what are the most common signs and symptoms of leukemia related to bone marrow involvement
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Nursing Elites

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Pediatric HESI 2024

1. What are the most common signs and symptoms of leukemia related to bone marrow involvement?

Correct answer: A

Rationale: The correct answer is A: petechiae, infection, fatigue. In leukemia, bone marrow involvement leads to a decrease in normal blood cell production, resulting in petechiae (small red or purple spots on the skin), increased susceptibility to infections due to decreased white blood cells, and fatigue from anemia. Choices B, C, and D are incorrect because they do not directly relate to the typical signs and symptoms of leukemia with bone marrow involvement. Headache, papilledema, irritability, muscle wasting, weight loss, decreased intracranial pressure, psychosis, and confusion are not typically associated with leukemia and bone marrow involvement.

2. The nurse is assessing an infant and notes that the infant's urine has a mousy or musty odor. What would the nurse suspect?

Correct answer: C

Rationale: The correct answer is C: Phenylketonuria (PKU). PKU is suggested by a mousy or musty odor of the urine, which is caused by the inability to metabolize phenylalanine. Choice A, Maple syrup urine disease, is characterized by a sweet-smelling urine. Choice B, Tyrosinemia, typically presents with cabbage-like odor in the urine. Choice D, Trimethylaminuria, is associated with a fishy odor in the urine, breath, and sweat.

3. A child has been admitted to the pediatric unit with a severe asthma attack. What type of acid-base imbalance should the nurse expect the child to develop?

Correct answer: C

Rationale: In a severe asthma attack, the child is likely to develop respiratory acidosis. This occurs due to impaired respirations, leading to the retention of carbon dioxide and the formation of carbonic acid. Choice A is incorrect as metabolic alkalosis is not expected in this situation. Choice B is incorrect as respiratory alkalosis does not align with the scenario of impaired respirations in severe asthma attacks. Choice D is also incorrect as it describes metabolic acidosis, which is not typically associated with severe asthma attacks.

4. A child with a diagnosis of bronchiolitis is admitted to the hospital. What is the most important nursing intervention?

Correct answer: B

Rationale: The most important nursing intervention for a child with bronchiolitis is providing respiratory therapy. This intervention helps to maintain airway patency and improve breathing, which are crucial in managing bronchiolitis. Administering bronchodilators (Choice A) may be a part of the treatment plan but is not the most important intervention. Monitoring oxygen saturation (Choice C) is important but falls secondary to providing direct respiratory support. Encouraging fluid intake (Choice D) is also essential but does not address the immediate respiratory needs of the child with bronchiolitis.

5. The healthcare provider is assessing the 'resilience' of a 16-year-old boy. Which exemplifies an external protective factor that may help promote resilience in this child?

Correct answer: C

Rationale: A caring relationship with family members is an external protective factor that promotes resilience in individuals, especially in adolescents. This support system provides a sense of security, stability, and emotional connection, which can help the teenager navigate challenges and setbacks. Choices A, B, and D allude to internal factors related to personal decision-making, self-awareness, and goal management, which are important but do not directly represent external protective factors involving external relationships or resources.

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