Question 1

What is an important priority in dealing with the child suspected of having Wilms tumor?

Accepted Answer

A)  Intervening to minimize bleeding 
B)  Monitoring temperature for infection 
C)  Ensuring the abdomen is protected from palpation 
D)  Teaching parents how to manage the parenteral nutrition 
A)  Intervening to minimize bleeding 
B)  Monitoring temperature for infection 
C)  Ensuring the abdomen is protected from palpation 
D)  Teaching parents how to manage the parenteral nutrition C

Question 2

Calculate the absolute neutrophil count for a child with a WBC = 3000/mm³, neutrophils = 10%, and nonsegmented neutrophils (bands) = 10%. Record your answer below in a whole number.
_____________

Accepted Answer

600
Perform the calculation
Determine the total percentage of neutrophils ("polys," or "segs," and "bands").
Multiply white blood cell (WBC) count by percentage of neutrophils.
WBC = 3000/mm³, neutrophils = 10%, and nonsegmented neutrophils (bands) = 10%
Step 1: 10% + 10% = 20%
Step 2: 0.2 * 3000 = 600/mm³ ANC

Question 3

A health care provider prescribes ondansetron (Zofran) 0.15 mg/kg intravenously (IV) 30 minutes before chemotherapy for a child with acute lymphoblastic leukemia. The child weighs 22 kg. The medication label states: "Ondansetron (Zofran) 2 mg/1 ml." The nurse prepares to administer the dose. How many milliliters will the nurse prepare to administer the dose? Fill in the blank. Round your answer to one decimal place.
________________

Accepted Answer

1.7
Follow the formula for dosage calculation.
22 * 0.15 = 3.3 mg as the dose
(Desired/Available)* Volume = ml per dose
3.3 mg/2 mg* 1 ml = 1.65 ml round to 1.7 ml

Question 4

What chemotherapeutic agent can cause an anaphylactic reaction?

Accepted Answer

A)  Prednisone (Deltasone) 
B)  Vincristine (Oncovin) 
C)  L-Asparaginase (Elspar) 
D)  Methotrexate (Trexall) 
A)  Prednisone (Deltasone) 
B)  Vincristine (Oncovin) 
C)  L-Asparaginase (Elspar) 
D)  Methotrexate (Trexall)

Question 5

A child, age 10 years, has a neuroblastoma and is in the hospital for additional chemotherapy treatments. What laboratory values are most likely this child's?

Accepted Answer

A)  White blood cell count, 17,000/mm3; hemoglobin, 15 g/dl 
B)  White blood cell count, 3,000/mm3; hemoglobin, 11.5 g/dl 
C)  Platelets, 450,000/mm3; hemoglobin, 12 g/dl 
D)  White blood cell count, 10,000/mm3; platelets, 175,000/mm3 
A)  White blood cell count, 17,000/mm3; hemoglobin, 15 g/dl 
B)  White blood cell count, 3,000/mm3; hemoglobin, 11.5 g/dl 
C)  Platelets, 450,000/mm3; hemoglobin, 12 g/dl 
D)  White blood cell count, 10,000/mm3; platelets, 175,000/mm3

Question 6

What chemotherapeutic agent is classified as an antitumor antibiotic?

Accepted Answer

A)  Cisplatin (Platinol AQ) 
B)  Vincristine (Oncovin) 
C)  Methotrexate (Texall) 
D)  Daunorubicin (Cerubidine) 
A)  Cisplatin (Platinol AQ) 
B)  Vincristine (Oncovin) 
C)  Methotrexate (Texall) 
D)  Daunorubicin (Cerubidine)

Question 7

A child has been diagnosed with a Wilms tumor. What should preoperative nursing care include?

Accepted Answer

A)  Careful bathing and handling 
B)  Monitoring of behavioral status 
C)  Maintenance of strict isolation 
D)  Administration of packed red blood cells 
A)  Careful bathing and handling 
B)  Monitoring of behavioral status 
C)  Maintenance of strict isolation 
D)  Administration of packed red blood cells

Question 8

A parent of a hospitalized child on chemotherapy asks the nurse if a sibling of the hospitalized child should receive the varicella vaccination. The nurse should give which response?

Accepted Answer

A)  The sibling can get a varicella vaccination. 
B)  The sibling should not get a varicella vaccination. 
C)  The sibling should wait until the child is finished with chemotherapy. 
D)  The sibling should get varicella-zoster immune globulin if exposed to chickenpox. 
A)  The sibling can get a varicella vaccination. 
B)  The sibling should not get a varicella vaccination. 
C)  The sibling should wait until the child is finished with chemotherapy. 
D)  The sibling should get varicella-zoster immune globulin if exposed to chickenpox.

Question 9

An adolescent will receive a bone marrow transplant (BMT). The nurse should explain that the bone marrow will be administered by which method?

Accepted Answer

A)  Bone grafting 
B)  Intravenous infusion 
C)  Bone marrow injection 
D)  Intraabdominal infusion 
A)  Bone grafting 
B)  Intravenous infusion 
C)  Bone marrow injection 
D)  Intraabdominal infusion

Question 10

The nurse is caring for a child with retinoblastoma that was treated with an enucleation. What interventions should the nurse plan for care of an eye socket after enucleation? (Select all that apply.)

Accepted Answer

A)  Clean the prosthesis. 
B)  Change the eye pad daily. 
C)  Keep the opposite eye covered initially. 
D)  Irrigate the socket daily with a prescribed solution. 
E)  Apply a prescribed antibiotic ointment after irrigation. 
A)  Clean the prosthesis. 
B)  Change the eye pad daily. 
C)  Keep the opposite eye covered initially. 
D)  Irrigate the socket daily with a prescribed solution. 
E)  Apply a prescribed antibiotic ointment after irrigation.

Question 11

Daily toothbrushing and flossing can be encouraged for the child on chemotherapy when the platelet count is above which?

Accepted Answer

A)  10,000/mm3 
B)  20,000/mm3 
C)  30,000/mm3 
D)  40,000/mm3 
A)  10,000/mm3 
B)  20,000/mm3 
C)  30,000/mm3 
D)  40,000/mm3

Question 12

What statement related to clinical trials developed for pediatric cancers is most accurate?

Accepted Answer

A)  Are accessible only in major pediatric centers 
B)  Do not require consent for standard therapy 
C)  Provide the best available therapy compared with an expected improvement 
D)  Are standardized to provide the same treatment to all children with the disease 
A)  Are accessible only in major pediatric centers 
B)  Do not require consent for standard therapy 
C)  Provide the best available therapy compared with an expected improvement 
D)  Are standardized to provide the same treatment to all children with the disease

Question 13

A young child with leukemia has anorexia and severe stomatitis. What approach should the nurse suggest that the parents try?

Accepted Answer

A)  Relax any eating pressures. 
B)  Firmly insist that the child eat normally. 
C)  Serve foods that are either hot or cold. 
D)  Provide only liquids because chewing is painful. 
A)  Relax any eating pressures. 
B)  Firmly insist that the child eat normally. 
C)  Serve foods that are either hot or cold. 
D)  Provide only liquids because chewing is painful.

Question 14

An adolescent is scheduled for a leg amputation in 2 days for treatment of osteosarcoma. What approach should the nurse implement?

Accepted Answer

A)  Answer questions with straightforward honesty. 
B)  Avoid discussing the seriousness of the condition. 
C)  Explain that although the amputation is difficult, it will cure the cancer. 
D)  Help the adolescent accept the amputation as better than a long course of chemotherapy. 
A)  Answer questions with straightforward honesty. 
B)  Avoid discussing the seriousness of the condition. 
C)  Explain that although the amputation is difficult, it will cure the cancer. 
D)  Help the adolescent accept the amputation as better than a long course of chemotherapy.

Question 15

One pediatric oncologic emergency is acute tumor lysis syndrome. Symptoms that this may be occurring include what?

Accepted Answer

A)  Muscle cramps and tetany 
B)  Respiratory distress and cyanosis 
C)  Thrombocytopenia and sepsis 
D)  Upper extremity edema and neck vein distension 
A)  Muscle cramps and tetany 
B)  Respiratory distress and cyanosis 
C)  Thrombocytopenia and sepsis 
D)  Upper extremity edema and neck vein distension

Question 16

The mother of an infant tells the nurse that sometimes there is a whitish "glow" in the pupil of his eye. The nurse should suspect which condition?

Accepted Answer

A)  Brain tumor 
B)  Retinoblastoma 
C)  Neuroblastoma 
D)  Rhabdomyosarcoma 
A)  Brain tumor 
B)  Retinoblastoma 
C)  Neuroblastoma 
D)  Rhabdomyosarcoma

Question 17

The nurse is caring for a child receiving chemotherapy for leukemia. The child's granulocyte count is 600/mm³ and platelet count is 45,000/mm³. What oral care should the nurse recommend for this child?

Accepted Answer

A)  Rinsing mouth with water 
B)  Daily toothbrushing and flossing 
C)  Lemon glycerin swabs for cleansing 
D)  Wiping teeth with moistened gauze or Toothettes 
A)  Rinsing mouth with water 
B)  Daily toothbrushing and flossing 
C)  Lemon glycerin swabs for cleansing 
D)  Wiping teeth with moistened gauze or Toothettes

Question 18

In teaching parents how to minimize or prevent bleeding episodes when the child is myelosuppressed, the nurse includes what information?

Accepted Answer

A)  Meticulous mouth care is essential to avoid mucositis. 
B)  Rectal temperatures are necessary to monitor for infection. 
C)  Intramuscular injections are preferred to intravenous ones. 
D)  Platelet transfusions are given to maintain a count greater than 50,000/mm3. 
A)  Meticulous mouth care is essential to avoid mucositis. 
B)  Rectal temperatures are necessary to monitor for infection. 
C)  Intramuscular injections are preferred to intravenous ones. 
D)  Platelet transfusions are given to maintain a count greater than 50,000/mm3.

Question 19

The nurse is precepting a new graduate nurse at an ambulatory pediatric hematology and oncology clinic. What cardinal signs of cancer in children should the nurse make the new nurse aware of? (Select all that apply.)

Accepted Answer

A)  Sudden tendency to bruise easily 
B)  Transitory, generalized pain 
C)  Frequent headaches 
D)  Excessive, rapid weight gain 
E)  Gradual, steady fever
F) Unexplained loss of energy 
A)  Sudden tendency to bruise easily 
B)  Transitory, generalized pain 
C)  Frequent headaches 
D)  Excessive, rapid weight gain 
E)  Gradual, steady fever
F) Unexplained loss of energy

Question 20

A child has an absolute neutrophil count (ANC) of 500/mm³. The nurse should expect to be administering which prescribed treatment?

Accepted Answer

A)  Platelets 
B)  Packed red blood cells 
C)  Zofran (ondansetron) 
D)  G-CSF (Neupogen) daily 
A)  Platelets 
B)  Packed red blood cells 
C)  Zofran (ondansetron) 
D)  G-CSF (Neupogen) daily

Exam 31: The Child with Cancer

What is an important priority in dealing with the child suspected of having Wilms tumor?

Calculate the absolute neutrophil count for a child with a WBC = 3000/mm³, neutrophils = 10%, and nonsegmented neutrophils (bands) = 10%. Record your answer below in a whole number. _____________

What chemotherapeutic agent can cause an anaphylactic reaction?

A child, age 10 years, has a neuroblastoma and is in the hospital for additional chemotherapy treatments. What laboratory values are most likely this child's?

What chemotherapeutic agent is classified as an antitumor antibiotic?

A child has been diagnosed with a Wilms tumor. What should preoperative nursing care include?

A parent of a hospitalized child on chemotherapy asks the nurse if a sibling of the hospitalized child should receive the varicella vaccination. The nurse should give which response?

An adolescent will receive a bone marrow transplant (BMT). The nurse should explain that the bone marrow will be administered by which method?

The nurse is caring for a child with retinoblastoma that was treated with an enucleation. What interventions should the nurse plan for care of an eye socket after enucleation? (Select all that apply.)

Daily toothbrushing and flossing can be encouraged for the child on chemotherapy when the platelet count is above which?

What statement related to clinical trials developed for pediatric cancers is most accurate?

A young child with leukemia has anorexia and severe stomatitis. What approach should the nurse suggest that the parents try?

An adolescent is scheduled for a leg amputation in 2 days for treatment of osteosarcoma. What approach should the nurse implement?

One pediatric oncologic emergency is acute tumor lysis syndrome. Symptoms that this may be occurring include what?

The mother of an infant tells the nurse that sometimes there is a whitish "glow" in the pupil of his eye. The nurse should suspect which condition?

The nurse is caring for a child receiving chemotherapy for leukemia. The child's granulocyte count is 600/mm³ and platelet count is 45,000/mm³. What oral care should the nurse recommend for this child?

In teaching parents how to minimize or prevent bleeding episodes when the child is myelosuppressed, the nurse includes what information?

The nurse is precepting a new graduate nurse at an ambulatory pediatric hematology and oncology clinic. What cardinal signs of cancer in children should the nurse make the new nurse aware of? (Select all that apply.)

A child has an absolute neutrophil count (ANC) of 500/mm³. The nurse should expect to be administering which prescribed treatment?

Perspectives of Pediatric Nursing

Social, Cultural, Religious, and Family Influences on Child Health Promotion

Hereditary Influences on Health Promotion of the Child and Family

Communication, Physical, and Developmental Assessment

Pain Assessment and Management in Children

Childhood Communicable and Infectious Diseases

Health Promotion of the Newborn and Family

Health Problems of Newborns

The High-Risk Newborn and Family

Health Promotion of the Infant and Family

Health Problems of the Infant

Health Promotion of the Toddler and Family

Health Promotion of the Preschooler and Family

Health Problems of Early Childhood

Health Promotion of the School-Age Child and Family

Health Problems of the School-Age Child

Health Promotion of the Adolescent and Family

Health Problems of the Adolescent

Family-Centered Care of the Child with Chronic Illness or Disability

Family-Centered Palliative Care

The Child with Cognitive, Sensory, or Communication Impairment

Family-Centered Care of the Child During Illness and Hospitalization

Pediatric Nursing Interventions and Skills

The Child with Fluid and Electrolyte Imbalance

The Child with Renal Dysfunction

The Child with Gastrointestinal Dysfunction

Overview of Oxygen and Carbon Dioxide Exchange

The Child with Respiratory Dysfunction

The Child with Cardiovascular Dysfunction

The Child with Hematologic or Immunologic Dysfunction

The Child with Cerebral Dysfunction

The Child with Endocrine Dysfunction

The Child with Musculoskeletal or Articular Dysfunction

The Child with Neuromuscular or Muscular Dysfunction

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