Deck 50: The Child With Cancer

Question 1

The child is admitted to the hospital unit newly diagnosed with retinoblastoma. Which clinical manifestation does the nurse anticipate upon assessment?
1) A white reflex
2) Blue-tinged sclerae
3) A red reflex
4) Yellow-tinged sclerae

Answer 1

1

Question 2

Which urine specific gravity, and corresponding pH, should the nurse include in a goal statement for a pediatric client receiving chemotherapy in the treatment of cancer?
1) Specific gravity 1.030 and pH 7.5
2) Specific gravity 1.005 and pH 6
3) Specific gravity 1.030 and pH 6
4) Specific gravity 1.005 and pH 7.5

Answer 2

4

Question 3

Which general manifestations should the nurse monitor for when conducting a physical assessment for a pediatric client who is diagnosed with cancer? Select all that apply.
1) Infection
2) Polycythemia
3) Petechiae
4) Pain
5) Cachexia

Answer 3

1, 3, 4, 5

Question 4

A pediatric client diagnosed with cancer is to receive 2 months of chemotherapy that is separated by a 6-week period. The mother asks why the child cannot receive the medication for 2 months straight. Which rationale should the nurse include when responding to the client's mother?
1) Prevention of nausea and vomiting from the drugs
2) Schedule requirement of the infusion center
3) Decrease incidence of heart failure
4) Allows normal cells to repair themselves while the cancer cells die

Question 5

The nurse is preparing to administer a prescribed, as needed, antiemetic drug for a child who is diagnosed with cancer. Which action by the nurse is most appropriate?
1) Administering the drug only if the child is nauseated
2) Administering the drug prophylactically prior to the next dose of chemotherapy
3) Administering the drug after the next dose of chemotherapy
4) Administering the drug only if the child is experiencing diarrhea

Question 6

The nurse is providing care to a pediatric client who is receiving chemotherapy to treat acute lymphocytic leukemia (ALL). Which nursing diagnoses should the nurse include in the plan of are based on the side effects associated with the treatment? Select all that apply.
1) Risk for Injury
2) Impaired Skin Integrity
3) Risk for Electrolyte Imbalance
4) Risk for Infection
5) Sleep Deprivation

Question 7

A preschool-age child is being seen in the oncology clinic. Which reaction should the nurse anticipate based on the child's stage of development?
1) Unawareness of the illness and its severity
2) Acceptance, especially if able to discuss the disease with children their own age
3) Understanding of what cancer is and how it is treated
4) Thoughts that they caused their illness and are being punished

Question 8

The child is receiving chemotherapy for acute lymphocytic leukemia (ALL). Which assessment data should the nurse immediately report to the healthcare provider due to a metabolic emergency?
1) Thrombocytopenia
2) Leukocytosis
3) Oliguria
4) Edema

Question 9

The adolescent client is receiving methotrexate chemotherapy after undergoing limb-salvage surgery for osteogenic sarcoma. The healthcare provider also prescribes leucovorin therapy. Which adolescent statement indicates correct understanding for the administration schedule for this newly prescribed drug?
1) "I do not have any pain, so I will not need to take the leucovorin this time."
2) "I do not have any nausea, so I .will not need the leucovorin."
3) "I am glad I only need one dose of the leucovorin."
4) "It is important that I receive my leucovorin on time, as it protects my body from the methotrexate."

Question 10

Which is a therapeutic nursing response when the mother of a pediatric client diagnosed with cancer states, "I regret not seeking medical attention earlier for my child."?
1) "You may feel guilty, but you should not blame yourself."
2) "Most cancers can be treated easily."
3) "Many types of cancer are difficult to diagnose and might not show early symptoms."
4) "Early diagnosis is not significant in the diagnosis and management of cancer."

Question 11

An adolescent female client, diagnosed with osteosarcoma, has a below-the-knee amputation as part of the treatment regimen. Which behavior, assessed by the nurse, indicates the client is beginning to accept the amputation?
1) Complaints of pain in the missing leg
2) Insists that a prosthetic be applied prior to participating in physical therapy.
3) Insists on covering the lower portion of the body prior to peer visitation.
4) Watches the dressing change

Question 12

The parent of a child diagnosed with Ewing sarcoma asks why multiple drugs are needed to treat this cancer. Which rationale should the nurse use when responding to the client's mother?
1) The prescribed drug protocol is needed due to the aggressive nature of the cancer.
2) The prescribed drug protocol decreases side effects.
3) The prescribed drug protocol is used in specifically in children.
4) The prescribed drug protocol involves a group of drugs that work in different modes.

Question 13

Which is the priority nursing intervention for a pediatric client, diagnosed with leukemia, who has a granulocyte count of 250/mm³ and a platelet count of 150,000/mm³?
1) Fluid restriction
2) Mouth care
3) Neutropenic precautions
4) Hand hygiene

Question 14

The nurse is providing care for a pediatric client who is diagnosed with a Wilms tumor. Which laboratory test result should the nurse monitor prior to administering the prescribed chemotherapy dose?
1) Hemoglobin
2) Red blood cell count
3) Platelets
4) Absolute neutrophil count (ANC)

Question 15

The school-age child, diagnosed with a medulloblastoma, will receive intrathecal chemotherapy injections after surgery. Which rationale for this type of chemotherapy administration should the nurse include in the medication teaching?
1) It reduces side effects.
2) It does not require the child being "stuck."
3) Many chemotherapy drugs do not cross the blood-brain barrier.
4) Intrathecal administration is less expensive than intravenous administration.

Question 16

A child with rhabdomyosarcoma is prescribed radiation therapy after surgical removal of the tumor. Which intervention should the nurse include in the child's plan of care?
1) Apply lotion to the area before radiation therapy.
2) Apply sunscreen to the area when the child is exposed to sunlight.
3) Remove any markings left after each radiation treatment.
4) Vigorously scrub the area when bathing the child.

Question 17

The sibling of a pediatric client diagnosed with leukemia expresses feelings of anger and guilt to the nurse. Which explanation should the nurse provide to the client's parents regarding the reaction of the sibling?
1) Abnormal; the sibling should be referred to a psychologist.
2) Unexpected; the cancer is easily treated.
3) Unusual; the illness does not affect the sibling.
4) Normal; the sibling is affected, too, and anger and guilt are expected feelings.

Question 18

A child diagnosed with cancer is prescribed chemotherapy. Recent laboratory data show a low white blood cell (WBC) count. Which prescription should the nurse anticipate based on the current data?
1) Epoetin alfa (Epogen)
2) Ondansetron (Zofran)
3) Oprelvekin (Neumega)
4) Filgrastim (Neupogen)

Question 19

A school-age child, diagnosed with rhabdomyosarcoma, is experiencing nausea and vomiting related to the prescribed chemotherapy in spite of the use of antiemetics. The mother is pushing the child to eat the food. Which statement by the nurse is appropriate to address this situation?
1) "Since your child is receiving IV fluids, it is not important to push oral intake of food."
2) "A food aversion may occur if you continue to force your child to eat."
3) "Emesis that is caused by your child being force-fed can damage the stomach."
4) "A psychologic conflict could occur between you and your child if you continue to push eating."

Question 20

Which nursing intervention is contraindicated for a pediatric client who is experiencing thrombocytopenia secondary to chemotherapy treatments?
1) Administering intramuscular injections
2) Monitoring intake and output
3) Palpating during the assessment
4) Providing oral hygiene

Question 21

The nurse is providing care to a pediatric client who will require radiation as a portion of the treatment regimen. Which topics should the nurse include in the teaching session related to long- term ramifications associated with this treatment option?
1) Scoliosis
2) Adhesions
3) Hypothyroidism
4) Visual impairment
5) Cardiotoxicity

Question 22

The school-age child is admitted to the pediatric neurologic unit with a suspected craniopharyngioma. Which assessment data collected by the nurse supports the suspected diagnosis? Select all that apply.
1) Evening nausea
2) Excessive urination
3) Nystagmus
4) Headaches
5) Orbital ecchymosis

Question 23

Which pediatric cancer diagnoses necessitate priority assessment by the nurses for clinical manifestations associated with emergencies related to space-occupying lesions? Select all that apply.
1) Hodgkin disease
2) Leukemia
3) Neuroblastoma
4) Melanoma
5) Lymphoma

Question 24

The nurse is preparing to assist with a lumbar puncture for a pediatric client who is diagnosed with cancer. Which statements should the nurse include in the teaching session for the client and family? Select all that apply.
1) "This procedure assesses the bone marrow."
2) "This procedure assesses cerebrospinal fluid."
3) "This procedure confirms the diagnosis of acute lympoblastic leukemia."
4) "The procedure determines if malignant cells are affecting the nervous system."
5) "This procedure assesses cellular components of the blood."

Question 25

Which nursing actions will decrease the risk of extravasation when administering chemotherapy to a pediatric client through a peripheral line? Select all that apply.
1) Ensuring that the intravenous line is a free flowing line
2) Administering the medication by infusion pump
3) Checking for blood return before and during chemotherapy administration
4) Diluting the medication with normal saline
5) Administering the vesicant drug last

Question 26

The nurse is providing care to a pediatric client who will require surgery as a portion of the treatment regimen. Which topics should the nurse include in the teaching session related to long- term ramifications associated with this treatment option?
1) Scoliosis
2) Adhesions
3) Hypothyroidism
4) Visual impairment
5) Cardiotoxicity

Question 27

Which assessment findings, indicative of a hematologic emergency, should the nurse report to the healthcare provider due to the need for immediate intervention? Select all that apply.
1) Anemia
2) Thrombocytopenia
3) Disseminated intravascular coagulation
4) Cardiac arrhythmias
5) Tetany