Question 1

A child is receiving chemotherapy.The nurse assesses the child's oral cavity and notes the following: raspy voice,thick saliva,and debris on the teeth.Which action by the nurse is the most appropriate?

Accepted Answer

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.

Question 2

A 4-year-old child is several days postoperative after a resection of a brain tumor.The nurse finds the child irritable and lethargic,and notes that she has vomited.Which medication does the nurse anticipate administering?

Accepted Answer

A)  Dexamethasone (Decadron) 
B)  Fosphenytoin (Cerebyx) 
C)  Odansetron (Zofran) 
D)  Phenytoin (Dilantin)

Question 3

A nurse is reviewing a patient's chart and notes that the patient has a cancerous tumor that has invaded other organs.Based on this information,at which stage is this patient's cancer classified?

Accepted Answer

A)  Stage O 
B)  Stage I 
C)  Stage III 
D)  Stage IV

Question 4

A nursing faculty member explains to the class that which item is the most important for tumor cell growth?

Accepted Answer

A)  Age of transforming cells 
B)  Programmed cell death 
C)  Proximity to a capillary 
D)  Rapidity of cell growth

Question 5

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?

Accepted Answer

A)  Auscultate lungs bilaterally. 
B)  Inspect skin on the back. 
C)  Palpate abdomen and neck. 
D)  Percuss abdomen and flank.

Question 6

A pediatric patient is receiving asparaginase (Elspar).What manifestations would lead the nurse to determine that the child is having a possible side effect from this drug?

Accepted Answer

A)  Blistering at infusion site 
B)  Increased PT and INR 
C)  Potassium of 2.7 mEq/L 
D)  Seizures 
E)  Shortness of breath

Question 7

A nurse has a RN preceptor student working on the pediatric oncology unit.When teaching the student about oncological crises,what disorders does the nurse include?

Accepted Answer

A)  Inferior vena cava infarction 
B)  Neurogenic shock 
C)  Perirectal abscess 
D)  Pleural effusion 
E)  Superior vena cava syndrome

Question 8

A child is being admitted with an infratentorial brain tumor.Which anatomical regions of the brain does the nurse know this tumor might include?

Accepted Answer

A)  Brainstem 
B)  Cerebellum 
C)  Cerebrum 
D)  Frontal lobe 
E)  Parietal lobe

Question 9

An 8-year-old child has been diagnosed with a brain tumor.Based on knowledge of childhood cancers,which intervention does the nurse plan to implement when the child is admitted to the hospital?

Accepted Answer

A)  Aspiration precautions 
B)  Protective isolation 
C)  Safety precautions 
D)  Seizure precautions

Question 10

A nursing student is caring for a child diagnosed with Wilms' tumor.Which action by the student causes the faculty member to intervene?

Accepted Answer

A)  Assesses urinary output per protocol 
B)  Involves the parents in the child's care 
C)  Palpates the abdomen in all four quadrants 
D)  Provides frequent nutritious snacks

Question 11

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?

Accepted Answer

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

Question 12

The staff nurse is educating nursing students on the long-term effects of childhood chemotherapy.Which problems does the nurse include in the educational session?

Accepted Answer

A)  Cardiac dysfunction 
B)  Hearing loss 
C)  Increased risk of multiple-gestation pregnancies 
D)  Learning disabilities 
E)  Peripheral neuropathy

Question 13

A student is learning about the process of hematopoiesis and how it is affected by leukemia.Which information does the student discover?

Accepted Answer

A)  Blast cells multiply faster than mature cells. 
B)  Leukemia disrupts normal hematopoiesis. 
C)  Lymphoid cells differentiate into B and T cells. 
D)  Myeloid cells crowd out normal cells in bone marrow. 
E)  Pancytopenia occurs from proliferation of mast cells.

Question 14

A nurse caring for a child receiving chemotherapy notes that the child's urine specific gravity is 1.010.Which action by the nurse is the most appropriate?

Accepted Answer

A)  Document the findings in the child's chart. 
B)  Increase the rate of the IV fluids per protocol. 
C)  Notify the provider about the laboratory results. 
D)  Prepare to administer an alkalizing agent.

Question 15

A nurse works on a pediatric oncology unit.After receiving report,which child should the nurse assess first?

Accepted Answer

A)  Having infusion of D5 1/4 NS and sodium bicarbonate 
B)  On high-dose methotrexate (Rheumatrex), urine pH of 7.8 
C)  Receiving cyclophosphamide (Cytoxan), urine specific gravity of 1.008 
D)  2 days post-tumor resection, complaining of pain

Question 16

The nurse working with pediatric oncology patients educates the patients and families regarding best long-term follow-up practices.Which recommendations does this include?

Accepted Answer

A)  Continued care by an interdisciplinary team 
B)  Height measurements until puberty is reached 
C)  Genetic testing prior to having children 
D)  Risk-based follow-up appointments 
E)  Thyroid screening for 5 years after remission

Question 17

A child has nausea after chemotherapy despite anti-emetics.However,the child complains that "my tummy is growling." Which other action should the nurse take to promote comfort for this child?

Accepted Answer

A)  Avoid hard, difficult-to-chew foods. 
B)  Encourage a high fluid intake with meals. 
C)  Offer the child hard candy to suck on. 
D)  Provide bland items, such as plain mashed potatoes.

Question 18

A parent brings a 10-year-old 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?

Accepted Answer

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

Question 19

A nurse is caring for several patients with acute lymphocytic leukemia (ALL).Which children does the nurse understand have the best prognosis?

Accepted Answer

A)  Infant 
B)   25% abnormal cells in bone marrow aspirate 
D)  White count 4,200/mm3 
E)  White count 25,000/mm3

Question 20

A child is being discharged after surgical resection of a retinoblastoma with enucleation.Which discharge instruction is most important based on the diagnosis?

Accepted Answer

A)  Encouraging healthy eating 
B)  Irrigation of the surgical site 
C)  Monitoring the child's temperature 
D)  Pain assessment and control

Exam 33: Caring for the Child With Cancer