Nursing care of a child who is immunosuppressed due to leukemia or chemotherapeutic agents should include:
(choose one best answer)
Have them share a room with a child with active mumps
Restrict oral fluids
Strict isolation
Use good handwashing
The Correct Answer is D
Choice A reason: This choice is incorrect because having them share a room with a child with active mumps may expose them to infection and worsen their condition. A child who is immunosuppressed due to leukemia or chemotherapeutic agents has a weakened immune system and is more susceptible to infections from bacteria, viruses, fungi, or parasites. Therefore, they should be placed in a private room or cohorted with another immunosuppressed child.
Choice B reason: This choice is incorrect because restricting oral fluids may cause dehydration and electrolyte imbalance in the child who is immunosuppressed due to leukemia or chemotherapeutic agents. A child who is immunosuppressed due to leukemia or chemotherapeutic agents may have increased fluid losses from vomiting, diarrhea, fever, or sweating. Therefore, they should be encouraged to drink adequate fluids to maintain hydration and electrolyte balance.
Choice C reason: This choice is incorrect because strict isolation may cause psychological distress and social isolation in the child who is immunosuppressed due to leukemia or chemotherapeutic agents. A child who is immunosuppressed due to leukemia or chemotherapeutic agents may benefit from protective isolation, which involves using standard precautions and additional measures such as wearing gloves, gowns, masks, or eye protection when in contact with the child or their body fluids. However, strict isolation, which involves limiting visitors and activities, may harm the child's emotional and developmental well-being.
Choice D reason: This choice is correct because using good handwashing is essential nursing care for a child who is immunosuppressed due to leukemia or chemotherapeutic agents. Handwashing is the most effective way to prevent the transmission of microorganisms that can cause infections. The nurse should wash their hands before and after touching the child or their belongings, and teach the child and their family members to do the same. The nurse should also use alcohol-based hand rubs when water and soap are not available.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
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.
Correct Answer is B
Explanation
Choice A: Skin cancer is a malignant growth of the skin cells, which can be caused by exposure to ultraviolet radiation, genetic mutations, or immunosuppression. Skin cancer does not affect the mouth and does not cause a white, milky plaque. Skin cancer may cause changes in the color, shape, size, or texture of a mole or a skin lesion.
Choice B: Candidiasis or thrush is a fungal infection of the mouth, which can be caused by overgrowth of Candida albicans, a type of yeast that normally lives in the body. Candidiasis or thrush can occur in people who have a weakened immune system, such as those who have a systemic disorder, take antibiotics, immunosuppressants, or corticosteroids, or have a smoking history. Candidiasis or thrush can cause soreness in the mouth and difficulty eating. Candidiasis or thrush can also cause a white, milky plaque that does not come off with rubbing.
Choice C: Squamous cell carcinoma is a type of skin cancer that affects the squamous cells, which are flat cells that form the outer layer of the skin. Squamous cell carcinoma can occur in areas that are exposed to sun damage, such as the face, ears, lips, or neck. Squamous cell carcinoma does not affect the mouth and does not cause a white, milky plaque. Squamous cell carcinoma may cause a red, scaly, crusty, or bleeding bump or patch on the skin.
Choice D: Herpes simplex is a viral infection that affects the skin and mucous membranes, such as the mouth, lips, genitals, or eyes. Herpes simplex is transmitted by direct contact with an infected person or object. Herpes simplex does not cause a white, milky plaque. Herpes simplex may cause painful blisters or ulcers that burst and form scabs.
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