a child with a diagnosis of leukemia is receiving chemotherapy what is the priority nursing intervention
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Nursing Elites

HESI LPN

Pediatric Practice Exam HESI

1. A child with a diagnosis of leukemia is receiving chemotherapy. What is the priority nursing intervention?

Correct answer: A

Rationale: The priority nursing intervention for a child with leukemia receiving chemotherapy is monitoring for signs of infection. Chemotherapy can suppress the immune system, increasing the risk of infections. Detecting and managing infections promptly is crucial to prevent complications and improve outcomes. Providing nutritional support is important, but infection prevention takes precedence due to the immediate threat it poses to the child's health. Monitoring for signs of bleeding is relevant in leukemia due to decreased platelet count, but infection surveillance is more critical. Monitoring for signs of pain is essential, but addressing infections promptly is the priority to prevent further deterioration in the child's condition.

2. Surgical repair for patent ductus arteriosus (PDA) is done to prevent the complication of

Correct answer: D

Rationale: Surgical repair of patent ductus arteriosus (PDA) aims to prevent increased pulmonary vascular congestion, which can lead to congestive heart failure and respiratory distress. Choice A, pulmonary infection, is not a direct complication of PDA but rather a result of other factors. Choice B, right-to-left shunt of blood, is a characteristic of a different heart condition (e.g., Tetralogy of Fallot) and not specifically associated with PDA. Choice C, decreased workload on the left side of the heart, is not a typical complication of PDA but rather a consequence of left-to-right shunting that can cause volume overload in the pulmonary circulation.

3. A 2-year-old child is admitted to the hospital with a diagnosis of Kawasaki disease. What is the primary goal of therapy during the acute phase?

Correct answer: A

Rationale: The primary goal of therapy during the acute phase of Kawasaki disease is to prevent coronary artery aneurysms. Kawasaki disease is characterized by systemic vasculitis and the most serious complication is the development of coronary artery aneurysms. While reducing fever and improving cardiac function are important aspects of managing Kawasaki disease, the primary focus in the acute phase is to prevent the development of coronary artery aneurysms. Preventing dehydration is also essential but not the primary goal in managing Kawasaki disease.

4. The parents of a child who is scheduled for open-heart surgery ask why their child must be subjected to chest tubes after surgery. What should the nurse consider before responding in language the parents will understand?

Correct answer: B

Rationale: Chest tubes are used to drain air and fluid from the chest cavity to prevent complications such as pneumothorax or cardiac tamponade after surgery. Choice A is incorrect as chest tubes are not used to increase tidal volumes. Choice C is incorrect as chest tubes do not maintain positive intrapleural pressure; instead, they assist in removing excess air or fluid. Choice D is incorrect as chest tubes do not regulate pressure on the pericardium and chest wall; they primarily aid in drainage.

5. What is the nurse’s priority intervention when preparing for admission of a child with acute laryngotracheobronchitis?

Correct answer: C

Rationale: The correct answer is to place a tracheotomy set at the bedside. Acute laryngotracheobronchitis can cause airway obstruction, which may require an emergency tracheotomy. Having the tracheotomy set readily available ensures quick access in case of respiratory distress. Padding the side rails of the crib, arranging for a quiet, cool room, and obtaining a recliner for a parent are important aspects of care but are not the priority when managing a potentially life-threatening airway emergency.

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