PrepU Ch. 26: Analysis and Application
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? A. "Let your child continue to attend preschool as much as possible." B. "Keep your child at home and spend as much one-on-one time with her as possible." C. "Keep your child out of school but invite some friends over for play dates." D. "Plan special outings with just the family during the time the child would normally have been at school."
A
A 4-year-old child diagnosed with Wilms tumor is admitted for surgery. What information would be most important for the nurse to include in the child's preoperative plan of care? A. Avoiding further abdominal palpation B. Performing dressing changes to the affected area C. Administering analgesics for pain D. Preparing the child for amputation
A
A child has undergone a hematopoietic stem cell transplant. When assessing the child, the nurse notes the development of a maculopapular rash on the child's palms and bottoms of the feet. Which condition would the nurse suspect? A. graft-versus-host disease B. disseminated intravascular coagulation C. graft failure D. veno-occlusive disease
A
What is the priority action the nurse should take when caring for a child newly diagnosed with Wilms tumor (nephroblastoma)? A. Protect the abdomen from manipulation. B. Assess for constipation. C. Control acute pain. D. Obtain a catheterized urine specimen.
A
When assessing a child with Wilms tumor, which part of the assessment should the nurse avoid? A. Palpation B. Inspection C. Auscultation D. Observation
A
When planning the care for a child with leukemia who is receiving methotrexate, the nurse would assess the child closely for which possible effect? A. mucositis B. cushingoid facial appearance C. weight gain D. paresthesias of the fingers
A
When providing care to a dying child and his family, which would be most important? A. Focusing on the family as the unit of care. B. Teaching the family appropriate care measures. C. Offering the child support and encouragement. D. Assisting the parents in decision making.
A
Wilms tumor is suspected in a 5-year-old child. Which action would be avoided? A. abdominal palpation B. fiber intake C. aspirin administration D. rectal suppository use
A
A child being treated for leukemia is diagnosed with neutropenia. What nursing instructions directly prevent client infections? Select all that apply. A. Avoid large crowds. B. Inspect the skin daily for scratches or scrapes. C. Increase the intake of fresh fruits and vegetables. D. Remove house plants, flowers, and goldfish from the home environment. E. Stay away from people who have obvious colds, rashes, or other infections.
A B D E
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 100.5°F (38.05°C) orally. His mother calls the child's physician. What is the appropriate information for the nurse to tell his mother at this time? A. "Continue to watch the child, giving him aspirin and cool fluids for the fever." B. "Plan to bring the child into the physician's office today." C. "Monitor the temperature, but not to worry unless it gets above 104° F (40° C)." D. "Keep the child warm and as comfortable as possible."
B
A child is receiving carboplatin as part of a chemotherapy protocol. What would be most important for the nurse to include in the child's plan of care? A. Monitoring for visual changes. B. Maintaining adequate hydration. C. Using prescribed eye drops to prevent conjunctivitis. D. Avoiding administration with food or meals.
B
The nurse is caring for a 9-year-old boy who is having chemotherapy. The nurse is developing a teaching plan for the child and family about nutrition. What instruction would the nurse be least likely to include? A. Emphasizing the intake of grains, fruits, and vegetables. B. Featuring high-fiber foods if opioid analgesics are being taken. C. Concentrating on consuming primarily high-calorie shakes and puddings. D. Avoiding milk products if diarrhea is a problem
C
Alopecia would most affect the body image of a child from which developmental stage? A. Toddler B. Preschool C. School-age D. Adolescence
D
A child with acute lymphoblastic leukemia (ALL) is receiving methotrexate for therapy. Which nursing diagnosis would best apply during therapy? A. Risk for impaired skin integrity related to oral ulcerations associated with chemotherapy B. Risk for impaired mobility related to depressant effects of methotrexate C. Excess fluid volume related to effect of methotrexate on aldosterone secretion D. Risk for self-directed violence related to effect of methotrexate on central nervous system
A
A child with acute lymphoblastic leukemia (ALL) is starting treatment with methotrexate in an attempt to eradicate the leukemic cells. Which stage of therapy is the child undergoing? A. induction stage B. sanctuary stage C. consolidation stage D. delayed intensive-therapy stage
A
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? A. keeping the child pain-free B. managing the symptoms of dyspnea C. providing emotional support D. delivering appropriate developmental care
A
A nurse is counseling parents of a child with leukemia regarding the goals of the chemotherapy program for their child. What should the nurse mention as the first goal? A. complete absence of leukemia cells B. prevention of leukemia cells from invading or growing in the central nervous system C. administration of delayed intensive therapy D. maintenance of the original remission
A
Before administering a chemotherapeutic drug to a 12-year-old child with leukemia, the nurse confirms appropriate medication dosage by which method? A. obtaining data to calculate the child's body surface area B. looking up the dosage from the drug guide C. obtaining current weight in kilograms D. confirming that the child's age is correct on the pharmacy worksheet
A
During a physical examination of a 13-year-old boy, the nurse observes a single, enlarged, rubbery-feeling cervical lymph node in the armpit. The boy also reports unexplained loss of weight and malaise. Which condition should the nurse most suspect in this client? A. Hodgkin lymphoma B. Non-Hodgkin lymphoma C. Acute lymphoblastic leukemia (ALL) D. Acute myeloid leukemia (AML)
A
The family of a terminally ill client is asking about the benefits of hospice care. Which statement by the nurse provides accurate information? A. Hospice is designed to meet the individual client's needs. B. Hospice uses alternative therapies to find a cure for the illness. C. Hospice is a separate care area located within a hospital setting. D. Hospice is designed to focus on supporting families of clients who are ill.
A
The health care provider prescribed an alkylating agent for a child's chemotherapy. Which best describes an action produced by these types of agents? A. They are cell cycle-nonspecific, destroying both resting and dividing cells. B. They damage cells by acting as a substitute for a natural metabolite in an important molecule. C. They are synthesized naturally by various bacterial and fungal agents. D. They are most active in the S phase and act similarly to normal cellular metabolites necessary for cell replication.
A
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? A. administering prescribed broad-spectrum IV antibiotics B. monitoring his vital signs every 4 hours C. restricting visitors with symptoms of infection D. assessing for signs of infection every 8 hours
A
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? A. Monitoring for allergic reactions or anaphylaxis. B. Assessing the child's hydration status secondary to vomiting. C. Monitoring for complaints of bone pain. D. Assessing for signs of capillary leak syndrome.
A
Which intervention is best to use with the 6-year-old who has developed stomatitis as a side effect of chemotherapy? A. Limit foods to cool, clear liquids B. Practice frequent, gentle oral hygiene C. Use lidocaine rinses D. Have the child freely choose desired foods and beverages
B
A child is to receive radiation therapy this morning. The nurse would expect to see which type of drug prescribed to this child? A. analgesic B. antiemetic C. antipyretic D. antineoplastic
B
A child is undergoing a series of diagnostic tests for a suspected malignancy. Which diagnostic test result is only present in Hodgkin disease? A. elevated lymphocytes B. Reed-Sternberg cells C. T-lymphocyte surface markers D. megakaryocyte cells
B
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: A. destroy any remaining cancer cells. B. kill enough cancerous cells to induce remission. C. destroy any residual cancer cells. D. follow up for recurrent disease or late effects.
B
Parents of a 10-year-old have just been informed that their child has stage III cancer. They ask the nurse what this means. What is the nurse's best response? A. "The cancer has spread to other organs." B. "The cancer cells have spread to the lymph nodes." C. "This means that the tumor has not extended into surrounding tissue." D. "This means there is some local spread, but complete surgical removal is possible."
B
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? A. The child has no appetite because of nausea. B. The child has increased urinary output or vomiting. C. The child has redness or swelling at the central venous access site. D. The child has a bruise on the arm.
C
A nurse is reviewing the laboratory test results of a 3-year-old child diagnosed with acute lymphoblastic leukemia (ALL). Which result would the nurse likely find? A. erythrocytosis B. lymphocytopenia C. thrombocytopenia D. polycythemia
C
An experienced nurse is orienting a new nurse to the oncology unit. Which action by the new nurse would require intervention? A. wearing gloves when administering chemotherapy B. washing hands well after administering chemotherapy C. pouring unused chemotherapy medicine into a sink drain D. providing information about nausea, mucositis, and susceptibility to infection
C
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? A. "Don't worry, the health care provider is very good at treating leukemia." B. "I don't blame you for being upset; any parent would be scared too." C. "I know this is scary, but leukemia has a high cure rate in children these days." D. "You are very lucky to have caught it so early; that makes the treatments easier."
C
The nurse is caring for a 5-year-old boy undergoing radiation treatment for a neuroblastoma. Which nursing diagnosis would be most applicable for this child? A. Activity intolerance related to anemia and weakness from medications B. Impaired skin integrity related to desquamation from cellular destruction C. Impaired oral mucosa related to the presence of oral lesions from malnutrition D. Imbalanced nutrition, less than body requirements related to nausea and vomiting
B
The nurse is caring for an 8-year-old girl who has been diagnosed with leukemia and will have a variety of tests, including a lumbar puncture, before beginning chemotherapy. What action would be the priority? A. Applying EMLA to the lumbar puncture site B. Educating the child and family about the testing procedures C. Administering promethazine as ordered for nausea D. Educating the family about chemotherapy and its side effects
B
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? A. earache, stiff neck, or sore throat B. blisters, ulcers, or a rash appear C. temperature of 101°F (38.3°C) or greater D. difficulty or pain when swallowing
C
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)? A. joint pain and swelling B. anorexia and weight loss C. abdominal pain, nausea, and vomiting D. lethargy, bruises, and lymphadenopathy
D
A child with cancer has developed neutropenia and is in isolation with neutropenic precautions. What nursing assessment takes priority for this child? A. infection symptoms B. vital signs C. mucositis D. bleeding
A
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? A. Encourage the adolescent to select hats or wigs to fit one's personality. B. Refer the adolescent to a peer support group. C. Have a Child Life specialist work with the adolescent. D. Support the adolescent's choice of comfortable clothing.
A
An oncology nurse is preparing to administer a chemotherapeutic medication to a 5-year-old child. Which information is most vital to determining the correct dose of medication? A. body surface area B. weight in kilograms C. age in months D. body mass index
A
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? A. painless, enlarged lymph node B. anorexia C. weight loss D. night sweats
A
