ALTERATION IN CELLULAR REGULATION HUMAN CASE STUDY REVISION, Exams of Medicine

ALTERATION IN CELLULAR REGULATION HUMAN CASE STUDY REVISION ALTERATION IN CELLULAR REGULATION HUMAN CASE STUDY REVISION

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2025/2026

Available from 01/27/2026

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ALTERATION IN CELLULAR REGULATION HUMAN
CASE STUDY REVISION
The nurse assesses that the client is at risk for an infection
related to chemotherapy-induced immunosuppression. What will
the nurse include in the teaching plan for the child and parents to
help reduce this risk? Select all that apply.
- Have the child sleep in a single bed and room.
- Encourage frequent, thorough handwashing.
- Provide a low-carbohydrate, low-protein diet.
- Encourage frequent contact with multiple visitors.
- Cheer up the environment with fresh flowers and plants. -
ANSWERS-- Have the child sleep in a single bed and room.
- Encourage frequent, thorough handwashing.
The nurse has been asked to participate in a community health
teaching session. Which interventions would the nurse include to
help achieve the 2030 National Health Goals to reduce the
incidence of anemias? Select all that apply.
- Explain the importance of healthy eating for adolescent
participants.
- Instruct pregnant women to take iron supplementation as
prescribed.
- Emphasize ways to reduce unintentional injuries at home, work,
and play.
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ALTERATION IN CELLULAR REGULATION HUMAN

CASE STUDY REVISION

The nurse assesses that the client is at risk for an infection related to chemotherapy-induced immunosuppression. What will the nurse include in the teaching plan for the child and parents to help reduce this risk? Select all that apply.

  • Have the child sleep in a single bed and room.
  • Encourage frequent, thorough handwashing.
  • Provide a low-carbohydrate, low-protein diet.
  • Encourage frequent contact with multiple visitors.
  • Cheer up the environment with fresh flowers and plants. - ANSWERS-- Have the child sleep in a single bed and room.
  • Encourage frequent, thorough handwashing. The nurse has been asked to participate in a community health teaching session. Which interventions would the nurse include to help achieve the 2030 National Health Goals to reduce the incidence of anemias? Select all that apply.
  • Explain the importance of healthy eating for adolescent participants.
  • Instruct pregnant women to take iron supplementation as prescribed.
  • Emphasize ways to reduce unintentional injuries at home, work, and play.
  • Review foods that are rich in iron that should be a part of a school-age child's diet.
  • Examine strategies for elderly community members to improve the quality of life. - ANSWERS-- Explain the importance of healthy eating for adolescent participants.
  • Instruct pregnant women to take iron supplementation as prescribed.
  • Review foods that are rich in iron that should be a part of a school-age child's diet. Wilms tumor is suspected in a 5-year-old child. Which action would be avoided? - ANSWERS-abdominal palpation When reviewing information about the incidence of the various types of childhood cancer, nursing students demonstrate understanding of the information when they identify which type as having the highest incidence? - ANSWERS-Acute lymphoblastic leukemia (ALL) A nurse is teaching the parents of a child with sickle cell disease about factors that predispose the child to a sickle cell crisis. The nurse determines that the teaching was successful when the parents identify what as a factor?
  • Infection
  • Pallor
  • Fluid overload
  • Respiratory distress - ANSWERS-Infection The pediatric nurse reviews the radiographs of a child and observes that there are lesions on the bone. The nurse interprets this finding as suggesting which condition?
  • Ask whether any family members or other close associates are ill.
  • Instruct the parent to administer acetaminophen every 4 hours until the fever dissipates.
  • Instruct the parent to immediately obtain and give the antibiotic that the oncologist calls in to the pharmacy. - ANSWERS-Have the parent bring the child to the pediatric oncology clinic as soon as possible. The nurse will select which meal as the best choice for a child with iron-deficiency anemia?
  • peanut butter sandwich, cheese stick, and applesauce
  • two slices of pepperoni pizza and a glass of skim milk
  • chicken breast, French fries, and sweetened tea
  • cheeseburger, broccoli, and fresh strawberries - ANSWERS- cheeseburger, broccoli, and fresh strawberries A 15-year-old client diagnosed with von Willebrand disease has reached menarche. Based on this fact, what information is most important for the nurse to convey to the client?
  • Occasional skipped periods can be expected.
  • Bruising may occur in the perineal area.
  • The duration of each period will be short.
  • Expect menstrual bleeding to be heavy. - ANSWERS-Expect menstrual bleeding to be heavy.

The nurse is caring for a 10-year-old boy with hemophilia. He asks the nurse for suggestions about appropriate physical activities. Which activity would the nurse most likely recommend?

  • Football
  • Soccer
  • Baseball
  • Wrestling - ANSWERS-Baseball A child diagnosed with idiopathic thrombocytopenic purpura (ITP) is scheduled to receive an infusion of intravenous immunoglobulin (IVIG) due to low platelet counts. Prior to the infusion, the nurse administers acetaminophen to the child. The nurse would explain to the parents that acetaminophen is administered to obtain which expected outcome?
  • to decrease fever produced from the medication
  • to relax the child during drug infusion
  • to reduce any pain at infusion site
  • to prevent chills from developing - ANSWERS-to decrease fever produced from the medication The nurse is assessing children in an ambulatory clinic. Which child would be most likely to have iron-deficiency anemia?
  • A 7-month-old infant who has started table food
  • A 3-month-old infant who is totally breastfed
  • An 8-year-old child who carries lunch to school
  • Apply a lip balm or petroleum jelly to prevent cracking. - ANSWERS-- Have the child rinse the mouth with lukewarm water three times a day.
  • Provide various soft and bland foods to minimize further irritation.
  • Apply a lip balm or petroleum jelly to prevent cracking. A school-aged child is admitted to the hospital with a vaso- occlusive sickle cell crisis. Which measure in the child's care plan should be given priority?
  • Beginning active range-of-motion exercises
  • Seeing that the child ingests a protein-rich diet
  • Encouraging the child to take deep breaths hourly
  • Maintaining fluids through an intravenous line - ANSWERS- Maintaining fluids through an intravenous line A nurse is talking with parents of a child who is to begin radiation treatment for cancer. The parents ask, "What kind of effects might we see soon after the child starts treatment?" Which effects would the nurse include when instructing the parents? Select all that apply.
  • Shortening of the spine
  • Sleepiness
  • Vomiting
  • Loss of appetite
  • Skin redness
  • Nausea - ANSWERS-- Vomiting
  • Loss of appetite
  • Skin redness
  • Nausea A 3-year-old boy has been brought to the doctor's office with symptoms of anorexia and abdominal pain. A blood test reveals a lead level of 20 μg/100 mL. The child is prescribed an oral chelating agent. On discharge, the nurse should counsel the parents regarding:
  • putting medicine away where children cannot reach it.
  • placing house plants out of reach of children.
  • removal or covering of flaking paint on the walls of the home.
  • putting child safety locks on kitchen cabinets. - ANSWERS- removal or covering of flaking paint on the walls of the home A child with cancer is dying and in hospice care. When developing the plan of care, which intervention should the nurse include as the primary focus?
  • providing emotional support
  • keeping the child pain-free
  • managing the symptoms of dyspnea
  • delivering appropriate developmental care - ANSWERS-keeping the child pain-free
  • total iron-binding capacity - ANSWERS-serum ferritin Parents ask why their child just diagnosed with leukemia needs a "spinal tap." Which is the best response by the nurse?
  • "It will help rule out a second malignancy."
  • "The spinal tap will help relieve pressure and headache for your child."
  • "Checking the cerebrospinal fluid will reveal whether leukemic cells have entered the central nervous system."
  • "A sample of cerebrospinal fluid is needed to check for possible central nervous system infection." - ANSWERS-"Checking the cerebrospinal fluid will reveal whether leukemic cells have entered the central nervous system." The nurse is preparing to send a child with cancer for a radiation treatment. Which medication should the nurse provide to premedicate the child for this procedure?
  • Antipyretic
  • Analgesic
  • Antineoplastic
  • Antiemetic - ANSWERS-Antiemetic The nurse is providing care for a 13-year-old child diagnosed with iron-deficiency anemia. The client's current hemoglobin level is 11 g/dL (110 g/L). Which intervention will the nurse anticipate including in the client's care?
  • providing a high dose of intravenous immunoglobulin weekly
  • giving ferrous sulfate with orange juice between meals
  • increasing the daily intake of fresh fruits and vegetables
  • packed red blood cell transfusions - ANSWERS-giving ferrous sulfate with orange juice between meals A couple is expecting a child. The fetus undergoes genetic testing and the couple discover the fetus has sickle cell disease. The couple ask the nurse how most commonly happens. Which statement is accurate for the nurse to provide?
  • "Sickle cell disease is passed to a fetus when one of the parents has the gene."
  • "Sickle cell disease is passed to a fetus when both parents have the gene."
  • "Sickle cell disease can be passed to the fetus in many ways. We will know more at birth."
  • "Sickle cell disease occurs from a random genetic mutation." - ANSWERS-"Sickle cell disease is passed to a fetus when both parents have the gene." The child has been prescribed chemotherapy. In order to properly calculate the child's dose, the nurse must first figure the child's body surface area (BSA). The child is 130 cm tall and weighs 27 kg. Calculate the child's BSA. Record your answer using two decimal places. - ANSWERS-0. Square root of (height [cm] x weight [kg] divided by 3,600) = BSA. The child is 130 cm tall and weighs 27 kg: 130 x 27 = 3,510; 3,510/3,600 = 0.975; and the square root of 0.975 is 0.9874. The
  • non-Hodgkin lymphoma. - ANSWERS-Ewing sarcoma. The parent tell the nurse that they recently saw a "white glow" in their infant's left pupil. How should the nurse respond?
  • "A plugged tear duct would not be unusual."
  • "I will report this to the pediatrician."
  • "Most parents mention a red color."
  • "Has your infant been rubbing either eye?" - ANSWERS-"I will report this to the pediatrician." An 8-month-old girl appears pale, irritable, and anorexic. On blood testing, the red blood cells are hypochromic and microcytic. The hemoglobin level is less than 5 g/100 mL, and the serum iron level is high. Which symptom should the nurse most expect as a result of excessive iron deposits?
  • An enlarged thyroid gland
  • Enlarged lymph nodes
  • An enlarged heart
  • An enlarged spleen - ANSWERS-An enlarged spleen The nurse is caring for a 4-year-old child following surgical removal of a stage I neuroblastoma. Which intervention is appropriate for this child?
  • maintaining isolation as prescribed to avoid infection
  • giving medications as prescribed via the least invasive route
  • administering antiemetics as prescribed for nausea
  • applying aloe vera to the postsurgical site to promote healing - ANSWERS-giving medications as prescribed via the least invasive route A school-aged child with cancer is receiving chemotherapy. Which nursing action would best promote the oral comfort of a child receiving chemotherapy?
  • Vigorously brushing the teeth and gums to remove secretions
  • Encouraging the use of acidic fruit juices to decrease mouth organisms
  • Keeping the child's lips moist with petroleum jelly to prohibit cracking
  • Having the child solely eat or drink cold foods to reduce mucosal pain - ANSWERS-Keeping the child's lips moist with petroleum jelly to prohibit cracking The nurse is developing a plan of care for a child who is to have a transfusion. Which would the nurse expect to administer because it is the most common form of transfusion?
  • Plasma factors
  • Whole blood
  • Washed red blood cells
  • Packed red blood cells - ANSWERS-Packed red blood cells After teaching a group of students about hemophilia, the instructor determines that the students have understood the

A 5-year-old child is at the pediatric clinic for a well-child visit. Which symptom alerts the health care provider that this child might have acute lymphoblastic leukemia (ALL)?

  • abdominal pain, nausea, and vomiting
  • lethargy, bruises, and lymphadenopathy
  • anorexia and weight loss
  • joint pain and swelling - ANSWERS-lethargy, bruises, and lymphadenopathy An 8-month-old girl appears pale, irritable, and anorexic. On blood testing, the red blood cells are hypochromic and microcytic. The hemoglobin level is less than 5 g/100 mL, and the serum iron level is high. Which symptom should the nurse most expect as a result of excessive iron deposits?
  • Enlarged lymph nodes
  • An enlarged spleen
  • An enlarged thyroid gland
  • An enlarged heart - ANSWERS-An enlarged spleen Parents of a 10-year-old have just been informed that their child has stage III cancer. They ask the nurse what this means. What is the nurse's best response?
  • "The cancer has spread to other organs."
  • "The cancer cells have spread to the lymph nodes."
  • "This means that the tumor has not extended into surrounding tissue."
  • "This means there is some local spread, but complete surgical removal is possible." - ANSWERS-"The cancer cells have spread to the lymph nodes." A school nurse is teaching a group of parents about signs and symptoms of cancer in children. Which symptom is an early sign of a brain tumor?
  • headache, vision changes, and vomiting
  • nystagmus, ataxia, and seizures
  • headache, epistaxis, and dizziness
  • projectile vomiting, lethargy, and coma - ANSWERS-headache, vision changes, and vomiting The nurse is preparing a discharge teaching plan for the parents of an 8-year-old girl with leukemia. Which instruction would be the priority?
  • Using acetaminophen if the child needs an analgesic
  • Writing down phone numbers and appointments
  • Calling the doctor if the child gets a sore throat
  • Keeping a written copy of the treatment plan - ANSWERS-Calling the doctor if the child gets a sore throat A teenage girl asks why chemotherapy causes hair loss. Which response by the nurse is accurate?
  • "She has been down, but playing in soccer camp will cheer her up."
  • "I bought the medication to give to her when she says she is in pain."
  • "She loves popsicles, so I'll let her have them as a snack or for dessert."
  • "I put her legs up on pillows when her knees start to hurt." - ANSWERS-"She has been down, but playing in soccer camp will cheer her up." The nurse is caring for a child who had a stem cell transplant and is being monitored for engraftment. Which nursing action is priority?
  • Remind parents to contact the child's school.
  • Monitor daily complete blood count (CBC).
  • Ensure neutropenic precautions are in place.
  • Encourage therapeutic play activities. - ANSWERS-Ensure neutropenic precautions are in place. The nurse is caring for a school-age child recovering from an allogeneic stem cell transplant. What nursing action best ensures the child does not develop an infection after the transplant? Select all that apply.
  • Encourage eating raw vegetables for each meal after the procedure.
  • Send for total body irradiation immediately after the transplant.
  • Provide sterilized age-appropriate play materials.
  • Restrict all visits from other children.
  • Arrange time for studying while in the hospital. - ANSWERS- Restrict all visits from other children. Provide sterilized age-appropriate play materials. A child is admitted with a diagnosis of aplastic anemia. The nurse is creating a plan of care for the child. Which intervention(s) will the nurse include in the plan of care? Select all that apply.
  • administration of hydroxyurea
  • adequate rest and activity
  • neutropenic precautions
  • increased iron intake
  • age-appropriate activities - ANSWERS-- adequate rest and activity
  • age-appropriate activities
  • neutropenic precautions A client with cancer is diagnosed with typhlitis. Which emergency intervention would the nurse perform?
  • Administer diuretics.
  • Maintain fluid restriction to below maintenance levels.
  • Monitor serum sodium levels.
  • Administer broad-spectrum antibiotics intravenously. - ANSWERS-Administer broad-spectrum antibiotics intravenously.