sickle cell disease (SCD) is on IV fluids and continuous IV morphine sulfate. An
assessment reveals the child is unarousable with respirations of 10 per minute. Which action should the
nurse take first?
A) Increase the IV fluids to decrease vaso-occlusion
B) Obtain a complete metabolic panel
C) Elevate the head of the bed to increase oxygen saturation
D) Administer naloxone to reverse the effects of the morphine
Correct Answer: Administer naloxone to reverse the effects of the morphine
Rationale: The child is exhibiting signs of opioid overdose (unresponsiveness and bradypnea). Naloxone
is an opioid antagonist that reverses the effects of morphine, making it the priority to restore respiratory
drive. Airway and breathing take precedence over other interventions.
5. The nurse is admitting a child who has a vaso-occlusive sickle cell crisis. Which intervention should the
nurse anticipate will be prescribed?
A) Factor VIII replacement
B) Packed red blood cell transfusions
C) Hydration and pain management
D) Anticoagulant therapy
, Correct Answer: Hydration and pain management
Rationale: The primary treatments for vaso-occlusive episodes in sickle cell disease are aggressive
intravenous hydration and pain control, typically with opioids. Hydration decreases blood viscosity and
facilitates the movement of sickled cells. Factor VIII is indicated for hemophilia, and transfusions are not
first-line treatment.
6. The nurse is caring for a child with hemophilia who developed a swollen knee after falling off a
bicycle. Which action should the nurse teach the parents to take if similar incidents occur at home?
A) Take the child to the nearest emergency department immediately
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 a dose of the child's prescribed factor replacement
Correct Answer: Apply an ice pack and compression dressings to the knee
Rationale: For a joint bleed in a child with hemophilia, the RICE (Rest, Ice, Compression, Elevation)
protocol is the appropriate immediate first aid. Ice and compression help reduce swelling and bleeding.
The child should be taken to the ED if bleeding does not stop or if it is a severe injury.
7. Which statement by a newly hired nurse is correct regarding the prevention of iron deficiency anemia
in infants?
A) "Whole cow's milk should be introduced at 6 months of age."
B) "Iron-fortified commercial formula should be given for the first 12 months."
C) "Infants should be started on iron supplements at birth."
D) "Fruit juices should be given to enhance iron absorption."
Correct Answer: "Iron-fortified commercial formula should be given for the first 12 months."
