Oncologic Disorders PREPU
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?
"I know this is scary, but leukemia has a high cure rate in children these days."
The toddler with a cancer diagnosis is seen for a well-child checkup. Which health maintenance activity will the nurse exclude?
Administering the measles, mumps, rubella (MMR) vaccine
A client and family have just been told that the child has a malignant brain tumor that appears inoperable. Which nursing intervention would be most beneficial to this family and client?
Explain that death is possible and offer curative and palliative care together.
When providing care to a dying child and his family, which would be most important?
Focusing on the family as the unit of care.
A nurse is giving instructions to the father of a boy who is receiving chemotherapy (including methotrexate) regarding how best to care for the boy during this period of treatment. What should the nurse mention to him?
Keep him away from people with known infections.
A mother contacts the oncology nurse concerned about the redness and tenderness of her child's skin following radiation treatments. What is the nurse's best response?
Use mild soap and nonscented moisturizer.
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?
"The cancer cells have spread to the lymph nodes."
A child is in treatment for cancer and has been experiencing pain. The nurse is talking with the parents about assisting with pain management using distraction. Which statement(s) indicates an understanding of the information provided? Select all that apply.
"The underlying principle of distraction is focusing on stimuli other than the pain being experienced." "Using media such as TV or movies can be a distraction technique." "Some people may find singing or counting a good form of distraction."
The nurse is preparing to send a child with cancer for a radiation treatment. Which medication should the nurse provide to premedicate the child for this procedure?
Antiemetic
The parents of a 9-year-old girl who is dying from cancer are distraught and guilt-ridden when they find that treatment is no longer successful. What is the best way for the nurse to respond?
Assure the parents that expert care of their child will continue.
How can the nurse most simply describe for distressed parents a rhabdomyosarcoma that has been found in their 5-year-old?
Call it a tumor of muscle tissue
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?
Encourage the adolescent to select hats or wigs to fit one's personality.
The nurse is assessing a 3-year-old boy whose mother reports that he is listless and has been having trouble swallowing. Which finding suggests the child may have a brain tumor?
Observation reveals nystagmus and head tilt.
Which intervention is best to use with the 6-year-old who has developed stomatitis as a side effect of chemotherapy?
Practice frequent, gentle oral hygiene
What is the priority action the nurse should take when caring for a child newly diagnosed with Wilms tumor (nephroblastoma)?
Protect the abdomen from manipulation.
A child is undergoing a series of diagnostic tests for a suspected malignancy. Which diagnostic test result is only present in Hodgkin disease?
Reed-Sternberg cells
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 redness or swelling at the central venous access site.
The nurse is preparing clients for diagnostic testing for cancer. Which test is used to differentiate a neuroblastoma from other tumors?
Urine catecholamine metabolites, homovanillic acid (HVA), and vanillylmandelic acid (VMA)
Wilms tumor is suspected in a 5-year-old child. Which action would be avoided?
abdominal palpation
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?
administering prescribed broad-spectrum IV antibiotics
A nurse is caring for a teenager who is in the end stage of cancer. Which of the following nursing interventions provides self-esteem and self-worth to the teen?
allowing the teenager to completely participate in decisions
A child is to receive radiation therapy this morning. The nurse would expect to see which type of drug prescribed to this child?
antiemetic
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?
complete absence of leukemia cells
A school nurse is teaching a group of parents about signs and symptoms of cancer in children. Which symptom is an early sign of a brain tumor?
headache, vision changes, and vomiting
A child is scheduled for chemotherapy as treatment for leukemia. As the nurse is collaborating with another colleague, the discussion turns to the client's first phase of chemotherapy. This phase is known as:
induction.
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
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:
kill enough cancerous cells to induce remission.
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)?
lethargy, bruises, and lymphadenopathy
Children with acute lymphoblastic leukemia (ALL) may need periodic lumbar punctures. The nurse would teach the parent that this is done to assess for:
leukemic cells.
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
The nurse is preparing a presentation for a parent group about childhood cancers, focusing on brain tumors in children younger than 14 years. Which type of tumor will the nurse include as one of the most common types in that age group?
medulloblastoma
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?
painless, enlarged lymph node
An experienced nurse is orienting a new nurse to the oncology unit. Which action by the new nurse would require intervention?
pouring unused chemotherapy medicine into a sink drain
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?
temperature of 101°F (38.3°C) or greater
The nurse is working with a family whose daughter is dying of a brain tumor. When addressing the situation with the child's sibling, the nurse should prioritize what consideration?
the sibling's stages of growth and development
A child with cancer is to start chemotherapy. The nurse wishes to assess the psychosocial status of the child and the family. Which therapeutic communication technique would be best for the nurse to use?
using broad openings
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
A nursing student asks one of the nurses on the unit, "What exactly is palliative care?" Which response by the nurse would be most accurate?
"Palliative care can coexist with other treatment that is focused on a cure, stabilization of a disease process, or prolongation of life."