NUR 254 Exam 4|Questions and
Answers | 2026 Update | 100%
Correct-Galen College of Nursing.
Course
NUR 254
1. A child with sickle cell disease is admitted with a vaso-occlusive crisis and reports severe
pain. Which intervention should the nurse prioritize?
A. Apply cold packs to painful joints
B. Administer prescribed analgesics
C. Restrict fluids
D. Encourage strenuous exercise
Correct Answer: B. Administer prescribed analgesics
Rationale: Vaso-occlusive crises cause ischemic tissue pain. Prompt, appropriately prescribed
analgesia is a priority. Hydration and oxygenation as clinically indicated also support
management. Cold exposure can promote vasoconstriction and should generally be avoided.
2. A child receiving IV morphine for a sickle-cell crisis is difficult to arouse and has a
respiratory rate of 8/min. What is the priority nursing action?
A. Increase IV fluids
B. Administer naloxone as prescribed/protocol allows
C. Encourage oral fluids
D. Place the child in a sitting position and reassess in 30 minutes
Correct Answer: B. Administer naloxone as prescribed/protocol allows
Rationale: Severe sedation and respiratory depression indicate possible opioid toxicity. Airway
and breathing take priority, with naloxone used to reverse opioid-induced respiratory
depression when indicated.
3. Which teaching should the nurse provide to the parents of a child with sickle cell disease?
A. Encourage adequate hydration
B. Restrict fluids during hot weather
,C. Avoid all physical activity permanently
D. Give aspirin routinely for pain
Correct Answer: A. Encourage adequate hydration
Rationale: Dehydration can contribute to sickling and vaso-occlusive episodes. Families should
encourage adequate fluid intake and follow the child's individualized care plan.
4. Which finding in a child with sickle cell disease requires immediate attention?
A. Mild chronic fatigue
B. Fever
C. Occasional joint discomfort
D. Mild appetite reduction
Correct Answer: B. Fever
Rationale: Children with sickle cell disease are at increased risk for serious infections. Fever can
indicate a potentially life-threatening infection and requires prompt evaluation.
5. A child with sickle cell disease suddenly develops chest pain, fever, cough, and hypoxemia.
Which complication should the nurse suspect?
A. Acute chest syndrome
B. Appendicitis
C. Otitis media
D. Nephrotic syndrome
Correct Answer: A. Acute chest syndrome
Rationale: Acute chest syndrome is a serious complication characterized by a new pulmonary
infiltrate accompanied by respiratory symptoms such as chest pain, cough, fever, or hypoxemia.
6. Which intervention is appropriate for a child experiencing an acute vaso-occlusive crisis?
A. Maintain hydration as prescribed
B. Apply ice packs continuously
C. Restrict analgesics
D. Encourage prolonged fasting
Correct Answer: A. Maintain hydration as prescribed
, Rationale: Adequate hydration supports circulation and may help reduce sickling-related
complications. Fluid administration should be individualized to the patient's condition.
7. A child with leukemia has severe neutropenia. Which nursing intervention is most
appropriate?
A. Encourage contact with individuals who have respiratory infections
B. Implement appropriate infection-prevention measures
C. Administer live vaccines without evaluation
D. Place the child with another immunocompromised patient routinely
Correct Answer: B. Implement appropriate infection-prevention measures
Rationale: Severe neutropenia increases infection risk. Hand hygiene, appropriate precautions,
careful monitoring, and avoidance of unnecessary exposure to infectious individuals are
important.
8. Which assessment finding in a child receiving chemotherapy should the nurse report
promptly?
A. Fever
B. Mild boredom
C. Temporary dislike of hospital food
D. Preference for quiet activities
Correct Answer: A. Fever
Rationale: Fever in an immunocompromised child may represent a serious infection requiring
rapid evaluation and treatment.
9. A child is suspected of having Wilms tumor. Which nursing action should be avoided?
A. Monitoring blood pressure
B. Assessing urine characteristics
C. Palpating the abdomen repeatedly
D. Monitoring intake and output
Correct Answer: C. Palpating the abdomen repeatedly
Answers | 2026 Update | 100%
Correct-Galen College of Nursing.
Course
NUR 254
1. A child with sickle cell disease is admitted with a vaso-occlusive crisis and reports severe
pain. Which intervention should the nurse prioritize?
A. Apply cold packs to painful joints
B. Administer prescribed analgesics
C. Restrict fluids
D. Encourage strenuous exercise
Correct Answer: B. Administer prescribed analgesics
Rationale: Vaso-occlusive crises cause ischemic tissue pain. Prompt, appropriately prescribed
analgesia is a priority. Hydration and oxygenation as clinically indicated also support
management. Cold exposure can promote vasoconstriction and should generally be avoided.
2. A child receiving IV morphine for a sickle-cell crisis is difficult to arouse and has a
respiratory rate of 8/min. What is the priority nursing action?
A. Increase IV fluids
B. Administer naloxone as prescribed/protocol allows
C. Encourage oral fluids
D. Place the child in a sitting position and reassess in 30 minutes
Correct Answer: B. Administer naloxone as prescribed/protocol allows
Rationale: Severe sedation and respiratory depression indicate possible opioid toxicity. Airway
and breathing take priority, with naloxone used to reverse opioid-induced respiratory
depression when indicated.
3. Which teaching should the nurse provide to the parents of a child with sickle cell disease?
A. Encourage adequate hydration
B. Restrict fluids during hot weather
,C. Avoid all physical activity permanently
D. Give aspirin routinely for pain
Correct Answer: A. Encourage adequate hydration
Rationale: Dehydration can contribute to sickling and vaso-occlusive episodes. Families should
encourage adequate fluid intake and follow the child's individualized care plan.
4. Which finding in a child with sickle cell disease requires immediate attention?
A. Mild chronic fatigue
B. Fever
C. Occasional joint discomfort
D. Mild appetite reduction
Correct Answer: B. Fever
Rationale: Children with sickle cell disease are at increased risk for serious infections. Fever can
indicate a potentially life-threatening infection and requires prompt evaluation.
5. A child with sickle cell disease suddenly develops chest pain, fever, cough, and hypoxemia.
Which complication should the nurse suspect?
A. Acute chest syndrome
B. Appendicitis
C. Otitis media
D. Nephrotic syndrome
Correct Answer: A. Acute chest syndrome
Rationale: Acute chest syndrome is a serious complication characterized by a new pulmonary
infiltrate accompanied by respiratory symptoms such as chest pain, cough, fever, or hypoxemia.
6. Which intervention is appropriate for a child experiencing an acute vaso-occlusive crisis?
A. Maintain hydration as prescribed
B. Apply ice packs continuously
C. Restrict analgesics
D. Encourage prolonged fasting
Correct Answer: A. Maintain hydration as prescribed
, Rationale: Adequate hydration supports circulation and may help reduce sickling-related
complications. Fluid administration should be individualized to the patient's condition.
7. A child with leukemia has severe neutropenia. Which nursing intervention is most
appropriate?
A. Encourage contact with individuals who have respiratory infections
B. Implement appropriate infection-prevention measures
C. Administer live vaccines without evaluation
D. Place the child with another immunocompromised patient routinely
Correct Answer: B. Implement appropriate infection-prevention measures
Rationale: Severe neutropenia increases infection risk. Hand hygiene, appropriate precautions,
careful monitoring, and avoidance of unnecessary exposure to infectious individuals are
important.
8. Which assessment finding in a child receiving chemotherapy should the nurse report
promptly?
A. Fever
B. Mild boredom
C. Temporary dislike of hospital food
D. Preference for quiet activities
Correct Answer: A. Fever
Rationale: Fever in an immunocompromised child may represent a serious infection requiring
rapid evaluation and treatment.
9. A child is suspected of having Wilms tumor. Which nursing action should be avoided?
A. Monitoring blood pressure
B. Assessing urine characteristics
C. Palpating the abdomen repeatedly
D. Monitoring intake and output
Correct Answer: C. Palpating the abdomen repeatedly
