A nurse is admitting a child who has leukemia. Which of the following clients should the nurse place in the same room with this child?

A child who has nephrotic syndrome

A child recovering from a ruptured appendix

A child who has rheumatic fever

A child who has cystic fibrosis

Answer and Explanation

The Correct Answer is A

Choice A reason: This choice is correct because a child who has nephrotic syndrome is the most appropriate roommate for a child who has leukemia. Nephrotic syndrome is a kidney disorder that causes proteinuria, edema, hypoalbuminemia, and hyperlipidemia. It does not pose any risk of infection or injury to the child who has leukemia, and it does not require any isolation or special precautions. Therefore, placing these two children in the same room can help to conserve resources and promote socialization.

Choice B reason: This choice is incorrect because a child recovering from a ruptured appendix is not an appropriate roommate for a child who has leukemia. A ruptured appendix is a medical emergency that occurs when the appendix becomes inﬂamed and bursts, releasing bacteria and pus into the abdominal cavity. It may cause peritonitis, sepsis, or abscess formation, and it requires surgery and antibiotics. It may pose a risk of infection to a child who has leukemia, who has a weakened immune system due to chemotherapy or bone marrow suppression. Therefore, placing these two children in the same room can increase the chance of cross-contamination and complications.

Choice C reason: This choice is incorrect because a child who has rheumatic fever is not an appropriate roommate for a child who has leukemia. Rheumatic fever is an inﬂammatory disease that occurs as a complication of streptococcal infection, such as strep throat or scarlet fever. It may affect the heart, joints, skin, or nervous system, and it requires anti-inﬂammatory and antibiotic medications. It may pose a risk of infection to the child who has leukemia, who has a compromised immune system due to cancer or treatment. Therefore, placing these two children in the same room can increase the likelihood of transmission and infection.

Choice D reason: This choice is incorrect because a child who has cystic fibrosis is not an appropriate roommate for a child who has leukemia. Cystic fibrosis is a genetic disorder that aﬀects the mucus glands of the lungs, pancreas, liver, intestines, and reproductive organs. It causes thick and sticky mucus to build up in the organs, leading to chronic lung infections, pancreatic insufficiency, malnutrition, and infertility. It requires respiratory therapy, enzyme supplements, nutritional support, and antibiotics. It may pose a risk of infection to the child who has leukemia, who has a reduced ability to fight germs due to malignancy or therapy. Therefore, placing these two children in the same room can increase the possibility of exposure and infection.

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Correct Answer is C

Explanation

Choice A reason: This choice is incorrect because a 1-year-old toddler who has roseola and a temperature of 39° C (102.2° F) is not the most urgent case to assess. Roseola is a viral infection that causes a rash on the trunk and limbs, followed by a high fever that lasts for several days. It usually affects infants and young children and is self-limiting.
The fever can be managed by giving antipyretics such as acetaminophen or ibuprofen, and by providing ﬂuids and comfort measures. The fever does not indicate any serious complication or threat to life.

Choice B reason: This choice is incorrect because a 4-year-old child who has asthma and an O2 sat of 97% is not the most urgent case to assess. Asthma is a chronic respiratory condition that causes inﬂammation and narrowing of the airways, leading to wheezing, coughing, chest tightness, or shortness of breath. It may be triggered by allergens, irritants, exercise, or infections. The O2 sat is a measure of oxygen saturation in the blood, which indicates how well oxygen is delivered to the tissues. A normal O2 sat range is 95% to 100%, so an O2 sat of 97% indicates that the child has adequate oxygenation and is not in respiratory distress.

Choice C reason: This choice is correct because a 10-year-old child who has sickle cell anemia and reports severe chest pain is the most urgent case to assess. Sickle cell anemia is a genetic disorder that causes the red blood cells to become sickle-shaped and clump together, blocking the blood flow and oxygen delivery to the organs and tissues. It may cause severe pain in the chest, abdomen, joints, or bones, as well as symptoms such as pallor, jaundice, fatigue, or shortness of breath. Severe chest pain may indicate acute chest syndrome, which is a life-threatening complication of sickle cell anemia that involves infection or infarction of the lungs. It may cause fever, cough, hypoxia, or respiratory failure. Therefore, assessing and treating this child is a priority to prevent further damage and death.

Choice D reason: This choice is incorrect because a 7-year-old child who has diabetes insipidus and a urine specific gravity of 1.016 is not the most urgent case to assess. Diabetes insipidus is a rare disorder that aﬀects the balance of ﬂuids in the body. It causes the kidneys to produce large amounts of dilute urine, leading to polyuria, polydipsia, dehydration, or electrolyte imbalance. It may be caused by a deficiency of antidiuretic hormone (ADH) or a resistance to its action. The urine specific gravity is a measure of urine concentration, which indicates how well the kidneys are functioning. A normal urine specific gravity range is 1.005 to 1.030, so a urine specific gravity of 1.016 indicates that the child has normal urine concentration and is not dehydrated.

A. Smiles when a parent appears B. Uses a pincer grasp to pick up a toy C. Sits with pillow props, cannot sit independently D. Tracks an object with eyes

Correct Answer is C

Explanation

Choice A: Smiling when a parent appears is not a manifestation of cerebral palsy, but rather a normal developmental milestone that indicates social and emotional development. An 8-month-old infant should be able to smile spontaneously and responsively at familiar people.

Choice B: Using a pincer grasp to pick up a toy is not a manifestation of cerebral palsy, but rather a normal developmental milestone that indicates fine motor development. An 8-month-old infant should be able to use their thumb and index finger to pick up small objects.

Choice C: Sitting with pillow props, cannot sit independently is a manifestation of cerebral palsy, which is a condition that causes impaired movement and posture due to brain damage or abnormal development. An 8-month-old infant should be able to sit without support and maintain balance. Sitting with pillow props, cannot sit independently indicates poor muscle tone, strength, or coordination.

Choice D: Tracking an object with eyes is not a manifestation of cerebral palsy, but rather a normal developmental milestone that indicates visual development. An 8-month-old infant should be able to follow an object or person with their eyes in all directions.

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A nurse is admitting a child who has leukemia. Which of the following clients should the nurse place in the same room with this child?

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