A nurse is caring for a 7-year-old child who has a fever, tachycardia, and low oxygen saturation. The nurse reviews the child's laboratory results and notes the following:

- WBC count 15,000/mm^3^ (normal range: 5,000 to 10,000/mm^3^)
- Hgb 8 g/dL (normal range: 10 to 15.5 g/dL)
- Hct 32% (normal range: 32% to 44%)

The nurse should suspect that the child has which of the following conditions?

Leukemia.

Sickle cell anemia.

Hemophilia.

Iron deficiency anemia.

Answer and Explanation

The Correct Answer is B

Choice A reason: Leukemia is not a probable condition, as it is a cancer of the white blood cells that causes abnormal proliferation and accumulation of immature or dysfunctional white blood cells. The child has a high WBC count, which can indicate leukemia, but not necessarily. The child does not have other signs of leukemia, such as bleeding, bruising, bone pain, or lymphadenopathy.

Choice B reason: Sickle cell anemia is a possible condition, as it is an inherited disorder that affects the shape and function of the red blood cells, causing them to become sickle-shaped and rigid. The child has a low Hgb and Hct, which can indicate anemia, and a fever, tachycardia, and low oxygen saturation, which can indicate a sickle cell crisis. A sickle cell crisis is a condition where the sickle-shaped red blood cells block the blood flow and cause tissue ischemia and inflammation.

Choice C reason: Hemophilia is not a likely condition, as it is an inherited disorder that affects the clotting factors, causing impaired blood clotting and increased risk of bleeding. The child has a low Hgb and Hct, which can indicate anemia, but not necessarily hemophilia. The child does not have other signs of hemophilia, such as bleeding, bruising, hemarthrosis, or hematuria.

Choice D reason: Iron deficiency anemia is not a definite condition, as it is a type of anemia that occurs when the body does not have enough iron to produce hemoglobin, the protein that carries oxygen in the blood. The child has a low Hgb and Hct, which can indicate iron deficiency anemia, but not necessarily. The child does not have other signs of iron deficiency anemia, such as pallor, fatigue, weakness, or pica.

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Correct Answer is B

Explanation

Choice A reason: A protective environment is a type of isolation precaution that is used for patients who are immunocompromised and at high risk of infection from environmental sources, such as fungi or bacteria. It involves using a private room with positive air pressure, high-efficiency particulate air (HEPA) filtration, and strict hand hygiene. It is not indicated for patients who have measles, as they are the source of infection, not the susceptible host.

Choice B reason: Airborne is a type of isolation precaution that is used for patients who have diseases that are transmitted by small droplets that can remain suspended in the air and travel over long distances, such as tuberculosis, chickenpox, or measles. It involves using a private room with negative air pressure, HEPA filtration, and respiratory protection for health care workers and visitors. It is the appropriate isolation precaution for patients who have measles, as it prevents the spread of the virus to others.

Choice C reason: Contact is a type of isolation precaution that is used for patients who have diseases that are transmitted by direct or indirect contact with the patient or their environment, such as Clostridioides difficile, scabies, or impetigo. It involves using a private room or cohorting with similar patients, wearing gloves and gowns, and using dedicated equipment. It is not indicated for patients who have measles, as the disease is not spread by contact.

Choice D reason: Droplet is a type of isolation precaution that is used for patients who have diseases that are transmitted by large droplets that are generated by coughing, sneezing, or talking, such as influenza, pertussis, or meningitis. It involves using a private room or cohorting with similar patients, wearing a surgical mask, and maintaining a distance of at least 3 feet from the patient. It is not indicated for patients who have measles, as the disease is spread by airborne transmission.

A. "I should not take my regular insulin when I am sick." B. "I can store unopened bottles of insulin in the freezer." C. "My morning blood glucose should be between 90 and 130." D. "I should eat a snack half an hour before playing soccer."

Correct Answer is D

Explanation

Choice A reason: This is not a correct statement by the child. The child should take their regular insulin as prescribed, even when they are sick. Insulin helps the body use glucose for energy and prevents high blood sugar levels, which can cause complications. The child may need to adjust their insulin dose or frequency depending on their blood glucose levels, food intake, and activity level.

Choice B reason: This is not a correct statement by the child. The child should not store unopened bottles of insulin in the freezer. Freezing can damage the insulin and make it ineffective. The child should store unopened bottles of insulin in the refrigerator, away from direct light and heat. The child should store opened bottles of insulin at room temperature and discard them after 28 days.

Choice C reason: This is not a correct statement by the child. The child's morning blood glucose should be between 70 and 110 mg/dL, according to the American Diabetes Association. A blood glucose level between 90 and 130 mg/dL may indicate that the child has hyperglycemia, or high blood sugar, which can cause symptoms such as thirst, hunger, fatigue, and frequent urination.

Choice D reason: This is a correct statement by the child. The child should eat a snack half an hour before playing soccer or engaging in any physical activity. Physical activity lowers blood glucose levels, and a snack can help prevent hypoglycemia, or low blood sugar, which can cause symptoms such as shakiness, sweating, dizziness, and confusion.

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Naxlex Comprehensive Predictor Exams

A nurse is assisting with the admission of a child who has measles. Which of the following isolation precautions should the nurse initiate?

Correct Answer is B

Explanation

A nurse is providing teaching to a school-age child who has a new diagnosis of type 1 diabetes mellitus. Which of the following statements by the child indicates an understanding of the teaching?

Correct Answer is D

Explanation

Which of the following findings should the nurse report to the health care provider immediately? (select all that apply)

A nurse is caring for a client who has a white blood cell (WBC) count of 15,000/mm3. Which of the following actions should the nurse take?

Which of the following is the correct way to write the date in the American format?

A nurse is caring for a client who has a history of chronic obstructive pulmonary disease (COPD) and is receiving oxygen therapy at home. The nurse should instruct the client to report which of the following findings as an indication of oxygen toxicity?

A nurse is creating a plan of care for a child who has sickle cell anemia. Which of the following interventions should the nurse include in the plan?

A nurse is providing discharge instructions to a parent and his school-age child who has juvenile idiopathic arthritis. Which of the following instructions should the nurse include?

A nurse is caring for a 3-year-old child who was admitted with acute diarrhea and dehydration. Which of the following findings indicates that oral rehydration therapy has been effective?