peds oncologic disorders prepu questions
The nurse is caring for 9-year-old boy undergoing chemotherapy whose complete blood count (CBC) with differential reports 7% banded and 13% segmented neutrophils with a white blood cell count of 2,540. He has an oral temperature of 38.6°C (101.5°F). Which intervention would be the priority?
administering prescribed broad-spectrum IV antibiotics
The nurse is preparing to send a child with cancer for a radiation treatment. Which medication should the nurse provide to premedicate the child for this procedure?
antiemetic
A 12-year-old child is suspected of having Hodgkin lymphoma. When preparing the child and family for diagnostic testing, which test would the nurse describe as being used to confirm the diagnosis?
Lymph node biopsy
The pediatric nurse is explaining to a new graduate nurse the differences in planning well-child maintenance for a child with cancer. Which statement by the new nurse demonstrates understanding of the teaching?
No routine live vaccines are administered while on chemotherapy.
Which intervention is best to use with the 6-year-old who has developed stomatitis as a side effect of chemotherapy?
Practice frequent, gentle oral hygiene
What is the priority action the nurse should take when caring for a child newly diagnosed with Wilms tumor (nephroblastoma)?
Protect the abdomen from manipulation.
The nurse is describing the phases of treatment to a child who was diagnosed with leukemia and his parents. How would the nurse describe the induction stage?
Rapid promotion of complete remission
A child is undergoing a series of diagnostic tests for a suspected malignancy. Which diagnostic test result is only present in Hodgkin disease?
Reed-Sternberg cells
A 5-year-old client has been diagnosed with leukemia and is currently on chemotherapy and radiation. The child is having difficulty due to mucositis. Which is the most appropriate nursing diagnosis for this child?
Risk for imbalanced nutrition, less than body requirements, related to inflammation
The health care provider has just informed the parents of a 3-year-old that their child has leukemia. The mother begins crying and tells the nurse she does not want her baby to die. What is the nurse's best response?
"I know this is scary, but leukemia has a high cure rate in children these days."
Parents tell the nurse who is admitting their infant for a well-child exam that they recently saw a "white glow" in their child's left pupil. What is the nurse's best response?
"I will report this to the pediatrician."
A 3-year-old who has been attending preschool has been diagnosed with leukemia. The caregivers of this child ask the nurse what they can do to help their child feel secure. Which recommendation could the nurse make to these caregivers that would be helpful in making the child feel secure?
"Let your child continue to attend preschool as much as possible."
A nursing student asks one of the nurses on the unit, "What exactly is palliative care?" Which response by the nurse would be most accurate?
"Palliative care can coexist with other treatment that is focused on a cure, stabilization of a disease process or prolongation of life."
A nurse is providing teaching to a child receiving chemotherapy and the parents. The nurse determines that the teaching was successful when the parents state that they will contact the primary health care provider if which occurs?
The child has redness or swelling at the central venous access site.
The nurse is preparing to administer epoetin alpha to a child undergoing chemotherapy. What consideration(s) will the nurse take into account when administering this therapy? Select all that apply.
-Monitor hemoglobin levels. -Administer according to the individual dosing plan.
A child with stage III rhabdomyosarcoma develops tumor lysis syndrome. Which actions would be appropriate to include when providing care to this child? Select all that apply.
-monitoring serum chemistry levels -managing electrolytes using oral and IV solutions specific to electrolyte needs -administering allopurinol or rasburicase to reduce uric acid production monitoring intake and output; providing dialysis if renal failure occurs
When reviewing information about the incidence of the various types of childhood cancer, nursing students demonstrate understanding of the information when they identify which type as having the highest incidence?
Acute lymphoblastic leukemia (ALL)
The nurse is working with a family whose daughter is dying of a brain tumor. When addressing the situation with the child's siblings, the nurse should prioritize what consideration?
The children's stages of growth and development
Why do nurses teach childhood cancer survivors to inform adult health care providers of their prior disease and treatments?
To monitor for late effects
The nurse is preparing clients for diagnostic testing for cancer. Which test is used to differentiate a neuroblastoma from other tumors?
Urine catecholamine metabolites, homovanillic acid (HVA), and vanillylmandelic acid (VMA)
A school nurse is teaching a group of parents about signs and symptoms of cancer in children. Which symptom is an early sign of a brain tumor?
headache, vision changes, and vomiting
A child with cancer has developed neutropenia and is in isolation with neutropenic precautions. What nursing assessment takes priority for this child?
infection symptoms
A child with cancer is dying and in hospice care. When developing the plan of care, which intervention should the nurse include as the primary focus?
keeping the child pain-free
A nurse is caring for a child with Hodgkin disease who is in the induction phase of a chemotherapy regimen. The nurse explains to the parents that the goal of this phase is to:
kill enough cancerous cells to induce remission.
A 5-year-old child is at the pediatric clinic for a well-child visit. Which symptom alerts the health care provider that this child might have acute lymphoblastic leukemia (ALL)?
lethargy, bruises, and lymphadenopathy
Children with acute lymphoblastic leukemia (ALL) may need periodic lumbar punctures. The nurse would teach the parent that this is done to assess for:
leukemic cells.
A 15-year-old boy has been diagnosed with an osteogenic sarcoma of the distal femur. He also demonstrates a chronic cough, dyspnea, and chest pain, along with chronic leg pain. Based on these findings, the nurse should suspect metastasis to which body area?
lungs
The nurse is preparing a presentation for a parent group about childhood cancers, focusing on brain tumors in children. What would the nurse describe as the most common type of brain tumor?
medulloblastoma
The nurse is reviewing the medical record of a child diagnosed with Hodgkin lymphoma at the asymptomatic stage. Which would the nurse identify as typically the first sign reported by the child?
painless, enlarged lymph node
The nurse is teaching the parents of a 15-year-old boy who is being treated for acute myeloid leukemia about the side effects of chemotherapy. For which symptoms should the parents seek medical care immediately?
temperature of 101°F (38.3°C) or greater
The school nurse is providing information to parents of adolescents about prevention of cervical cancer. Which information is included in the teaching?
vaccine against human papillomavirus (HPV)
The toddler with a cancer diagnosis is seen for a well-child checkup. Which health maintenance activity will the nurse exclude?
Administering the measles, mumps, rubella (MMR) vaccine
A nurse is caring for a teen who is in the end stage of cancer. Which of the following nursing interventions provides self-esteem and self-worth to the teen?
Allowing the teen to completely participate in decisions
The parents of a 9-year-old girl who is dying from cancer are distraught and guilt-ridden when they find that treatment is no longer successful. What is the best way for the nurse to respond?
Assure the parents that expert care of their child will continue.
How can the nurse most simply describe for distressed parents a rhabdomyosarcoma that has been found in their 5-year-old?
Call it a tumor of muscle tissue
The nurse is providing care to a child who is nearing death. Which of the following would be most important for the nurse to keep in mind when communicating with the child?
Communication can be key in helping to meet the psychological needs of the dying child
An adolescent receiving chemotherapy has lost all hair and is sad about self-image. Which action should the nurse take to support this adolescent and involve the client in decision making?
Encourage the adolescent to select hats or wigs to fit one's personality.
The pediatric nurse examines the radiographs of a client that indicate lesions on the bone. This finding is indicative of:
Ewing sarcoma.
A patient and family have just been told that the child has a malignant brain tumor that appears inoperable. Which of the following nursing interventions would be most beneficial to this family and patient?
Explain that death is possible and offer curative and palliative care together.
When providing care to a dying child and his family, which would be most important?
Focusing on the family as the unit of care.
The family of a terminally ill client is asking about the benefits of hospice care. Which statement by the nurse provides accurate information?
Hospice is designed to meet the individual client's needs.