A four-year-old patient has been diagnosed with leukemia. The patient's parents, who follow the Jehovah's Witness faith, inform the physician that they will not approve any type of blood transfusions. The pediatric nurse is aware that:

The patient can only receive blood that has been donated by family members.

Under no circumstances will the patient receive blood products.

In an emergency, a court order can be obtained for the patient to receive blood transfusions.

The patient can receive volume expanders.

Answer and Explanation

The Correct Answer is C

The correct answer is: c. In an emergency, a court order can be obtained for the patient to receive blood transfusions.

Choice A: The patient can only receive blood that has been donated by family members.

Jehovah’s Witnesses refuse blood transfusions, including those from family members, due to their religious beliefs. They believe that both the Old and New Testaments command them to abstain from blood (Genesis 9:4; Leviticus 17:10; Deuteronomy 12:23; Acts 15:28, 29). Therefore, this option is incorrect.

Choice B: Under no circumstances will the patient receive blood products.

While Jehovah’s Witnesses generally refuse blood transfusions, there are exceptional circumstances where medical professionals can seek a court order to administer blood transfusions, especially in life-threatening situations involving minors. Thus, this statement is not entirely accurate.

Choice C: In an emergency, a court order can be obtained for the patient to receive blood transfusions.

In life-threatening emergencies, especially involving minors, courts can intervene and issue orders to administer necessary medical treatments, including blood transfusions, despite parental objections based on religious beliefs. This ensures the child’s right to life and health is protected. Therefore, this is the correct answer.

Choice D: The patient can receive volume expanders.

Volume expanders can be used to increase blood volume and maintain circulation, but they do not carry oxygen or replace lost blood cells. While they are an option for managing blood loss, they are not a substitute for blood transfusions in severe cases of anemia or blood loss, which are common in leukemia patients. Thus, this option is not entirely correct.

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Correct Answer is C

Explanation

Choice A reason: Pneumonia could present with these symptoms, but it is less likely in this case due to the specific combination of symptoms described.
Choice B reason: Active pulmonary tuberculosis is less common in infants and does not typically present with these acute symptoms.
Choice C reason: This is the correct choice. The symptoms described are characteristic of Respiratory Syncytial Virus (RSV), especially in infants.
Choice D reason: Croup could cause some of these symptoms, but it is more commonly associated with a distinctive barking cough and stridor.

A. Ensure IV fluid replacement is a hypertonic solution. B. Assess for cardiac arrest related to high potassium levels. C. Monitor the child's vital signs for hypertension. D. Administer intravenous NPH insulin in high doses.

Correct Answer is B

Explanation

Choice A reason: IV fluid replacement in DKA is typically isotonic, not hypertonic, to avoid rapid changes in osmolality.
Choice B reason: This is correct. While the total body potassium is depleted in DKA, the initial lab values often show hyperkalemia (high potassium) due to the metabolic acidosis, which shifts potassium out of the cells. This can lead to serious cardiac dysrhythmias and even cardiac arrest, making continuous cardiac monitoring and potassium level assessment a top priority.
Choice C reason: Monitoring for hypertension is important, but the primary concern in DKA is managing the acidosis and hyperglycemia.
Choice D reason: This is incorrect. Treatment for DKA involves a continuous IV infusion of regular insulin at a low, steady rate, not high doses of NPH insulin. NPH insulin is an intermediate-acting insulin and is not suitable for the acute management of DKA.

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A four-year-old patient has been diagnosed with leukemia. The patient's parents, who follow the Jehovah's Witness faith, inform the physician that they will not approve any type of blood transfusions. The pediatric nurse is aware that:

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Naxlex Comprehensive Predictor Exams

Correct Answer is C

Explanation

Which of the following is of primary importance for a child who is admitted to the PICU for DKA (diabetic ketoacidosis)?

Correct Answer is B

Explanation

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