Question 1

The health care provider prescribes ceftazidime (Fortaz)75 mg per intravenous piggyback (IVPB)every 8 hours for a child with cancer admitted with fever and neutropenia.The pharmacy sends the medication to the unit in a 50-ml bag with directions to run the medication over 30 minutes.What milliliters per hour will the nurse set the intravenous pump to run the medication over 30 minutes? Fill in the blank and record your answer in a whole number.
_____________

Accepted Answer

100
Perform the calculation.
50 ml
________ × 60 minutes = 100 ml/hr
30 minutes

Question 2

One pediatric oncologic emergency is acute tumor lysis syndrome.Symptoms that this may be occurring include what?

Accepted Answer

A)   Muscle cramps and tetany
B)   Respiratory distress and cyanosis
C)   Thrombocytopenia and sepsis
D)   Upper extremity edema and neck vein distension A

Question 3

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 C

Question 4

The nurse is precepting a new graduate nurse at an ambulatory pediatric hematology and oncology clinic.What cardinal signs of cancer in children should the nurse make the new nurse aware of?

Accepted Answer

A)   Sudden tendency to bruise easily
B)   Transitory, generalized pain
C)   Frequent headaches
D)   Excessive, rapid weight gain
E)   Gradual, steady feverF)  Unexplained loss of energy

Question 5

In teaching parents how to minimize or prevent bleeding episodes when the child is myelosuppressed,the nurse includes what information?

Accepted Answer

A)   Meticulous mouth care is essential to avoid mucositis.
B)   Rectal temperatures are necessary to monitor for infection.
C)   Intramuscular injections are preferred to intravenous ones.
D)   Platelet transfusions are given to maintain a count greater than 50,000/mm³.

Question 6

Daily toothbrushing and flossing can be encouraged for the child on chemotherapy when the platelet count is above which?

Accepted Answer

A)   10,000/mm³
B)   20,000/mm³
C)   30,000/mm³
D)   40,000/mm³

Question 7

What is an important priority in dealing with the child suspected of having Wilms tumor?

Accepted Answer

A)   Intervening to minimize bleeding
B)   Monitoring temperature for infection
C)   Ensuring the abdomen is protected from palpation
D)   Teaching parents how to manage the parenteral nutrition

Question 8

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 9

A parent of a hospitalized child on chemotherapy asks the nurse if a sibling of the hospitalized child should receive the varicella vaccination.The nurse should give which response?

Accepted Answer

A)   The sibling can get a varicella vaccination.
B)   The sibling should not get a varicella vaccination.
C)   The sibling should wait until the child is finished with chemotherapy.
D)   The sibling should get varicella-zoster immune globulin if exposed to chickenpox.

Question 10

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 11

What description identifies the pathophysiology of leukemia?

Accepted Answer

A)   Increased blood viscosity
B)   Abnormal stimulation of the first stage of coagulation process
C)   Unrestricted proliferation of immature white blood cells (WBCs) 
D)   Thrombocytopenia from an excessive destruction of platelets

Question 12

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.
_____________

Accepted Answer

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

Question 13

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 14

What are favorable prognostic criteria for acute lymphoblastic leukemia?

Accepted Answer

A)   Male gender
B)   CALLA positive
C)   Early pre-B cell
D)   2 to 10 years of age
E)   Leukocyte count ?7?50,000/mm³

Question 15

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 16

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 17

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 18

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.

Question 19

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

Question 20

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."

Exam 31: The Child With Cancer