Question 5071)
A 5-year-old boy is admitted because he bled profusely when he lost his first baby
tooth. After a workup, he is diagnosed as having classic hemophilia. His mother asks the nurse if
his two younger sisters will also develop hemophilia. What is the best answer for the nurse to
give?
A. “They will not develop the disease.”
B. “Statistically, one of them is likely to develop the disease.”
C. “They are not likely to get the disease, but they may be carriers.”
D. “If it doesn’t show up by the time they start school, they are unlikely to develop the condition.”
Answer:
C
Explanation: Hemophilia is carried on the X chromosome and causes disease when it appears in combination with
the Y chromosome in the male. Answer 1 is a true statement, but it is not complete and, therefore, not the best
answer.
Question 5072)
The nurse has been teaching the parents of a child with hemophilia about the care
he will need. Which statement by the parents indicates a need for more instruction?
A. “If my child needs something for pain or a fever, I will give him acetaminophen instead of aspirin.”
B. “I will take my child to the dentist for regular checkups.”
C. “I will keep my child in the house most of the time.”
D. “My son’s Medic Alert Bracelet arrived.”
Answer: C
Explanation: Parents of children with hemophilia tend to overprotect them. A goal is to have the child lead as
normal a life as possible. Answer 1 is correct. He should not receive aspirin because it is an anticoagulant. Answer
2 indicates good knowledge. Prophylactic dental care is important so he will not need dental work or extractions.
Answer 4 indicates good knowledge. He should always wear a Medic Alert Bracelet in case he is injured.
Question 5073)
A college student who is diagnosed as having infectious mononucleosis asks how
the disease is spread. The nurse’s response is based on the knowledge that the usual mode of
transmission is through
A. skin.
B. genital contact.
C. contaminated water
D. intimate oral contact
Answer: D
Explanation: The virus is spread through intimate oral contact. It is called the “kissing disease.” It can also be
spread by sharing eating and drinking utensils and by coughing and sneezing.
Question 5074)
A young man who has infectious mononucleosis asks what the treatment is for his
condition. What is the best response for the nurse to make?
A. “You will receive large doses of antibiotics for the next 10 days.”
B. “Rest and good nutrition are the best things you can do.”
C. “You will be given an antiviral agent that will help to control the symptoms.”
D. “You will probably be given steroid medications for several months.”
Answer: B
Explanation: Rest and good nutrition are the hallmarks of treatment for mononucleosis. Recovery may take several
months. Because it is caused by a virus, antibiotics are not indicated. He would receive antibiotics only if he
develops a secondary infection. There are no effective antiviral agents for this condition. Steroids are not
indicated.
Question 5075)
An 8-year-old boy is admitted to the unit with a diagnosis of acute lymphocytic
leukemia. During a routine physical exam, numerous ecchymotic areas were noted on his body.
The parent reported that the child has been more tired than usual lately. The parent says that the
child has had a cold for the last several weeks and asks if this is related to the leukemia. The
nurse’s response is based on the knowledge that:
A. leukemia causes a decrease in the number of normal white blood cells in the body.
B. a chronic infection such as the child has had makes a child more likely to develop leukemia.
C. the virus responsible for colds is thought to cause leukemia.
D. having an infection prior to the onset of leukemia is merely a coincidence.
Answer: A
Explanation: Leukemia causes a decrease in normal white blood cells. White blood cells are the infection fighting
cells. Infections occur because of the decrease in white blood cells due to leukemia. Infections do not cause
leukemia.
Question 5076)
A child with leukemia bruises easily. This is most likely due to which of the
following?
A. Decreased fibrinogen levels
B. Excessive clotting elsewhere in the body
C. Decreased platelets
D. Decreased erythrocytes
Answer: C
Explanation: n leukemia, there is bone marrow failure. In addition to producing abnormal, immature white blood
cells, the bone marrow fails and does not produce stem cells from which red blood cells and platelets develop.
Question 5077)
A child who is being treated for leukemia develops stomatitis. Which of the
following nursing care measures is essential?
A. Using dental floss to clean the teeth
B. Frequent cleaning of the mouth with an astringent mouthwash
C. Use of an overbed cradle
D. Swabbing the mouth with moistened cotton swabs
Answer: D
Explanation: Stomatitis (mouth inflammation) is a frequent complication of chemotherapy for leukemia. He has a
tendency to bleed because of his decreased platelets. Dental floss might cause bleeding. An astringent mouthwash
is too strong for his tender mouth. An overbed cradle does not relate to stomatitis. Moistened cotton swabs are a
gentle means of cleaning the mouth.
Question 5078)
When planning care for a client who is HIV positive, the nurse should do what?
A. Teach persons coming in contact with the client to wear a gown and mask at all times
B. Teach persons to wear gloves when handling any of the client’s body fluids
C. Restrict visitors to immediate family
D. Encourage the client to stay away from other persons as much as possible
Answer: B
Explanation: Standard precautions are indicated. Answer 1 is not correct. It is not necessary to wear a gown and
mask unless there is a risk of exposure to body fluids. Answer 3 is not correct. There is no reason to limit visitors.
Answer 4 is not correct. The client is HIV positive. There is no indication that the client is immunocompromised
and at an increased risk of infection from others. The client will not transmit the disease unless there is contact
with body fluids.
Question 5079)
Which action should the nurse expect to perform after a client has a bone marrow
biopsy taken from the iliac crest?
A. Apply pressure to the site for one minute
B. Administer a narcotic analgesic
C. Apply an adhesive bandage to the site
D. Place the client in a recumbent position
Answer: D
Explanation: The client should lie in bed in a recumbent position on top of a pressure dressing that has been
applied to the site. Hemorrhage poses a slight risk after this procedure. Pressure should be applied to the site for
several minutes. A pressure dressing should then be applied for one hour to reduce the chances of bleeding or
hemorrhage. An analgesic may be ordered and administered prior to the procedure. Use of deep breathing and
relaxation techniques may also be helpful. There is seldom any pain after the biopsy, although the site may ache
for a few days.
Question 5080)
Which of the following would be the most appropriate snack for a client who has
iron deficiency anemia?
A. Half of a grapefruit
B. A carrot raisin salad
C. A cup of yogurt
D. Apple slices and cheese
Answer: B
Explanation: Carrots and raisins are both high in iron. Red meats and spinach are other good iron sources. Citrus
fruits such as grapefruit are high in folic acid, vitamin C, and potassium, but not iron. Dairy products such as yogurt
and cottage cheese provide calcium but no iron. Apples are not good sources of iron.
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