Deck 48: The Child With Cancer

Question 1

What is the most appropriate nursing action when the nurse notes a reddened area on the forearm of a neutropenic child with leukemia?

A) Massage the area.
B) Turn the child more frequently.
C) Document the finding and continue to observe the area.
D) Notify the physician.

Answer 1

Notify the physician.

Question 2

What is an appropriate nursing action before surgery when caring for a child diagnosed with a Wilms' tumor?

A) Limit fluid intake.
B) Do not palpate the abdomen.
C) Force oral fluids.
D) Palpate the abdomen every 4 hours.

Answer 2

Do not palpate the abdomen.

Question 3

The nurse understands that the type of precautions needed for children receiving chemotherapy is based on which actions of chemotherapeutic agents?

A) Gastrointestinal upset
B) Bone marrow suppression
C) Decreased creatinine level
D) Alopecia

Answer 3

Bone marrow suppression

Question 4

What should the nurse teach parents about oral hygiene for the child receiving chemotherapy?

A) Brush the teeth briskly to remove bacteria.
B) Use a mouthwash that contains alcohol.
C) Inspect the child's mouth daily for ulcers.
D) Perform oral hygiene twice a day.

Question 5

Which nursing intervention should not be included in the postoperative plan of care for a child undergoing surgery for a brain tumor?

A) Place the child in Trendelenburg position.
B) Perform neurologic assessments.
C) Assess dressings for drainage.
D) Monitor temperature.

Question 6

A child with a history of fever of unknown origin,excessive bruising,lymphadenopathy,anemia,and fatigue is exhibiting symptoms most suggestive of

A) Ewing sarcoma
B) Wilms' tumor
C) Neuroblastoma
D) Leukemia

Question 7

The nurse notes that a child's gums bleed easily and he has bruising and petechiae on his extremities.What laboratory values are consistent with these symptoms?

A) Platelet count of 19,000/mm³
B) Prothrombin time of 11 to 15 seconds
C) Hematocrit of 34
D) Leukocyte count of 14,000/mm³

Question 8

The nurse should base a response to a parent's question about the prognosis of acute lymphoblastic leukemia (ALL)on the knowledge that

A) Leukemia is a fatal disease, although chemotherapy provides increasingly longer periods of remission.
B) Research to find a cure for childhood cancers is very active.
C) The majority of children go into remission and remain symptom free when treatment is completed.
D) It usually takes several months of chemotherapy to achieve a remission.

Question 9

Children with non-Hodgkin lymphoma are at risk for complications resulting from tumor lysis syndrome (TLS).The nurse should assess for

A) Liver failure
B) CNS deficit
C) Kidney failure
D) Respiratory distress

Question 10

A child with acute myeloblastic leukemia is scheduled to have a bone marrow transplant (BMT).The donor is the child's own umbilical cord blood that had been previously harvested and banked.This type of BMT is termed

A) Autologous
B) Allogeneic
C) Syngeneic
D) Stem cell

Question 11

Which statement,if made by a nurse to the parents of a child with leukemia,indicates an understanding of teaching related to home care associated with the disease?

A) "Your son's blood pressure must be taken daily while he is on chemotherapy."
B) "Limit your son's fluid intake just in case he has central nervous system involvement."
C) "Your son must receive all of his immunizations in a timely manner."
D) "Your son's temperature should be taken frequently."

Question 12

What is a priority nursing diagnosis for the 4-year-old child newly diagnosed with leukemia?

A) Ineffective Breathing Pattern related to mediastinal disease
B) Risk for Infection related to immunosuppressed state
C) Disturbed Body Image related to alopecia
D) Impaired Skin Integrity related to radiation therapy

Question 13

The nurse is aware that an abdominal mass found in a 10-month-old infant corresponds with which childhood cancer?

A) Osteogenic sarcoma
B) Rhabdomyosarcoma
C) Neuroblastoma
D) Non-Hodgkin lymphoma

Question 14

Which clinical finding is an overt sign of retinoblastoma in children?

A) Whitish reflex in the eye
B) Lymphadenopathy
C) Bone pain
D) Change in gait

Question 15

A child with non-Hodgkin lymphoma will be starting chemotherapy.What intervention is initiated before chemotherapy to prevent tumor lysis syndrome?

A) Insertion of a central venous catheter
B) Intravenous (IV) hydration containing sodium bicarbonate
C) Placement of an externalized ventriculoperitoneal (VP) shunt
D) Administration of pneumococcal and Haemophilus influenzae type B vaccines

Question 16

Hematopoietic stem cell transplantation (HSCT)is the standard treatment for a child in his or her first remission with what cancer?

A) ALL
B) Non-Hodgkin lymphoma
C) Wilms' tumor
D) Acute myeloblastic leukemia (AML)

Question 17

While completing an assessment on a 6-month-old infant,which finding should the nurse recognize as a symptom of a brain tumor in an infant?

A) Blurred vision
B) Increased head circumference
C) Vomiting when getting out of bed
D) Headache

Question 18

What is an expected physical assessment finding for an adolescent with a diagnosis of Hodgkin disease?

A) Protuberant, firm abdomen
B) Enlarged, painless, firm cervical lymph nodes
C) Soft tissue swelling
D) Soft to hard, nontender mass in pelvic area

Question 19

A nurse determines that parents understood the teaching from the pediatric oncologist if the parents indicate that which test confirms the diagnosis of leukemia in children?

A) Complete blood cell count (CBC)
B) Lumbar puncture
C) Bone marrow biopsy
D) Computed tomography (CT) scan

Question 20

What is the nurse's best response to a mother whose child has a diagnosis of acute lymphoblastic leukemia and is expressing guilt about not having responded sooner to her boy's symptoms?

A) "You should always call the physician when your child has a change in what is normal for him."
B) "It is better to be safe than sorry."
C) "It is not uncommon for parents not to notice subtle changes in their children's health."
D) "I hope this delay does not affect the treatment plan."

Question 21

Complementary and alternative medical therapies (CAM)are those that are scientifically proven or are not proven; however,they are deemed to be useful as an adjunct to treatment.It is not uncommon for families to try CAM without disclosing this information to the health care team.Is this statement true or false?

Question 22

In recent years the use of _____________ stem cell transplantation has become the accepted therapy for the treatment of several hematologic and oncologic disorders.

Question 23

What should the nurse recognize as symptoms of a brain tumor in a school-age child for whom she is caring? Select all that apply.

A) Blurred vision
B) Increased head circumference
C) Vomiting when getting out of bed
D) Intermittent headache
E) Declining academic performance

Question 24

What fluid is the best choice when a child with mucositis asks for something to drink?

A) Hot chocolate
B) Lemonade
C) Popsicle
D) Orange juice

Question 25

A child with a brain tumor is undergoing radiation therapy.What should the nurse include in the discharge instructions to the child's parents? Select all that apply.

A) Apply over-the-counter creams to the area daily.
B) Avoid excessive skin exposure to the sun.
C) Use a washcloth when cleaning the area receiving radiation.
D) Plan for adequate rest periods for the child.
E) A darkening of the skin receiving radiation is expected.

Question 26

A less common malignancy of muscle or striated tissue is known as ______________.

Question 27

When an adolescent with a new diagnosis of Ewing sarcoma asks the nurse about treatment,the nurse's response is based on the knowledge that (select all that apply)

A) This type of tumor invades the bone.
B) Management includes chemotherapy, surgery, and radiation.
C) Ewing sarcoma is usually not responsive to either chemotherapy or radiation.
D) Affected bones such as ribs and proximal fibula may be removed to excise the tumor.
E) Is the most common bone tumor seen in children.