Question 1

The child is admitted to the hospital unit newly diagnosed with retinoblastoma. Which clinical manifestation does the nurse anticipate upon assessment?

Accepted Answer

A white reflex or leukocoria is a classic sign of retinoblastoma. This may be seen in flash photography or upon direct ophthalmoscopic examination. Blue-tinged or yellow-tinged sclerae and a red reflex are not typically associated with retinoblastoma.

Question 2

Which urine specific gravity, and corresponding pH, should the nurse include in a goal statement for a pediatric client receiving chemotherapy in the treatment of cancer?

Accepted Answer

A specific gravity of 1.005 indicates well-hydrated status, and a pH of 7.5 is slightly alkaline, which is often desirable to prevent complications like tumor lysis syndrome in pediatric clients receiving chemotherapy.

Question 3

Which general manifestations should the nurse monitor for when conducting a physical assessment for a pediatric client who is diagnosed with cancer? Select all that apply.

Accepted Answer

General manifestations that the nurse should monitor for in a pediatric client with cancer include infection, petechiae, pain, and cachexia. Polycythemia is not a common manifestation associated with cancer in pediatric clients.

Question 4

A pediatric client diagnosed with cancer is to receive 2 months of chemotherapy that is separated by a 6-week period. The mother asks why the child cannot receive the medication for 2 months straight. Which rationale should the nurse include when responding to the client's mother?

Accepted Answer

The reason for the break in chemotherapy is to allow normal cells to repair themselves while the cancer cells die. This helps to prevent some of the negative side effects associated with chemotherapy, such as damage to healthy cells and tissues.

Question 5

The nurse is preparing to administer a prescribed, as needed, antiemetic drug for a child who is diagnosed with cancer. Which action by the nurse is most appropriate?

Accepted Answer

Administering the drug prophylactically prior to the next dose of chemotherapy is the most appropriate action as it can prevent nausea and vomiting associated with chemotherapy. Waiting for the child to become nauseated before administering the drug (Option A) may not be effective in preventing vomiting. Administering after the next dose of chemotherapy (Option C) may not be timely enough to prevent nausea and vomiting. Administering the drug only if the child is experiencing diarrhea (Option D) is not relevant to nausea and vomiting associated with chemotherapy.

Question 6

The nurse is providing care to a pediatric client who is receiving chemotherapy to treat acute lymphocytic leukemia (ALL). Which nursing diagnoses should the nurse include in the plan of are based on the side effects associated with the treatment? Select all that apply.

Accepted Answer

Chemotherapy for ALL can cause side effects such as increased risk of bleeding (Risk for Injury), skin issues (Impaired Skin Integrity), electrolyte imbalances due to nausea/vomiting (Risk for Electrolyte Imbalance), and immunosuppression (Risk for Infection). Sleep deprivation is not a direct side effect of chemotherapy.

Question 7

A preschool-age child is being seen in the oncology clinic. Which reaction should the nurse anticipate based on the child's stage of development?

Accepted Answer

At the preschool age, children are in the magical thinking stage of development. They often believe that their thoughts can cause events, which can lead to misconceptions such as believing they caused their illness as a form of punishment for real or imagined misdeeds.

Question 8

The child is receiving chemotherapy for acute lymphocytic leukemia (ALL). Which assessment data should the nurse immediately report to the healthcare provider due to a metabolic emergency?

Accepted Answer

Oliguria (decreased urine output) can be a sign of tumor lysis syndrome, a metabolic emergency that can occur in patients receiving chemotherapy. The rapid destruction of cancer cells can cause an increase in uric acid, potassium, and phosphorus levels, leading to kidney failure and potentially life-threatening complications. Thrombocytopenia (low platelet count), leukocytosis (high white blood cell count), and edema (swelling due to fluid accumulation) are potential side effects of chemotherapy, but are not indicative of a metabolic emergency like tumor lysis syndrome.

Question 9

The adolescent client is receiving methotrexate chemotherapy after undergoing limb-salvage surgery for osteogenic sarcoma. The healthcare provider also prescribes leucovorin therapy. Which adolescent statement indicates correct understanding for the administration schedule for this newly prescribed drug?

Accepted Answer

Leucovorin is given to reduce the toxic effects of methotrexate. It is important that it is administered on time as prescribed by the healthcare provider to ensure the maximum benefit. The statements A and B are incorrect as they indicate incorrect understanding of the purpose of leucovorin therapy, and the statement in C is incorrect as it does not specify the frequency of the dose.

Question 10

Which is a therapeutic nursing response when the mother of a pediatric client diagnosed with cancer states, "I regret not seeking medical attention earlier for my child."?

Accepted Answer

This response acknowledges the mother's feelings and provides reassurance by explaining that many cancers are difficult to diagnose early, which can help alleviate her guilt.

Question 11

An adolescent female client, diagnosed with osteosarcoma, has a below-the-knee amputation as part of the treatment regimen. Which behavior, assessed by the nurse, indicates the client is beginning to accept the amputation?

Accepted Answer

Watching the dressing change indicates that the client is beginning to accept the amputation and is willing to face the reality of the situation. Complaints of pain in the missing leg and insisting on covering the lower portion of the body indicate possible denial or difficulty accepting the amputation. Insisting on the application of a prosthetic prior to participating in physical therapy may indicate impatience or unrealistic expectations.

Question 12

The parent of a child diagnosed with Ewing sarcoma asks why multiple drugs are needed to treat this cancer. Which rationale should the nurse use when responding to the client's mother?

Accepted Answer

The prescribed drug protocol for Ewing sarcoma involves a group of drugs that work in different modes, such as targeting different aspects of the cancer cells and preventing the development of drug resistance. This approach is known as combination therapy and is a standard practice to treat especially aggressive cancers like Ewing sarcoma. The use of multiple drugs can also help decrease side effects by allowing for lower doses of each individual drug. Additionally, this drug protocol is not specific to children and can be used in both children and adults.

Question 13

Which is the priority nursing intervention for a pediatric client, diagnosed with leukemia, who has a granulocyte count of 250/mm³ and a platelet count of 150,000/mm³?

Accepted Answer

The answer of Which is the priority nursing intervention for...

Question 14

The nurse is providing care for a pediatric client who is diagnosed with a Wilms tumor. Which laboratory test result should the nurse monitor prior to administering the prescribed chemotherapy dose?

Accepted Answer

When administering chemotherapy, it is important to monitor the ANC because chemotherapy can suppress the bone marrow and lower the client's immune system. This increases the risk for infections and sepsis. Therefore, monitoring the ANC helps to prevent such complications.

Question 15

The school-age child, diagnosed with a medulloblastoma, will receive intrathecal chemotherapy injections after surgery. Which rationale for this type of chemotherapy administration should the nurse include in the medication teaching?

Accepted Answer

Medulloblastoma is a type of brain tumor, and many chemotherapy drugs do not cross the blood-brain barrier. Intrathecal administration allows the medication to reach the cerebrospinal fluid directly, providing localized treatment to the central nervous system.

Question 16

A child with rhabdomyosarcoma is prescribed radiation therapy after surgical removal of the tumor. Which intervention should the nurse include in the child's plan of care?

Accepted Answer

The child should avoid exposure to sunlight during radiation therapy and should wear protective clothing when outside. Sunscreen should be applied to protect the area from any accidental exposure. Applying lotion to the area before radiation therapy or vigorously scrubbing the area when bathing the child can irritate the skin, and removing markings left after each treatment can interfere with accurate placement of subsequent treatments.

Question 17

The sibling of a pediatric client diagnosed with leukemia expresses feelings of anger and guilt to the nurse. Which explanation should the nurse provide to the client's parents regarding the reaction of the sibling?

Accepted Answer

It is normal for siblings to experience anger and guilt when a sibling is diagnosed with a serious illness. The sibling may feel neglected, jealous, or even responsible for the diagnosis. It is important for the nurse to provide support and resources to help the sibling cope with these emotions.

Question 18

A child diagnosed with cancer is prescribed chemotherapy. Recent laboratory data show a low white blood cell (WBC) count. Which prescription should the nurse anticipate based on the current data?

Accepted Answer

Chemotherapy can cause a decrease in WBC count, which puts the child at an increased risk for infection. Filgrastim (Neupogen) is a medication that stimulates the production and release of neutrophils, a type of WBC, which can help increase the child's WBC count and reduce the risk of infection. Epoetin alfa (Epogen) is a medication that stimulates the production of red blood cells and is not indicated for a low WBC count. Ondansetron (Zofran) is an antiemetic medication used to prevent nausea and vomiting caused by chemotherapy. Oprelvekin (Neumega) is a medication that stimulates the production of platelets and is not indicated for a low WBC count.

Question 19

A school-age child, diagnosed with rhabdomyosarcoma, is experiencing nausea and vomiting related to the prescribed chemotherapy in spite of the use of antiemetics. The mother is pushing the child to eat the food. Which statement by the nurse is appropriate to address this situation?

Accepted Answer

Forcing the child to eat may lead to a food aversion, which could cause the child to avoid eating altogether. Therefore, it is important to address the mother's behavior and encourage her to create a positive mealtime environment where the child feels comfortable and safe to eat. Option A is incorrect since IV fluids alone do not provide adequate nutrition for a child undergoing treatment. Option C is incorrect since emesis can occur due to chemotherapy, and force-feeding is unlikely to cause stomach damage. Option D is incorrect since it does not address the issue of food aversion and is too vague in its warning of potential conflicts.

Question 20

Which nursing intervention is contraindicated for a pediatric client who is experiencing thrombocytopenia secondary to chemotherapy treatments?

Accepted Answer

Administering intramuscular injections can increase the risk of bleeding in a client with thrombocytopenia, so it is contraindicated. The other options are appropriate for nursing care of a pediatric client with thrombocytopenia. Monitoring intake and output can help detect signs of bleeding, palpating during an assessment can help identify potential areas of bleeding, and providing oral hygiene is important to prevent infections that could further compromise the client's health.

Quiz 50: The Child With Cancer

The child is admitted to the hospital unit newly diagnosed with retinoblastoma. Which clinical manifestation does the nurse anticipate upon assessment?

Which urine specific gravity, and corresponding pH, should the nurse include in a goal statement for a pediatric client receiving chemotherapy in the treatment of cancer?

Which general manifestations should the nurse monitor for when conducting a physical assessment for a pediatric client who is diagnosed with cancer? Select all that apply.

A pediatric client diagnosed with cancer is to receive 2 months of chemotherapy that is separated by a 6-week period. The mother asks why the child cannot receive the medication for 2 months straight. Which rationale should the nurse include when responding to the client's mother?

The nurse is preparing to administer a prescribed, as needed, antiemetic drug for a child who is diagnosed with cancer. Which action by the nurse is most appropriate?

The nurse is providing care to a pediatric client who is receiving chemotherapy to treat acute lymphocytic leukemia (ALL) . Which nursing diagnoses should the nurse include in the plan of are based on the side effects associated with the treatment? Select all that apply.

A preschool-age child is being seen in the oncology clinic. Which reaction should the nurse anticipate based on the child's stage of development?

The child is receiving chemotherapy for acute lymphocytic leukemia (ALL) . Which assessment data should the nurse immediately report to the healthcare provider due to a metabolic emergency?

Which is a therapeutic nursing response when the mother of a pediatric client diagnosed with cancer states, "I regret not seeking medical attention earlier for my child."?

An adolescent female client, diagnosed with osteosarcoma, has a below-the-knee amputation as part of the treatment regimen. Which behavior, assessed by the nurse, indicates the client is beginning to accept the amputation?

The parent of a child diagnosed with Ewing sarcoma asks why multiple drugs are needed to treat this cancer. Which rationale should the nurse use when responding to the client's mother?

Which is the priority nursing intervention for a pediatric client, diagnosed with leukemia, who has a granulocyte count of 250/mm³ and a platelet count of 150,000/mm³?

The nurse is providing care for a pediatric client who is diagnosed with a Wilms tumor. Which laboratory test result should the nurse monitor prior to administering the prescribed chemotherapy dose?

The school-age child, diagnosed with a medulloblastoma, will receive intrathecal chemotherapy injections after surgery. Which rationale for this type of chemotherapy administration should the nurse include in the medication teaching?

A child with rhabdomyosarcoma is prescribed radiation therapy after surgical removal of the tumor. Which intervention should the nurse include in the child's plan of care?

The sibling of a pediatric client diagnosed with leukemia expresses feelings of anger and guilt to the nurse. Which explanation should the nurse provide to the client's parents regarding the reaction of the sibling?

A child diagnosed with cancer is prescribed chemotherapy. Recent laboratory data show a low white blood cell (WBC) count. Which prescription should the nurse anticipate based on the current data?

A school-age child, diagnosed with rhabdomyosarcoma, is experiencing nausea and vomiting related to the prescribed chemotherapy in spite of the use of antiemetics. The mother is pushing the child to eat the food. Which statement by the nurse is appropriate to address this situation?

Which nursing intervention is contraindicated for a pediatric client who is experiencing thrombocytopenia secondary to chemotherapy treatments?

Quiz 50: The Child With Cancer

The child is admitted to the hospital unit newly diagnosed with retinoblastoma. Which clinical manifestation does the nurse anticipate upon assessment?

Which urine specific gravity, and corresponding pH, should the nurse include in a goal statement for a pediatric client receiving chemotherapy in the treatment of cancer?

Which general manifestations should the nurse monitor for when conducting a physical assessment for a pediatric client who is diagnosed with cancer? Select all that apply.

A pediatric client diagnosed with cancer is to receive 2 months of chemotherapy that is separated by a 6-week period. The mother asks why the child cannot receive the medication for 2 months straight. Which rationale should the nurse include when responding to the client's mother?

The nurse is preparing to administer a prescribed, as needed, antiemetic drug for a child who is diagnosed with cancer. Which action by the nurse is most appropriate?

The nurse is providing care to a pediatric client who is receiving chemotherapy to treat acute lymphocytic leukemia (ALL) . Which nursing diagnoses should the nurse include in the plan of are based on the side effects associated with the treatment? Select all that apply.

A preschool-age child is being seen in the oncology clinic. Which reaction should the nurse anticipate based on the child's stage of development?

The child is receiving chemotherapy for acute lymphocytic leukemia (ALL) . Which assessment data should the nurse immediately report to the healthcare provider due to a metabolic emergency?

Which is a therapeutic nursing response when the mother of a pediatric client diagnosed with cancer states, "I regret not seeking medical attention earlier for my child."?

An adolescent female client, diagnosed with osteosarcoma, has a below-the-knee amputation as part of the treatment regimen. Which behavior, assessed by the nurse, indicates the client is beginning to accept the amputation?

The parent of a child diagnosed with Ewing sarcoma asks why multiple drugs are needed to treat this cancer. Which rationale should the nurse use when responding to the client's mother?

Which is the priority nursing intervention for a pediatric client, diagnosed with leukemia, who has a granulocyte count of 250/mm3 and a platelet count of 150,000/mm3?

The nurse is providing care for a pediatric client who is diagnosed with a Wilms tumor. Which laboratory test result should the nurse monitor prior to administering the prescribed chemotherapy dose?

The school-age child, diagnosed with a medulloblastoma, will receive intrathecal chemotherapy injections after surgery. Which rationale for this type of chemotherapy administration should the nurse include in the medication teaching?

A child with rhabdomyosarcoma is prescribed radiation therapy after surgical removal of the tumor. Which intervention should the nurse include in the child's plan of care?

The sibling of a pediatric client diagnosed with leukemia expresses feelings of anger and guilt to the nurse. Which explanation should the nurse provide to the client's parents regarding the reaction of the sibling?

A child diagnosed with cancer is prescribed chemotherapy. Recent laboratory data show a low white blood cell (WBC) count. Which prescription should the nurse anticipate based on the current data?

A school-age child, diagnosed with rhabdomyosarcoma, is experiencing nausea and vomiting related to the prescribed chemotherapy in spite of the use of antiemetics. The mother is pushing the child to eat the food. Which statement by the nurse is appropriate to address this situation?

Which nursing intervention is contraindicated for a pediatric client who is experiencing thrombocytopenia secondary to chemotherapy treatments?

Which is the priority nursing intervention for a pediatric client, diagnosed with leukemia, who has a granulocyte count of 250/mm³ and a platelet count of 150,000/mm³?