Answer to Question 1
C
The confirming test for leukemia is microscopic examination of bone marrow obtained by bone marrow aspiration and biopsy. A CBC may show blast cells that would raise suspicion of leukemia. It is not a confirming diagnostic study. A lumbar puncture is done to check for central nervous system involvement in the child who has been diagnosed with leukemia. A CT scan may be done to check for bone involvement in the child with leukemia. It does not confirm a diagnosis.
Answer to Question 2
B
Leukemia is characterized by the proliferation of immature white blood cells, which lack the ability to fight infection. An ineffective breathing pattern related to mediastinal disease would apply to a child with non-Hodgkin's lymphoma or any cancer involving the chest area. Disturbed body image related to alopecia is a nursing diagnosis related to chemotherapy, but it is not of the highest priority. Not all children have a body image disturbance as a result of alopecia, especially not preschoolers. This would be of more concern to an adolescent. Radiation therapy is not a treatment for leukemia.
The nurse is using Standard Precautions to draw blood.
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