Retinoblastoma, Wilm's tumor, Neuroblastoma

A nurse is conducting a staff in-service on childhood cancers. Which is the primary site of osteosarcoma? a. Femur b. Humerus c. Pelvis d. Tibia

A

An adolescent with osteosarcoma is scheduled for a leg amputation in 2 days. The nurses approach should include which action? a. Answering questions with straightforward honesty b. Avoiding discussing the seriousness of the condition c. Explaining that, although the amputation is difficult, it will cure the cancer d. Assisting the adolescent in accepting the amputation as better than a long course of chemotherapy

A

A neutropenic child is admitted to the hospital and placed in protective isolation. Which instruction does the nurse give the family to help maintain a safe environment for the child? a. Do not let the child have chewing gum b. Flowers, plants, and produce are not allowed c. The child can only have one visitor at a time d. Toys and items from home cannot be brought in

B

A nurse assesses a toddler using the FLACC score. The child is kicking and crying steadily. The mother is upset, as she is unable to console the child. Which action by the nurse is most appropriate? a. Administer acetaminophen (Tylenol). b. Give a dose of morphine (Duramorph). c. Play soothing, quiet music. d. Prepare a dose of propofol (Diprovan).

B

A nurse is caring for a child who is scheduled to have intrathecal chemotherapy today. Which action by the nurse is most important when providing care to this patient and family? a. Educating family on side effects of chemotherapy b. Ensuring a signed consent is on the chart c. Providing distraction techniques during the process d. Reassuring the child the parents will be present

B

A pediatric nurse specialist provides a teaching session to the nursing staff regarding osteogenic sarcoma. Which statement by a member of the nursing staff indicates a need for clarification of the information presented? A. "The femur is the most common site of this sarcoma." B. "The child does not experience pain at the primary tumor site." C. "Limping, if a weight-bearing limb is affected, is a clinical manifestation." D. "The symptoms of the disease in the early stage are almost always attributed to normal growing pains."

B

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

A

A child has been admitted with a paraspinal Ewings sarcoma. The nursing instructor questions the student about assessing for signs of spinal cord compression. Which manifestations does this include? (Select all that apply.) a. Burning pain down the legs b. Difficulty with swallowing c. Foot drop, causing a limp d. Respiratory depression e. Weakness in the hands

A,C,E

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

A child has been cured of retinoblastoma. When the parents ask how long monitoring for bone-related complications of radiation therapy should continue, which is the most appropriate response by the nurse? a. After 5 years, you can stop worrying about this b. Cancers of the bone can occur up to 15 years later c. Probably all complications will occur within 3 years d. Radiation complications do not occur in bones

B

A child is being discharged after surgical resection of a retinoblastoma with enucleation. Which discharge instruction is most important based on the diagnosis? a. Encouraging healthy eating b. Irrigation of the surgical site c. Monitoring the childs temperature d. Pain assessment and control

B

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? A. Palpating the abdomen for a mass. B. Assessing the urine for hematuria C. Monitoring the temperature for presence of fever D. Monitoring the blood pressure for presence of hypertension

B

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

B

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 child is receiving chemotherapy. The nurse assesses the childs oral cavity and notes the following: raspy voice, thick saliva, and debris on the teeth. Which action by the nurse is the most appropriate? a. Have the child use commercial mouthwash. b. Hold the next dose of chemotherapy. c. Increase the frequency of oral care. d. Place the child on NPO status.

C

A child needs surgery to resect a tumor, but is scheduled for several weeks of radiation therapy first. The parents are frustrated and want to know why the surgery that can cure the cancer is being delayed. Which response by the nurse is the most appropriate? a. Children who have radiation first generally do better than others. b. If the radiation destroys the tumor, surgery will not be needed. c. Radiation will shrink the tumor, making it easier to get all of it out. d. The surgeons must be worried that they cannot get the whole tumor.

C

A clinic nurse notes that a child brought in for a physical has swelling and bruising around the eyes. The patient denies any trauma and the parent reports no environmental allergies. Which assessment is most important? a. Auscultate lungs bilaterally b. Inspect skin on the back c. Palpate abdomen and neck d. Percuss abdomen and flank

C

A nurse hears that a new admission to the hospital was recently diagnosed with the most common kind of childhood cancer. Which collaborative care does the nurse prepare to provide to this patient? a. Antibiotic administration b. Bone marrow transplant c. Chemotherapy d. Liver transplant

C

A nurse is looking at photographs of a friends infant. The nurse notes a whitish glow in the child's eyes, and the friend asks why the baby's eye looks so odd. Which response by the nurse is most appropriate? a. If his eyes look like this by 6 months, he needs to see a doctor b. Take him to the doctor to see what is wrong with his eyes c. This is called leukocoria and may signify retinoblastoma d. Your baby may have a brain tumor, take him to the hospital

C

A nurse notes in a patients medical record high levels of vanillymandelic acid (VMA). Based on this information, which condition does the nurse prepare to educate the patient and family about? a. Ewing's sarcoma b. Hodgkin's Lymphoma c. Neuroblastoma d. Wilms tumor

C

A nursing student is caring for a child with Wilms tumor. Which action by the student causes the faculty member to intervene? a. Assesses the urinary output per protocol b. Involves the parents in the childs care c. Palpates the abdomen in four quadrants d. Provides frequent nutritious snacks

C

A parent brings a 10yo child to the clinic, reporting that the child fell while playing and now has a limp several days later. In completing a history, which other finding would the nurse correlate more with bone cancer than a minor trauma? a. Decreased appetite for the last month b. Fatigues easily when playing outdoors c. Limping several weeks prior to the fall d. Often has unexplained extremity bruises

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 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

D

A nurse works on the pediatric oncology floor. After receiving report, which child does the nurse assess first? a. Child on protective isolation b. 4 hours post bone marrow biopsy c. Not eating an hour after chemotherapy d. Temperature of 101.5

D

A student nurse wants to provide nonpharmacological pain management interventions to a hospitalized child with cancer. Which action by the student causes the faculty member to intervene? a. Applying a moist heat pack b. Giving the child a massage c. Reading the child a story d. Using candles for aromatherapy

D

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

D

The parents of a child with cancer ask the nurse why the child is losing weight even though he is eating what he normally does. Which response by the nurse is most appropriate? a. Cancer consumes body tissues, causing weight loss b. He may be going through a growth spurt right now c. How do you know he is eating like he normally does? d. When you are sick, you need more nutrition than usual

D