1
NUR 254 Maternal Exam 4 | Study Guide | Practice
Questions & Answers | Latest Update 2026 |
Comprehensive Exam Prep
SUMMARIZED EXAM COVERAGE
Cancer & Hematological Disorders:
Leukemia, Sickle Cell Anemia, Hemophilia, Iron Deficiency Anemia, Aplastic Anemia,
Neuroblastoma, Wilms Tumor, Osteosarcoma, Retinoblastoma
Neurological Disorders:
Increased Intracranial Pressure (ICP), Meningitis, Reye's Syndrome, Cerebral Palsy, Seizure
Disorders, Head Trauma, Hydrocephalus, Neural Tube Defects (Spina Bifida, Myelomeningocele)
Musculoskeletal Disorders:
Scoliosis, Clubfoot (Talipes Equinovarus), Developmental Hip Dysplasia, Juvenile Idiopathic
Arthritis, Compartment Syndrome, Fractures, Spica Cast Care
Endocrine Disorders:
Diabetes Mellitus Type 1, Hypothyroidism, Hyperthyroidism, Precocious Puberty, Phenylketonuria
(PKU)
Infectious & Dermatological Conditions:
Impetigo Contagiosa, Pediculosis Capitis, Atopic Dermatitis, Cellulitis, Bug Bites, Meningococcal
Meningitis
Developmental & Genetic Disorders:
Down Syndrome, Autism Spectrum Disorder, ADHD
, 2
Psychosocial & Developmental Concepts:
Views of Death (Toddler, Preschool, School-age, Adolescent), Parental Grief, Pain Management,
Immunizations, Abuse Recognition (TEN4)
1. A nurse is caring for a child with leukemia who has a WBC count of less than 1000 mm³.
Which intervention should the nurse include in the child's plan of care?
A) Administer prescribed influenza vaccination
B) Place the child in a private room with neutropenic precautions
C) Encourage the child to visit the playroom daily
D) Allow fresh flowers in the child's room
Answer: B) Place the child in a private room with neutropenic precautions
Children with WBC count below 1000 mm³ are severely neutropenic and at high risk for infection.
Neutropenic precautions include private room, strict handwashing, masks for visitors, and no
fresh flowers or plants which can harbor fungi. Influenza vaccination should not be administered
during active chemotherapy or severe immunosuppression.
2. During a teaching session about osteosarcoma, which statement by an attendee indicates
a need for additional teaching?
A) "In the early stage, symptoms are often attributed to normal growing pains."
B) "Osteosarcoma commonly affects the long bones of the body."
C) "The primary treatment approach involves limb salvage or amputation."
D) "This type of cancer typically affects the bone marrow directly."
Answer: D) "This type of cancer typically affects the bone marrow directly."
, 3
Osteosarcoma affects the long bones (femur, tibia, humerus) and presents with bone pain,
limping, and local swelling. It does not primarily affect the bone marrow; that is characteristic of
leukemias. Early symptoms are frequently mistaken for growing pains, and treatment involves
limb salvage or amputation.
3. The nurse is caring for a child suspected of having a Wilms tumor. Which action indicates
the nurse needs additional training?
A) Monitoring blood pressure frequently
B) Assessing intake and output
C) Palpating the child's abdomen
D) Checking for hypertension
Answer: C) Palpating the child's abdomen
Palpation of the abdomen in a child with suspected Wilms tumor is contraindicated because it
can cause tumor rupture and seeding of cancer cells. Wilms tumor is a kidney tumor that typically
does not cross the midline. Nursing care includes monitoring for hypertension, assessing I&O, and
avoiding abdominal palpation.
4. A 5-year-old with sickle cell disease is on IV fluids and continuous IV morphine.
Assessment shows respirations of 10 and unarousable. What should the nurse do first?
A) Increase the IV fluid rate
B) Administer oxygen via non-rebreather mask
C) Administer naloxone to reverse morphine effects
D) Notify the primary health care provider
Answer: C) Administer naloxone to reverse morphine effects
The child is exhibiting signs of opioid toxicity including respiratory depression (respirations of 10)
and decreased level of consciousness (unarousable). Naloxone should be administered
, 4
immediately to reverse the effects of morphine. This is a priority before other interventions.
Oxygen may be needed, but reversal of the opioid effect is the priority.
5. A child with a vaso-occlusive sickle cell crisis is being admitted. Which intervention
should the nurse anticipate?
A) Blood transfusion and iron supplementation
B) Hydration and pain management
C) Antibiotic therapy and isolation
D) Corticosteroids and physical therapy
Answer: B) Hydration and pain management
Vaso-occlusive sickle cell crisis is a painful episode caused by sickled cells blocking blood
vessels. Treatment focuses on aggressive hydration to reduce blood viscosity and pain
management, often with PCA pumps. Oxygen therapy may also be used. Antibiotics are not
indicated unless there is infection.
6. A child with hemophilia develops a swollen knee after falling off a bicycle. What should
the nurse teach the parents?
A) Apply a heating pad to the knee
B) Administer aspirin for pain relief
C) Apply ice pack and compression dressings to the knee
D) Encourage weight-bearing activities
Answer: C) Apply ice pack and compression dressings to the knee
RICE (Rest, Ice, Compression, Elevation) is the appropriate initial management for hemarthrosis
in hemophilia patients. Ice and compression help reduce bleeding and swelling. NSAIDs and
aspirin should be avoided due to bleeding risk. Contact sports should be avoided to prevent injury.
NUR 254 Maternal Exam 4 | Study Guide | Practice
Questions & Answers | Latest Update 2026 |
Comprehensive Exam Prep
SUMMARIZED EXAM COVERAGE
Cancer & Hematological Disorders:
Leukemia, Sickle Cell Anemia, Hemophilia, Iron Deficiency Anemia, Aplastic Anemia,
Neuroblastoma, Wilms Tumor, Osteosarcoma, Retinoblastoma
Neurological Disorders:
Increased Intracranial Pressure (ICP), Meningitis, Reye's Syndrome, Cerebral Palsy, Seizure
Disorders, Head Trauma, Hydrocephalus, Neural Tube Defects (Spina Bifida, Myelomeningocele)
Musculoskeletal Disorders:
Scoliosis, Clubfoot (Talipes Equinovarus), Developmental Hip Dysplasia, Juvenile Idiopathic
Arthritis, Compartment Syndrome, Fractures, Spica Cast Care
Endocrine Disorders:
Diabetes Mellitus Type 1, Hypothyroidism, Hyperthyroidism, Precocious Puberty, Phenylketonuria
(PKU)
Infectious & Dermatological Conditions:
Impetigo Contagiosa, Pediculosis Capitis, Atopic Dermatitis, Cellulitis, Bug Bites, Meningococcal
Meningitis
Developmental & Genetic Disorders:
Down Syndrome, Autism Spectrum Disorder, ADHD
, 2
Psychosocial & Developmental Concepts:
Views of Death (Toddler, Preschool, School-age, Adolescent), Parental Grief, Pain Management,
Immunizations, Abuse Recognition (TEN4)
1. A nurse is caring for a child with leukemia who has a WBC count of less than 1000 mm³.
Which intervention should the nurse include in the child's plan of care?
A) Administer prescribed influenza vaccination
B) Place the child in a private room with neutropenic precautions
C) Encourage the child to visit the playroom daily
D) Allow fresh flowers in the child's room
Answer: B) Place the child in a private room with neutropenic precautions
Children with WBC count below 1000 mm³ are severely neutropenic and at high risk for infection.
Neutropenic precautions include private room, strict handwashing, masks for visitors, and no
fresh flowers or plants which can harbor fungi. Influenza vaccination should not be administered
during active chemotherapy or severe immunosuppression.
2. During a teaching session about osteosarcoma, which statement by an attendee indicates
a need for additional teaching?
A) "In the early stage, symptoms are often attributed to normal growing pains."
B) "Osteosarcoma commonly affects the long bones of the body."
C) "The primary treatment approach involves limb salvage or amputation."
D) "This type of cancer typically affects the bone marrow directly."
Answer: D) "This type of cancer typically affects the bone marrow directly."
, 3
Osteosarcoma affects the long bones (femur, tibia, humerus) and presents with bone pain,
limping, and local swelling. It does not primarily affect the bone marrow; that is characteristic of
leukemias. Early symptoms are frequently mistaken for growing pains, and treatment involves
limb salvage or amputation.
3. The nurse is caring for a child suspected of having a Wilms tumor. Which action indicates
the nurse needs additional training?
A) Monitoring blood pressure frequently
B) Assessing intake and output
C) Palpating the child's abdomen
D) Checking for hypertension
Answer: C) Palpating the child's abdomen
Palpation of the abdomen in a child with suspected Wilms tumor is contraindicated because it
can cause tumor rupture and seeding of cancer cells. Wilms tumor is a kidney tumor that typically
does not cross the midline. Nursing care includes monitoring for hypertension, assessing I&O, and
avoiding abdominal palpation.
4. A 5-year-old with sickle cell disease is on IV fluids and continuous IV morphine.
Assessment shows respirations of 10 and unarousable. What should the nurse do first?
A) Increase the IV fluid rate
B) Administer oxygen via non-rebreather mask
C) Administer naloxone to reverse morphine effects
D) Notify the primary health care provider
Answer: C) Administer naloxone to reverse morphine effects
The child is exhibiting signs of opioid toxicity including respiratory depression (respirations of 10)
and decreased level of consciousness (unarousable). Naloxone should be administered
, 4
immediately to reverse the effects of morphine. This is a priority before other interventions.
Oxygen may be needed, but reversal of the opioid effect is the priority.
5. A child with a vaso-occlusive sickle cell crisis is being admitted. Which intervention
should the nurse anticipate?
A) Blood transfusion and iron supplementation
B) Hydration and pain management
C) Antibiotic therapy and isolation
D) Corticosteroids and physical therapy
Answer: B) Hydration and pain management
Vaso-occlusive sickle cell crisis is a painful episode caused by sickled cells blocking blood
vessels. Treatment focuses on aggressive hydration to reduce blood viscosity and pain
management, often with PCA pumps. Oxygen therapy may also be used. Antibiotics are not
indicated unless there is infection.
6. A child with hemophilia develops a swollen knee after falling off a bicycle. What should
the nurse teach the parents?
A) Apply a heating pad to the knee
B) Administer aspirin for pain relief
C) Apply ice pack and compression dressings to the knee
D) Encourage weight-bearing activities
Answer: C) Apply ice pack and compression dressings to the knee
RICE (Rest, Ice, Compression, Elevation) is the appropriate initial management for hemarthrosis
in hemophilia patients. Ice and compression help reduce bleeding and swelling. NSAIDs and
aspirin should be avoided due to bleeding risk. Contact sports should be avoided to prevent injury.
