A nurse is caring for a 7-year-old child who has a fever, tachycardia, and low oxygen saturation. The nurse reviews the child's laboratory results and notes the following:

- WBC count 15,000/mm^3^ (normal range: 5,000 to 10,000/mm^3^)
- Hgb 8 g/dL (normal range: 10 to 15.5 g/dL)
- Hct 32% (normal range: 32% to 44%)

The nurse should suspect that the child has which of the following conditions?

Leukemia.

Sickle cell anemia.

Hemophilia.

Iron deficiency anemia.

Answer and Explanation

The Correct Answer is B

Choice A reason: Leukemia is not a probable condition, as it is a cancer of the white blood cells that causes abnormal proliferation and accumulation of immature or dysfunctional white blood cells. The child has a high WBC count, which can indicate leukemia, but not necessarily. The child does not have other signs of leukemia, such as bleeding, bruising, bone pain, or lymphadenopathy.

Choice B reason: Sickle cell anemia is a possible condition, as it is an inherited disorder that affects the shape and function of the red blood cells, causing them to become sickle-shaped and rigid. The child has a low Hgb and Hct, which can indicate anemia, and a fever, tachycardia, and low oxygen saturation, which can indicate a sickle cell crisis. A sickle cell crisis is a condition where the sickle-shaped red blood cells block the blood flow and cause tissue ischemia and inflammation.

Choice C reason: Hemophilia is not a likely condition, as it is an inherited disorder that affects the clotting factors, causing impaired blood clotting and increased risk of bleeding. The child has a low Hgb and Hct, which can indicate anemia, but not necessarily hemophilia. The child does not have other signs of hemophilia, such as bleeding, bruising, hemarthrosis, or hematuria.

Choice D reason: Iron deficiency anemia is not a definite condition, as it is a type of anemia that occurs when the body does not have enough iron to produce hemoglobin, the protein that carries oxygen in the blood. The child has a low Hgb and Hct, which can indicate iron deficiency anemia, but not necessarily. The child does not have other signs of iron deficiency anemia, such as pallor, fatigue, weakness, or pica.

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Correct Answer is D

Explanation

Choice A reason: This is not a statement that indicates a need for further teaching. The client is doing wheelchair exercises while watching TV, which is a good way to maintain physical activity and prevent muscle atrophy and contractures. The nurse should praise the client for this behavior and encourage them to continue.

Choice B reason: This is not a statement that indicates a need for further teaching. The client is carrying a water bottle with them and drinking a lot of water, which is a good way to prevent dehydration and urinary tract infections. The nurse should praise the client for this behavior and remind them to drink at least 2 liters of water per day.

Choice C reason: This is not a statement that indicates a need for further teaching. The client is using a suppository every night to have a bowel movement, which is a common method of managing bowel dysfunction in clients with spina bifida. The nurse should ask the client about their bowel routine and provide any additional education or support as needed.

Choice D reason: This is a statement that indicates a need for further teaching. The client is only catheterizing themselves twice every day, which is not enough to prevent urinary retention and infection. The nurse should explain to the client that they need to catheterize themselves at least every 4 to 6 hours, or as prescribed by the provider. The nurse should also demonstrate the proper technique and hygiene for catheterization and assess the client's ability to perform it.

A. Protective environment B. Airborne C. Contact D. Droplet

Correct Answer is B

Explanation

Choice A reason: A protective environment is a type of isolation precaution that is used for patients who are immunocompromised and at high risk of infection from environmental sources, such as fungi or bacteria. It involves using a private room with positive air pressure, high-efficiency particulate air (HEPA) filtration, and strict hand hygiene. It is not indicated for patients who have measles, as they are the source of infection, not the susceptible host.

Choice B reason: Airborne is a type of isolation precaution that is used for patients who have diseases that are transmitted by small droplets that can remain suspended in the air and travel over long distances, such as tuberculosis, chickenpox, or measles. It involves using a private room with negative air pressure, HEPA filtration, and respiratory protection for health care workers and visitors. It is the appropriate isolation precaution for patients who have measles, as it prevents the spread of the virus to others.

Choice C reason: Contact is a type of isolation precaution that is used for patients who have diseases that are transmitted by direct or indirect contact with the patient or their environment, such as Clostridioides difficile, scabies, or impetigo. It involves using a private room or cohorting with similar patients, wearing gloves and gowns, and using dedicated equipment. It is not indicated for patients who have measles, as the disease is not spread by contact.

Choice D reason: Droplet is a type of isolation precaution that is used for patients who have diseases that are transmitted by large droplets that are generated by coughing, sneezing, or talking, such as influenza, pertussis, or meningitis. It involves using a private room or cohorting with similar patients, wearing a surgical mask, and maintaining a distance of at least 3 feet from the patient. It is not indicated for patients who have measles, as the disease is spread by airborne transmission.

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Naxlex Comprehensive Predictor Exams

A nurse is caring for an adolescent who has spina bifida and is paralyzed from the waist down. Which of the following statements by the client should indicate to the nurse a need for further teaching?

Correct Answer is D

Explanation

A nurse is assisting with the admission of a child who has measles. Which of the following isolation precautions should the nurse initiate?

Correct Answer is B

Explanation

A nurse is providing teaching to a parent of a child who has celiac disease. The nurse should include which of the following food choices for this child?

A nurse is planning care for an infant who has spina bifida and is to undergo surgical closure of the myelomeningocele sac. Which of the following interventions should the nurse include in the plan of care?

A nurse is assessing a school-age child whose blood glucose level is 280 mg/dL. Which of the following findings should the nurse expect?

A nurse in a provider's office is caring for a child who has a history of asthma. Which of the following findings should the nurse report to the provider?

A nurse is caring for an 18-month-old toddler in the emergency department. The nurse reviews the toddler's medical record and assessment findings. Which of the following provider prescriptions should the nurse anticipate?

A nurse is planning care for a 4-year-old child who requires airborne precautions. Which of the following activities should the nurse plan for the child?

A nurse on a pediatric unit is preparing to admit a preschooler after receiving a transfer report from a nurse in the emergency department. Which of the following findings should the nurse report to the provider immediately?

A nurse is caring for an adolescent following a cardiac catheterization. Which of the following assessment findings should the nurse report to the provider? (Select the 4 findings that the nurse should report to the provider.)