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 assists the patient in reflecting on his feelings
The nurse needs to note the source of the patient health history
Application of an ostomy bag or pouch: B, An ostomy nurse applying an ostomy bag to a stoma;
Patient teaching: nose and sinus assessment
Thank your parents if you’re smart
Wong's Essentials of Pediatric Nursing