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 B

Explanation

Choice A: Cranberry juice is not a suitable ﬂuid item to oﬀer the child at this time, as it is acidic and can irritate the throat and cause pain or bleeding. Cranberry juice can also stain the surgical site and make it difficult to assess for signs of hemorrhage.

Choice B: Crushed ice is a suitable ﬂuid item to oﬀer the child at this time, as it is cold and can soothe the throat and
reduce swelling or inﬂammation. Crushed ice can also hydrate the child and prevent dehydration.

Choice C: Orange juice is not a suitable ﬂuid item to oﬀer the child at this time, as it is acidic and can irritate the throat and cause pain or bleeding. Orange juice can also interfere with the clotting process and increase the risk of hemorrhage.

Choice D: A strawberry milkshake is not a suitable ﬂuid item to oﬀer the child at this time, as it contains dairy products and can increase mucus production and cause coughing or gagging. A strawberry milkshake can also stain the surgical site and make it difficult to assess for signs of hemorrhage.

A. "The insulin can be injected anywhere there is adipose tissue." B. "I will be sure my child rotates sites after 5 injections in one area." C. "I will be sure my child aspirates before injecting the insulin." D. "The insulin should be injected at a 90-degree angle."

Correct Answer is C

Explanation

Choice A: This statement does not indicate a need for further teaching, as it is correct that insulin can be injected anywhere there is adipose tissue. Adipose tissue is the layer of fat under the skin that can absorb insulin and prevent damage to muscles or organs. The common sites for insulin injection are the abdomen, thighs, buttocks, or upper arms.

Choice B: This statement does not indicate a need for further teaching, as it is correct that the child should rotate sites after 5 injections in one area. Rotating sites can prevent lipodystrophy, which is a condition that causes abnormal changes in fat tissue due to repeated injections. Lipodystrophy can affect the appearance and absorption of insulin in the aﬀected area.

Choice C: This statement indicates a need for further teaching, as it is incorrect that the child should aspirate before injecting the insulin. Aspiration is the process of pulling back on the plunger of the syringe to check for blood before injecting the medication. Aspiration is not recommended for insulin injection, as it can cause pain, bruising, or leakage of insulin from the injection site.

Choice D: This statement does not indicate a need for further teaching, as it is correct that insulin should be injected at a 90-degree angle. Injecting insulin at a 90-degree angle can ensure that the medication reaches the adipose tissue and prevents skin irritation or muscle damage. The only exception is if the child has very thin skin or uses very short needles, in which case they may inject at a 45-degree angle.

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