Question 1

The treatment of brain tumors in children consists of which therapies? (Select all that apply.)

Accepted Answer

A)  Surgery 
B)  Bone marrow transplantation 
C)  Chemotherapy 
D)  Stem cell transplantation 
E)  Radiation
F) Myelography

Question 2

A school-age child with leukemia experienced severe nausea and vomiting when receiving chemotherapy for the first time. Which is the most appropriate nursing action to prevent or minimize these reactions with subsequent treatments?

Accepted Answer

A)  Encourage drinking large amounts of favorite fluids. 
B)  Encourage child to take nothing by mouth (remain NPO) until nausea and vomiting subside. 
C)  Administer an antiemetic before chemotherapy begins. 
D)  Administer an antiemetic as soon as child has nausea.

Question 3

A young boy will receive a bone marrow transplant (BMT). This is possible because one of his older siblings is a histocompatible donor. Which is this type of BMT called?

Accepted Answer

A)  Syngeneic 
B)  Allogeneic 
C)  Monoclonal 
D)  Autologous

Question 4

What is the most common clinical manifestation(s) of brain tumors in children?

Accepted Answer

A)  Irritability 
B)  Seizures 
C)  Headaches and vomiting 
D)  Fever and poor fine motor control

Question 5

The home care nurse has been visiting an adolescent with recently acquired tetraplegia. The teen's mother tells the nurse, "I'm sick of providing all the care while my husband does whatever he wants to, whenever he wants to do it." Which should be the initial action of the nurse?

Accepted Answer

A)  Refer mother for counseling. 
B)  Listen and reflect mother's feelings. 
C)  Ask father, in private, why he does not help. 
D)  Suggest ways the mother can get her husband to help.

Question 6

The nurse is taking care of an adolescent with osteosarcoma. The parents ask the nurse about treatment. The nurse should make which accurate response about treatment for osteosarcoma?

Accepted Answer

A)  Treatment usually consists of surgery and chemotherapy. 
B)  Amputation of the affected extremity is rarely necessary. 
C)  Intensive irradiation is the primary treatment. 
D)  Bone marrow transplantation offers the best chance of long-term survival.

Question 7

Myelosuppression, associated with chemotherapeutic agents or some malignancies such as leukemia, can cause bleeding tendencies because of a(n):

Accepted Answer

A)  decrease in leukocytes. 
B)  increase in lymphocytes. 
C)  vitamin C deficiency. 
D)  decrease in blood platelets.

Question 8

The nurse is caring for an adolescent with osteosarcoma being admitted to undergo chemotherapy. The adolescent had a right above-the-knee amputation 2 months ago and has been experiencing "phantom limb pain." Which prescribed medication is appropriate to administer to relieve phantom limb pain?

Accepted Answer

A)  Amitriptyline (Elavil) 
B)  Hydrocodone (Vicodin) 
C)  Oxycodone (OxyContin) 
D)  Alprazolam (Xanax)

Question 9

Which is most descriptive of the pathophysiology of leukemia?

Accepted Answer

A)  Increased blood viscosity occurs. 
B)  Thrombocytopenia (excessive destruction of platelets) occurs. 
C)  Unrestricted proliferation of immature white blood cells (WBCs) occurs. 
D)  First stage of coagulation process is abnormally stimulated.

Question 10

A ventilator-dependent child is cared for at home by his parents. Nurses come for 4 hours each day giving the parents some relief. Which other strategy should the nurse recommend to give the parents a break from the responsibilities of caring for a ventilator-dependent child?

Accepted Answer

A)  Encourage members from the parent's church group to provide some relief care. 
B)  Train a trusted grandparent to provide an occasional break from the responsibilities of care. 
C)  Encourage the parents to pay out of pocket for additional private duty nurses. 
D)  Suggest the parents place the child in a care facility.

Question 11

Which is the most effective pain-management approach for a child who is having a bone marrow aspiration?

Accepted Answer

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

Question 12

An adolescent with osteosarcoma is scheduled for a leg amputation in 2 days. The nurse's approach should include which action?

Accepted Answer

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

Question 13

In which position should the nurse place a 10-year-old child after a large tumor was removed through a supratentorial craniotomy?

Accepted Answer

A)  On the inoperative side with the bed flat 
B)  On the inoperative side with the head of bed elevated 20 to 30 degrees 
C)  On the operative side with the bed flat and pillows behind the head 
D)  On the operative side with the head of bed elevated 45 degrees

Question 14

Which is often administered to prevent or control hemorrhage in a child with cancer?

Accepted Answer

A)  Nitrosoureas 
B)  Platelets 
C)  Whole blood 
D)  Corticosteroids

Question 15

The nurse is admitting a child with a Wilms tumor. Which is the initial assessment finding associated with this tumor?

Accepted Answer

A)  Abdominal swelling 
B)  Weight gain 
C)  Hypotension 
D)  Increased urinary output

Question 16

A young child with leukemia has anorexia and severe stomatitis. The nurse should suggest that the parents try which intervention?

Accepted Answer

A)  Relax any eating pressures. 
B)  Firmly insist that child eat normally. 
C)  Begin gavage feedings to supplement diet. 
D)  Serve foods that are either hot or cold.

Question 17

The nurse is teaching nursing students about childhood nervous system tumors. Which best describes a neuroblastoma?

Accepted Answer

A)  Diagnosis is usually made after metastasis occurs. 
B)  Early diagnosis is usually possible because of the obvious clinical manifestations. 
C)  It is the most common brain tumor in young children. 
D)  It is the most common benign tumor in young children.

Question 18

The home health nurse asks a child's mother many questions as part of the assessment. The mother answers many questions and then stops and says, "I don't know why you ask me all this. Who gets to know this information?" The nurse should take which action?

Accepted Answer

A)  Determine why the mother is so suspicious. 
B)  Determine what the mother does not want to tell. 
C)  Explain who will have access to the information. 
D)  Explain that everything is confidential and that no one else will know what is said.

Question 19

The home health nurse is caring for a child who requires complex care. The family expresses frustration related to obtaining accurate information about their child's illness and its management. Which is the best action for the nurse?

Accepted Answer

A)  Determine why family is easily frustrated. 
B)  Refer family to child's primary care practitioner. 
C)  Clarify family's request, and provide information they want. 
D)  Answer only questions that family needs to know about.

Question 20

A clinic nurse is conducting a staff in-service for other clinic nurses about signs and symptoms of a rhabdomyosarcoma tumor. Which should be included in the teaching session? (Select all that apply.)

Accepted Answer

A)  Bone fractures 
B)  Abdominal mass 
C)  Sore throat and ear pain 
D)  Headache 
E)  Ecchymosis of conjunctiva

Exam 25: The Child with Cancer