Pediatric Cancer NCLEX Questions

"A child is admitted to the hospital with a diagnosis of Wilm's tumor, Stage II. Which of the following statements most accurately describes this stage? "A) The tumor is less than 3 cm. in size and requires no chemotherapy. B) The tumor did not extend beyond the kidney and was completely resected. C) The tumor extended beyond the kidney but was completely resected. D) The tumor has spread into the abdominal cavity and cannot be resected."

"1. Answer: C The staging of Wilm's tumor is confirmed at surgery as follows: Stage I, the tumor is limited to the kidney and completely resected; stage II, the tumor extends beyond the kidney but is completely resected; stage III, residual nonhematogenous tumor is confined to the abdomen; stage IV, hematogenous metastasis has occurred with spread beyond the abdomen; and stage V, bilateral renal involvement is present at diagnosis."

"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 the subjective data, the mother tells the nurse that the child has been eating well and that the activity level of the child is unchanged. The nurse, suspecting the possibility of a Wilm's tumor, would avoid which of the following during the physical assessment? "1. Palpating the abdomen for a mass. 2. Assessing the urine for hematuria 3. Monitoring the temperature for presence of fever 4. Monitoring the blood pressure for presence of hypertension"

"Answer: 1 Rationale: Wilm's tumor is the most common intra-abdominal and kidney tumor of childhood. If Wilm's tumor is suspected, the tumor mass should not be palpated by the nurse. Excessive manipulation can cause the seeding of the tumor and spread of cancerous cells. Fever, hematuria, and hypertension are all clinical manifestations of Wilm's tumor."

"When assessing a child with Wilm's tumor, the nurse should keep in mind that it is most important to avoid which of the following? "A. Measuring the child's chest circumference B. Palpating the child's abdomen C. Placing the child in an upright position D. Measuring the child's occipitofrontal circumference"

"Answer: B. The abdomen of the child with Wilm's tumor should not be palpated because of the danger of disseminating tumor cells. Children with Wilm's tumor should always be handled gently and carefully. Other answers. The child's head and chest measuring will not affect Wilm's tumor. Repositioning a child in the upright position may cause more pain to the child, but priority this is not worse than disseminating tumor cells."

"A 10 year old child with hemophilia A has slipped on the ice and bumped his knee. The nurse should prepare to administer an: "A. injection of factor X B. intravenous infusion of iron C. intravenous infusion of factor VIII D. intramuscular injection of iron using the Z track method"

"CORRECT: C Hemophila refers to a group of bleeding disorders resulting from a deficiency of specific coagulation proteins. the primary meds used are to replace missing clotting factor. Factor VIII will be prescribed intravenously to replace the missing clotting factor and minimize the bleeding,"

"A child is diagnosed with Wilms' tumor. During assessment, the nurse in charge expects to detect: "a. Gross hematuria b. Dysuria c. Nausea and vomiting d. An abdominal mass"

"CORRECT: D The most common sign of Wilms' tumor is a painless, palpable abdominal mass, sometimes accompanied by an increase in abdominal girth. Gross hematuria is uncommon, although microscopic hematuria may be present. Dysuria is not associated with Wilms' tumor. Nausea and vomiting are rare in children with Wilms' tumor."

"A child with cancer has the following lab result: WBC 10,000, RBC 5, and plts of 20,000. When planning this child's care, which risk should the nurse consider most significant? "A. Hemorrage B. Anemia C. Infection D. Pain"

"Correct answer: A Hemorrhage The lab values presented all are normal except for the platelet count. Decreases in platelet counts place the child at greatest risk for hemorrhage."

Which condition assessed by the nurse would be an early warning sign of childhood cancer? 1. difficulty swallowing \ 2. nagging cough or hoarseness 3. slight changes in bowel and bladder function 4. swelling, lumps, masses on body

"Correct: 4. Swelling or lumps or masses anywhere on the body are early warning signs whereas difficulty swallowing or cough or hoarseness are signs of cancer in adults. there may be a marked sign in changes to bowel or bladder function, not a slight change"

A nurse is discussing childhood cancer with the parents of a child in an oncology unit. Which statement by the nurse would be the most accurate? "A. ""The most common site for children's cancer is the bone marrow."" B. ""All childhood cancers have a high mortality rate."" C. ""Children with leukemia have a higher survival rate if they are older than 11 when diagnosed."" D. ""The prognosis for children with cancer isn't affected by treatment strategies."""

"Correct: A. Childhood cancers occur most commonly in rapidly growing tissue, especially in the bone marrow. Mortality depends on the time of diagnosis, the type of cancer, and the age at which the child was diagnosed. Children who are diagnosed between the ages of 2 and 9 consistently demonstrate a better prognosis. Treatment strategies are tailored to produce the most favarable prognosis. (NCLEX-RN Questions & Answers, made Incredibly Easy)"

"David, age 15 months, is recovering from surgery to remove Wilms' tumor. Which findings best indicates that the child is free from pain? "a. Decreased appetite b. Increased heart rate c. Decreased urine output d. Increased interest in play"

"Correct: D Answer D. One of the most valuable clues to pain is a behavior change: A child who's pain-free likes to play. A child in pain is less likely to consume food or fluids. An increased heart rate may indicate increased pain; decreased urine output may signify dehydration."

"A 4-year-old has a right nephrectomy to remove a Wilms tumor. The nurse knows that it is essential to: "A. Request a low-salt diet B. Restrict fluids C. Educate the family regarding renal transplants D. Prevent urinary tract infections"

Answer D is correct. Because the child has only one remaining kidney, it is important to prevent urinary tract infections. Answers A, B, and C are not necessary, so they are incorrect.

A child is diagnosed with Wilms' tumor. In planning teaching interventions, what key point should the nurse emphasize to the parents? "1. Do not put pressure on the abdomen. 2. Frequent visits from friends and family will improve morale. 3. Appropriate protective equipment should be worn for contact sports. 4. Encourage the child to remain active."

Correct answer: 1. Do not put pressure on the abdomen. Palpation of Wilms' tumor can cause rupture and spread of cancerous cells. Frequent visitation might allow the child to be exposed to more infections, and activity and sports are discouraged because of the risk of rupture of the encapsulated tumor.