Peds Final - Oncology

Leukemia

Nursing students are reviewing information about childhood cancers. They demonstrate understanding of the information when they identify what as the most frequent type?

"The cancer cells have spread to the lymph nodes."

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?

Mediastinal mass

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?

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.

Lungs

A 15-year-old boy has been diagnosed with an osteogenic sarcoma 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?

"Let your child continue to attend preschool as much as possible."

A 3-year-old who has been attending preschool has been diagnosed with leukemia. The caregivers of this child ask the nurse what they can do to help their child feel secure. Which recommendation could the nurse make to these caregivers that would be helpful in making the child feel secure?

graft-versus-host disease

A child has undergone a hematopoietic stem cell transplant. When assessing the child, the nurse notes the development of a maculopapular rash on the child's palms and bottoms of the feet. Which condition would the nurse suspect?

Use mild soap and nonscented moisturizer.

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?

kill enough cancerous cells to induce remission.

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:

Allowing the teen to completely participate in decisions

A nurse is caring for a teen who is in the end stage of cancer. Which of the following nursing interventions provides self-esteem and self-worth to the teen?

complete absence of leukemia cells

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?

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

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?

"Palliative care can coexist with other treatment that is focused on a cure, stabilization of a disease process or prolongation of life."

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?

Children's cancers, unlike those of adults, often are detected accidentally, not through screening.

A nursing student compares and contrasts childhood and adult cancers. Which statement does so accurately?

headache, vision changes, and vomiting

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?

The most common site is the distal femur. The lungs are a common site of metastasis.

A treatment team meeting is focused on care of children with bone tumors. The nurse is most correct to identify which characteristics anticipated in a client diagnosed with osteogenic sarcoma? Select all that apply.

Hospice is designed to meet the individual client's needs.

The family of a terminally ill client is asking about the benefits of hospice care. Which statement by the nurse provides accurate information?

They are cell cycle-nonspecific, destroying both resting and dividing cells.

The health care provider prescribed an alkylating agent for a child's chemotherapy. Which best describes an action produced by these types of agents?

sibling jealousy.

The nurse is admitting an 8-year-old client diagnosed with a metastatic brain tumor. When the client's 5-year-old sibling becomes loud and distracting, the nurse identifies this behavior as:

Observation reveals nystagmus and head tilt.

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?

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. What finding would suggest this child has a neuroblastoma?

Stop the infusion.

The nurse is caring for a child who is receiving peripheral intravenous (IV) chemotherapy. The child tells the nurse that the IV "hurts." The nurse finds that the insertion site is reddened and edematous. Which is the first action the nurse should take?

Explain to the sister that her sibling's conditioned has worsened in simple terms and ask the sister if she has any questions.

The nurse is caring for the family of a terminally ill child whose condition has rapidly deteriorated. The sister of the patient is in the hall upset and confused over the change in status. Which of the following nursing interventions is most beneficial to the sibling at this time?

fever with no response to repeated antibiotics

The nurse is meeting with a parent and child at the pediatric clinic. Which statement made by the parent during the history would alert the nurse that there might be a possible malignancy in the child?

urine catecholamines VMA, HVA

The nurse is preparing a child for diagnostic testing because neuroblastoma is suspected. The nurse would most likely prepare the child for which testing?

medulloblastoma

The nurse is preparing a presentation for a parent group about childhood cancers, focusing on brain tumors in children. What would the nurse describe as the most common type of brain tumor?

Urine catecholamine metabolites, homovanillic acid (HVA), and vanillylmandelic acid (VMA)

The nurse is preparing clients for diagnostic testing for cancer. Which test is used to differentiate a neuroblastoma from other tumors?

temperature of 101°F (38.3°C) or greater

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?

The children's stages of growth and development

The nurse is working with a family whose daughter is dying of a brain tumor. When addressing the situation with the child's siblings, the nurse should prioritize what consideration?

Assure the parents that expert care of their child will continue.

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?

Accept the parents' anger and respond with empathy and acceptance.

The parents of a child with a malignancy disagree with each other about the treatment plan, then express frustration at the staff for not answering call lights quickly enough. Which nursing intervention will best address their needs?

Ewing Sarcoma

The pediatric nurse examines the radiographs of a client that indicate lesions on the bone. This finding is indicative of:

No routine live vaccines are administered while on chemotherapy.

The pediatric nurse is explaining to a new graduate nurse the differences in planning well-child maintenance for a child with cancer. Which statement by the new nurse demonstrates understanding of the teaching?

vaccine against human papillomavirus (HPV)

The school nurse is providing information to parents of adolescents about prevention of cervical cancer. Which information is included in the teaching?

Administering the measles, mumps, rubella (MMR) vaccine

The toddler with a cancer diagnosis is seen for a well-child checkup. Which health maintenance activity will the nurse exclude?

prognosis of cancer family's coping strategies prevention and alleviation of pain monitoring for side effects of treatment stage of grief of child, parents, and siblings

What are important considerations when the nurse is planning care for the family of a child with cancer? Select all that apply.

Protect the abdomen from manipulation.

What is the priority action the nurse should take when caring for a child newly diagnosed with Wilms tumor (nephroblastoma)?

Disturbed sensory perception related to enucleation

Which diagnosis would be most appropriate for an infant with a large retinoblastoma after surgery?

Practice frequent, gentle oral hygiene

Which intervention is best to use with the 6-year-old who has developed stomatitis as a side effect of chemotherapy?

The child says the fingertips feel numb.

Which symptom would lead the nurse to suspect that a child is developing a common side effect of vincristine?

alkylating agent

After teaching a group of nursing students about chemotherapy agents used in treatment cancer, the instructor determines that the teaching was successful when the students identify cisplatin as which type of drug?

Encourage the adolescent to select hats or wigs to fit one's personality.

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?

leukemic cells.

Children with acute lymphoblastic leukemia (ALL) may need periodic lumbar punctures. The nurse would teach the parent that this is done to assess for:

Hodgkin lymphoma

During a physical examination of a 13-year-old boy, the nurse observes a single, enlarged, rubbery-feeling cervical lymph node in the armpit. The boy also reports unexplained loss of weight and malaise. Which condition should the nurse most suspect in this client?

Call it a tumor of muscle tissue

How can the nurse most simply describe for distressed parents a rhabdomyosarcoma that has been found in their 5-year-old?

keeping the child pain-free

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?

The child has a low platelet count.

The nurse is caring for a 4-year-old child with acute lymphoblastic leukemia (ALL). Why should the nurse assess this child's temperature using the axillary route instead of a rectal temperature?

Monitor vital signs. Monitor for arrhythmias. Notify the health care provider if the child reports muscle cramps.

The nurse is caring for a child with tumor lysis syndrome. What intervention(s) will the nurse include in the plan of care? Select all that apply.

Teaching the child that death is not punishment.

The nurse is caring for a preschool-age child who is receiving palliative care for end-stage cancer. What would be the focus of age-appropriate interventions for this child?

allopurinol

What would the nurse expect to be ordered for a child with acute lymphoblastic leukemia who develops tumor lysis syndrome?

Focusing on the family as the unit of care.

When providing care to a dying child and his family, which would be most important?

lethargy, bruises, and lymphadenopathy

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)?

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

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?

Antiemetic

A child is to receive radiation therapy this morning. The nurse would expect to see which type of drug prescribed to this child?

constipation

A child with cancer is receiving vincristine. It is most important to observe this child for which of the following side effects?

Avoiding further abdominal palpation

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?

Explain that death is possible and offer curative and palliative care together.

A patient and family have just been told that the child has a malignant brain tumor that appears inoperable. Which of the following nursing interventions would be most beneficial to this family and patient?

"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."

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.

Reed-Sternberg cells

A child is undergoing a series of diagnostic tests for a suspected malignancy. Which diagnostic test result is only present in Hodgkin disease?

Impaired skin integrity related to desquamation from cellular destruction

The nurse is caring for a 5-year-old boy undergoing radiation treatment for a neuroblastoma. Which nursing diagnosis would be most applicable for this child?

painless, enlarged lymph node

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?

Acute lymphoblastic leukemia (ALL)

When reviewing information about the incidence of the various types of childhood cancer, nursing students demonstrate understanding of the information when they identify which type as having the highest incidence?

induction

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:

"I will report this to the pediatrician."

Parents tell the nurse who is admitting their infant for a well-child exam that they recently saw a "white glow" in their child's left pupil. What is the nurse's best response?

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

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?

administering prescribed broad-spectrum IV antibiotics

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?

Positioning the child on the unaffected side

A child underwent surgery for removal of an astrocytoma. What would be most appropriate to include in the plan of care?

infection symptoms

A child with cancer has developed neutropenia and is in isolation with neutropenic precautions. What nursing assessment takes priority for this child?

monitoring serum chemistry levels managing electrolytes using oral and IV solutions specific to electrolyte needs administering allopurinol or rasburicase to reduce uric acid production monitoring intake and output; providing dialysis if renal failure occurs

A child with stage III rhabdomyosarcoma develops tumor lysis syndrome. Which actions would be appropriate to include when providing care to this child? Select all that apply.