A caregiver for a child who is undergoing chemotherapy for cancer ...

[newyorker26]

A caregiver for a child who is undergoing chemotherapy for cancer shares with the nurse that the child's temperature is being taken rectally every 4 hours. Which of the following is the nurse's best response?
 
  a. Good for you for paying close attention to whether your child has a fever or not.
  b. Once a day, at the same time each day, is the best practice for taking the temperature.
  c. It is not necessary to take the temperature so often. You need only take the child's temperature if you suspect fever.
  d. Stop this practice, because the thermometer can cause breaks in the rectal mucosa and cause bacteria to enter the bloodstream, resulting in sepsis or abscess.

Question 2

High self-esteem can best be identified in which of the following instances?
 
  a. A child is respectful of the parents and other adult and authority figures.
  b. A child keeps quiet around others and displays good listening skills.
  c. A child perceives him- or herself to be close to how he or she would like to be.
  d. A child is asked if he or she has high self-esteem, and the child answers yes.

[shaquita]

Answer to Question 1

D

Feedback
A Incorrect. The nurse might praise the caregiver for paying close attention to whether the child has a fever, but this is not the best response since it does not address the issue of rectal temperatures.
B Incorrect. This is not the best response since it does not address the issue of rectal temperatures. Additionally, the temperature for a child undergoing chemotherapy should be monitored closely. Once a day is not often enough.
C Incorrect. This is not the best response since it does not address the issue of rectal temperatures. Additionally, the temperature for a child undergoing chemotherapy should be monitored closely. Taking it only if the caregiver suspects a fever is not often enough.
D Correct. The nurse's best response is to advise the caregiver to not allow rectal temperatures to be taken. Rectal temperatures, rectal medications or performing a rectal exam should be avoided because they could lead to a break in the rectal mucosa, allowing bacteria into the bloodstream. This could result in sepsis, a rectal abscess, or bleeding.

Answer to Question 2

C

Feedback
A Incorrect: High self-esteem is not best identified with a child being respectful of the parents and other adult and authority figures.
B Incorrect: High self-esteem is not best identified with a child keeping quiet around others and displaying good listening skills.
C Correct: The closer the perceived self is to the ideal self (how the child would like to be) the higher the child's self-esteem.
D Incorrect: Although a child who answers yes if asked if he or she has high self-esteem may have a positive self-concept, this is not the best indicator of high self-esteem.