Nclex-Rn Practice Questions-Care Of The Child - Hematologic & İmmune Disorders Part 1
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Question 1 |
A child comes to the emergency department feeling feverish and lethargic. Which assessment finding suggests Reye’s syndrome to the nurse?
A | Fever, profoundly impaired consciousness, and hepatomegaly |
B | Fever, splenomegaly, and hyperactive reflexes |
C | Afebrile, intractable vomiting, and rhinorrhea |
D | Malaise, cough, and sore throat |
Question 2 |
A parent asks the nurse if it is alright to let his child scratch the chickenpox on his abdomen. The nurse explains that if the child scratches the chickenpox, he may be at risk for developing which condition?
A | Myocarditis |
B | Neuritis |
C | Obstructive laryngitis |
D | Secondary bacterial infection |
Question 3 |
The nurse is assessing a child with suspected roseola. The nurse determines the child has a roseola rash when she observes which finding?
A | Maculopapular red spots |
B | Macular and pruritic, with papules and vesicles |
C | Rose-pink macules that fade on pressure |
D | Red maculopapular eruption, beginning on the face |
Question 4 |
A parent calls the school nurse to ask when her child who developed chickenpox can return to school. What is the most appropriate response by the nurse?
A | When the child is afebrile |
B | When all vesicles have dried |
C | When vesicles begin to crust over |
D | When lesions and vesicles are gone |
Question 5 |
On assessment of a child’s skin, the nurse notes a papular, pruritic rash with some vesicles. The rash is profuse on the trunk and sparse on the distal limbs. Based on this assessment, which illness does the client have?
A | Measles |
B | Mumps |
C | Roseola |
D | Chickenpox |
Question 6 |
A child is admitted to the hospital with a diagnosis of severe combined immunodeficiency disease (SCID). During the admission interview and assessment, the nurse should observe the child for which symptom?
A | Bruising |
B | Failure to thrive |
C | Prolonged bleeding |
D | Susceptibility to infection |
Question 7 |
A nurse is caring for a child with sickle cell anemia. The nurse anticipates that which type of transfusion is most likely to be given to the child?
A | Plasma |
B | Platelets |
C | Whole blood |
D | Packed red blood cells (RBCs) |
Question 8 |
Which is the treatment of choice for severe aplastic anemia?
A | Liver transplantation |
B | Exchange transfusion |
C | Bone marrow transplantation |
D | Administration of intravenous immunoglobulins |
Question 9 |
The child who’s diagnosed with thalassemia major (Cooley’s anemia) typically suffers complications from the disease and from the treatment. The nurse is aware that this child is at risk for which of the following?
A | Hypertrophy of the thyroid |
B | Hypertrophy of the thymus |
C | Polycythemia vera and thrombosis |
D | Chronic hypoxia and iron overload |
Question 10 |
The nurse is caring for an unconscious child with Reye’s syndrome. What is the most appropriate nursing intervention?
A | Keeping the arms and legs flexed |
B | Placing the child on a sheepskin |
C | Avoiding the use of lotions on the skin |
D | Placing the client in a supine position |
Question 11 |
Which aspect is most important for successful management of the child with Reye’s syndrome?
A | Early diagnosis |
B | Initiation of antibiotics |
C | Isolation of the child |
D | Staging of the illness |
Question 12 |
The nurse is aware that parents of a child with Reye’s syndrome need a great deal of emotional support. What is the most important intervention for the nurse to include in the plan of care?
A | Not accepting aggressive behavior from the parents |
B | Encouraging the parents not to overreact and to hope for the best |
C | Letting the parents interpret the child’s behaviors and responses |
D | Explaining therapies and clarifying or reinforcing the information given |
Question 13 |
A child with Reye’s syndrome is in stage I of the illness. Which measure can be taken to prevent further progression of the illness?
A | Invasive monitoring |
B | Endotracheal intubation |
C | Hypertonic glucose solution |
D | Pancuronium bromide (Pavulon) |
Question 14 |
Which goal should be achieved by performing a craniotomy on a client with Reye’s syndrome?
A | Decreasing carbon dioxide levels |
B | Determining the extent of brain injury |
C | Reducing pressure from an edematous brain |
D | Allowing continuous monitoring of intracranial pressure (ICP) |
Question 15 |
The nurse is caring for a client with Reye’s syndrome who’s receiving pancuronium (Pavulon). What is the most important intervention for the nurse to include in the plan of care?
A | Applying artificial tears as needed |
B | Providing regular tactile stimulation |
C | Performing active range-of-motion (ROM) exercises |
D | Placing the client in a supine position |
Question 16 |
A nurse should tell parents to stop the administration of acetylsalicylic acid (aspirin) and notify a physician if their child is exposed to which of the following?
A | Stress |
B | Scabies |
C | Influenza |
D | Environmental allergies |
Question 17 |
A parent asks the nurse if medications can cause Reye’s syndrome. The most appropriate response by the nurse is that Reye’s syndrome has been connected to:
A | acetaminophen (Tylenol). |
B | aspirin. |
C | ibuprofen (Motrin). |
D | guaifenesin (Robitussin). |
Question 18 |
The nurse is caring for a client in stage V of Reye’s syndrome. The nurse documents which assessment data?
A | Vomiting, lethargy, and drowsiness |
B | Seizures, flaccidity, and respiratory arrest |
C | Hyperventilation and coma |
D | Disorientation, aggressiveness, and combativeness |
Question 19 |
The goal of nursing care for a client with Reye’s syndrome is to minimize intracranial pressure (ICP). Which nursing intervention helps to meet this goal?
A | Keeping the head of the bed flat |
B | Frequent position changes |
C | Positioning to avoid neck flexion |
D | Suctioning and chest physiotherapy |
Question 20 |
The nurse is reviewing lab results of a newly admitted client. Which group of laboratory results, along with the clinical manifestations, establishes a diagnosis of Reye’s syndrome?
A | Elevated liver enzymes and prolonged prothrombin and partial thromboplastin times |
B | Increased serum glucose and insulin levels |
C | Increased bilirubin and alkaline phosphatase levels |
D | Decreased serum glucose and ammonia levels |
Question 21 |
A client with Reye’s syndrome is exhibiting increased intracranial pressur (ICP). Which nursing intervention would be the most appropriate for this client?
A | Position the child with the head elevated and the neck in a neutral position. |
B | Maintain the child in the prone position. |
C | Cluster together interventions that may be perceived as noxious. |
D | Position the child in the supine position, with the child’s head turned to the side. |
Question 22 |
The nurse is assessing a child acutely ill with Reye’s syndrome. Which assessment change would the nurse be most concerned about?
A | Irritability and quick pupil response |
B | Increased blood pressure and decreased heart rate |
C | Decreased blood pressure and increased heart rate |
D | Sluggish pupil response and decreased blood pressure |
Question 23 |
The nurse is caring for a client who is in the latter stages of Reye’s syndrome. What is the most important intervention by the nurse to prevent or reduce cerebral edema?
A | Noninvasive pressure monitoring |
B | Paralysis and sedation |
C | Liberal fluid replacement |
D | Nonassisted ventilation |
Question 24 |
What information is most important for the nurse to be aware of when administering immunizations?
A | Properly store the vaccine, and follow the recommended procedure for injection. |
B | Monitor clients for approximately 1 hour after administration for adverse reactions. |
C | Take the vaccine out of refrigeration 1 hour before administration. |
D | Inject multiple vaccines at the same injection site. |
Question 25 |
A child is admitted to the hospital for an asthma exacerbation. The nursing history reveals this client was exposed to chickenpox 1 week ago. The nurse is correct in her assessment of room assignment when she determines that:
A | isolation isn’t required. |
B | immediate isolation is required. |
C | isolation would be required 10 days after exposure. |
D | isolation would be required 12 days after exposure. |
Question 26 |
A nurse is administering an immunization to a 2-month-old child. Which immunity will the child form?
A | Acquired immunity |
B | Active immunity |
C | Natural immunity |
D | Passive immunity |
Question 27 |
Which immunizations should a healthy 2-month-old infant receive?
A | Measles, mumps, rubella (MMR), and inactivated polio (IPV) |
B | MMR and varicella |
C | Diphtheria, tetanus, and pertussis (DTP), and influenza nasal mist |
D | DTP and IPV |
Question 28 |
A parent calls the nurse “hotline” to ask about the clinical manifestations associated with roseola. What is the best response by the nurse?
A | “Apparent sickness, fever, and rash” |
B | “Fever for 3 to 4 days, followed by rash” |
C | “Rash, without history of fever or illness” |
D | “Rash for 3 to 4 days, followed by high fevers” |
Question 29 |
The parent of a neonate asks the nurse what is the recommended age for beginning hepatitis B immunization. Which response is the most accurate?
A | Birth |
B | 4 months |
C | 6 months |
D | 1 year |
Question 30 |
It would be most appropriate for which infant to begin receiving the measles vaccine?
A | A 6-month old |
B | A 12-month old |
C | An 18-month old |
D | A 24-month old |
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