PEDS Cancer and end of life questions

Bone marrow and lymphatic systems

The nurse understands that leukemias affect which systems?

Lymphoid and hematopoietic systems

The nurse understands that lymphomas affect which systems?

"Wigs can be very expensive"

Which statement by the student nurse to the pediatric patient's family about hair loss following chemotherapy or cranial radiation requires correction?

"Make you take time for your own" "Break problems into small" "Depend on your family members"

The parents of a child diagnosed with lymphoma inform the nurse that they feel guilty because of the changes in the family dynamics. What coping skills can the nurse provide that would help the parents manage stress? Select all that apply.

Prolonged fever Frequent headaches Sudden tendency to bruise

What are cardinal symptoms of cancer in children? Select all that apply.

"Maintaining awareness" "Educating parents and children"

What are the nurse's roles regarding the prevention of childhood cancer? Select all that apply.

Replacement of normal cells with malignant cells in the bone marrow

What causes anemia in the pediatric patient with cancer?

Pain

Which symptom of cancer in children may be overlooked as a normal part of growing?

Apply a head dressing to a doll to demonstrate the physical appearance

What is the most appropriate way for the nurse to prepare the pediatric patient with a brain tumor for what to expect following surgery?

The donors marrow contains antigens not matched to the recipient's antigens, which attack the body cells

What is the most likely complication of bone marrow transplantation in the pediatric patient with cancer?

Ewing Sarcoma

What type of tumors arise in the marrow spaces of the bone?

Hyperuricemia Hyperkalemia Hyperphosphatemia Hypocalcemia

Which are hallmark metabolic abnormalities of tumor lysis syndrome? Select all that apply.

Sucralfate Chlorhexidine mouthwash Sodium Bicarbonate and salt

Which nursing interventions are recommended for the pediatric patient experiencing oral mucosal ulceration following chemotherapy? Select all that apply.

"The majority of pediatric patients with bone cancer will require amputation"

Which statement by the student nurse regarding childhood cancer therapies requires correction?

Large doses of opioids are justified when there are no other treatment options

A child who is terminally ill with bone cancer is in severe pain. What should nursing interventions be based on?

Hyperleukocytosis

A pediatric patient undergoing treatment for cancer is experiencing respiratory distress and cyanosis. Laboratory reports show a peripheral white blood cell (WBC) count of 110,000/mm 3. Which complication from cancer therapy does the nurse identify?

Encourage further expression of emotion

An adolescent who has been diagnosed with metastatic bone cancer has failed to respond to treatment. The patient has begun to need more pain medication. The nurse tells the patient that too much will affect respiration and could be fatal. The patient, who has been very withdrawn, responds "Cancer is fatal. I'd just as soon die now from an overdose." Which action conveys greatest empathy from the nurse?

Alopecia

For which side effect of radiotherapy should the nurse introduce to the patient the idea of a wig or other head covering?

Fever

In a pediatric patient with cancer, the body may not be able to produce an adequate inflammatory response to infection, suppressing the usual clinical signs of infection. What clinical sign of infection will still occur?

Marrow Cord blood Stem cells

In transplantation for a pediatric patient with cancer, what may be administered to the patient via intravenous (IV) transfusion? Select all that apply.

Appropriate because it can assist in the resolution of personal grief

Several nurses tell their nursing supervisor that they want to be able to attend the funeral of a child for whom they had cared. They say they felt especially close to both the child and the family. The supervisor should recognize that attending the funeral is what?

Overwhelming infection General Malaise Invasion of organisms

The child with a fever who has an absolute neutrophil count (ANC) lower than 500/mm 3 is at risk for which complications? Select all that apply.

"Encourage all family" "Discuss the plan of treatment"

The nurse is caring for a 10-year-old child diagnosed with a terminal illness. What interventions should the nurse include to provide effective care to the patient and family? Select all that apply.

Have the parents focus on the quality of the child's remaining life

The nurse is caring for a child who is in the final stages of death. What can the nurse do to provide comfort for the parents?

"unexplained genetic alterations cause cancerous cells to grow and multiply. There's nothing you could have done to prevent it"

The nurse is caring for a child with leukemia. The child's parents ask the nurse what caused the child to get cancer. What is the nurse's most appropriate response?

Platelet count

The nurse is caring for a pediatric patient and observes ecchymosis and petechiae on the patient's legs and ankles. Which diagnostic test should be ordered based on this finding?

Test muscle strength, gait, coordination and reflexes

The nurse is caring for a pediatric patient who presents with loss of balance and hyporeflexia. What assessment should the nurse perform?