Question 1

A health care provider prescribes Osmitrol (mannitol) 0.25 g/kg intravenously (IV) every 6 hours for a child after a brain tumor removal. The child weighs 20 kg. The medication label states: "Osmitrol (Mannitol) 250 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. Record your answer in a whole number.
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Accepted Answer

The answer of A health care provider prescribes Osmitrol (mannitol)...

Question 2

What immunization should not be given to a child receiving chemotherapy for cancer?

Accepted Answer

A)  Tetanus vaccine 
B)  Inactivated poliovirus vaccine 
C)  Diphtheria, pertussis, tetanus (DPT) 
D)  Measles, mumps, rubella (MMR)

Question 3

A child with cancer being treated with chemotherapy is receiving a platelet transfusion. The nurse understands that the transfused platelets should survive the body for how many days?

Accepted Answer

A)  1 to 3 days 
B)  4 to 6 days 
C)  7 to 9 days 
D)  10 to 12 days

Question 4

The nurse is caring for a 6-year-old child with acute lymphoblastic leukemia (ALL). The parent states, "My child has a low platelet count, and we are being discharged this afternoon. What do I need to do at home?" What statement is most appropriate for the nurse to make?

Accepted Answer

A)  "You should give your child aspirin instead of acetaminophen for fever or pain." 
B)  "Your child should avoid contact sports or activities that could cause bleeding." 
C)  "You should feed your child a bland, soft, moist diet for the next week." 
D)  "Your child should avoid large groups of people for the next week."

Question 5

What is appropriate mouth care for a toddler with mucosal ulceration related to chemotherapy?

Accepted Answer

A)  Mouthwashes with plain saline 
B)  Lemon glycerin swabs for cleansing 
C)  Mouthwashes with hydrogen peroxide 
D)  Swish and swallow with viscous lidocaine

Question 6

What type of chemotherapeutic agent alters the function of cells by replacing a hydrogen atom of a molecule?

Accepted Answer

A)  Plant alkaloids 
B)  Antimetabolites 
C)  Alkylating agents 
D)  Antitumor antibiotics

Question 7

Calculate the absolute neutrophil count for a child with a WBC = 15,000/mm³, neutrophils = 29%, and nonsegmented neutrophils (bands) = 29%. Record your answer in a whole number.
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Accepted Answer

The answer of Calculate the absolute neutrophil count for a...

Question 8

What strategies should the nurse implement to increase nutritional intake for the child receiving chemotherapy? (Select all that apply.)

Accepted Answer

A)  Allow the child any food tolerated. 
B)  Fortify foods with nutritious supplements. 
C)  Allow the child to be involved in food selection. 
D)  Encourage the parents to place pressure on the importance of eating. 
E)  Encourage the child to eat favorite foods during infusion of chemotherapy medications.

Question 9

Calculate the absolute neutrophil count for a child with a WBC = 6000/mm³, neutrophils = 18%, and nonsegmented neutrophils (bands) = 20%. Record your answer below in a whole number.
____________

Accepted Answer

The answer of Calculate the absolute neutrophil count for a...

Question 10

The nurse should teach the family that which residual disabilities can occur for a child being treated for a brain tumor? (Select all that apply.)

Accepted Answer

A)  Ataxia 
B)  Anorexia 
C)  Dysphagia 
D)  Sensory deficits 
E)  Crania nerve palsies

Question 11

Postoperative positioning for a child who has had a medulloblastoma brain tumor (infratentorial) removed should be which?

Accepted Answer

A)  Trendelenburg 
B)  Head of bed elevated above heart level 
C)  Flat on operative side with pillows behind the head 
D)  Flat, on either side with pillows behind the back

Question 12

What specific gravity of the urine is desired so that hemorrhagic cystitis is prevented?

Accepted Answer

A)  1.035 
B)  1.030 
C)  1.025 
D)  1.005

Question 13

A child with leukemia is receiving intrathecal chemotherapy to prevent which condition?

Accepted Answer

A)  Infection 
B)  Brain tumor 
C)  Central nervous system (CNS) disease 
D)  Drug side effects

Question 14

The nurse is preparing a child for possible alopecia from chemotherapy. What information should the nurse include?

Accepted Answer

A)  Wearing hats or scarves is preferable to a wig. 
B)  Expose head to sunlight to stimulate hair regrowth. 
C)  Hair may have a slightly different color or texture when it regrows. 
D)  Regrowth of hair usually begins 12 months after chemotherapy ends.

Question 15

After chemotherapy is begun for a child with acute leukemia, prophylaxis to prevent acute tumor lysis syndrome includes which therapeutic intervention?

Accepted Answer

A)  Hydration 
B)  Oxygenation 
C)  Corticosteroids 
D)  Pain management

Question 16

What are the most common clinical manifestations of brain tumors in children?

Accepted Answer

A)  Headaches and vomiting 
B)  Blurred vision and ataxia 
C)  Hydrocephalus and clumsy gait 
D)  Fever and poor fine motor control

Question 17

A child with osteosarcoma is experiencing phantom limb pain after an amputation. What prescribed medication is effective for short-term phantom pain relief?

Accepted Answer

A)  Phenytoin (Dilantin) 
B)  Gabapentin (Neurontin) 
C)  Valproic Acid (Depakote) 
D)  Phenobarbital (Phenobarbital)

Question 18

The nurse is collecting a 24-hour urine sample on a child with suspected diagnosis of neuroblastoma. What finding in the urine is expected with neuroblastomas?

Accepted Answer

A)  Ketones 
B)  Catecholamines 
C)  Red blood cells 
D)  Excessive white blood cells

Question 19

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

Accepted Answer

A)  Administer the chemotherapy between meals. 
B)  Give an antiemetic before chemotherapy begins. 
C)  Have the child bring favorite foods for snacks. 
D)  Keep the child NPO (nothing by mouth) until nausea and vomiting subside.

Question 20

What guidelines should the nurse follow when handling chemotherapeutic agents? (Select all that apply.)

Accepted Answer

A)  Use clean technique. 
B)  Prepare medications in a safety cabinet. 
C)  Wear gloves designed for handling chemotherapy. 
D)  Wear face and eye protection when splashing is possible. 
E)  Discard gloves and protective clothing in a special container.

Exam 31: The Child with Cancer