Keenan-Lindsay: Leifer’s Introduction to Maternity and Pediatric Nursing in Canada, 1st Edition
MULTIPLE CHOICE
1. A child with thalassemia major receives blood transfusions frequently. A nurse is aware
that which of the following is a complication of repeated blood transfusions?
a. Hemarthrosis
b. Hematuria
c. Hemoptysis
d. Hemosiderosis
ANS: D
As a result of repeated blood transfusions, excessive deposits of iron (hemosiderosis)
are stored in tissues.
DIF: Cognitive Level: Comprehension REF: 647 OBJ: 16
TOP: Thalassemia KEY: Nursing Process Step: Data Collection
2. A child has just been diagnosed with acute lymphoblastic leukemia. What is the result of
an overproduction of immature white blood cells in the bone marrow?
a. Decreased T-cell production
b. Decreased hemoglobin
c. Increased blood clotting
d. Increased susceptibility to infection
ANS: D
An overproduction of immature white blood cells increases the child’s susceptibility
to infection.
DIF: Cognitive Level: Comprehension REF: 650 OBJ: 14 | 15
, TOP: Leukemia KEY: Nursing Process Step: Data Collection
3. A child receiving a transfusion states symptoms of back pain and itching. What is the best
initial action by a nurse?
a. Notify the charge nurse.
b. Disconnect intravenous lines immediately.
c. Give diphenhydramine (Benadryl).
d. Clamp off blood and keep line open with normal saline.
ANS: D
If a blood transfusion reaction occurs, the first action is to stop the blood infusion,
keep the line open with normal saline, and notify the charge nurse.
DIF: Cognitive Level: Application REF: 654 OBJ: 16
TOP: Blood Transfusion KEY: Nursing Process Step:
Implementation
4. What would a nurse include in a teaching plan about mouth care of a child receiving
chemotherapy?
a. Use a commercial mouthwash.
b. Clean teeth with a soft toothbrush.
c. Avoid use of a Water-Pik.
d. Inspect the mouth weekly for ulcerations.
ANS: B
A soft toothbrush reduces capillary damage and mucous membrane breakdown and
prevents bleeding and infection. Commercial mouthwashes may kill oral flora that
combat infection. Water-Pik is useful for toughening gums.
DIF: Cognitive Level: Application REF: 650 OBJ: 15
TOP: Leukemia Care KEY: Nursing Process Step: Planning
5. A nurse notes that a 4-year-old child’s gums bleed easily and there is bruising and
petechiae on the extremities. Which lab value is consistent with these symptoms?
a. Platelet count of 25 109/L
MULTIPLE CHOICE
1. A child with thalassemia major receives blood transfusions frequently. A nurse is aware
that which of the following is a complication of repeated blood transfusions?
a. Hemarthrosis
b. Hematuria
c. Hemoptysis
d. Hemosiderosis
ANS: D
As a result of repeated blood transfusions, excessive deposits of iron (hemosiderosis)
are stored in tissues.
DIF: Cognitive Level: Comprehension REF: 647 OBJ: 16
TOP: Thalassemia KEY: Nursing Process Step: Data Collection
2. A child has just been diagnosed with acute lymphoblastic leukemia. What is the result of
an overproduction of immature white blood cells in the bone marrow?
a. Decreased T-cell production
b. Decreased hemoglobin
c. Increased blood clotting
d. Increased susceptibility to infection
ANS: D
An overproduction of immature white blood cells increases the child’s susceptibility
to infection.
DIF: Cognitive Level: Comprehension REF: 650 OBJ: 14 | 15
, TOP: Leukemia KEY: Nursing Process Step: Data Collection
3. A child receiving a transfusion states symptoms of back pain and itching. What is the best
initial action by a nurse?
a. Notify the charge nurse.
b. Disconnect intravenous lines immediately.
c. Give diphenhydramine (Benadryl).
d. Clamp off blood and keep line open with normal saline.
ANS: D
If a blood transfusion reaction occurs, the first action is to stop the blood infusion,
keep the line open with normal saline, and notify the charge nurse.
DIF: Cognitive Level: Application REF: 654 OBJ: 16
TOP: Blood Transfusion KEY: Nursing Process Step:
Implementation
4. What would a nurse include in a teaching plan about mouth care of a child receiving
chemotherapy?
a. Use a commercial mouthwash.
b. Clean teeth with a soft toothbrush.
c. Avoid use of a Water-Pik.
d. Inspect the mouth weekly for ulcerations.
ANS: B
A soft toothbrush reduces capillary damage and mucous membrane breakdown and
prevents bleeding and infection. Commercial mouthwashes may kill oral flora that
combat infection. Water-Pik is useful for toughening gums.
DIF: Cognitive Level: Application REF: 650 OBJ: 15
TOP: Leukemia Care KEY: Nursing Process Step: Planning
5. A nurse notes that a 4-year-old child’s gums bleed easily and there is bruising and
petechiae on the extremities. Which lab value is consistent with these symptoms?
a. Platelet count of 25 109/L
