Cancer Practice Q's

Which intervention would be included in the preparation of a 9-year-old child undergoing infratentorial craniotomy?

*Having the child draw a picture of a brain and briefly clarifying misconceptions*

A teenager diagnosed with osteosarcoma is to have the affected leg amputated. Which should promote psychological adjustment and early function immediately after surgery?

*Helping the patient adjust to the temporary prosthesis*

Which education about cranial radiation would the nurse provide to the parents of a child with leukemia?

*Helps prevent CNS involvement*

Which provider prescription would the nurse question for a young child with a tentative diagnosis of Wilms tumor?

*Renal biopsy* -Invasive procedure, in salt stages the tumor is encapsulated -MRI, CT, and abdominal U/S are helpful with diagnosis

The nurse palpates a heavy, hard mass on the lateral aspect of the testis. Which treatment is contraindicated for this condition?

*Testicular biopsy* -It can spread malignant cells and worsen disease -*Radical inguinal orchiectomy* is the preferred treatment -At risk for testicular cancer = infertility, cryptorchidism, Klinefelter syndrome

An adolescent who is undergoing chemotherapy for the treatment of bone cancer has stomatitis as a result. Which would the nurse include when teaching the child about self-care?

-Clean teeth with a swab -Drink fluids through a straw -Avoid foods served at extremes of temperature

Which clinical manifestation would the nurse expect in a 3-year-old child newly diagnosed with a Wilms tumor?

*Abdominal swelling* -Nephroblastoma is first observed as a firm, painless intrabdomninal mass located on one side of the abdomen -DO NOT PALPATE THE ABDOMEN

Which S&S would the nurse expect when assessing a 4-year-old child with newly diagnosed acute lymphocytic leukemia?

*Anorexia and petechiae* -Anorexia from the catabolic alterations of metabolism -Bone marrow depression results in bleeding -Child with be lethargic and sleepy due to low RBC

An adolescent girl is concerned about her body image after amputation of a leg for bone cancer. After the nurse has obtained consent, which action is the most therapeutic?

*Encouraging her peers to visit* -Peer acceptance is crucial during this period

Which interventions would the nurse implement to prevent infection in a preschool child with acute non lymphoid leukemia who is admitted with fever and neutropenia?

*Placing the child in a private room, restricting ill visitors, and using strict hand washing*

A child is to be discharged home on a protocol that includes severe antineoplastic medications. Which would the nurse plan to teach their parents?

*Notify the HCP if the child has a temperature of 100 degrees to obtain an antibiotic prescription*

A child is undergoing chemo to treat a neuroblastoma, stage IV, and had his first chemo session last week. He arrives with his mother for this week's session. How would the nurse greet the child?

*"How did you feel after your last treatment"*

The parents of a 4-year-old child with newly diagnosed acute lymphoblastic leukemia express confusion over the care plan. Which response would the nurse provide?

*"Maybe you could talk with your HCP about getting a second opinion from a leukemia specialist"*

An adolescent is admitted with a tentative diagnosis of bone tumor of the left femur. During the admission procedure the adolescent casually asks, "Do they ever have to cut off a leg if someone has bone cancer?" How would the nurse respond?

*"Sometimes it's necessary. What do you think about that treatment?"*

Which response would the nurse provide the parents of a dying child when they ask about the DNR orders?

*"The final decision must be made by you and your practitioner, but it's important to talk about"*

Which diagnostic test report will the nurse review for confirmation of a client's suspected brain tumor?

*CT*

Which clinical findings would the nurse anticipate when assessing a child newly diagnosed with acute lymphoblastic leukemia?

-Pallor (from anemia) -Fatigue (from anemia) -Multiple bruises (from thrombocytopenia)

The father of a child who is dying of cancer asks the nurse whether he should tell his 7-year-old son that his sister is dying. What is the most appropriate response by the nurse?

*"Your son probably doesn't;t understand death as we do but fears it just the same. He should be told the truth to let him prepare fr his sister's death"*

An adolescent with terminal cancer tells the home care nurse, "I'd really like to get my GED. Do you think that is possible?" Which is the best approach to the adolescent's question?

*Arranging a conference with the school and encouraging the adolescent to prepare for the test*

A child with leukemia is to continue taking prednisone at home. The nurse discovers that the child's sibling has chickenpox. Which is the nurse's priority concern?

*Chickenpox can be fatal to individuals with leukemia* -No pox vaccine either

Which education would the nurse provide the parents of a preschool-aged child with leukemia who is undergoing chemo and is susceptible to rectal ulcerations?

*Clean the child's perianal area after each bowel movement*

Which regimen would be included in the skin care of a child undergoing radiation for a brain tumor?

*Cleansing the head with water*

The parents of a 4-year-old child with newly diagnosed acute lymphocytic leukemia blame themselves for not seeking care sooner after notching changed in their child's behavior and the "black and blue" marks. Which response would the nurse provide based on the patho of leukemia and the typical diagnostic process?

*Early S&S of leukemia are similar to those of other mild childhood illnesses*

A child is prescribed dactinomycin and doxorubicin therapy after a nephrectomy for Wilms tumor. Which intervention would the nurse include in the plan of care?

*Ensuring meticulous oral hygiene*

The nurse is caring for a 15-year-old client who is undergoing chemotherapy for leukemia. Which would the nurse recognize that adolescents with health problems are most concerned about?

*Feeling different regarding changes in body image*

Which method would the nurse use to measure the temperature of a 4-year-old child with leukemia who has mucositis?

-Infrared, tympanic -Temporal artery -NO rectal, oral, ear-based (controversial in reliability) -Oral is accurate otherwise