ch-48
A pediatric oncology patient has developed a nose bleed. Which finding would account for this occurrence? A. Increased white blood cell count B. Increased neutrophils C. Decreased hemoglobin and hematocrit D. Decreased platelet count
d
A preschool-age child undergoing chemotherapy experiences nausea and vomiting. Which of the following would be the best intervention to include in the child's plan of care? a. Administer tube feedings. b. Offer small, frequent meals. c. Offer fluids only between meals. d. Allow the child to choose what to eat for meals.
d
An example of a disease process that is based on a "two-hit" hypothesis leading to a cancer diagnosis is: A. Fanconi anemia. B. Wiskott Aldrich syndrome. C. Klinefelter syndrome. D. Retinoblastoma.
d
Chemotherapy dosage is frequently based on total body surFace area (BSA), so it is important for the nurse to do which of the following before administering chemotherapy? A. Measure abdominal girth B. Calculate BMI C. Ask the client about his/her height and weight D. Weigh and measure the client on the day of medication administration
d
In taking care of a pediatric oncology patient, which diagnostic finding would indicate a critical concern for the development of bleeding? A. Absolute neutrophil count of 1000 mm3 B. Temperature of 99.2° F C. White blood cell count 18,000 mm3 D. Platelet count 50,000 mm3
d
The nurse is completing a care plan for a client diagnosed with leukemia. Which independent problem should be addressed? A. Infection. B. Anemia. C. Nutrition. D. Grieving.
d
The mother of a 5-year-old child asks the nurse questions regarding the importance of vigilant use of sunscreen.Which information is most important for the nurse to convey to the mother? a.) Appropriate use of sunscreen decreases the risk of skin cancer. b.) Repeated exposure to the sun causes premature aging of the skin. c.) A child's skin is delicate, and burns easily. d.) In addition to causing skin cancer, repeated sun exposure predisposes the child to other forms of cancer.
A
Which statement, if made by a nurse to the parents of a child with leukemia, indicates an understanding of teaching related to home care associated with the disease? a. "Your son's blood pressure must be taken daily while he is on chemotherapy." b. "Limit your son's fluid intake just in case he has central nervous system involvement." c. "Your son must receive all of his immunizations in a timely manner." d. "Your son's temperature should be taken frequently."
d
Which finding if observed would warrant intervention regarding the administration of an antiemetic in a chemotherapy protocol for a pediatric patient? A.Providing the medication on a scheduled basis regardless of the patient's clinical symptoms. B. Administering the medication via the parenteral route prior to infusion of chemotherapy protocol. C. Providing medication with sips of water following clinical symp- toms of nausea and/or vomiting. D.Administering 30 to 60 minutes prior to initiation of therapy.
c
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
d
A child is undergoing remission induction therapy to treat leukemia. Allopurinol is included in the regimen. The main reason for administering allopurinol as part of the client's chemotherapy regimen is to: a. Prevent metabolic breakdown of xanthine to uric acid b. Prevent uric acid from precipitating in the ureters c. Enhance the production of uric acid to ensure adequate excretion of urine d. Ensure that the chemotherapy doesn't adversely affect the bone marrow"
a
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. Hemorrhage B. Anemia C. Infection D. Pain
a
A child with lymphoma is receiving extensive radiotherapy. Which of the following is the most common side effect of this treatment? A. Malaise B. Seizures C. Neuropathy D. Lymphadenopathy
a
A diagnostic workup is being performed on a 1-year-old child with suspected neuroblastoma. The nurse reviews the results of the diagnostic tests and understands that which of the following findings is most specifically related to this type of tumor? A. Elevated vanillylmandelic acid (VMA) urinary levels B. Presence of blast cells in the bone marrow C. Projectile vomiting, usually in the morning D. Postive Babinski's sign"
a
A nurse is teaching a client about the risk factors associated with colorectal cancer. The nurse determines that further teaching related to the colorectal cancer is necessary if the client identifies which of the following as an associated risk factor? A. Age younger than 50 years B. History of colorectal polyps C. Family history of colorectal cancer D. Chronic inflammatory bowel disease"
a
The nurse notes that a child's gums bleed easily and he has bruising and petechiae on his extremities. What laboratory values are consistent with these symptoms? a. Platelet count of 19,000/mm3 b. Prothrombin time of 11 to 15 seconds c. Hematocrit of 34 d. Leukocyte count of 14,000/mm3
a
Which nursing intervention should not be included in the post- operative plan of care for a child undergoing surgery for a brain tumor? a. Place the child in Trendelenburg position. b. Perform neurologic assessments. c. Assess dressings for drainage. d. Monitor temperature.
a
What should the nurse recognize as symptoms of a brain tumor in a school-age child for whom she is caring? (Select all that apply.) a. Blurred vision b. Increased head circumference c. Vomiting when getting out of bed d. Intermittent headache e. Declining academic performance
a, c, d, e
A 15-year-old has been admitted to the hospital with the diagnosis of acute lymphocytic leukemia. Which of the following signs and symptoms require the most immediate nursing intervention? A. Fatigue and Anorexia B. Fever and Petechiae C. Swollen lymph nodes in the neck and lethargy. D. Enlarged liver and spleen
b
A 9-year old child with leukemia is in remission and has returned to school. The school nurse calls the mother of the child and tells the mother that a classmate has just been diagnosed with chick- enpox. The mother immediately calls the clinic nurse because the leukemic child has never had chickenpox. The appropriate response by the clinic nurse to the mother is: A. There is no need to be concerned. B. Bring the child into the clinic for a vaccine. C. Keep the child out of school for 2 week period. D. Monitor the child for an elevated temperature, and call the clinic if this happens.
b
A pediatric oncology patient is undergoing chemotherapy. Which observation would lead the nurse to suspect that the patient has developed sterile hemorrhagic cystitis? A. Absence of hematuria B. Presence of proteinuria C. Complaints by the patient that it burns upon urination D. Increased sensation of thirst.
b
A pediatric patient has been diagnosed with leukemia and pre- sents with a white blood cell (WBC) count of 80,000 mm3. Which statement if provided by a nursing student indicates that additional teaching is needed with regard to pathophysiological mechanisms of leukemia? A. The increase in WBC provides protection against bacterial infections. B. Although the WBC count is elevated, there are increased blast cells which help to protect the patient against infection. C. The amount of white blood cells is greatly increased, which affords protection against viral infections. D. Increases in white blood cells are expected but associated with a low leukocyte count.
b
A preschool-aged child is to undergo several painful procedures. Which of the following techniques is most-appropriate for the nurse to use in preparing the child? A. Allow the child to practice injections on a favorite doll. B. Explain the procedure in simple terms. C. Allow a family member to explain the procedure to the child. D. Allow the child to watch an educational video.
b
After a client is admitted to the pediatric unit with a diagnosisof acute lymphocytic leukemia, the laboratory test indicates that the client is neutropenic. The nurse should perform which of the following? a. Advise the client to rest and avoid exertion b. Prevent client exposure to infections c. Monitor the blood pressure frequently d. Observe for increased bruising
b
The pediatric nurse understands that the most common cancer found in children is: A. Non-hodgkin's lymphoma B. Acute lymphocytic leukemia C. Chronic lymphocytic leukemia D. Ewing's sarcoma"
b
A school-age child is being seen in the oncology clinic for possible Hodgkin's disease. During the course of the nursing assessment, which findings would be expected? Select all that apply. a) fever. b) painless cervical nodes. c) painful cervical nodes. d) poor appetite. e) complaints of night sweats"
b, d
A child with a brain tumor is undergoing radiation therapy. What should the nurse include in the discharge instructions to the child's parents? (Select all that apply.) a. Apply over-the-counter creams to the area daily b. Avoid excessive skin exposure to the sun. c. Use a washcloth when cleaning the area receiving radiation. d. Plan for adequate rest periods for the child. e. A darkening of the skin receiving radiation is expected.
b, d, e
A child being treated for Acute Lymphocytic Leukemia (ALL) has a white blood cell (WBC) count of 7,000/mm3. the nursing care plan lists risk for infection as a priority nursing diagnosis, and measures are being taken to reduce the child's exposure to infection. the nurse determines that the plan has been successful when which outcome has been met? A. child's WBC count goes up. B. child's WBC count goes down. C. child's temperature remains within normal range. D. parents demonstrate good hand washing technique."
c
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.
c
A client is admitted to the hospital for a colon resection and in preparation for surgery the physician orders neomycin. The nurse understands the main reason why this antibiotic is especially useful before colon surgery is because it: A. Will not affect the kidneys B. Acts systemically without delay C. Has limited absorption from the GI tract. D. Is effective against many different organisms
c
A nurse determines that parents understood the teaching from the pediatric oncologist if the parents indicate that which test confirms the diagnosis of leukemia in children? a. Complete blood cell count (CBC) b. Lumbar puncture c. Bone marrow biopsy d. Computed tomography (CT) scan
c
A pediatric oncology patient has been discharged home following a course of chemotherapy. Which information should be included as part of discharge planning with regard to health promotion? A. No further treatments are needed and the patient can resume routine health assessments as developmentally appropriate. B. There are no restrictions based on activity and/or contacts with friends and family members. C. Certain restrictions will be in place related to immunizations that can be administered. D. The patient should limit fluid intake for several months in order to prevent over hydration from occurring.
c
Administration of colony stimulating agents for the pediatric oncology patient are used to: A.decrease nausea. B. shrink tumor size. C. increase bone marrow response. D. decrease production of stem cells.
c
Children with non-Hodgkin lymphoma are at risk for complications resulting from tumor lysis syndrome (TLS). The nurse should assess for: a. Liver failure b. CNS deficit c. Kidney failure d. Respiratory distress
c
The nurse should base a response to a parent's question about the prognosis of acute leukemia (ALL) on the knowledge that: a. Leukemia is a fatal disease, although chemotherapy provides increasingly longer periods of remission. b. Research to find a cure for childhood cancers is very active. c. The majority of children go into remission and remain symptom free when treatment is completed. d. It usually takes several months of chemotherapy to achieve a remission.
c
A nurse analyzes the lab values of a child with leukemia who is receiving chemotherapy. The nurse notices that the platelet count is 19,500 cell/mm3. Based on this lab value which intervention would the nurse document in her plan of care. A. Monitor closely for signs of infection. B. Temp every four hours. C. Isolation precautions D. Use a small toothbrush for mouth care"
d
You are working with the parents of a pediatric oncology patient who has successfully responded to therapy but is now expe- riencing body image changes as a result of hair loss due to chemotherapy regimen. The parents are upset about this change in their child's appearance. Which response would be appropriate with regard to the parent's concern? A. As the therapy has been successful, it is important to focus on that rather than body image changes. B. Tell the parents that the child's hair will grow back soon. C. Tell the parents that the child's hair will grow back stronger and healthier. D. Acknowledge the parent's concern and focus on available options that may be used to help with body image concerns.
d
