A child has been admitted to the pediatric unit. Her absolute neutrophil count is 225 and the child has been placed in neutropenic isolation. Which action by a nurse indicates that the nurse requires further education? (Select all that apply)

The nurse monitors the child's vital signs every 2 to 4 hours

The nurse carefully washes his/her hands before and after providing care

The child has been placed in a semi-private room

The nurse assesses the child for clinical signs of an infection

Answer and Explanation

The Correct Answer is C

A. The nurse monitors the child's vital signs every 2 to 4 hours is appropriate. Regular monitoring of vital signs is important in children with neutropenia to detect early signs of infection or sepsis.

B. The nurse carefully washes his/her hands before and after providing care is appropriate. Hand hygiene is critical in preventing the transmission of infection, especially in neutropenic patients who are at high risk of infections.

C. The child has been placed in a semi-private room requires further education. A child with a neutrophil count of 225 is at significant risk of infection, and placing the child in a semi-private room increases the risk of exposure to pathogens. The child should be placed in a private room to minimize exposure to infectious agents.

D. The nurse assesses the child for clinical signs of an infection is appropriate. Vigilant monitoring for infection is essential in neutropenic patients, as they are more susceptible to infections.

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Correct Answer is B

Explanation

A. No venipuncture or blood pressure in left arm is incorrect. This instruction is often associated with patients who have a shunt, a limb with an established intravenous line, or another condition, but it is not specific to Wilms' tumor.
B. Do not palpate abdomen is correct. Wilms' tumor is a type of kidney cancer in children, and the tumor is often palpable in the abdomen. Palpating the abdomen could cause the tumor to rupture, leading to the spread of cancerous cells. To avoid this risk, the abdomen should not be palpated.
C. Collect all urine is incorrect. While urine collection might be necessary for monitoring renal function or assessing signs of metastasis, it is not a standard precaution or warning for a child with Wilms' tumor.
D. Contact precautions is incorrect. Wilms' tumor is not contagious, so contact precautions are not required unless there is a coexisting infectious condition.

A. Age of the child B. Range of motion in the affected area C. Health complications from the tumor D. Whether or not the tumor has metastasized

Correct Answer is D

Explanation

A. Age of the child is important in determining the approach to treatment and potential outcomes, but the priority in planning treatment is addressing the extent of the disease, particularly whether it has spread. Age may influence treatment choices but is secondary to assessing metastasis.

B. Range of motion in the affected area is important in managing functional outcomes, especially for tumors that affect muscles or joints, but the highest priority when planning care is understanding the extent of the disease, specifically metastasis, before focusing on rehabilitation.

C. Health complications from the tumor are significant for symptom management and treatment planning, but the critical first step in treatment is determining the stage of the cancer and whether the tumor has spread. This information guides treatment decisions.

D. Whether or not the tumor has metastasized is the highest priority. The spread of the tumor (metastasis) directly impacts the treatment plan and prognosis, influencing decisions such as the need for systemic therapies (chemotherapy) in addition to local treatments like surgery or radiation.

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A child has been admitted to the pediatric unit. Her absolute neutrophil count is 225 and the child has been placed in neutropenic isolation. Which action by a nurse indicates that the nurse requires further education? (Select all that apply)

Nursing Test Bank

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