NUR 410 prepu peds
Parents ask why their child just diagnosed with leukemia needs a "spinal tap." Which is the bestresponse by the nurse?
"Checking the cerebrospinal fluid will reveal whether leukemic cells have entered the central nervous system."
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."
Wilm's tumor is suspected in a 5-year-old child. Which action would be avoided?
Abdominal palpation
A nurse is assessing a child with cancer and suspects that the child has developed sepsis based on what findings? Select all that apply.
Absolute neutrophil count (ANC) less than 500 Increased blood urea nitrogen (BUN) Hyperkalemia
The parents of a child with a malignancy disagree with each other about the treatment plan, then express frustration at the staff for not answering call lights quickly enough. Which nursing intervention will best address their needs?
Accept the parents' anger and respond with empathy and acceptance.
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 lymphocytic (lymphoblastic) leukemia
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
After teaching a group of nursing students about chemotherapy agents used in treatment cancer, the instructor determines that the teaching was successful when the students identify cisplatin as which type of drug?
Alkylating agent
What would the nurse expect to be ordered for a child with acute lymphoblastic leukemia who develops tumor lysis syndrome?
Allopurinol
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
A teenage girl asks why chemotherapy causes hair loss. Which response by the nurse is accurate?
Chemotherapy affects cancer cells and normal cells that multiply rapidly.
A 10-year-old client diagnosed with metastatic brain cancer is experiencing a notable decline in function. Keeping the client's needs in mind, which nursing interventions should be included in the plan of care at this time? Select all that apply.
Encourage typical daily activities as able. Allow for expression of client feelings. Prepare for vocal and physical aggression. Use open-ended questions.
The pediatric nurse examines the radiographs of a client that indicate lesions on the bone. This finding is indicative of:
Ewing sarcoma.
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.
The parents bring their 4-year-old son to the emergency department. The child is receiving chemotherapy for acute lymphoblastic leukemia. The parents report that the child has become lethargic and has had significant episodes of vomiting and diarrhea. What findings would lead the nurse to suspect the child may be experiencing tumor lysis syndrome? Select all that apply.
Hyperkalemia Hypocalcemia Hyperuricemia
A child is scheduled for chemotherapy as treatment for leukemia. As the nurse is collaborating with another collegue, it is asked in which phase of the chemotherapy treatment the client is. The nurse is most correct to outline the phases as which? Place the phases in the order in which the nurse would describe from first to last.
Induction
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?
Leucovorin
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
A child is receiving carboplatin as part of a chemotherapy protocol. What would be mostimportant for the nurse to include in the child's plan of care?
Maintaining adequate hydration
The nurse is planning a discussion group for parents with children who have cancer. How would the nurse describe a difference between cancer in children and adults?
Most childhood cancers affect the tissues rather than organs.
The nurse is assessing a 3-year-old boy whose mother reports that he is listless and has been having trouble swallowing. Which finding suggests the child may have a brain tumor?
Observation reveals nystagmus and head tilt
What is the priority nursing action for a dying child who is restless, moaning, and vomiting?
Pain assessment and control
The nurse is reviewing the medical record of a child diagnosed with Hodgkin's lymphoma. Which would the nurse identify as typically the first sign reported by the child?
Painless, enlarged lymph node
The nurse is assessing a 14-year-old girl with a tumor. Which finding indicates Ewing sarcoma?
Palpation reveals swelling and redness on the right ribs.
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.
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 parents of an 11-year-old boy who is dying from cancer are concerned that he is not eating. Which intervention would serve both the parents' and child's needs?
Serving small meals of things the child likes
The nurse is teaching the parents of a 15-year-old boy who is being treated for acute myelogenous 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 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
A nurse practitioner suspects a 13-month-old child has a neuroblastoma. Which diagnostic test would be most helpful in confirming the nurse practitioner's suspicion?
Urine catecholamine metabolites
The mother of a 13-year-old adolescent is concerned about her daughter getting cervical cancer later in life and asks the nurse if there are any ways to reduce the risk. Which would the nurse recommend?
Vaccination for the human papilloma virus
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 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 lymphocytic leukemia?
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.
An experienced nurse is orienting a new nurse to the oncology unit. Which action by the new nurse would require intervention?
pouring unused chemotherapy medicine into a sink drain
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)
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 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 3-year-old boy has been on chemotherapy for cancer. He complains about a sore throat, is experiencing malaise, and has a temperature of 99.8° F (37.7° C) orally. His mother calls the child's physician. What is the appropriate information for the nurse to tell his mother at this time?
"Plan to bring the child into the physician's office today."
A child who has been diagnosed with a terminal brain tumor states, "I'm dying." What is the best response by the nurse?
"Tell me more."
The nurse is speaking to the mother of a dying child about the best ways to manage pain and discomfort. Which is the best response by the nurse?
"We will provide pain medication around the clock to help prevent recurrence or escalation of pain."
The nurse is explaining the procedure of bone marrow aspiration to a 6-year-old child with leukemia. What explanation would be best to give to the child?
"You may feel pressure on your hip during the procedure."
An important nursing intervention to institute with an infant prior to surgery for a Wilms' tumor is to place a sign over his crib that reads:
"do not palpate abdomen."
Which child would the nurse identify as having the greatest risk for stomatitis and therefore needs meticulous oral hygiene?
A 7-year-old male with leukemia
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 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
The nurse is caring for a 2-year-old girl who is receiving chemotherapy using antitumor antibiotics. Which intervention would the nurse question?
Assessing the mouth for redness, lesions, or ulcers
The nurse is admitting to an examination room a child with the diagnosis of "probable acute lymphoblastic leukemia (ALL)." What will confirm this diagnosis?
Bone marrow aspiration
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 caring for a 6-year-old boy with non-Hodgkin lymphoma who is being treated with monoclonal antibodies. What recommendation would the nurse include in the child's plan of care?
Monitoring for allergic reactions or anaphylaxis
