Question 1

A child with rhabdomyosarcoma is to undergo radiation therapy after surgical removal of the tumor. The parents should be taught to:

Accepted Answer

The child should avoid exposure to sunlight during radiation therapy and the parents should always apply sunscreen to the area when the child is exposed to sunlight. This is because radiation therapy can cause the skin to become more sensitive and increase the risk of sunburn.

Question 2

The 10-year-old boy is admitted to the pediatric neurologic unit with a suspected craniopharyngioma. The nurse will assess the child with which symptoms related to this brain tumor?

Accepted Answer

B,C,D

Question 3

The child has been admitted to the hospital unit newly diagnosed with retinoblastoma. What would the nurse expect to see when examining the child's eye?

Accepted Answer

A white reflex, also known as leukocoria, is a common finding in retinoblastoma as it is caused by the reflection off of the tumor in the eye. It can often appear as a white or yellowish glow in the pupil rather than the normal red reflection seen in healthy eyes. Blue-tinged sclera (B) and yellow sclera (D) are not typical findings in retinoblastoma. A red reflex (C) is a normal finding in a healthy eye, but not necessarily in an eye with retinoblastoma.

Question 4

A child is receiving chemotherapy induction for acute lymphocytic leukemia (ALL). Taking common side effects into consideration, which nursing diagnoses would be appropriate during the induction chemotherapy?

Accepted Answer

The answer of A child is receiving chemotherapy induction for...

Question 5

A child has been diagnosed with a Wilms' tumor and is being treated with chemotherapy. Prior to administering the chemotherapy, what will the nurse monitor to determine if the child has any capability of fighting infection?

Accepted Answer

The ANC is the most accurate indicator of a child's ability to fight infection. Chemotherapy can cause neutropenia, which is a decrease in the number of neutrophils, which are the white blood cells that fight infection. Monitoring the ANC allows the nurse to determine if the child is at risk for infection and may need additional interventions, such as prophylactic antibiotics or isolation precautions. Hemoglobin, red blood cell count, and platelets are important to monitor during chemotherapy, but they do not accurately reflect a child's ability to fight infection.

Question 6

A child has been diagnosed with Ewing sarcoma and is being started on a chemotherapy protocol. The mother questions the nurse on why more than one drug is being used as it would seem that using fewer drugs would decrease the side effects. The best response by the nurse would include the information that:

Accepted Answer

A protocol involves using a combination of drugs that work in different modes and have different side effects, which can improve the effectiveness of the treatment and minimize the development of drug resistance. Using fewer drugs may not be as effective in treating the cancer or may increase the risk of resistance.

Question 7

A child with leukemia has a granulocyte count of 250/mm³ and a platelet count 150,000/mm³. Nursing intervention would include which of the following?

Accepted Answer

Good hand washing is important to prevent infection in immunocompromised patients, such as those with leukemia. Fluid restriction or avoidance of mouth care are not indicated based on the given information. Strict isolation may be necessary in some cases, but it is not specified in this scenario.

Question 8

A child has recently been diagnosed with leukemia. The child's sibling is expressing feelings of anger and guilt. This reaction by the sibling is:

Accepted Answer

Siblings of children with cancer often experience a range of emotions, including anger and guilt. It is normal for them to have these feelings as they may feel neglected or responsible for the illness. It is important to acknowledge and support their emotions and provide them with resources such as counseling if needed.

Question 9

An adolescent is receiving methotrexate chemotherapy after undergoing limb-salvage surgery for osteogenic sarcoma. The nurse knows the teen understands what to expect for the schedule of administration for leucovorin therapy if the teen says:

Accepted Answer

Leucovorin is administered after methotrexate to protect the body from its toxic effects. It is essential that the adolescent receives leucovorin on time to maximize its effectiveness. Choices A, B, and C all demonstrate a lack of understanding about the purpose and schedule for leucovorin therapy.

Question 10

The parent of a child newly diagnosed with cancer verbalizes regret to the nurse for not seeking earlier medical attention for the child's symptoms. Which response would be most therapeutic?

Accepted Answer

Option C is the most therapeutic response because it provides understanding and reassurance without dismissing the parent's feelings. It acknowledges the complexity of cancer diagnosis, which can help alleviate some of the parent's guilt or regret by understanding that early symptoms of cancer can be difficult to detect and are not always obvious.

Question 11

A child has cancer and has been treated with chemotherapy. The most recent lab value indicates that the white blood cell count is very low. Based on this result, which would the nurse expect to administer?

Accepted Answer

Chemotherapy can cause a decrease in white blood cells, which can increase the risk of infection. Filgrastim (Neupogen) is a medication that stimulates the production of white blood cells, and is often given to patients who have a low white blood cell count due to chemotherapy. Epoetin alfa (Epogen) is a medication that stimulates the production of red blood cells, and is used for patients with anemia. Ondansetron (Zofran) is a medication used to prevent nausea and vomiting associated with chemotherapy. Oprelvekin (Neumega) is a medication that stimulates the production of platelets, and is used for patients with low platelet counts (thrombocytopenia) due to chemotherapy.

Question 12

The nurse works in an oncology clinic. A preschool-age child is being seen in the clinic, and the nurse anticipates a diagnosis of cancer. The nurse prepares for which of the common reactions preschool-age children have following illnesses and hospitalizations?

Accepted Answer

Preschool-age children often have thoughts that they caused their illness and are being punished, known as magical thinking. It is important for the nurse to anticipate this and provide reassurance to the child and family. The other options are not commonly seen in preschool-age children.

Question 13

A five-year-old child is on chemotherapy for rhabdomyosarcoma. Despite antiemetics, the child complains of nausea. The mother wants the child to eat and is pushing the child to eat the food. The nurse would talk with the mother and suggest that she not push the food on the nauseated child because:

Accepted Answer

Forcing a nauseated child to eat can lead to a negative association between illness and food, potentially resulting in a long-term food aversion. It is important to encourage the child to eat when they are feeling well and hungry, but when they are experiencing nausea, it is best to let them rest and avoid food until they feel better. It is important for the nurse to provide education and support to the mother to alleviate her concerns and ensure the child's comfort and well-being.

Question 14

The ten-year-old child was diagnosed with a medulloblastoma; following surgery the child is started on chemotherapy by intrathecal injection. While preparing the family for the start of chemotherapy, the nurse will explain that intrathecal administration was chosen because:

Accepted Answer

Many chemotherapy drugs do not cross the blood-brain barrier, so intrathecal administration is chosen to ensure that the medication reaches the brain and the cerebrospinal fluid surrounding it.

Question 15

The child is receiving chemotherapy for acute lymphocytic leukemia. The nurse recognizes that a potential oncological emergency for this child would be tumor lysis syndrome. For which symptoms should the nurse monitor this child?

Accepted Answer

Tumor lysis syndrome is a potential oncologic emergency that can occur in patients undergoing chemotherapy. It is characterized by the rapid release of intracellular contents (potassium, phosphate, and nucleic acids) from dying cancer cells, which can lead to electrolyte disturbances, acute kidney injury, and other complications. Symptoms to monitor for include oliguria (decreased urine output), altered levels of consciousness, nausea/vomiting, muscle cramps, seizures, and cardiac arrhythmias. Respiratory distress and cyanosis, thrombocytopenia and leukocytosis, and upper-extremity edema and neck vein distension are not typically associated with tumor lysis syndrome.

Question 16

Following diagnosis of osteosarcoma, a 14-year-old girl has a below-the-knee amputation. The girl has had trouble accepting the reality of her amputation. Which behavior, when observed by the nurse, indicates she is beginning to accept the amputation?

Accepted Answer

The answer of Following diagnosis of osteosarcoma, a 14-year-old girl...

Question 17

The nurse is monitoring the urine specific gravity and pH on a child receiving chemotherapy. The nurse will try to maintain the urine values at what levels?

Accepted Answer

Maintaining a low specific gravity (1.005) ensures the child is well-hydrated, which is important during chemotherapy to prevent kidney damage. A slightly alkaline pH (7.5) helps reduce the risk of uric acid crystallization.

Question 18

The nurse is explaining to the mother that her child with cancer will receive chemotherapy daily for one month and then no treatments for six weeks. Following the period of rest, chemotherapy will be administered again for another month. The mother asks why the child can't receive the medication for two months straight. The nurse would explain that the rest period:

Accepted Answer

The rest period allows normal cells to repair themselves while the cancer cells die. If the medication is administered continuously for more than a month, it could damage the healthy cells and lead to further complications.

Question 19

A child has thrombocytopenia secondary to chemotherapy treatments. Based on this finding, what should the nurse do?

Accepted Answer

Thrombocytopenia is a condition where there is a low platelet count, which can lead to impaired blood clotting and an increased risk of bleeding. Administering intramuscular injections can increase the risk of bleeding and should be avoided. Instead, subcutaneous injections or other non-invasive routes should be considered. Monitoring intake and output is important for all patients, but it is not specifically related to thrombocytopenia. Palpation may also be appropriate, but it should be gentle to avoid causing any trauma that could lead to bleeding. Oral hygiene is important for preventing infection but should be done gently to avoid trauma to the oral tissues.

Question 20

The antiemetic drug ondansetron (Zofran) is being administered to a child receiving chemotherapy. It should be administered:

Accepted Answer

Ondansetron is commonly administered before chemotherapy to prevent nausea and vomiting. It is more effective when used as a prophylactic measure rather than waiting for the child to experience symptoms before administering the medication.

Quiz 51: The Child With Cancer

A child with rhabdomyosarcoma is to undergo radiation therapy after surgical removal of the tumor. The parents should be taught to:

The 10-year-old boy is admitted to the pediatric neurologic unit with a suspected craniopharyngioma. The nurse will assess the child with which symptoms related to this brain tumor?

The child has been admitted to the hospital unit newly diagnosed with retinoblastoma. What would the nurse expect to see when examining the child's eye?

A child is receiving chemotherapy induction for acute lymphocytic leukemia (ALL) . Taking common side effects into consideration, which nursing diagnoses would be appropriate during the induction chemotherapy?

A child has been diagnosed with a Wilms' tumor and is being treated with chemotherapy. Prior to administering the chemotherapy, what will the nurse monitor to determine if the child has any capability of fighting infection?

A child with leukemia has a granulocyte count of 250/mm³ and a platelet count 150,000/mm³. Nursing intervention would include which of the following?

A child has recently been diagnosed with leukemia. The child's sibling is expressing feelings of anger and guilt. This reaction by the sibling is:

An adolescent is receiving methotrexate chemotherapy after undergoing limb-salvage surgery for osteogenic sarcoma. The nurse knows the teen understands what to expect for the schedule of administration for leucovorin therapy if the teen says:

The parent of a child newly diagnosed with cancer verbalizes regret to the nurse for not seeking earlier medical attention for the child's symptoms. Which response would be most therapeutic?

A child has cancer and has been treated with chemotherapy. The most recent lab value indicates that the white blood cell count is very low. Based on this result, which would the nurse expect to administer?

The nurse works in an oncology clinic. A preschool-age child is being seen in the clinic, and the nurse anticipates a diagnosis of cancer. The nurse prepares for which of the common reactions preschool-age children have following illnesses and hospitalizations?

A five-year-old child is on chemotherapy for rhabdomyosarcoma. Despite antiemetics, the child complains of nausea. The mother wants the child to eat and is pushing the child to eat the food. The nurse would talk with the mother and suggest that she not push the food on the nauseated child because:

The ten-year-old child was diagnosed with a medulloblastoma; following surgery the child is started on chemotherapy by intrathecal injection. While preparing the family for the start of chemotherapy, the nurse will explain that intrathecal administration was chosen because:

The child is receiving chemotherapy for acute lymphocytic leukemia. The nurse recognizes that a potential oncological emergency for this child would be tumor lysis syndrome. For which symptoms should the nurse monitor this child?

Following diagnosis of osteosarcoma, a 14-year-old girl has a below-the-knee amputation. The girl has had trouble accepting the reality of her amputation. Which behavior, when observed by the nurse, indicates she is beginning to accept the amputation?

The nurse is monitoring the urine specific gravity and pH on a child receiving chemotherapy. The nurse will try to maintain the urine values at what levels?

A child has thrombocytopenia secondary to chemotherapy treatments. Based on this finding, what should the nurse do?

The antiemetic drug ondansetron (Zofran) is being administered to a child receiving chemotherapy. It should be administered:

Quiz 51: The Child With Cancer

A child with rhabdomyosarcoma is to undergo radiation therapy after surgical removal of the tumor. The parents should be taught to:

The 10-year-old boy is admitted to the pediatric neurologic unit with a suspected craniopharyngioma. The nurse will assess the child with which symptoms related to this brain tumor?

The child has been admitted to the hospital unit newly diagnosed with retinoblastoma. What would the nurse expect to see when examining the child's eye?

A child is receiving chemotherapy induction for acute lymphocytic leukemia (ALL) . Taking common side effects into consideration, which nursing diagnoses would be appropriate during the induction chemotherapy?

A child has been diagnosed with a Wilms' tumor and is being treated with chemotherapy. Prior to administering the chemotherapy, what will the nurse monitor to determine if the child has any capability of fighting infection?

A child with leukemia has a granulocyte count of 250/mm3 and a platelet count 150,000/mm3. Nursing intervention would include which of the following?

A child has recently been diagnosed with leukemia. The child's sibling is expressing feelings of anger and guilt. This reaction by the sibling is:

An adolescent is receiving methotrexate chemotherapy after undergoing limb-salvage surgery for osteogenic sarcoma. The nurse knows the teen understands what to expect for the schedule of administration for leucovorin therapy if the teen says:

The parent of a child newly diagnosed with cancer verbalizes regret to the nurse for not seeking earlier medical attention for the child's symptoms. Which response would be most therapeutic?

A child has cancer and has been treated with chemotherapy. The most recent lab value indicates that the white blood cell count is very low. Based on this result, which would the nurse expect to administer?

The nurse works in an oncology clinic. A preschool-age child is being seen in the clinic, and the nurse anticipates a diagnosis of cancer. The nurse prepares for which of the common reactions preschool-age children have following illnesses and hospitalizations?

A five-year-old child is on chemotherapy for rhabdomyosarcoma. Despite antiemetics, the child complains of nausea. The mother wants the child to eat and is pushing the child to eat the food. The nurse would talk with the mother and suggest that she not push the food on the nauseated child because:

The ten-year-old child was diagnosed with a medulloblastoma; following surgery the child is started on chemotherapy by intrathecal injection. While preparing the family for the start of chemotherapy, the nurse will explain that intrathecal administration was chosen because:

The child is receiving chemotherapy for acute lymphocytic leukemia. The nurse recognizes that a potential oncological emergency for this child would be tumor lysis syndrome. For which symptoms should the nurse monitor this child?

Following diagnosis of osteosarcoma, a 14-year-old girl has a below-the-knee amputation. The girl has had trouble accepting the reality of her amputation. Which behavior, when observed by the nurse, indicates she is beginning to accept the amputation?

The nurse is monitoring the urine specific gravity and pH on a child receiving chemotherapy. The nurse will try to maintain the urine values at what levels?

A child has thrombocytopenia secondary to chemotherapy treatments. Based on this finding, what should the nurse do?

The antiemetic drug ondansetron (Zofran) is being administered to a child receiving chemotherapy. It should be administered:

A child with leukemia has a granulocyte count of 250/mm³ and a platelet count 150,000/mm³. Nursing intervention would include which of the following?