Question 1

Which of the following would be most appropriate to include in the plan of care for a child who has undergone surgery for removal of an astrocytoma?

Accepted Answer

Positioning the child on the unaffected side helps to prevent pressure on the surgical site and allows for proper drainage, reducing the risk of complications.

Question 2

Which test result would the nurse least likely expect to find in a child diagnosed with Wilms tumor?

Accepted Answer

Elevated homovanillic acid (HVA) with a 24-hour urine collection is more commonly associated with neuroblastoma, another type of pediatric cancer, rather than Wilms tumor, which primarily affects the kidneys.

Question 3

The nurse is describing the phases of treatment to a child who was diagnosed with leukemia and his parents. The nurse explains the induction stage as which of the following?

Accepted Answer

The induction stage in leukemia treatment aims for rapid promotion of complete remission, where the goal is to kill the leukemia cells in the blood and bone marrow to induce a remission.

Question 4

A 14-year-old boy is diagnosed with Hodgkin disease. When palpating for enlarged lymph nodes, the nurse would expect to find which nodes as most commonly enlarged? Select all answers that apply.

Accepted Answer

Hodgkin disease commonly presents with enlargement of the cervical and supraclavicular lymph nodes, reflecting the typical pattern of lymph node involvement in this condition.

Question 5

A child is receiving methotrexate as part of his chemotherapy protocol. The nurse would anticipate administering which agent to counteract the toxic effects of methotrexate?

Accepted Answer

Leucovorin is used to counteract the toxic effects of methotrexate. It is a form of folic acid that helps protect healthy cells from the effects of methotrexate, which is a folic acid antagonist.

Question 6

A group of nursing students are reviewing the various drug classes used for cancer chemotherapy. The students demonstrate an understanding of these classes when they identify which agent as an example of a nitrosourea?

Accepted Answer

Carmustine is an example of a nitrosourea, which is a class of chemotherapy drugs that work by cross-linking DNA and RNA, thereby inhibiting DNA synthesis. Nitrosoureas are known for their ability to cross the blood-brain barrier, making them useful in treating brain tumors.

Question 7

The nurse is developing a plan of care for a child who is receiving cyclophosphamide. Which of the following would the nurse expect to include?

Accepted Answer

Cyclophosphamide is a chemotherapy drug that can be toxic to the bladder, potentially causing hemorrhagic cystitis. Encouraging frequent voiding during and after the infusion helps to flush the drug out of the bladder, reducing the risk of toxicity.

Question 8

The nurse is reviewing the laboratory test results of a child who is receiving chemotherapy. To calculate the child's absolute neutrophil count, in addition to the total number of white blood cells, which results would the nurse use? Select all answers that apply.

Accepted Answer

The absolute neutrophil count (ANC) is calculated using the total number of white blood cells and the percentage of neutrophils, which includes both bands (immature neutrophils) and segs (segmented, mature neutrophils). Eosinophils and basophils are not used in this calculation.

Question 9

A nurse is instituting neutropenic precautions for a child. Which of the following would the nurse most likely include? Select all answers that apply.

Accepted Answer

The answer of A nurse is instituting neutropenic precautions for...

Question 10

A child is scheduled to undergo radiation therapy as part of his treatment plan for newly diagnosed cancer. After teaching the child and parents about this treatment, the nurse determines that additional teaching is needed when the parents state which of the following?

Accepted Answer

Petroleum jelly or any ointment should not be applied to the radiation treatment area unless specifically recommended by the healthcare provider, as it can interfere with the treatment and exacerbate skin reactions.

Quiz 46: Nursing Care of the Child With an Alteration in Cellular Regulation/Hematologic or Neoplastic Disorder