QUESTIONS

The nurse is caring for a child with a diagnosis of neutropenia. Which nursing interventions are most appropriate for a child placed in protective isolation for neutropenia? Select all that apply.

• A. Place the child on a low-bacteria diet.

• B.Change dressings using sterile technique.

• C. Put flowers in a vase with water before placing in the room.

• D. Peel and cook fruits and vegetables before allowing the child to eat them.

• E. Allow individuals who are ill to visit as long as they wear a mask

Answer explanation

•For the hospitalized neutropenic child, flowers or plants should not be kept in the room because standing water and damp soil harbor Aspergillus and Pseudomonas species, to

which these children are very susceptible. Fruits and

vegetables not peeled before being eaten harbor molds and should be avoided until the white blood cell count rises. The child is placed on a low-bacteria diet. Dressings are always changed using sterile technique. Individuals who are ill are not allowed to visit the client

A nurse is providing teaching about lice to the parents of a school-age child at a well-child visit. Which of the following information should the nurse include in the teaching?

• a. Lice can jump from one lice to another

• b. Encourage your child to avoid sharing hats with other children.

• c. Live lice can survive for 2 weeks away from the host.

• d. Washing your child's hair daily will prevent lice

Answer explanation

Lice are not able to jump to jump or fly.

Lice are transmitted from person to person on personal items, such as hats, hair ornaments, scarves combs, and brushes.

Live lice survive for up to 48 hr away from the host.

Washing the child's hair daily will not prevent lice. The only way to prevent lice infestation is to avoid head-to-head contact and the sharing of personal items.

An adolescent client with type 1 diabetes mellitus is admitted to the emergency department for treatment of diabetic ketoacidosis. Which assessment findings should the nurse expect to note?

• a. Sweating and tremors

• b. Hunger and Hypertension

• c. Cold, clammy skin, and irritability

• d. Fruity breath odor and decreasing level of conciousness

Answer explanation

•Diabetic ketoacidosis is a complication of diabetes mellitus that   develops when a severe insulin deficiency occurs. Hyperglycemia

occurs with diabetic ketoacidosis. Signs of hyperglycemia include fruity breath odor and a decreasing level of consciousness. Hunger can be a sign of hypoglycemia or hyperglycemia, but hypertension is not a sign of diabetic ketoacidosis. Hypotension occurs because of a decrease in

blood volume related to the dehydrated state that occurs during diabetic ketoacidosis. Cold clammy skin, irritability, sweating, and tremors all are signs of hypoglycemia.

A pediatric nurse educator provides a teaching session to the nursing staff regarding phenylketonuria. Which statement should the nurse educator include in the session?

• A."Treatment includes dietary restriction of tyramine."

• B."Phenylketonuria is an autosomal dominant disorder."

• C."Phenylketonuria primarily affects the gastrointestinal system."

• D."All 50 states require routine screening of all newborn infants for phenylketonuria."

Answer explanation

•All 50 states require routine screening in newborn infants.   Phenylketonuria is an autosomal recessive disorder.   Treatment includes dietary restriction of phenylalanine   intake. Phenylketonuria is a genetic disorder that results in   central nervous system damage from toxic levels of   phenylalanine in the blood.

A nurse is assessing an adolescent client who has attention deficit hyperactivity disorder (ADHD). Which of the following findings should the nurse expect.?

• A. Emotional numbing

• B. Elevated mood

• C. Anxiety

• D. Impulsivity

A 7-year-old child with juvenile idiopathic arthritis has difficulty getting ready for school in the morning because of joint pain and stiffness. Which recommendation should the nurse make to the family?

• A. Administer acetaminophen before bedtime.

• B. Ice the joints that are painful in the evening.

• C. Encourage a program of active exercise after awakening.

• D. Provide warm, moist heat to the affected joints before arising.

Answer explanation

•Warm, moist heat will reduce inflammation and pain, thus promoting   mobility.

•  – Acetaminophen administered at night will not decrease pain experienced the following morning.

–Ice will not be beneficial regardless of the time it is administered.

–Gentle stretching, not active exercise, should be employed.