The nurse analyzes the laboratory values of a pediatric client with leukemia who is receiving chemotherapy. The nurse notes the following lab values: platelets 19,500/mcl (nl. 140,000-400,000/mcL), hemoglobin 11 g/dL (nl. 12-16 g/dL), white blood cell count 9,800/mcl (nl. 5,000-10,000/mcL). Based on these findings, which intervention should the nurse prioritize in the plan of care?

Monitoring closely for signs of infection.

Transfusing packed red blood cells.

Administering intravenous immunoglobulins.

Initiating bleeding precautions.

Answer and Explanation

The Correct Answer is D

A. Monitoring for infection is important, but the white blood cell count is within normal limits, so it is not the immediate priority.

B. Although the hemoglobin is slightly low, it is not critically low, so transfusion of packed red blood cells is not immediately necessary.

C. Intravenous immunoglobulins are not indicated based on the current lab values.

D. The platelet count is critically low, placing the client at high risk for bleeding. Initiating bleeding precautions is the priority to prevent hemorrhage.

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Correct Answer is A

Explanation

A. Keeping a dedicated thermometer in the toddler's room is an appropriate infection control measure to prevent cross-contamination with other patients.

B. RSV is primarily transmitted through droplet and contact, not airborne, so contact and droplet precautions are more appropriate than airborne precautions.

C. Nebulized racemic epinephrine is not typically used for RSV; it is more commonly used for croup. Treatment for RSV may include supportive care such as hydration and oxygen therapy.

D. While monitoring pulse oximetry is important, assessing it every 3 hours might be insufficient. Continuous monitoring may be more appropriate depending on the severity of the illness.

A. "We will limit our child's caffeinated beverages" B. "We will limit fluid during the day." C. "We will wake our child at scheduled intervals at night to void." D. "We will need to administer anticholinergics if behavioral strategies are ineffective."

Correct Answer is B

Explanation

A. Limiting caffeinated beverages is a good strategy as caffeine can increase urine production and contribute to enuresis.

B. Limiting fluid intake during the day is not recommended as it can lead to dehydration. Instead, fluids should be limited in the evening before bedtime.

C. Waking the child at scheduled intervals to void is a common behavioral strategy to help manage enuresis.

D. Anticholinergic medications may be prescribed if behavioral strategies are ineffective, indicating that the parents have received proper education on this potential intervention.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is admitting a toddler who has respiratory syncytial virus (RSV). What is an appropriate action for the nurse to take when caring for this client?

Correct Answer is A

Explanation

A nurse has developed a plan of care for a family whose 7-year-old has been experiencing enuresis. Which of the following statements by the parents indicates that further teaching is needed?

Correct Answer is B

Explanation

While assessing a preadolescent client, the nurse notes curvature of the client's spine. Which statement by the parent supports this observation?

The nurse is explaining to parents that the preschooler's developmental task is focused on the development of initiative rather than guilt. What is a priority intervention the nurse might recommend for parents of preschoolers to stimulate initiative?

A child allergic to insect stings presents to the school nurse stating, "A bee stung me on the playground." Which action by the school nurse should be prioritized?

An infant is admitted to the unit with a diagnosis of bladder exstrophy. What should the nurse prioritize when caring for a client with this condition?

A nurse is admitting a pediatric client to the unit who has leukemia. Which client should the nurse place in the same room with this child?

A 1-month-old infant is seen in a clinic and is diagnosed with developmental dysplasia of the hip (DDH). On assessment, the nurse understands that which finding would be noted in this condition?

A pediatric client is admitted to the unit with failure to thrive. The mother states that the child has been "spitting up" and excessively crying immediately after every bottle. What diagnostic test will the nurse anticipate to confirm a diagnosis?