A healthcare provider is assessing a child with acute lymphocytic leukemia. Which of the following findings is the priority for the healthcare provider to report?

Correct Answer: B

Rationale: The priority finding to report for a child with acute lymphocytic leukemia is petechiae. Petechiae indicate a low platelet count, which increases the risk of bleeding. Therefore, the healthcare provider should promptly report petechiae to initiate appropriate interventions to prevent bleeding complications.

Correct Answer: C

Rationale: The correct test for an x-ray examination of the bladder and urethra before and during micturition is a voiding cystourethrogram. This procedure allows visualization of the bladder and urethra while the patient is urinating to assess for any abnormalities in the anatomy or function of these structures.

Correct Answer: C

Rationale: In pediatric nursing, it is crucial to educate adolescents on preventive measures for urinary tract infections (UTIs). The best beverage to recommend to maintain acidic urine, thereby preventing UTIs, is apple juice (Option C). Apple juice contains ascorbic acid, which can help acidify urine and create an environment less conducive to bacterial growth, reducing the risk of UTIs. Milk (Option A) is not recommended as it can make the urine less acidic due to its calcium content. Grape juice (Option B) and orange juice (Option D) are also acidic, but they are not as effective as apple juice in acidifying the urine. Educating adolescents on the importance of maintaining proper hydration and consuming specific beverages can empower them to take control of their health and prevent common issues like UTIs. By explaining the rationale behind recommending apple juice over other options, healthcare providers can help adolescents make informed choices about their dietary habits and promote preventive healthcare practices. This educational context ensures that adolescents understand the reasoning behind the recommendations and can apply this knowledge to maintain their urinary health effectively.

Correct Answer: B

Rationale: In nephrotic syndrome, edema is a common symptom that is generalized and not easily noticeable, even by parents. However, an early sign that can be assessed by the nurse is periorbital edema, which refers to swelling around the eyes. This can be an initial indicator of nephrosis and may prompt further evaluation and intervention.

Correct Answer: D

Rationale: Rationale: The correct answer is D) Should be delayed. Prednisone, a corticosteroid, suppresses the immune system, reducing the body's ability to mount a proper response to vaccines. Administering live vaccines such as MMR or varicella to a child on prednisone can lead to an inadequate immune response and potential vaccine failure. Therefore, it is recommended to delay live vaccines until the child has completed the course of prednisone and their immune system has recovered. Option A) Can interfere with the treatment for nephrosis is incorrect because receiving immunizations while on prednisone does not directly interfere with the treatment of nephrotic syndrome. It is more about the effectiveness of the vaccines themselves. Option B) Require that the child have antibiotic coverage is incorrect as antibiotics are not typically needed when delaying vaccinations due to corticosteroid use. Option C) Can be given in smaller, divided doses is incorrect because the issue with prednisone and immunizations is not about the dose size but rather the compromised immune response while on prednisone. In an educational context, understanding the impact of corticosteroids on the immune system and vaccination efficacy is crucial for pediatric nurses to provide safe and effective care to children with chronic conditions like nephrotic syndrome. Delaying vaccines until the child is off prednisone allows for better protection against vaccine-preventable diseases.