A nurse is planning care for a child who has neutropenia due to leukemia. Which of the following interventions should the nurse include in the plan of care?

Screen the child's visitors for active infections.

Prepare the child for a platelet transfusion.

Monitor the child for indications of active bleeding.

Initiate a low-protein diet for the child.

Answer and Explanation

The Correct Answer is A

A. Screen the child's visitors for active infections. Neutropenia places the child at high risk for infection due to a severely weakened immune system. Screening visitors for signs of illness is essential to minimize exposure to infectious agents.
B. Prepare the child for a platelet transfusion. Platelet transfusions are used to treat thrombocytopenia, not neutropenia. While leukemia may cause both conditions, neutropenia specifically increases infection risk, not bleeding risk.
C. Monitor the child for indications of active bleeding. While bleeding is a concern in leukemia, it is more directly linked to low platelet levels. The priority intervention for neutropenia is infection prevention, not bleeding control.
D. Initiate a low-protein diet for the child. A low-protein diet is not appropriate for a child with leukemia. These children need adequate protein for healing, immune support, and maintaining strength during treatment.

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Correct Answer is {"dropdown-group-1":"C","dropdown-group-2":"A"}

Explanation

Miosis : Pinpoint pupils are a hallmark of opioid overdose due to stimulation of the parasympathetic nervous system. This finding helps distinguish opioid toxicity from other types of substance use, which often cause pupil dilation instead.

Respiratory depression : Opioids depress the medullary respiratory centers in the brainstem, leading to slowed breathing. A respiratory rate of 10/min is significantly reduced and signals impaired ventilation, making it a critical diagnostic clue.

Opioid overdose: The clinical signs—needle marks, sedation, pinpoint pupils, bradypnea, and a positive response to naloxone—all strongly point to an opioid overdose. A similar prior episode adds to the likelihood of chronic opioid misuse.

Alcohol intoxication: While alcohol can depress the central nervous system, it does not typically cause miosis or respond to naloxone. Also, the pattern of rapid reversal with naloxone suggests opioid involvement rather than alcohol alone.

Benzodiazepine overdose: Though it shares features like sedation and respiratory depression with opioid overdose, benzodiazepine toxicity does not cause miosis, and naloxone has limited or no effectiveness as a reversal agent.

Cocaine intoxication : Typically causes stimulant effects including mydriasis (dilated pupils), increased heart rate, hypertension, and agitation. These are not consistent with the symptoms in this case, which reflect CNS depression.

A. Providing a needle exchange program for community members. B. Providing education to fifth graders about the risks of substance use. C. Providing a list of outpatient substance use support services to give to clients who are discharged from inpatient treatment. D. Providing education to pregnant clients in a sober living community about the fetal risks of substance use during pregnancy E. None F. None

Correct Answer is B

Explanation

A. Providing a needle exchange program is considered secondary prevention, as it reduces complications in those already using substances rather than preventing initial use.
B. Teaching fifth graders about the risks of substance use is primary prevention, because it aims to stop substance use before it begins.
C. Giving a list of outpatient support services to clients leaving inpatient treatment is tertiary prevention, since it helps prevent relapse in those already affected.
D. Educating pregnant clients who are already in a sober living community is also not primary prevention, because they have a history of substance use; this falls under secondary/tertiary prevention.

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A nurse is planning care for a child who has neutropenia due to leukemia. Which of the following interventions should the nurse include in the plan of care?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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