When caring for the child with leukemia who is at risk for bleeding, which of the following measures should be avoided?

Correct Answer: D

Rationale: The correct answer is D: Performing a rectal examination. This should be avoided in a child with leukemia at risk for bleeding because it can increase the risk of rectal trauma and bleeding. Stool softeners (choice A) are appropriate to prevent constipation and straining. Frequent position changes (choice B) help prevent pressure ulcers. Visits with friends and siblings (choice C) are important for the child's emotional well-being.

Correct Answer: C

Rationale: The correct answer is C: Absolute neutrophil count (ANC). Neutrophils are a type of white blood cell that plays a crucial role in fighting infections. Chemotherapy can suppress the bone marrow, leading to a decrease in neutrophil count, putting the child at risk for infections. Monitoring ANC before chemotherapy helps determine the child's infection-fighting capability. A: Hemoglobin - Measures oxygen-carrying capacity of red blood cells, not directly related to infection-fighting capability. B: Red-blood-cell count - Measures the number of red blood cells, not directly related to infection-fighting capability. D: Platelets - Important for blood clotting, not directly related to infection-fighting capability.

Correct Answer: B

Rationale: The correct answer is B: Monitor for hematuria. Rhabdomyosarcoma is a type of cancer that originates from muscle tissue and can potentially lead to bleeding in the urine (hematuria). Monitoring for hematuria is crucial to assess the child's condition and detect any signs of complications. A: Positioning the child with the head elevated is not directly related to managing rhabdomyosarcoma. C: Demonstrating the use of a conformer is not relevant to the immediate nursing care for rhabdomyosarcoma. D: Administering oxygen may be necessary in some cases, but monitoring for hematuria is more specific and directly related to the potential complications of rhabdomyosarcoma.

Correct Answer: B

Rationale: The correct answer is B: Excess Fluid Volume Related to Decreased Plasma Filtration. In acute glomerulonephritis, the glomeruli are inflamed, leading to decreased filtration of plasma and retention of fluid. This results in excess fluid volume. This nursing diagnosis addresses the specific physiological issue of fluid retention in this condition. A: Risk for Urinary Tract Injury is not directly related to acute glomerulonephritis but rather to other factors such as urinary obstruction or trauma. C: Risk for Infection is not the priority nursing diagnosis in acute glomerulonephritis. Hypertension is a common complication, but infection risk is not directly related to the condition. D: Disturbed Personal Identity is not a relevant nursing diagnosis in this case as it does not address the physiological issue of fluid volume excess.

Correct Answer: A

Rationale: The correct answer is A: Anemia. End-stage renal failure leads to decreased production of erythropoietin, resulting in anemia. This causes a decrease in red blood cell production, leading to fatigue, weakness, and pale skin in the child. Explanation for why other choices are incorrect: B: Diarrhea is not typically associated with end-stage renal failure. C: Hypotension may occur in some cases of renal failure, but it is not a common problem in end-stage renal failure. D: Renal calculi are more common in conditions like kidney stones, which may lead to renal failure, but they are not directly expected in a child in end-stage renal failure.