A nurse is assessing a toddler who has leukemia and is receiving his first round of chemotherapy. Which of the following is the priority for the nurse to report to the provider?

Urticaria

Fatigue

Anorexia

Vomiting

Answer and Explanation

The Correct Answer is A

A. Urticaria (hives) could indicate an allergic reaction or hypersensitivity to the chemotherapy, which needs to be addressed immediately to prevent more severe reactions, such as anaphylaxis.

B. Fatigue is a common side effect of chemotherapy and not usually an immediate concern unless accompanied by signs of more serious complications.

C. Anorexia can occur during chemotherapy but is typically managed with dietary adjustments and does not usually require urgent attention unless it leads to dehydration or significant weight loss.

D. Vomiting is a common side effect of chemotherapy, but it is usually managed with antiemetic medication and is not as immediately concerning as an allergic reaction.

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Correct Answer is A

Explanation

A. Clinicians should be involved in discussions about the child’s prognosis to ensure that the family receives clear, compassionate information for decision-making.

B. Palliative care can and should be introduced earlier in the course of the illness, not just when the child is expected to live less than 6 months.

C. Parents expressing hope for survival do not necessarily reject palliative care. Palliative care can focus on comfort and quality of life even when there is still hope for recovery.

D. Palliative care should be integrated with curative care, as it can improve the quality of life while still pursuing treatment options.

A. A toddler who has a concussion and an episode of forceful vomiting B. An adolescent who was placed into halo traction 1 hr ago and rates his pain at a 6 on a 0 to 10 scale C. A school-age child who has acute glomerulonephritis and brown-colored urine D. An adolescent who has infective endocarditis and reports having a headache

Correct Answer is A

Explanation

A. Forceful vomiting in a child with a concussion could indicate increased intracranial pressure (ICP), which is a medical emergency. Vomiting is a common symptom of ICP, and prompt assessment is necessary to determine the severity of the concussion and prevent further complications.

B. Pain following halo traction is expected, and a pain score of 6 is moderate. The pain can be managed with appropriate interventions, and it does not indicate an immediate life-threatening situation.

C. Brown-colored urine in acute glomerulonephritis is concerning for hematuria, but it typically develops over several days and is not an acute emergency.

D. A headache in a patient with infective endocarditis could indicate a potential complication such as embolism or increased intracranial pressure, but it is not as immediately life-threatening as the signs of a concussion.

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A nurse is assessing a toddler who has leukemia and is receiving his first round of chemotherapy. Which of the following is the priority for the nurse to report to the provider?

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