Chapter 27: The Child with a Condition of the
Blood, Blood-Forming Organs, or Lymphatic
System
Leifer: Introduction to Maternity and Pediatric Nursing, 9th Edition
MULTIPLE CHOICE
1. The child receiving a transfusion complains of back pain and itching. What is the best initial
action by the nurse?
a. Notify the charge nurse.
b. Disconnect intravenous lines immediately.
c. Give diphenhydramine (Benadryl).
d. Clamp off blood and keep line open with normal saline.
ANS: D
If a blood transfusion reaction occurs, the first action is to stop the blood infusion, keep the
line open with normal saline, and notify the charge nurse.
DIF: Cognitive Level: Application REF: p. 652 OBJ: 16
TOP: Blood Transfusion KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity
2. What would the nurse include in a teaching plan about mouth care of a child receiving
chemotherapy?
a. Use commercial mouthwash.
b. Clean teeth with a soft toothbrush.
c. Avoid use of a Water-Pik.
d. Inspect the mouth weekly for ulcerations.
ANS: B
, A soft toothbrush reduces capillary damage and mucous membrane breakdown and prevents
bleeding and infection. Commercial mouthwashes may kill oral flora that combat infection.
Water-Pik is useful for toughening gums.
DIF: Cognitive Level: Application REF: p. 652 OBJ: 15
TOP: Leukemia KEY: Nursing Process Step: Planning
MSC: NCLEX: Physiological Integrity: Basic Care and Comfort
3. A 6-year-old child with leukemia asks, “Who will take care of me in heaven?” What is the best
response by the nurse?
a. “Who do you think will take care of you?”
b. “Your grandparents and God will take care of you.”
c. “Your mom will know more about that than I do.”
d. “Why are you asking me that?”
ANS: A
This response gives the child an opportunity to verbalize his or her feelings and concerns,
whereas closed responses shut off communication. The asking of a “why” question is not
therapeutic as it calls for justification.
DIF: Cognitive Level: Application REF: p. 652 OBJ: 18
TOP: Leukemia KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation
4. The nurse is dealing with a preschool child with a life-threatening illness. What should the nurse
remember the child‘s concept of death is at this age?
a. That it is final
b. Only a fear of separation from her parents
c. That a person becomes alive again soon after death
d. An understanding based on simple logic
ANS: C
The preschooler views death as reversible and temporary.
DIF: Cognitive Level: Comprehension REF: p. 655 OBJ: 19
TOP: Nursing Care of the Dying Child KEY: Nursing Process Step: Data
Collection
Blood, Blood-Forming Organs, or Lymphatic
System
Leifer: Introduction to Maternity and Pediatric Nursing, 9th Edition
MULTIPLE CHOICE
1. The child receiving a transfusion complains of back pain and itching. What is the best initial
action by the nurse?
a. Notify the charge nurse.
b. Disconnect intravenous lines immediately.
c. Give diphenhydramine (Benadryl).
d. Clamp off blood and keep line open with normal saline.
ANS: D
If a blood transfusion reaction occurs, the first action is to stop the blood infusion, keep the
line open with normal saline, and notify the charge nurse.
DIF: Cognitive Level: Application REF: p. 652 OBJ: 16
TOP: Blood Transfusion KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity
2. What would the nurse include in a teaching plan about mouth care of a child receiving
chemotherapy?
a. Use commercial mouthwash.
b. Clean teeth with a soft toothbrush.
c. Avoid use of a Water-Pik.
d. Inspect the mouth weekly for ulcerations.
ANS: B
, A soft toothbrush reduces capillary damage and mucous membrane breakdown and prevents
bleeding and infection. Commercial mouthwashes may kill oral flora that combat infection.
Water-Pik is useful for toughening gums.
DIF: Cognitive Level: Application REF: p. 652 OBJ: 15
TOP: Leukemia KEY: Nursing Process Step: Planning
MSC: NCLEX: Physiological Integrity: Basic Care and Comfort
3. A 6-year-old child with leukemia asks, “Who will take care of me in heaven?” What is the best
response by the nurse?
a. “Who do you think will take care of you?”
b. “Your grandparents and God will take care of you.”
c. “Your mom will know more about that than I do.”
d. “Why are you asking me that?”
ANS: A
This response gives the child an opportunity to verbalize his or her feelings and concerns,
whereas closed responses shut off communication. The asking of a “why” question is not
therapeutic as it calls for justification.
DIF: Cognitive Level: Application REF: p. 652 OBJ: 18
TOP: Leukemia KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation
4. The nurse is dealing with a preschool child with a life-threatening illness. What should the nurse
remember the child‘s concept of death is at this age?
a. That it is final
b. Only a fear of separation from her parents
c. That a person becomes alive again soon after death
d. An understanding based on simple logic
ANS: C
The preschooler views death as reversible and temporary.
DIF: Cognitive Level: Comprehension REF: p. 655 OBJ: 19
TOP: Nursing Care of the Dying Child KEY: Nursing Process Step: Data
Collection
