Question 1

Parents of a child with acute lymphoblastic leukemia (ALL)ask about their child's prognosis.The nurse should base the response on the knowledge that

Accepted Answer

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. 
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

Question 2

What is an expected physical assessment finding for an adolescent with a diagnosis of Hodgkin disease?

Accepted Answer

A)  Protuberant, firm abdomen 
B)  Enlarged, painless, firm cervical lymph nodes 
C)  Soft tissue swelling 
D)  Soft to hard, nontender mass in pelvic area 
A)  Protuberant, firm abdomen 
B)  Enlarged, painless, firm cervical lymph nodes 
C)  Soft tissue swelling 
D)  Soft to hard, nontender mass in pelvic area B

Question 3

What is a priority nursing diagnosis for the 4-year-old child newly diagnosed with leukemia?

Accepted Answer

A)  Ineffective Breathing Pattern related to mediastinal disease 
B)  Risk for Infection related to immunosuppressed state 
C)  Disturbed Body Image related to alopecia 
D)  Impaired Skin Integrity related to radiation therapy 
A)  Ineffective Breathing Pattern related to mediastinal disease 
B)  Risk for Infection related to immunosuppressed state 
C)  Disturbed Body Image related to alopecia 
D)  Impaired Skin Integrity related to radiation therapy B

Question 4

The nurse notes a reddened area on the forearm of a neutropenic child with leukemia.What action by the nurse is most appropriate?

Accepted Answer

A)  Massage the area. 
B)  Turn the child more frequently. 
C)  Document the finding and continue to observe the area. 
D)  Notify the provider. 
A)  Massage the area. 
B)  Turn the child more frequently. 
C)  Document the finding and continue to observe the area. 
D)  Notify the provider.

Question 5

While completing an assessment on a 6-month-old infant,which finding should the nurse recognize as a symptom of a brain tumor?

Accepted Answer

A)  Blurred vision 
B)  Increased head circumference 
C)  Vomiting when getting out of bed 
D)  Headache 
A)  Blurred vision 
B)  Increased head circumference 
C)  Vomiting when getting out of bed 
D)  Headache

Question 6

What should the nurse recognize as symptoms of a brain tumor in a school-age child? (Select all that apply.)

Accepted Answer

A)  Blurred vision 
B)  Increased head circumference 
C)  Vomiting when getting out of bed 
D)  Intermittent headache 
E)  Declining academic performance 
A)  Blurred vision 
B)  Increased head circumference 
C)  Vomiting when getting out of bed 
D)  Intermittent headache 
E)  Declining academic performance

Question 7

A nurse has taught the parents about home care of their child who has leukemia.Which statement made by the parents indicates an understanding of this teaching?

Accepted Answer

A)  "We will take our child's blood pressure daily." 
B)  "We will restrict fluids in case there is central nervous system involvement." 
C)  "We will make sure our child gets all immunizations in a timely manner." 
D)  "We will take our child's temperature frequently." 
A)  "We will take our child's blood pressure daily." 
B)  "We will restrict fluids in case there is central nervous system involvement." 
C)  "We will make sure our child gets all immunizations in a timely manner." 
D)  "We will take our child's temperature frequently."

Question 8

A child with non-Hodgkin lymphoma will be starting chemotherapy.What intervention is initiated before chemotherapy to prevent tumor lysis syndrome?

Accepted Answer

A)  Insertion of a central venous catheter 
B)  Intravenous (IV) hydration containing sodium bicarbonate 
C)  Placement of an externalized ventriculoperitoneal (VP) shunt 
D)  Administration of pneumococcal and Haemophilus influenzae type B vaccines 
A)  Insertion of a central venous catheter 
B)  Intravenous (IV) hydration containing sodium bicarbonate 
C)  Placement of an externalized ventriculoperitoneal (VP) shunt 
D)  Administration of pneumococcal and Haemophilus influenzae type B vaccines

Question 9

The nurse is aware that an abdominal mass found in a 10-month-old infant corresponds with which childhood cancer?

Accepted Answer

A)  Osteogenic sarcoma 
B)  Rhabdomyosarcoma 
C)  Neuroblastoma 
D)  Non-Hodgkin lymphoma 
A)  Osteogenic sarcoma 
B)  Rhabdomyosarcoma 
C)  Neuroblastoma 
D)  Non-Hodgkin lymphoma

Question 10

When an adolescent with a new diagnosis of Ewing sarcoma asks the nurse about treatment,the nurse's response is based on the knowledge that (Select all that apply.)

Accepted Answer

A)  this type of tumor invades the bone. 
B)  management includes chemotherapy, surgery, and radiation. 
C)  Ewing sarcoma is usually not responsive to either chemotherapy or radiation. 
D)  affected bones such as ribs and proximal fibula may be removed to excise the tumor. 
E)  is the most common bone tumor seen in children. 
A)  this type of tumor invades the bone. 
B)  management includes chemotherapy, surgery, and radiation. 
C)  Ewing sarcoma is usually not responsive to either chemotherapy or radiation. 
D)  affected bones such as ribs and proximal fibula may be removed to excise the tumor. 
E)  is the most common bone tumor seen in children.

Question 11

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.)

Accepted Answer

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. 
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.

Question 12

Children with non-Hodgkin lymphoma are at risk for complications resulting from tumor lysis syndrome (TLS).What findings would the nurse assess for to identify this complication early?

Accepted Answer

A)  Increased ALT, AST 
B)  Change in level of consciousness 
C)  Elevated BUN and creatinine 
D)  Oxygen saturation of 93% 
A)  Increased ALT, AST 
B)  Change in level of consciousness 
C)  Elevated BUN and creatinine 
D)  Oxygen saturation of 93%

Question 13

Hematopoietic stem cell transplantation (HSCT)is the standard treatment for a child in his or her first remission with what cancer?

Accepted Answer

A)  Acute lymphocytic leukemias 
B)  Non-Hodgkin lymphoma 
C)  Wilms' tumor 
D)  Acute myeloblastic leukemia (AML) 
A)  Acute lymphocytic leukemias 
B)  Non-Hodgkin lymphoma 
C)  Wilms' tumor 
D)  Acute myeloblastic leukemia (AML)

Question 14

A nurse has taught parents about diagnostic testing for their child who is suspected of having leukemia.What test described by the parents shows good understanding of this information?

Accepted Answer

A)  Complete blood cell count (CB
C)  
B)  Lumbar puncture 
C)  Bone marrow biopsy 
D)  Computed tomography (CT) scan 
A)  Complete blood cell count (CB
C)  
B)  Lumbar puncture 
C)  Bone marrow biopsy 
D)  Computed tomography (CT) scan

Question 15

The nurse notes that a child's gums bleed easily and that the child has bruising and petechiae on his extremities.What laboratory values are consistent with these symptoms?

Accepted Answer

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)  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

Question 16

Which clinical finding is an overt sign of retinoblastoma in children?

Accepted Answer

A)  Whitish reflex in the eye 
B)  Lymphadenopathy 
C)  Bone pain 
D)  Change in gait 
A)  Whitish reflex in the eye 
B)  Lymphadenopathy 
C)  Bone pain 
D)  Change in gait

Question 17

A child has a brain tumor.What assessment finding leads the nurse to request a physical therapy consultation?

Accepted Answer

A)  Dizziness 
B)  Ataxia 
C)  Slurred speech 
D)  Visual changes 
A)  Dizziness 
B)  Ataxia 
C)  Slurred speech 
D)  Visual changes

Question 18

A child has just been diagnosed with acute lymphoblastic leukemia,and the mother is expressing guilt about not taking the child to the doctor right away.What response by the nurse is best?

Accepted Answer

A)  "Always call the physician when your child has a change in what is normal for him." 
B)  "It is better to be safe than sorry." 
C)  "It is common for parents not to notice subtle changes in their children's health." 
D)  "I hope this delay does not affect the treatment plan." 
A)  "Always call the physician when your child has a change in what is normal for him." 
B)  "It is better to be safe than sorry." 
C)  "It is common for parents not to notice subtle changes in their children's health." 
D)  "I hope this delay does not affect the treatment plan."

Question 19

What fluid is the best choice when a child with mucositis asks for something to drink?

Accepted Answer

A)  Hot chocolate 
B)  Lemonade 
C)  Popsicle 
D)  Orange juice 
A)  Hot chocolate 
B)  Lemonade 
C)  Popsicle 
D)  Orange juice

Question 20

A child with acute myeloblastic leukemia is scheduled to have a bone marrow transplant (BMT).The donor is the child's own umbilical cord blood that had been previously harvested and banked.This type of BMT is termed

Accepted Answer

A)  autologous. 
B)  allogeneic. 
C)  syngeneic. 
D)  stem cell. 
A)  autologous. 
B)  allogeneic. 
C)  syngeneic. 
D)  stem cell.

Exam 48: The Child with Cancer

Parents of a child with acute lymphoblastic leukemia (ALL)ask about their child's prognosis.The nurse should base the response on the knowledge that

What is an expected physical assessment finding for an adolescent with a diagnosis of Hodgkin disease?

What is a priority nursing diagnosis for the 4-year-old child newly diagnosed with leukemia?

The nurse notes a reddened area on the forearm of a neutropenic child with leukemia.What action by the nurse is most appropriate?

While completing an assessment on a 6-month-old infant,which finding should the nurse recognize as a symptom of a brain tumor?

What should the nurse recognize as symptoms of a brain tumor in a school-age child? (Select all that apply.)

A nurse has taught the parents about home care of their child who has leukemia.Which statement made by the parents indicates an understanding of this teaching?

A child with non-Hodgkin lymphoma will be starting chemotherapy.What intervention is initiated before chemotherapy to prevent tumor lysis syndrome?

The nurse is aware that an abdominal mass found in a 10-month-old infant corresponds with which childhood cancer?

When an adolescent with a new diagnosis of Ewing sarcoma asks the nurse about treatment,the nurse's response is based on the knowledge that (Select all that apply.)

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.)

Children with non-Hodgkin lymphoma are at risk for complications resulting from tumor lysis syndrome (TLS).What findings would the nurse assess for to identify this complication early?

Hematopoietic stem cell transplantation (HSCT)is the standard treatment for a child in his or her first remission with what cancer?

A nurse has taught parents about diagnostic testing for their child who is suspected of having leukemia.What test described by the parents shows good understanding of this information?

The nurse notes that a child's gums bleed easily and that the child has bruising and petechiae on his extremities.What laboratory values are consistent with these symptoms?

Which clinical finding is an overt sign of retinoblastoma in children?

A child has a brain tumor.What assessment finding leads the nurse to request a physical therapy consultation?

A child has just been diagnosed with acute lymphoblastic leukemia,and the mother is expressing guilt about not taking the child to the doctor right away.What response by the nurse is best?

What fluid is the best choice when a child with mucositis asks for something to drink?

A child with acute myeloblastic leukemia is scheduled to have a bone marrow transplant (BMT).The donor is the child's own umbilical cord blood that had been previously harvested and banked.This type of BMT is termed

Foundations of Maternity, Women’s Health, and Child Health Nursing

The Nurse’s Role in Maternity, Women’s Health, and Pediatric Nursing

The Childbearing and Child-Rearing Family

Communicating with Children and Families

Health Promotion for the Developing Child

Health Promotion for the Infant

Health Promotion During Early Childhood

Health Promotion for the School-Age Child

Health Promotion for the Adolescent

Hereditary and Environmental Influences on Development

Reproductive Anatomy and Physiology

Conception and Prenatal Development

Adaptations to Pregnancy

Nutrition for Childbearing

Prenatal Diagnostic Tests

Giving Birth

Intrapartum Fetal Surveillance

Pain Management for Childbirth

Nursing Care during Obstetric Procedures

Postpartum Adaptations

The Normal Newborn: Adaptation and Assessment

The Normal Newborn: Nursing Care

Newborn Feeding

The Childbearing Family with Special Needs

Pregnancy-Related Complications

Concurrent Disorders during Pregnancy

The Woman with an Intrapartum Complication

The Woman with a Postpartum Complication

The High-Risk Newborn: Problems Related to Gestational Age and Development

The High-Risk Newborn: Acquired and Congenital Conditions

Management of Fertility and Infertility

Women’s HealthCare

Physical Assessment of Children

Emergency Care of the Child

The Ill Child in the Hospital and Other Care Settings

The Child with a Chronic Condition or Terminal Illness

Principles and Procedures for Nursing Care of Children

Medication Administration and Safety for Infants and Children

Pain Management for Children

The Child with a Fluid and Electrolyte Alteration

The Child with an Infectious Disease

The Child with an Immunologic Alteration

The Child with a Gastrointestinal Alteration

The Child with a Genitourinary Alteration

The Child with a Respiratory Alteration

The Child with a Cardiovascular Alteration

The Child with a Hematologic Alteration

The Child with an Alteration in Tissue Integrity

The Child with a Musculoskeletal Alteration

The Child with an Endocrine or Metabolic Alteration

The Child with a Neurologic Alteration

Psychosocial Problems in Children and Families

The Child With an Intellectual Disability or Developmental Disability

The Child with a Sensory Alteration

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