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 D

Explanation

A. Increasing fiber intake is beneficial for overall digestive health and can prevent constipation, which may help in reducing the risk of UTIs.

B. Wiping from front to back is crucial in preventing the spread of bacteria from the anal area to the urinary tract, reducing the risk of recurrent UTIs.

C. Follow-up with a specialist may be necessary if the child has recurrent UTIs, to rule out underlying issues such as vesicoureteral reflux.

D. No additional testing after antibiotics might be needed for a simple UTI, but in cases of recurrent UTIs, further testing is often required to ensure the infection has resolved and to investigate any underlying causes.

A. A child who is recovering from nasopharyngitis B. A child who has nephrotic syndrome C. A child who has gastroenteritis D. A child who has rheumatic fever

Correct Answer is B

Explanation

A. A child recovering from nasopharyngitis could still be contagious, and since children with leukemia have compromised immune systems, they are at higher risk of infections.

B. A child with nephrotic syndrome, although potentially needing special care, does not pose the same infection risk as a child recovering from an infectious disease. Therefore, they are a more suitable roommate for a child with leukemia.

C. A child with gastroenteritis may still be infectious and could expose the child with leukemia to gastrointestinal pathogens.

D. A child with rheumatic fever does not have a contagious illness, but the specific needs of the child with leukemia and the potential for complications from infections make it less ideal compared to a non-infectious condition like nephrotic syndrome.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A 5-year-old girl presents to the clinic with a urinary tract infection (UTI). After educating the family on preventing recurrent infections, what statement by the family indicates further teaching is needed?

Correct Answer is D

Explanation

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?

Correct Answer is B

Explanation

A newborn has been admitted to the intensive care unit with a diagnosis of myelomeningocele. The nurse could expect which of the following with the disorder?

A 4-year-old client presents to the emergency department with drooling, agitation, and inability to cough. The nurse should recognize these findings are associated with which diagnosis?

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 nurse is caring for a pediatric client who has been admitted with nephrotic syndrome. Which medication should the nurse expect to administer for the therapeutic management of nephrotic syndrome?

The nurse analyzes the laboratory results of a pediatric client with hemophilia. The nurse understands which result will most likely be abnormal in this client?

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?

A nurse is caring for an 8-year-old client who has been diagnosed with acute rheumatic fever. Which action is the nurse's priority for a client with this presentation?