NUR 254 EXAM 4 2024/2025 WITH
COMPLETE SOLUTIONS
Maternal
1. The nurse is caring for a child who has leukemia with a white blood cell (WBC) count of <
1000 mm. Which of the following should the nurse include in the child’s plan of care?
a. Administer prescribed influenza vaccination
b. Assign the child to a room with other children
c. Allow the child to play with other children who do not have a fever
d. Use sterile techniques for any procedures
2. The nurse is providing a teaching session to the health care staff regarding
osteosarcoma. Which of the following statements by an attendee indicates a need for
additional teaching?
a. “A common clinical manifestation is limping if a weight-bearing limb is affected.”
b. “The sternum is the most common site of this sarcoma.”
c. “Children typically experience pain at the primary tumor site.”
d. “In the early stage, the symptoms of this disease are usually attributed to normal
growing pains.”
3. The nurse is caring for a child who is suspected of having a Wilm’s tumor. Which of the
following actions by the nurse indicates the need for additional training?
a. Instructing the parents that the child needs to remain in bed.
b. Preventing a child from playing tag in the playroom.
c. Requesting a bland soft diet for the child.
d. Palpating the child’s abdomen.
4. The nurse is caring for a 5-year-old child who has sickle cell disease (SCD). An assessment
of the child includes the following: respirations 10 and unarousable. The child is
currently on intravenous (IV) fluids and continuous IV morphine sulfate Based on the
assessment information, which of the following actions should the nurse take first?
a. Increase the IV fluids to decrease vaso-occlusion.
b. Obtain a complete metabolic laboratory blood sample.
c. Elevate the head of the bed (HOB) to increase oxygen saturation.
d. Administer naloxone to reverse the effect of the morphine.
5. The nurse is admitting a child who has a vaso-occlusive sickle cell crisis. Which of the
following interventions should the nurse anticipate to be prescribed for the child?
a. Correction of alkalosis and reduction of energy expenditure.
b. Globulins and factor VIII replacement.
c. Hydration and pain management.
d. Electrolyte replacement and administration of heparin.
6. The nurse working in the emergency department (ED) is caring for a child who has
hemophilia and developed a swollen knee after falling off a bicycle. The nurse is teaching
the child’s parents about care when similar incidents occur at home in the future. Which
of the following actions should the nurse teach the parents?
a. Take the child to the nearest emergency department (ED).
b. Keep the child’s affected knee below the level of the heart.
c. Apply an ice pack and compression dressings to the knee.
d. Administer recommended dose of aspirin.
