Question 1

Chemotherapeutic agents are classified according to what feature?

Accepted Answer

A)  Side effects 
B)  Effectiveness 
C)  Mechanism of action 
D)  Route of administration 
A)  Side effects 
B)  Effectiveness 
C)  Mechanism of action 
D)  Route of administration

Question 2

The nurse should expect to care for which age of child if the admitting diagnosis is retinoblastoma?

Accepted Answer

A)  Infant or toddler 
B)  Preschool- or school-age child 
C)  School-age or adolescent child 
D)  Adolescent 
A)  Infant or toddler 
B)  Preschool- or school-age child 
C)  School-age or adolescent child 
D)  Adolescent

Question 3

A child on chemotherapy has developed rectal ulcers. What interventions should the nurse teach to the child and parents to relieve the discomfort of rectal ulcers? (Select all that apply.)

Accepted Answer

A)  Warm sitz baths 
B)  Use of stool softeners 
C)  Record bowel movements 
D)  Use of an opioid for discomfort 
E)  Occlusive ointment applied to the area 
A)  Warm sitz baths 
B)  Use of stool softeners 
C)  Record bowel movements 
D)  Use of an opioid for discomfort 
E)  Occlusive ointment applied to the area

Question 4

Nursing care of the child with myelosuppression from leukemia or chemotherapeutic agents should include which therapeutic intervention?

Accepted Answer

A)  Restrict oral fluids. 
B)  Institute strict isolation. 
C)  Use good hand-washing technique. 
D)  Give immunizations appropriate for age. 
A)  Restrict oral fluids. 
B)  Institute strict isolation. 
C)  Use good hand-washing technique. 
D)  Give immunizations appropriate for age.

Question 5

A child is receiving vincristine (Oncovin). The nurse should monitor for which side effect of this medication?

Accepted Answer

A)  Diarrhea 
B)  Photosensitivity 
C)  Constipation 
D)  Ototoxicity 
A)  Diarrhea 
B)  Photosensitivity 
C)  Constipation 
D)  Ototoxicity

Question 6

What side effect commonly occurs with corticosteroid (prednisone) therapy?

Accepted Answer

A)  Alopecia 
B)  Anorexia 
C)  Nausea and vomiting 
D)  Susceptibility to infection 
A)  Alopecia 
B)  Anorexia 
C)  Nausea and vomiting 
D)  Susceptibility to infection

Question 7

Calculate the absolute neutrophil count for a child with a WBC = 10,000/mm³, neutrophils = 25%, and nonsegmented neutrophils (bands) = 22%. Record your answer in a whole number.
_____________

Accepted Answer

4700
Perform the calculation
Determine t

Question 8

What pain management approach is most effective for a child who is having a bone marrow test?

Accepted Answer

A)  Relaxation techniques 
B)  Administration of an opioid 
C)  EMLA cream applied over site 
D)  Conscious or unconscious sedation 
A)  Relaxation techniques 
B)  Administration of an opioid 
C)  EMLA cream applied over site 
D)  Conscious or unconscious sedation

Question 9

What childhood cancer may demonstrate patterns of inheritance that suggest a familial basis?

Accepted Answer

A)  Leukemia 
B)  Retinoblastoma 
C)  Rhabdomyosarcoma 
D)  Osteogenic sarcoma 
A)  Leukemia 
B)  Retinoblastoma 
C)  Rhabdomyosarcoma 
D)  Osteogenic sarcoma

Question 10

Essential postoperative nursing management of a child after removal of a brain tumor includes which nursing care?

Accepted Answer

A)  Turning and positioning every 2 hours 
B)  Measuring all fluid intake and output 
C)  Changing the dressing when it becomes soiled 
D)  Using maximum lighting to ensure accurate observations 
A)  Turning and positioning every 2 hours 
B)  Measuring all fluid intake and output 
C)  Changing the dressing when it becomes soiled 
D)  Using maximum lighting to ensure accurate observations

Question 11

The nurse is administering an intravenous chemotherapeutic agent to a child with leukemia. The child suddenly begins to wheeze and have severe urticaria. What nursing action is most appropriate to initiate?

Accepted Answer

A)  Recheck the rate of drug infusion. 
B)  Stop the drug infusion immediately. 
C)  Observe the child closely for next 10 minutes. 
D)  Explain to the child that this is an expected side effect. 
A)  Recheck the rate of drug infusion. 
B)  Stop the drug infusion immediately. 
C)  Observe the child closely for next 10 minutes. 
D)  Explain to the child that this is an expected side effect.

Question 12

Total-body irradiation is indicated for what reason?

Accepted Answer

A)  Palliative care 
B)  Lymphoma therapy 
C)  Definitive therapy for leukemia 
D)  Preparation for bone marrow transplant 
A)  Palliative care 
B)  Lymphoma therapy 
C)  Definitive therapy for leukemia 
D)  Preparation for bone marrow transplant

Question 13

What is a common clinical manifestation of Hodgkin disease?

Accepted Answer

A)  Petechiae 
B)  Bone and joint pain 
C)  Painful, enlarged lymph nodes 
D)  Nontender enlargement of lymph nodes 
A)  Petechiae 
B)  Bone and joint pain 
C)  Painful, enlarged lymph nodes 
D)  Nontender enlargement of lymph nodes

Question 14

The health care provider prescribes vancomycin 200 mg per intravenous piggyback (IVPB) every 6 hours for a child with cancer admitted to the hospital for fever and neutropenia. The pharmacy sends the medication to the unit in a 240-ml bag with directions to run the medication over 120 minutes. What milliliters per hour will the nurse set the intravenous pump to run the medication over 120 minutes? Fill in the blank and record your answer in a whole number.
_____________

Accepted Answer

120
Perform the calculation.
C

Question 15

As part of the diagnostic evaluation of a child with cancer, biopsies are important for staging. What statement explains what staging means?

Accepted Answer

A)  Extent of the disease at the time of diagnosis 
B)  Rate normal cells are being replaced by cancer cells 
C)  Biologic characteristics of the tumor or lymph nodes 
D)  Abnormal, unrestricted growth of cancer cells producing organ damage 
A)  Extent of the disease at the time of diagnosis 
B)  Rate normal cells are being replaced by cancer cells 
C)  Biologic characteristics of the tumor or lymph nodes 
D)  Abnormal, unrestricted growth of cancer cells producing organ damage

Question 16

A parent tells the nurse that 80% of children with the same type of leukemia as his son's have a 5-year survival. He believes that because another child on the same protocol as his son has just died, his son now has a better chance of success. What is the best response by the nurse?

Accepted Answer

A)  "It is sad for the other family but good news for your child." 
B)  "Each child has an 80% likelihood of 5-year survival." 
C)  "The data suggest that 20% of the children in the clinic will die. There are still many hurdles for your son." 
D)  "You should avoid the grieving family because you will be benefiting from their loss." 
A)  "It is sad for the other family but good news for your child." 
B)  "Each child has an 80% likelihood of 5-year survival." 
C)  "The data suggest that 20% of the children in the clinic will die. There are still many hurdles for your son." 
D)  "You should avoid the grieving family because you will be benefiting from their loss."

Question 17

Calculate the absolute neutrophil count (ANC) for the following: WBC count of 5000 mm³; neutrophils (segs) of 10%; and nonsegmented neutrophils (bands) of 12%.

Accepted Answer

A)  110/mm3 
B)  500/mm3 
C)  1100/mm3 
D)  5000/mm3 
A)  110/mm3 
B)  500/mm3 
C)  1100/mm3 
D)  5000/mm3

Question 18

The parents of a child with cancer tell the nurse that a bone marrow transplant (BMT) may be necessary. What information should the nurse recognize as important when discussing this with the family?

Accepted Answer

A)  BMT should be done at the time of diagnosis. 
B)  Parents and siblings of the child have a 25% chance of being a suitable donor. 
C)  If BMT fails, chemotherapy or radiotherapy will need to be continued. 
D)  Finding a suitable donor involves matching antigens from the human leukocyte antigen (HL
A)  system. 
A)  BMT should be done at the time of diagnosis. 
B)  Parents and siblings of the child have a 25% chance of being a suitable donor. 
C)  If BMT fails, chemotherapy or radiotherapy will need to be continued. 
D)  Finding a suitable donor involves matching antigens from the human leukocyte antigen (HL
A)  system.

Question 19

A 5-year-old child is being prepared for surgery to remove a brain tumor. Preparation for surgery should be based on which information?

Accepted Answer

A)  Removal of the tumor will stop the various signs and symptoms. 
B)  Usually the postoperative dressing covers the entire scalp. 
C)  He is not old enough to be concerned about his head being shaved. 
D)  He is not old enough to understand the significance of the brain. 
A)  Removal of the tumor will stop the various signs and symptoms. 
B)  Usually the postoperative dressing covers the entire scalp. 
C)  He is not old enough to be concerned about his head being shaved. 
D)  He is not old enough to understand the significance of the brain.

Question 20

What are favorable prognostic criteria for acute lymphoblastic leukemia? (Select all that apply.)

Accepted Answer

A)  Male gender 
B)  CALLA positive 
C)  Early pre-B cell 
D)  2 to 10 years of age 
E)  Leukocyte count > 50,000/mm3 
A)  Male gender 
B)  CALLA positive 
C)  Early pre-B cell 
D)  2 to 10 years of age 
E)  Leukocyte count > 50,000/mm3

Exam 31: The Child with Cancer

Chemotherapeutic agents are classified according to what feature?

The nurse should expect to care for which age of child if the admitting diagnosis is retinoblastoma?

A child on chemotherapy has developed rectal ulcers. What interventions should the nurse teach to the child and parents to relieve the discomfort of rectal ulcers? (Select all that apply.)

Nursing care of the child with myelosuppression from leukemia or chemotherapeutic agents should include which therapeutic intervention?

A child is receiving vincristine (Oncovin). The nurse should monitor for which side effect of this medication?

What side effect commonly occurs with corticosteroid (prednisone) therapy?

Calculate the absolute neutrophil count for a child with a WBC = 10,000/mm³, neutrophils = 25%, and nonsegmented neutrophils (bands) = 22%. Record your answer in a whole number. _____________

What pain management approach is most effective for a child who is having a bone marrow test?

What childhood cancer may demonstrate patterns of inheritance that suggest a familial basis?

Essential postoperative nursing management of a child after removal of a brain tumor includes which nursing care?

The nurse is administering an intravenous chemotherapeutic agent to a child with leukemia. The child suddenly begins to wheeze and have severe urticaria. What nursing action is most appropriate to initiate?

Total-body irradiation is indicated for what reason?

What is a common clinical manifestation of Hodgkin disease?

As part of the diagnostic evaluation of a child with cancer, biopsies are important for staging. What statement explains what staging means?

A parent tells the nurse that 80% of children with the same type of leukemia as his son's have a 5-year survival. He believes that because another child on the same protocol as his son has just died, his son now has a better chance of success. What is the best response by the nurse?

Calculate the absolute neutrophil count (ANC) for the following: WBC count of 5000 mm³; neutrophils (segs) of 10%; and nonsegmented neutrophils (bands) of 12%.

The parents of a child with cancer tell the nurse that a bone marrow transplant (BMT) may be necessary. What information should the nurse recognize as important when discussing this with the family?

A 5-year-old child is being prepared for surgery to remove a brain tumor. Preparation for surgery should be based on which information?

What are favorable prognostic criteria for acute lymphoblastic leukemia? (Select all that apply.)

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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