Chapter 53 Maternal and Child Health Nursing 7th Edition

Chapter 53  Maternal and Child Health Nursing 7th Edition

Complete Chapter Questions And Answers
 

Sample Questions

1.
The nurse is caring for a 4-year-old child with acute lymphocytic leukemia (ALL). Why should the nurse assess this child’s temperature using the axillary route instead of a rectal temperature?
A)
The child has anemia.
B)
The child is prone to diarrhea.
C)
The child has a low platelet count.
D)
The child has a low white blood cell count.
Ans:
C

Feedback:

Because platelet production is limited in children with leukemia, children are extremely prone to hemorrhage. Gastrointestinal bleeding can occur. An axillary temperature is not taken because the child has anemia, prone to diarrhea, or has a low white blood cell count.

2.
A female patient asks the nurse why she is always asked if she is pregnant before having an X-ray. What should the nurse explain to the patient?
A)
“Radiation to a fetus can cause a malignancy.”
B)
“It is just something that we are expected to do.”
C)
“It identifies how much radiation your body can stand.”
D)
“It determines how long you can be in the radiation room.”
Ans:
A

Feedback:

Radiation during intrauterine life is a documented cause of leukemia. Radiation of the thyroid in infancy is known to cause thyroid cancer later in life. Asking a female patient about pregnancy status is not something that a nurse is expected to perform. Asking a female patient about being pregnant is not done to determine how much radiation the body can stand or determine how long the patient can be in the radiation room.

3.
The nurses caring for children on an oncology unit are planning an open-house presentation on cancer prevention actions to support the 2020 National Health Goals. Which topics should the nurses include in their presentation? (Select all that apply.)
A)
Teaching testicular self-examination
B)
The need to take vitamin supplements every day
C)
The importance of getting adequate rest and daily exercise
D)
Explaining the reasons to avoid excessive sun exposure
E)
The importance of frequent health assessments to identify the symptoms of leukemia
Ans:
A, D, E

Feedback:

Nurses can help the nation achieve the 2020 National Health Goals for cancer prevention in children by careful history taking at health assessments to reveal the symptoms of leukemia and by active teaching of self-screening measures such as testicular examination and preventive measures such as avoiding excessive sun exposure. Vitamin supplementation, rest, and exercise are not identified as actions to prevent cancer in children.

4.
A child with leukemia is receiving methotrexate for therapy. Which nursing diagnosis should the nurse use to best guide this patient’s care at this time?
A)
Impaired oral mucous membrane related to effects of chemotherapy
B)
Risk for impaired mobility related to depressant effects of methotrexate
C)
Excess fluid volume related to effect of methotrexate on aldosterone secretion
D)
Risk for self-directed violence related to effect of methotrexate on central nervous system
Ans:
A

Feedback:

Mucositis or ulcers of the gum line and mucous membranes of the mouth is a frequent effect of antimetabolic drugs. This is the diagnosis that would have the highest priority for the patient’s care at this time. Methotrexate does not impair mobility, impact aldosterone secretion, or cause adverse effects to the central nervous system.

5.
A child with leukemia is prescribed to receive ondansetron hydrochloride (Zofran) 0.15 mg/kg intravenously prior to receiving the first dose of chemotherapy. The child weighs 55 lb. How many milligrams of the medication should the nurse provide to the child? (Numeric value only. Calculate to the nearest tenth decimal point.)
Ans:
3.8 mg

Feedback:

The nurse needs to first determine the child’s weight in kilograms by dividing 55 lb by 2.2 or 55 / 2.2 = 25. Then the nurse should multiply the prescribed dose of 0.15 mg by the child’s weight or 0.15 mg × 25 kg = 3.75. After rounding, the nurse should provide the patient with 3.8 mg of the medication prior to receiving chemotherapy.