Ch 53: child and adolescent have a malignancy

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23. The school nurse is teaching a group of adolescents about cancer prevention. What information will the nurse include when teaching these adolescents?.

- A. "Human papillomavirus (HPV) vaccines are needed for all genders to prevent cancer." - B. "Do not give in to peer pressure to start smoking." - C. "Use sunscreen any time you are out in the sun."

13. A child being treated for leukemia is diagnosed with neutropenia. What nursing instructions directly prevent client infections?

- A. Avoid large crowds. - B. Inspect the skin daily for scratches or scrapes. - D. Remove house plants, flowers, and goldfish from the home environment. - E. Stay away from people who have obvious colds, rashes, or other infections.

24. A nurse is providing discharge teaching to the parents of a 5-year-old child who has developed neutropenia secondary to chemotherapy. Which statement(s) by the parents indicates the need for additional teaching?

- C. "It is okay if our relatives bring our child plants or flowers to cheer our child up." - D. "We will make sure to give our child plenty of raw fresh fruits and vegetables." - E. "It is okay if we take our child to the movie theater once or twice per month."

4. A child with cancer is receiving vincristine. It is most important to observe this child for which of the following side effects?

A. constipation

22. 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

11. 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

20. The nurse is preparing to send a child with cancer for a radiation treatment. Which medication should the nurse provide to pre-medicate the child for this procedure?

B. Antiemetic

8. The nurse is planning care for a child recovering from neck surgery for rhabdomyosarcoma. Which outcome suggests the best long-term prognosis for this client?

C. The child tolerates chemotherapy provided after complete removal of the neck tumor.

1. A 4-year-old child has developed acute lymphoblastic leukemia (ALL). Nursing care for the child with ALL involves taking axillary, rather than rectal, temperatures because the child:

C. has a low platelet count.

10. 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?

C. thrombocytopenia

12. The nurse is preparing the medication leucovorin to provide to a child who is currently receiving methotrexate for a brain tumor. What should the nurse explain to the child and parents regarding the purpose of this medication?

D. It prevents methotrexate that is not incorporated into leukemia cells from entering normal cells.

21. The nurse is assessing a school-age child with a brain tumor. During morning rounds, the child has an episode of projectile vomiting. What nursing intervention is most helpful?

D. Provide a snack until the breakfast tray arrives.

19. The nurse is preparing to post a sign above the crib of an infant with a Wilms tumor. Which statement should the nurse post immediately?

A. "Do not palpate abdomen."

17. The nurse is completing the health history of a 6-month-old infant with retinoblastoma with the child's parents. Which symptom should the nurse expect that the parents have observed?

A. One pupil appears white.

3. 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

15. The nurse is planning outcomes for an adolescent male diagnosed withHodgkin lymphoma. Which outcome should the nurse use to address feelings of powerlessness with the disease?

A. The client attends recommended appointments.

6. 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?

B. "You may feel pressure on your hip during the procedure."

5. Which symptom would lead the nurse to suspect that a child is developing a common side effect of vincristine?

B. The child says the fingertips feel numb.

25. A 4-year-old child receiving vincristine develops peripheral neuropathy. The parents report that the child continues to struggle with fine motor control and state, "He can't even hold apencil to draw a picture." Which medication would the nurse anticipate being prescribed by the primary care provider?

B. gabapentin

2. Children with acute lymphoblastic leukemia (ALL) may need periodic lumbar punctures. The nurse would teach the parent that this is done to assess for:

B. leukemic cells.

14. The nurse is concerned that a child receiving vincristine is developing an adverse reaction to the medication. What did the nurse most likely assess in the client?

B. numb fingertips

16. The parent of a high school soccer player diagnosed with osteosarcoma of the femur tells the nurse, "I never wanted my child to play soccer in the first place." Which response by the nurse is appropriate?

C. "The recent trauma did not cause the tumor to develop; it just called attention to the problem."

7. A high school football player has been diagnosed as having osteosarcoma of the femur. The parents are angry because they told their son not to play football. Which health teaching points would the nurse include in the teaching plan for the adolescent and his parents?

C. Football injuries do not contribute to the development of a tumor.

9. A school-aged child with cancer is receiving chemotherapy. Which nursing action would best promote the oral comfort of a child receiving chemotherapy?

C. Keeping the child's lips moist with petroleum jelly to prohibit cracking

8. Which diagnosis would be most appropriate for an infant with a large retinoblastoma after surgery?

D. Disturbed sensory perception related to enucleation


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