Deck 52: The Child With Cancer

Question 1

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

A)Apply sunscreen to the area when the child is exposed to sunlight.
B)Vigorously scrub the area when bathing.
C)Remove any markings left after each radiation treatment.
D)Apply lotion to the area before radiation therapy.

Answer 1

Apply sunscreen to the area when the child is exposed to sunlight.

Question 2

The nurse is admitting a client with an infratentorial brain tumor.The nurse is teaching the parents about the tumor.Identify the area of the brain the nurse should show the parents where this type of tumor occurs.

Answer 2

Correct placement of the mark is below the tentorium area (brainstem gliomas,medulloblastoma,cerebellar astrocytoma,ependymoma).Incorrect placement of the mark would be above the tentorium area (cerebral astrocytoma,ependymoma,optic nerve glioma).

Question 3

The child has been admitted to the hospital unit newly diagnosed with retinoblastoma.The nurse would expect to see:

A)A red reflex.
B)Yellow sclera.
C)A white pupil.
D)Blue-tinged sclera.

Answer 3

A white pupil.

Question 4

A child has thrombocytopenia secondary to chemotherapy treatments.The nurse should not:

A)Administer intramuscular (IM)injections.
B)Perform oral hygiene.
C)Monitor intake and output.
D)Use palpation as a component of assessment.

Question 5

The nurse is monitoring the urine-specific gravity and pH of a child receiving chemotherapy.The nurse will try to maintain the urine values at:

A)Specific gravity 1.030;pH 6.
B)Specific gravity 1.030;pH 7.
C)Specific gravity 1.005;pH 6.
D)Specific gravity 1.005;pH 7.5.

Question 6

A child has been diagnosed with Wilms' tumor,and is being treated with chemotherapy.Because many chemotherapeutic agents cause bone marrow depression,before administering the chemotherapy,the nurse will determine if this child has any infection-fighting capability by monitoring the:

A)Hemoglobin.
B)Red blood cell count.
C)Absolute neutrophil count (ANC).
D)Platelets.

Question 7

A child undergoing chemotherapeutic treatment for cancer is being admitted to the hospital for fever and possible sepsis.Cultures,antibiotics,and acetaminophen (Tylenol)have been ordered for this child.Which order should the nurse do first?

A)Administer the antibiotics.
B)Administer the Tylenol.
C)Obtain the cultures.
D)Any of the three

Question 8

An adolescent is receiving methotrexate chemotherapy after undergoing limb salvage surgery for osteogenic sarcoma.The nurse knows the teen understands the purpose of leucovorin therapy after the methotrexate if the teen says:

A)"I'm glad I only need one dose of the leucovorin."
B)"I don't have any pain,so I won't need to take the leucovorin this time."
C)"I know I will be taking the leucovorin every 6 hours for about the next 3 days."
D)"I don't have any nausea,so I won't need the leucovorin."

Question 9

A child has cancer,and has been treated with chemotherapy.The latest lab value indicates the white blood cell count is very low.The nurse would expect to administer:

A)Filgrastim (Neupogen).
B)Ondansetron (Zofran).
C)Oprelvekin (Neumega).
D)Epoetin (human recombinant erythropoietin).

Question 10

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

A)Abnormal,and she should be referred to a psychologist.
B)Unusual,as the illness doesn't affect the sibling.
C)Unexpected,as the cancer is easily treated.
D)Normal,as the sibling is affected too,and anger and guilt are expected feelings.

Question 11

A preschool-age child is being seen in the oncology clinic for a suspected diagnosis of cancer.A common reaction preschool-age children have to a diagnosis of cancer is:

A)Acceptance,especially if able to discuss the disease with children their own age.
B)Thoughts that they caused their illness and are being punished.
C)An understanding of what cancer is and how it is treated.
D)Unawareness of what the illness is.

Question 12

The child is receiving chemotherapy for acute lymphocytic leukemia.The nurse should monitor the child for which of the following signs of tumor lysis syndrome?

A)Thrombocytopenia and leukocytosis
B)Oliguria and altered levels of consciousness
C)Respiratory distress and cyanosis
D)Upper-extremity edema and neck vein distension

Question 13

A child has been diagnosed with Wilms' tumor.Preoperative nursing care would involve:

A)Careful bathing and handling.
B)Monitoring of behavioral status.
C)Maintenance of strict isolation.
D)Administration of packed red blood cells.

Question 14

A school-age child is being seen in the oncology clinic for possible Hodgkin's disease.During the course of the nursing assessment,which findings would be expected? Select all that apply.

A)Fever
B)Painless cervical nodes
C)Painful cervical nodes
D)Complaints of night sweats
E)Poor appetite

Question 15

A 24-hour urine for vanillylmandelic acid (VMA)has been ordered on a child suspected of having neuroblastoma.The nurse begins the collection:

A)At 0700.
B)After the next time the child voids.
C)At bedtime.
D)When the order is noted.