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?

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.

Choice A: This action is not appropriate, as it may cause more harm than good to separate the child from the parents without sufficient evidence or reason. Separating the child from the parents can cause fear, anxiety, or resentment in both parties and may interfere with establishing rapport and trust. The nurse should only separate the child from the parents if there is an immediate threat or danger to the child's safety.

Choice B: This action is premature, as it may violate confidentiality and ethical principles to report suspected abuse to the authorities without sufficient evidence or reason. Reporting suspected abuse to the authorities can have serious legal and social consequences for both parties and may escalate or worsen the situation. The nurse should only report suspected abuse to the authorities if there is clear evidence or indication of abuse or if mandated by law.

Choice C: This action is irrelevant, as it may not address the issue or help resolve it to ask a psychiatrist to talk with the parents without sufficient evidence or reason. Asking a psychiatrist to talk with the parents can imply that they have mental health problems or that they are guilty of abuse, which can cause stigma, anger, or denial. The nurse should only ask a psychiatrist to talk with the parents if there is evidence or indication of mental health problems or if requested by them.

Choice D: This action is appropriate, as it can help determine whether there is any evidence or reason to suspect abuse or not. Obtaining a detailed history can provide information about how, when, where, and why the bruises occurred and whether they are consistent with accidental or intentional injury. The nurse should obtain a detailed history from both parties separately and in a nonjudgmental and supportive manner.