Prep U

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? "Don't worry, the health care provider is very good at treating leukemia." "I don't blame you for being upset; any parent would be scared too." "I know this is scary, but leukemia has a high cure rate in children these days." "You are very lucky to have caught it so early; that makes the treatments easier."

"I know this is scary, but leukemia has a high cure rate in children these days."

An adolescent is diagnosed with Ewing sarcoma. The adolescent has undergone surgery following a course of chemotherapy and is currently undergoing radiation and additional chemotherapy. Which statement by the family indicates that reteaching is needed? "Our child is looking forward to playing football again." "We will remind our child to care for the skin following radiation." "Our child's friends shaved their heads in solidarity to show their support." "We will watch for signs of infection and report it to our health care provider."

"Our child is looking forward to playing football again."

Parents ask why their child is receiving prednisone to treat leukemia because it is not a chemotherapy drug. Which nursing instruction is most accurate? "Prednisone is excellent for reducing inflammation." "The drug will stimulate the child's appetite." "The medication will promote weight gain." "Prednisone decreases swelling caused by dead or dying cancer cells."

"Prednisone decreases swelling caused by dead or dying cancer cells."

A 9-year-old child with leukemia is scheduled to undergo an allogeneic hematopoietic stem cell transplant. When teaching the child and parents, what information would the nurse include? "We'll need to have a match to a donor." "The risk for rejection is much less with this type of transplant." "You won't need to receive the high doses of chemotherapy before the transplant." "You'll need to have an incision in your hip area to instill the cells."

"We'll need to have a match to a donor."

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? Avoiding further abdominal palpation Performing dressing changes to the affected area Administering analgesics for pain Preparing the child for amputation

Avoiding further abdominal palpation

What is one advantage of an implanted port (central venous access device) that the nurse will explain to an adolescent? No tunneling is needed when the port is inserted. Flushing of the device is not necessary. Body appearance changes very little. No special procedure is necessary for removal.

Body appearance changes very little.

The father of an 8-year-old boy who is receiving radiation therapy is upset that his son has to go through 6 weeks of treatments. He doesn't understand why it takes so long. In explaining the need for radiation over such a long time, what should the nurse mention? Cells are only susceptible to treatment by radiation during certain phases of the cell cycle It is difficult to locate where the cancer cells are in the body, so the entire body must be irradiated Radiation therapy is very weak, and therefore it takes a long time to achieve therapeutic doses Insurance companies typically allow only a short radiation treatment per week, to contain costs

Cells are only susceptible to treatment by radiation during certain phases of the cell cycle

The nurse is assessing a 10-year-old girl with acute lymphoblastic leukemia. What information would lead the nurse to suspect that the cancer has infiltrated the central nervous system? Child reports facial palsy and vision problems Observing petechiae, purpura, or unusual bruising Noting adventitious breath sounds during auscultation Palpation of abdomen reveals enlarged liver and spleen

Child reports facial palsy and vision problems

The nurse is providing care to an adolescent who has been diagnosed with cancer. Which actions would be appropriate for the nurse to take to foster the adolescent's ability to cope? Select all that apply. Encourage the adolescent to engage in usual activities. Encourage the adolescent to make plans for the future. Control the amount of information given to others about the adolescent's condition. Discourage relationships with other adolescents who have cancer Act as an advisor, not a friend, to promote cooperation in the care plan. Encouraging postponing the return to school for as long as possible.

Encourage the adolescent to engage in usual activities. Encourage the adolescent to make plans for the future. Control the amount of information given to others about the adolescent's condition.

A 15-year-old client diagnosed with von Willebrand disease has reached menarche. Based on this fact, what information is most important for the nurse to convey to the client? Bruising may occur in the perineal area. Expect menstrual bleeding to be heavy. Occasional skipped periods can be expected. The duration of each period will be short.

Expect menstrual bleeding to be heavy.

A school-aged child with cancer is receiving chemotherapy. Which nursing action would best promote the oral comfort of a child receiving chemotherapy? Having the child solely eat or drink cold foods to reduce mucosal pain Encouraging the use of acidic fruit juices to decrease mouth organisms Keeping the child's lips moist with petroleum jelly to prohibit cracking Vigorously brushing the teeth and gums to remove secretions

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

Nursing students are reviewing information about childhood cancers. They demonstrate understanding of the information when they identify what as the most frequent type? Wilms tumor Leukemia Brain stem tumor Non-Hodgkin lymphoma

Leukemia

A 15-year-old boy has been diagnosed with an osteosarcoma of the distal femur. He also demonstrates a chronic cough, dyspnea, and chest pain, along with chronic leg pain. Based on these findings, the nurse should suspect metastasis to which body area? Lungs Heart Brain Rib cage

Lungs

A 14-year-old adolescent with Hodgkin disease is experiencing difficulty breathing and is sent for a radiograph. Which finding should the nurse expect to see on the x-ray report? Mediastinal mass Retinoblastoma Lymphadenopathy Tumor in the liver

Mediastinal mass

A high school football player has been diagnosed as having osteosarcoma of the femur. The parents are angry because they told their adolescent not to play football. Which health teaching points will the nurse include in the teaching plan for the adolescent and parents? Osteosarcoma often follows trauma, such as a football injury. There will be some discoloration of the leg following chemotherapy. Football injuries do not contribute to the development of a tumor. Tumor growth is related to the adolescent's dislike of milk.

Osteosarcoma often follows trauma, such as a football injury.

A child diagnosed with hemophilia presents with warm, swollen, painful joints. Which action will the nurse take first? Document the presence of hemarthrosis in the client's chart Notify the client's primary health care provider Assess the client's urine and stool for blood Prepare to administer factor replacement medication

Prepare to administer factor replacement medication

A 5-year-old client has been diagnosed with leukemia and is currently on chemotherapy and radiation. The child is having difficulty due to mucositis. Which is the most appropriate nursing diagnosis for this child? Pain due to neoplastic process in bone Disturbed body image related to loss of hair after chemotherapy Compromised family coping related to long-term chemotherapy regimen Risk for imbalanced nutrition, less than body requirements, related to inflammation

Risk for imbalanced nutrition, less than body requirements, related to inflammation

When developing the postoperative plan of care for a child with sickle cell anemia who has undergone a splenectomy, which would the nurse identify as the priority? Risk for infection Impaired skin integrity Deficient fluid volume Risk for delayed growth and development

Risk for infection

The nurse is talking with a 9-year-old child diagnosed with acute leukemia who will soon begin chemotherapy. The child expresses worry that when her hair falls out friends won't like her or want to play with her anymore. Which response by the nurse would be best? Reassure the child that her hair will grow back in 3 to 6 months. Tell the child that having chemotherapy is the only way she'll get better. Talk with her and her family about wearing a wig, cap, or scarf. Distract the child with a book or educational computer games.

Talk with her and her family about wearing a wig, cap, or scarf.

The nurse is planning care for a school-aged child recovering from being hit by a motor vehicle while riding a bicycle. For what will the nurse assess to determine the onset of disseminated intravascular coagulation (DIC) in this child? blurred vision nausea and vomiting sudden onset of knee pain bleeding from intravenous sites

bleeding from intravenous sites

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? keeping the child pain-free managing the symptoms of dyspnea providing emotional support delivering appropriate developmental care

keeping the child pain-free

The nurse develops a meal plan for a child with iron-deficiency anemia. Which meal would the nurse teach the parent has the highest amount of iron? red meat, eggs, oatmeal, and dried fruit chicken, corn, brown rice, and oranges pork, broccoli, white rice, and strawberries tuna salad with eggs, whole wheat crackers, and blueberries

red meat, eggs, oatmeal, and dried fruit

The nurse is caring for a pediatric client who is scheduled for the surgical removal of a Wilms tumor. Which action is contraindicated in the client's care? Intravenous fluids Abdominal palpation Foley catheter placement Supine positioning

Abdominal palpation

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? The child has no appetite because of nausea. The child has increased urinary output or vomiting. The child has redness or swelling at the central venous access site. The child has a bruise on the arm.

The child has redness or swelling at the central venous access site.