CANCER REVIEW Q&A

Palpating the abdomen for a mass

The mother of a 4-year old child brings the child to the clinic and tells the pediatric nurse specialist that the child's abdomen seems to be swollen. During further assessment of subjective data, the mother tells the nurse that the child is eating well and that the activity level of the child is unchanged. The nurse, suspecting the possibility of Wilm's tumor, would avoid which of the following during the physical assessment? -Palpating the abdomen for a mass -Assessing the urine for the presence of hematuria -Monitoring the temperature for the presence of fever -Monitoring the blood pressure for the presence of hypertension

Use a soft, small toothbrush for mouth care.

The nurse analyzes the laboratory values of a child with leukemia who is receiving chemotherapy. The nurse notes that the platelet count is 20,000 cells/microliter. Based on this lab finding, which intervention will the nurse document in the plan of care? -Initiate protective isolation precautions. -Monitor the temperature every four hours. -Monitor closely for signs of infection. -Use a soft, small toothbrush for mouth care.

The parents report that their son is vomiting and not eating well.

The nurse is assessing a 3-year old boy whose parents brought him to the clinic when they noticed that the right side of his abdomen was swollen. Which of the following findings would suggest this child has a neuroblastoma? -The child has a maculopapular rash on his palms. -The parents report that their son is vomiting and not eating well. -The parents report that their son is irritable and not gaining weight. -Auscultation reveals wheezing with diminished lung sounds.

Involving the boy in decisions whenever possible

The nurse is caring for a 13-year old boy with acute myelogenous leukemia who is experiencing feelings of powerlessness due to the effects of chemotherapy. Which of the following interventions will best help the teen's sense of control? -Involving the boy in decisions whenever possible -Acknowledging the boy's feelings of anger with the disease -Providing realistic expectations of treatments and outcomes -Recognizing abilities that are unaffected by the disease

"He takes his antibiotic twice a day.

The nurse is educating the parents of a 4-year old boy with a Wilms tumor who is about to have chemotherapy prior to surgery. Which statement by the parents indicates that the nurse should review the instructions about preventing infection? -"He takes his antibiotic twice a day." -"We check his temperature daily." -"We keep him away from crowds." -"He must be clean and his teeth brushed."

Avoiding rectal exams, suppositories, and enemas Placing a mask on the child when outside the room Discouraging fresh flowers in the child's room

The nurse is initiating neutropenic precautions for a child. Which of the following would the nurse most likely include? Select all that apply. -Placing the child in a semiprivate room -Avoiding rectal exams, suppositories, and enemas -Placing a mask on the child when outside the room -Encouraging an intake of raw fruits and vegetables -Discouraging fresh flowers in the child's room

The presence of Reed-Sternberg cells in the lymph nodes

A 12-year old child is seen in a clinic, and a diagnosis of Hodgkin's disease is suspected. Several diagnostic studies are performed to determine the presence of this disease. When evaluating the diagnostic results, a nurse would expect to note which of the following, if this child had Hodgkin's disease? -The presence of blast cells in the bone marrow -The presence of Reed-Sternberg cells in the lymph nodes -The presence of Epstein-Barr virus in the blood -Elevated vanillylmandelic acid urine levels

Cervical Supraclavicular

A 14-year old boy is diagnosed with Hodgkin disease. When palpating for enlarged lymph nodes, the nurse would expect to find which nodes as *most commonly* enlarged? Select all that apply. -Cervical -Axillary -Supraclavicular -Occipital -Inguinal

Bone marrow biopsy

A 4-year old child is admitted to the hospital for abdominal pain. The mother reports that the child has been pale and excessively tired and is bruising easily. On physical examination, lymphadenopathy and hepatosplenomegaly are noted. Diagnostic studies are being performed on the child because acute lymphocytic leukemia is suspected. The nurse understands that which diagnostic study will confirm this diagnosis? -White blood cell count -Lumbar puncture -Bone marrow biopsy -Platelet count

Cool, clear liquids

A child with leukemia is complaining of nausea. A nurse suspects that the nausea is related to the chemotherapy. The nurse, concerned about the child's nutritional status, most appropriately would offer which of the following during this episode of nausea? -The child's favorite foods -Cool, clear liquids -Low-protein foods -Low-calorie foods

"I will take rectal temperatures daily."

A nurse instructs the parents of a child with leukemia regarding measures related to monitoring for infection. Which statement if made by a parent indicates a need for further instructions? -"I will perform proper hand washing techniques." -"I will take rectal temperatures daily." -"I will inspect the skin daily for redness." -"I will inspect the mouth daily for lesions."

Notify the physician.

A nurse is monitoring a child for bleeding following surgery for removal of a brain tumor. The nurse checks the head dressing for the presence of blood and notes colorless drainage on the back of the dressing. Which of the following would be the most appropriate nursing intervention? -Circle the area of drainage and continue to monitor. -Reinforce the dressing. -Notify the physician. -Document the findings and continue to monitor.

Painless, firm, and movable adenopathy in the cervical area

A nurse is performing an assessment on a 10-year old child suspected of having Hodgkin's disease. The nurse understands that which data are most characteristic of this disease? -Painful, enlarged inguinal lymph nodes -Fever and malaise -Painless, firm, and movable adenopathy in the cervical area -Anorexia and weight loss

The presence of a Reed-Sternberg cell is found on biopsy

A pediatric nurse clinician is discussing the pathophysiology related to childhood leukemia with a class of nursing students. Which statement made by a nursing student indicates a lack of understanding of the pathophysiology of the disease? -Normal bone marrow is replaced by blast cells -Red blood cell production is affected -The platelet count is decreased -The presence of a Reed-Sternberg cell is found on biopsy

A renal tumor

A pediatric nurse is assigned to care for a child with a diagnosis of Wilm's tumor. In planning care for the child, the nurse understands that this tumor is -An abdominal tumor -A renal tumor -A brain tumor -A bone tumor

"The child does not experience pain at the primary tumor site."

A pediatric nurse specialist provides a teaching session to the nursing staff regarding osteogenic sarcoma. Which statement by a member of the nursing staff indicates a need for clarifying the information presented? -"The symptoms of the disease in the early stage are almost always attributed to normal growing pains." -"The femur is the most common site of this sarcoma." -"Limping, if a weight-bearing limb is affected, is a clinical manifestation." -"The child does not experience pain at the primary tumor site."