Essentials of Pediatric Nursing ALL VERSIONS 2025 | LATEST AND ACCURATE REAL EXAM QUESTIONS WITH DETAILED ANSWERS | VERIFIED FOR GUARANTEED PASS | LATEST UPDATE

The nurse is teaching an in-service program to a group of nurses on the topic of children diagnosed with sickle cell anemia. The nurses in the group make the following statements. Which statement is most accurate regarding sickle cell anemia? A. "If the trait is inherited from both parents the child will have the disease." B. "The disease is most often seen in individuals of Asian descent." C. "The trait or the disease is seen in one generation and skips the next generation." D. "Males are much more likely to have the disease than females." Correct Answer: A Rationale: Sickle cell disease is inherited when a child receives the sickle cell trait from both parents. It is not sex-linked and does not skip generations. It is most common in African, Mediterranean, and Middle Eastern populations. Which nursing diagnosis would be most appropriate for a child with idiopathic thrombocytopenic purpura (ITP)? A. Risk for infection related to abnormal immune system B. Ineffective tissue perfusion related to poor platelet formation C. Ineffective breathing pattern related to decreased white blood count D. Risk for altered urinary elimination related to kidney impairment Correct Answer: B Rationale: ITP causes a low platelet count, impairing clot formation and tissue perfusion. Infection risk is not the primary concern unless treatment causes immunosuppression. The nurse is administering meperidine as ordered for pain management for a 10-year-old boy in sickle cell crisis. The nurse would be alert for: A. Seizures B. Behavioral addiction C. Leg ulcers D. Priapism Correct Answer: A Rationale: Meperidine (Demerol) can accumulate and cause seizures, especially with repeated dosing. Other listed options are complications of sickle cell disease itself, not meperidine. A 9-year-old child with leukemia is scheduled to undergo an allogenic hematopoietic stem cell transplant. When teaching the child and parents, what information would the nurse include? A. "We'll need to have a match to a donor." B. "The risk for rejection is much less with this type of transplant." C. "You'll need to have an incision in your hip area to instill the cells." D. "You won't need to receive the high doses of chemotherapy before the transplant." Correct Answer: A Rationale: An allogenic transplant requires a donor match, usually a sibling or compatible donor. Rejection is still a risk, chemotherapy is required, and infusion is IV, not by hip incision. A group of nursing students are studying childhood cancers. Which location is an unlikely site for childhood cancer? A. Brain B. Bladder C. Blood D. Kidney Correct Answer: B Rationale: Childhood cancers commonly affect blood (leukemia), brain, and kidney (Wilms tumor). Bladder cancer is more typical in adults. The nurse is admitting a child with "probable acute lymphoblastic leukemia." What will confirm this diagnosis? A. Complete white blood count B. Lethargy, bruising, and pallor C. History of leukemia in twin D. Bone marrow aspiration Correct Answer: D Rationale: The gold standard for diagnosing leukemia is bone marrow aspiration, which shows blast cells. A preschooler who received chemotherapy 1 week ago now has a temperature of 101.5°F (38.6°C). What is the most appropriate response by the nurse? A. Instruct the parent to immediately obtain and give antibiotics. B. Ask whether family members are ill. C. Tell the parent to administer acetaminophen every 4 hours. D. Have the parent bring the child to the pediatric oncology clinic as soon as possible. Correct Answer: D Rationale: Fever in an immunocompromised child is an emergency. The child must be evaluated promptly for possible sepsis. What is one advantage of an implanted port (central venous access device) that the nurse will explain to an adolescent? A. No special procedure is necessary for removal. B. Body appearance changes very little. C. No tunneling is needed when inserted. D. Flushing is not necessary. Correct Answer: B Rationale: Implanted ports are under the skin, making them cosmetically acceptable. They still require flushing and surgical removal. A nurse is providing care to a toddler with nephroblastoma. Which nursing action is most important? A. Preventing weight-bearing activities B. Restricting the child's visitors C. Placing a "no abdominal palpation" sign above the child's bed D. Preparing the child for chemotherapy Correct Answer: C Rationale: Abdominal palpation may rupture a nephroblastoma and spread malignant cells. A nurse is preparing a 7-year-old girl for bone marrow aspiration. Which site should she prepare? A. Sternum B. Anterior tibia C. Iliac crest D. Femur Correct Answer: C Rationale: The iliac crest is the preferred site in children for bone marrow aspiration. The nurse is completing the health history of a 6-month-old infant with retinoblastoma. Which symptom would the nurse expect? A. The infant's eye appears to be protruding. B. The infant always keeps eyes tightly closed. C. One pupil appears white. D. The infant tugs at one ear. Correct Answer: C Rationale: Retinoblastoma often presents as a white pupillary reflex (leukocoria). The nurse is preparing to send a child with cancer for radiation treatment. Which medication should be given as premedication? A. Antineoplastic B. Antiemetic C. Antipyretic D. Analgesic Correct Answer: B Rationale: Radiation often causes nausea; antiemetics are given prophylactically. The nurse is providing preoperative care for a 7-year-old boy with a brain tumor. Which intervention is priority? A. Assessing the child's level of consciousness B. Educating the child and parents about shunts C. Providing a tour of the ICU D. Having the child talk with another surgical patient Correct Answer: A Rationale: Neurological assessment is the priority in brain tumor patients to monitor for increased ICP. A 5-year-old with leukemia is having difficulty due to mucositis from chemotherapy. Which is the most appropriate nursing diagnosis? A. Risk for imbalanced nutrition, less than body requirements, related to inflammation B. Compromised family coping, related to chemotherapy regimen C. Disturbed body image related to hair loss D. Pain related to neoplastic process in bone Correct Answer: A Rationale: Mucositis causes painful oral sores, interfering with oral intake and nutrition. A 3-year-old with sickle cell anemia is in a pain crisis with a pain score of 10/10. What is the nurse's priority? A. Ask the parent if they have questions. B. Implement strategies to address the child's pain. C. Contact the provider to meet with the parent. D. Provide diversional activities. Correct Answer: B Rationale: Managing pain is the top priority in a sickle cell crisis. A child with leukemia is prescribed a transfusion at 5 mL/kg/hr. The child weighs 25 kg. At what rate should the pump be set? A. 75 mL/hr B. 100 mL/hr C. 125 mL/hr D. 150 mL/hr Correct Answer: C (125 mL/hr) Rationale: 25 kg × 5 mL = 125 mL/hr. To prevent further sickle cell crisis, the nurse would advise parents to: A. Administer an iron supplement daily. B. Encourage long-distance running. C. Prevent excess fluid intake daily. D. Notify a provider if the child develops a respiratory infection. Correct Answer: D Rationale: Infections are a major trigger for sickle cell crisis; prompt reporting is vital. A nurse is teaching a child with hemophilia. Which action should NOT be included in bleeding management? A. Apply heat to the site of bleeding. B. Apply direct pressure. C. Administer factor VIII replacement. D. Elevate the injured area. Correct Answer: A Rationale: Heat increases blood flow and bleeding. Cold and pressure should be used. What is the priority action when caring for a child newly diagnosed with Wilms tumor (nephroblastoma)? A. Assess for constipation. B. Control acute pain. C. Protect the abdomen from manipulation. D. Obtain a catheterized urine specimen. Correct Answer: C Rationale: Abdominal palpation may rupture the tumor and spread malignant cells. The toddler with cancer is seen for a well-child checkup. Which health maintenance activity will the nurse exclude? A. Administering the MMR vaccine B. Teaching water safety measures C. Assessing picky eating habits D. Plotting growth on chart Correct Answer: A Rationale: Children receiving chemotherapy should not receive live vaccines such as MMR. Parents ask why their child with leukemia needs a spinal tap. Which is the best response? A. "A sample of CSF checks for infection." B. "It checks if leukemic cells have entered the CNS." C. "It relieves pressure and headache." D. "It rules out a second malignancy." Correct Answer: B Rationale: A spinal tap (lumbar puncture) is done to check for CNS involvement. How can the nurse describe a rhabdomyosarcoma to parents? A. Develops in nerves outside the CNS B. A tumor of muscle tissue C. A bone tumor D. Another name for Hodgkin’s disease Correct Answer: B Rationale: Rhabdomyosarcoma is a malignant tumor of skeletal muscle tissue. The nurse is caring for a child with aplastic anemia. The parents ask about recent labs (granulocyte 500, platelets 20,000, reticulocytes 1%). What is the best response? A. "These are just routine labs." B. "These values will help us monitor the disease." C. "The doctor will discuss these results with you." D. "I cannot discuss lab findings with you." Correct Answer: B Rationale: Nurses should provide accurate, supportive information—labs are monitored to track disease progression.