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CPHON PRACTICE EXAM 150 QUESTIONS A,B & C WITH VERIFIED ANSWERS,100% CORRECT
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CPHON Practice Exam 50 Questions A with Verified Answers,100% CORRECT
CPHON Practice Exam 50 Questions A with Verified Answers BEARS - The BEARS tools assesses the child's sleep history with respect to Bedtime, Excessive d... [Show More] aytime sleepiness, Awakenings, Regularity and Snoring. - CORRECT ANSWER Parents report that their school- aged child with leukemia is not sleeping well at home. Which tool is used to assess for sleep disturbance? Autonomy versus doubt - Psychosocial autonomy versus doubt is the developmental task of a toddler. - CORRECT ANSWER Which of the following describes the developmental stage of a toddler? Denial allows the patient to maintain hope in order to function productively. - CORRECT ANSWER The nurse notices that a 13-year- old has been cheerful since learning of her cancer diagnosis, avoids discussing her illness and treatment, and allows her parents ask all the questions. The best interpretation of her behavior is that the patient is: Be emotionally involved and available to the teen. - CORRECT ANSWER The parent of an adolescent with cancer seeks advice on how to best promote the emotional well- being of the child while receiving therapy. The nurse's best advice to the parent is to? Translocation of B-cell immunoglobulin genes - Burkitt lymphoma and Burkitt-like lymphoma are characterized by the chromosomal translocation of B-cell immunoglobulin - CORRECT ANSWER Which of the following is a cytogenetic feature for a patient diagnosed with Burkitt lymphoma? Localized nodal disease - Involvement of a single lymph node is a favorable prognostic indicator. The presence of B symptoms, male gender, and an elevated sedimentation rate are considered unfavorable prognostic indicators. - CORRECT ANSWER What is a favorable prognostic indicator for a child diagnosed with Hodgkin lymphoma? Langerhans cell histiocytosis - CORRECT ANSWER Which of the following is a disorder of dendritic cells? Vagus - Brainstem gliomas effect cranial nerves V-X, and are located below the tentorium cerebelli. - CORRECT ANSWER Which nerve will most likely be compromised for a child diagnosed witha brainstem glioma? Oncogenes promote cell growth and prevent apoptosis. - CORRECT ANSWER Oncogenes transform normal cells in to cancer cells by which of the following actions? Abdominal lymphomas are at increased risk for tumor lysis syndrome and bowel obstruction - CORRECT ANSWER A patient with non-Hodgkin lymphoma with abdominal involvement is at greatest risk for which of the following complications? Leukocyte-reduction prevents the transmission of cytomegalovirus - CORRECT ANSWER Blood products are leukocyte- reduced to prevent which of the following? 50GY - CORRECT ANSWER Moist desquamation of the skin occurs with radiation doses of: 1000 mg/m2 of intravenous cytarabine - CORRECT ANSWER Which of the following doses of medication is most likely associated with neurocognitive sequelae? Signs of precocious puberty include advanced bone age, early onset breast development, early epiphyseal fusion, short stature. - CORRECT ANSWER Which of the following is an indication that a child is experiencing precocious puberty? "Which therapies have you looked in to?" Nurses should encourage open communication with families about complementary therapies. Nurses should assess which therapies the patient would like to have more information about. - CORRECT ANSWER After receiving treatment information, the parents of a child recently diagnosed with cancer ask if complementary and alternative treatments are an option. What is the nurse's best response? The mechanism of action determines how the medication is classified. - CORRECT ANSWER Chemotherapy medications are either cell-cycle specific or nonspecific as determined by the medication's? Verify that the product is leukocyte-reduced - CORRECT ANSWER Which of the following is the most important action for the nurse to take prior to beginning the first platelet transfusion for a patient with leukemia? Decreased incidence of graft-versus-host disease - The potential for a low incidence of graft-versus-host-disease (GVHD) may be one of the most important advantages for using umbilical cord blood - CORRECT ANSWER Which of the following is an advantage of cord blood transplantation? "It is contraindicated with your child's treatment plan." Echinacea, antioxidants and immune-enhancing herbal therapies are contraindicated during bone marrow transplant. - CORRECT ANSWER Parents ask the nurse if echinacea supplements can be administered prior to their child's allogeneic stem transplant. What is the nurse's best response? Nephrotoxicity - Cisplatin intensifies aminoglycoside toxicity and should be used in caution when administered concurrently with gentamicin. - CORRECT ANSWER What is a potential risk for patients receiving gentamicin concurrently with cisplatin? The current treatment plan will provide the best possible outcome. "What concerns do you have?" Parents should verbalize the understanding of the primary diagnosis and treatment plan. - CORRECT ANSWER A patient with cancer has just completed scans to evaluate the response to treatment. The patient's mother states, "Now that the tumor is almost gone, can we switch to a less aggressive protocol?" Which of the following is the nurse's best response? Anemia - The clinical presentation of anemia includes: behavioral changes, skin color changes, dyspnea, and tachycardia - CORRECT ANSWER A child presents to the clinic with malaise, dizziness, jaundice, dyspnea, and tachycardia. What does the nurse anticipate the laboratory results will reveal? a bolus of isotonic fluids- Septic shock can quickly lead to decreased tissue perfusion, cellular hypoxia, and death. Volume resuscitation is critical for management of patients experiencing septic shock. - CORRECT ANSWER What is the initial intervention for a patient with neutropenia who develops fever and hypotension? Administer: Pneumocystis jiroveci is a yeast- like fungus that cause pneumocystis jiroveci pneumonia (PCP) in immunocompromised patients. - CORRECT ANSWER What protozoal organism is responsible for causing respiratory distress, tachypnea, and fever? The patient has adequate caloric intake- Patients are discharged from inpatient care when they meet specific criteria after a hematopoietic stem cell transplant, including evidence of engraftment, absence of fever, controlled graft-versus-host disease, adequate calorie intake, and completion of discharge education. - CORRECT ANSWER Caregivers ask when their child can be discharged after a stem cell transplant. A child can go home following transplant when: Intravenous opioids are recommended for severe pain. A patient- controlled-analgesia (PCA) device is recommended for complex and multimodal pain management. - CORRECT ANSWER An adolescent with osteosarcoma who recently had surgery reports his pain as a 9 out of 10. What is the best choice for his pain management? Cytomegalovirus - Ganciclovir, foscarnet, cidofovir, or high-dose immunoglobulin therapy may be administered to patients with an active cytomegalovirus pneumonitis infection. - CORRECT ANSWER Ganciclovir is used to treat pneumonia caused by which of the following organisms? Ondansetron is a serotonin receptor antagonist that is used to prevent and treat nausea and vomiting - CORRECT ANSWER Which anti-emetic is used for patients receiving highly emetogenic chemotherapy? The development of an inhibitor to factor VIII requires the use of a bypassing agent to stop bleeding, such as Recombinant factor VIlla. - CORRECT ANSWER A patient with a history of severe hemophilia A and an inhibitor presents with a swollen, painful elbow. The nurse anticipates administering which medication? Neuropathic pain results from nerve damage, such as after an injury to the peripheral nervous system following an amputation. - CORRECT ANSWER Phantom limb pain following a surgical amputation is an example of what type of pain? There are 5 stages of mucositis - CORRECT ANSWER How many stages of mucositis are there? Children with medulloblastoma are at an increased risk of developing increased intracranial pressure. - CORRECT ANSWER Which type of cancer places a patient at a higher risk for developing increased intracranial pressure? Administration of L-asparaginase is considered a risk factor for anaphylaxis. If a patient begins to complain of difficulty swallowing, the first thing the nurse must do is stop the infusion. - CORRECT ANSWER A child receiving L-asparaginase reports, "It is hard to swallow." What should the nurse's initial action be? Cyclophosphamide and vincristine both can cause the syndrome of inappropriate antidiuretic hormone which results in decreased urine output and low sodium. The treatment for SIADH is furosemide. - CORRECT ANSWER A child receiving cyclophosphamide and vincristine develops decreased urine output and sodium level 108 mEg/L. What does the nurse anticipate an order for? Serum sodium of 126 mEq/L. Syndrome of inappropriater antidiuretic hormone (SIADH) is associated with a decrease in urine output and increase in weight gain without edema, which leads to hyponatremia - CORRECT ANSWER A patient with the syndrome of inappropriate antidiuretic hormone would most likely have which of the following laboratory values? increased intracranial pressure - The classic triad of symptom that result from elevated intracranial pressure are morning headaches, lethargy, and nausea and/or vomiting. In younger children irritability is a common symptom of increased intracranial pressure. - CORRECT ANSWER A 5-year-old patient presents with irritability, lethargy, and vomiting. The nurse recognizes these may be symptoms of: Superior vena cava syndrome - Superior vena cava syndrome can occur when there is an occlusion from central venous catheter thrombosis. - CORRECT ANSWER A child with a central venous access device presents with flushed cheeks and facial swelling. What does the nurse suspect? Posterior fossa syndrome presents within 48 hours of posterior fossa surgery and can persist for six months. - CORRECT ANSWER A patient develops restlessness, ataxia, and progressive mental status changes following resection of a brain tumor. Which of the following oncologic complications is this patient experiencing? Nursing interventions for typhlitis include hyperhydration, broad-spectrum antibiotics coverage, pain management, and vasopressors when clinically indicated. - CORRECT ANSWER Which of the following interventions should be included in the treatment of typhlitis for a pediatric oncology patient? checking for child care assistance in the community - Nurses need to facilitate social support connections for families, and help families identify resources to help them at home. - CORRECT ANSWER The parents of a child diagnosed with cancer preparing for discharge are concerned that they will not be able to handle the care and activities of their two younger children, as well as their child with cancer. The nurse suggests? School age - Ophthalmologic examinations should be started at school age and repeated every few years due to the high risk for the development of retinopathy. - CORRECT ANSWER The initial ophthalmology exam for a child with sickle cell disease should be scheduled during which of the following developmental ages? Create a medication calendar to travel with the child - Tools such as home medication schedules, calendars, and pill boxes are recommended to assure medication adherence. - CORRECT ANSWER Which of the following interventions is the most appropriate to ensure medication adherence for a patient who's parents are divorced and sharing custody of the patient? "My pediatrician told me it was time to stop giving my child penicillin." Penicillin prophylaxis for children with sickle cell disease should continue until the child is between three and five years of age depending on the type of sickle cell disease. - CORRECT ANSWER Which of the following comments by the father of a 12-month-old child with sickle cell disease indicates the need for further teaching? Suggest that the parent be genuine and sincere - Children at this age have a limited understanding of death and it is best to be truthful and to answer the child's questions. School-age children may take words literally and develop a fear of sleeping. This child is old enough to understand some of the concepts of death. Although it may be appropriate to involve a trained professional, a parent should be the one to answer the questions the child has directly. Reference: Baggott, - CORRECT ANSWER The parent of a 7-year-old child with end-stage disease asks the nurse, "My child has been asking questions about death, what do I say?" What would be the most appropriate response from the nurse? There are 5 types of complicated grief: exaggerated, masked, delayed, chronic, and disenfranchised - CORRECT ANSWER Which of the following is a type of complicated grief? Medulloblastoma - Survivors of CNS tumors have the highest risk of poor quality of life. - CORRECT ANSWER Survivors of which of the following cancer diagnoses generally report the poorest quality of life? Following the death of a child, the grief of a parent will plateau between 12 - 18 months - CORRECT ANSWER Parental grief following the death of a child from cancer generally plateau's at what point in time? Maintain well-defined boundaries between self and the patient and family - According to the American Nurse Association's position statement on professional boundaries; the nurse must recognize and maintain boundaries when caring for patients and families. - CORRECT ANSWER Which of the following nursing actions is the most appropriate for fostering therapeutic relationships with patients? Phase 2 trials investigate the effectiveness of medication on a specific cancer. - CORRECT ANSWER The goal of a phase 2 clinical trial is to determine the: Veracity is the ethical duty to tell the truth - CORRECT ANSWER The ethical duty to tell the truth is known as: [Show Less]
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CPHON B Practice Exam 50 Questions with Verified Answers,100% CORRECT
CPHON B Practice Exam 50 Questions with Verified Answers Demonstrate the dressing change on a doll - Preschoolers need to explore pretend situations bef... [Show More] ore they experience them. Nurses should facilitate opportunities for imaginary play to meet the developmental needs of a preschool age child. - CORRECT ANSWER Which of the following nursing actions is the most appropriate prior to a first time central line dressing change for a four-year old? providing only essential information - Teaching materials should be focused on relevant and essential information for caregivers. Materials should be at the appropriate education level and learning preference of the learner. - CORRECT ANSWER While teaching parents of a child who was recently diagnosed with cancer, the nurse avoids overwhelming the parents by: saying up to six words - Normal language development for a 15-month-old child includes saying four to six words, gesturing, pointing, and understanding simple words. - CORRECT ANSWER A 15-month-old patient with cancer is at the nurses' station cooing at all the people who walk by. The nurse is concerned because the patient's language should include: Encouraging open communication - Engaging in open communication allows the nurse to assess the family and promotes a trusting relationship. - CORRECT ANSWER Which of the following actions by the nurse promotes effective coping for families dealing with a cancer diagnosis? Angiogenesis is the proliferation of new capillaries. - CORRECT ANSWER What is the term used to describe the process when tumors form their own blood supply to continue to grow? Stage III lymphoma involvement is on both side of diaphragm. - CORRECT ANSWER Which stage of Hodgkin lymphoma involves lymph node regions on both sides of the diaphragm? Specialty nursing practice guidelines There are three components to these standards: standards of professional practice, standards of professional performance, and specialty practice quidelines. - CORRECT ANSWER Which of the following is a component of the standards of nursing care? Reduce hospital-acquired infections Protective isolation measures such as positive-pressure single rooms, low- microbial diets, and strict hand-washing should be used for children requiring allogeneic transplant. - CORRECT ANSWER Protective isolation with positive- pressure air flow designed to do which of the following? 0.04 - CML accounts for less than 5% of pediatric cancers - CORRECT ANSWER Chronic myeloid leukemia accounts for approximately what percentage of childhood cancers? Non-Hodgkin lymphoma - Children with Wiskott-Aldrich syndrome, ataxia-telangiectasis, and other inherited or acquired immunodeficiency syndromes are at increased risk for non- Hodgkin lymphoma. - CORRECT ANSWER A patient with Wiskott-Aldrich syndrome has an increased risk for developing which of the following types of cancer? Trisomy 21 is considered a favorable prognostic indicator for patient diagnosed with both acute lymphoblastic leukemia and acute myeloid leukemia. - CORRECT ANSWER Which of the following genetic factors is associated with a favorable outcome in patients diagnosed with acute myeloid leukemia? Beckwith-Wiedemann syndrome - Hepatoblastoma is associated with Beckwith-Wiedemann syndrome, Li- Fraumeni syndrome, and chromosomal abnormalities. - CORRECT ANSWER Which of the following is an inherited condition that is associated with hepatoblastoma? blue-green - Mitoxantrone is dark blue in color and may turn urine blue/green - CORRECT ANSWER What is important to explain to a patient who is receiving mitoxantrone? The color of his urine may be: Hyponatremia The early clinical presentation of syndrome of inappropriate antidiuretic: hormone includes serum sodium levels less than 130 mEgL with thirst, anorexia, headache, muscle cramps, weakness, and lethargy. - CORRECT ANSWER What is the syndrome of inappropriate antidiuretic hormone manifested by? Obtain baseline laboratory studies, including blood cultures - Baseline laboratory studies must be obtained. This includes blood cultures, complete blood count, electrolytes, blood urea nitrogen, creatinine, liver function tests. - CORRECT ANSWER A patient with acute lymphoblastic leukemia presents to the emergency department with a fever of 102 degrees Fahrenheit (38.9 degrees Celsius). What initial order should the nurse expect? the first of three consecutive days with an absolute neutrophil count higher than 500. The standard definition of myeloid engraftment as defined by the Center for International Blood and Bone Marrow Transplant Research and FACT is the first 3 consecutive days with and ANC of greater than 500. - CORRECT ANSWER Myeloid engraftment is defined as: Transient radiation myelopathy myelopathy clinical manisfestation symptoms are characterized by momentary, electrical shock-like paresthesias or numbness radiating from the neck to the extremities occurring after neck flexion. It typically occurs 2-4 months after spinal cord exposure to radiation therapy. - CORRECT ANSWER A 10-year-old patient who received mantle radiation therapy four months ago presents with shock-like sensations moving down both arms after bending his neck forward. What is the patient experiencing? Temozolamide is an alkylating agent - CORRECT ANSWER Temozolamide is classified as an: Debulking is done when it is not possible to remove more than 90% of the tumor. - CORRECT ANSWER Which of the following is considered criteria for debulking surgery? The only know side effect of the administration of immunizations is soreness at the injection site - CORRECT ANSWER What is a known side effect of the HPV immunization? Stage 4 mucositis is characterized by ulcerations - CORRECT ANSWER Which stage of mucositis is characterized by ulcerations of the oral mucosa? Mantle radiation - Contemporary Hodgkin therapy now attempts to avoid exposing female patients to chest radiation whenever possible. - CORRECT ANSWER Treatment plans for females with Hodgkin lymphoma often avoid the use of which of the following treatments? Vincristine is a plant derivative. Their mechanism of action causes an arrest during mitosis - CORRECT ANSWER Which of the following medications causes cellular arrest? tolerated dose and shortest possible interval between doses Chemotherapy should be administered at maximum dose intensity maximum tolerated dose and shortest possible interval between doses. - CORRECT ANSWER The definition of maximum dose intensity is the maximum? Urinary function - Symptoms of spinal cord compression are dependent on the location of the tumor and may include back pain, weakness, ataxia, paralysis, bowel or bladder dysfunction, paresthesia. - CORRECT ANSWER A school-age child with metastatic Ewing sarcoma reports lower back pain during a clinic visit. What should the nurse further assess? Dexamethasone - Metoclopramide should be administered with dexamethasone or benadryl due to the side effects it may cause in children, most notably the extrapyramidal reactions - CORRECT ANSWER Which medication should be given concurrently with metoclopramide to help eliminate extrapyramidal reactions in pediatric patients? Venous irritation - Cladribine is an irritant and symptoms of venous irritation include sensations of aching and tightening along a peripheral vein, above the administration site during the infusion. - CORRECT ANSWER Cladribine is being administered peripherally to a patient who reports aching and tightness along the vein. What does the nurse suspect the patient is experiencing? Perform frequent clinical assessments - Decreased respiratory rate and decreased oxygen saturation are late signs of an opioid overdose. Baseline assessment of a patient's level of consciousness is the most reliable way to remain alert to excessive sedation and prevent respiratory depression. - CORRECT ANSWER An 18-year-old patient receiving a continuous infusion of morphine has a respiratory rate of 16 breaths per minute while sleeping. What is the most appropriate nursing action? Reacting to medications - Skin breakdown may be exacerbated by hypersensitivity reactions to medications. - CORRECT ANSWER Which of the following factors can contribute to impaired skin integrity for a patient receiving treatment for cancer? Hyaluronidase is the suggested antidote for vincristine - CORRECT ANSWER What is the recommended antidote for a vincristine extravasation? Pulmonary fibrosis - Bleomycin is most commonly associated with pulmonary toxicity, specifically pulmonary fibrosis. - CORRECT ANSWER The long term side-effects of bleomycin include which of the following? 2-6 months - Posterior fossa syndrome usually presents within 24 - 48 hours after posterior fossa surgery and can last for approximately 2 -6 months - CORRECT ANSWER Posterior fossa syndrome can last approximately how long? 6 months - Chronic pain is persistent pain that lasts for more than 6 months. - CORRECT ANSWER Chronic pain is defined as persistent pain that lasts for more than: Syndrome of inappropriate antidiuretic hormone Patients receiving cyclophosphamide have a risk for developing syndrome of antidiuretic hormone (SIADH). Polydipsia is an early sign of SIADH - CORRECT ANSWER A patient receiving cyclophosphamide reports extreme thirst. The nurse is concerned that the patient is exhibiting early signs of: Pulmonary edema is increased capillary permeability that causes fluid to leak into the lungs. Clinical features include weight gain, fluid retention, ascites, cough, and shortness of breath. - CORRECT ANSWER One week after an allogeneic transplant, a patient receiving multiple blood products develops a cough and shortness of breath. What is the most likely cause for the patient's oxygen saturation of 91%, respiratory rate of 28, and rales? Myocarditis - High doses of cyclophosphamide given in short doses and in conjunction with total body irradiation can induce acute or chronic myopericarditis that has been associated with pericardial tamponade, hemorrhagic myocardial necrosis, or PEA - CORRECT ANSWER Patients who have received high- dose cyclophosphamide in conjunction with radiation are monitored for which of the following complications? Hyperleukocytosis - The clinical presentation of hyperleukocytosis includes shortness of breath, tachypnea, cyanosis, blurred vision, headaches, seizures, papilledema, agitation, ataxia, confusion, delirium, and stupor. Hyperleukocytosis is a condition when white blood cell count is greater than 100,000/mm3. - CORRECT ANSWER An adolescent male presents with irritability, headache, and blurred vision. Laboratory data includes white blood count 275,000/mm3, hemoglobin 7 g/dL, and platelet count 20,000/mm3. These clinical presentations are indicative of which oncologic emergency? Malnutrition - Risk factors for sepsis include prolonged neutropenia, mucositis, malnutrition, asplenia, and the use of invasive devices, - CORRECT ANSWER Which of the following co- morbidities increases a patient's risk for developing sepsis? Disseminated intravascular coagulation - DIC is caused by an alteration in clotting factors in the blood stream. Clinical presentation may include: petechiae, ecchymosis, purpuric rash, prolonged/uncontrolled bleeding, abnormal PT/PTT - CORRECT ANSWER A patient comes to clinic with a temperature of 101.7°F (38.7°C), blood pressure 110/65 mmHg, platelet count 19,000/mm3, diffuse petechiae, and oozing at the port site. Which of the following is most likely the cause? "I feel overwhelmed with all of my new responsibilities." - Family members should be given adequate time and instruction to develop and begin implementing a coordinated plan of care for discharge. - CORRECT ANSWER A patient is being discharged following a hematopoietic stem cell transplant. Which statement made by the parent indicates that more teaching is required? Azoospermia - Radiation doses greater than 600cGy can cause permanent azoospermia - CORRECT ANSWER A patient who received 600cGy testicular radiation will most likely experience which of the following? 4-year-old with medulloblastoma receiving 4,000 cGy of whole-brain radiation with a posterior fossa boost dose - Patients receiving whole-brain radiation have the greatest risk of developing neurocognitive impairment. - CORRECT ANSWER Which patient is at greatest risk for developing neurocognitive impairment following treatment? Provide teaching about the use of contraception - An appropriate nursing intervention for sexually active patients is to provide education regarding the use of contraceptive methods to prevent unwanted pregnancy and sexually transmitted - CORRECT ANSWER What is the most appropriate nursing intervention for a sexually active female adolescent currently being treated with chemotherapy who reports having unprotected sex? At the time of diagnosis - Palliative care begins at the time of diagnosis with a life-threatening or life- limiting disease. - CORRECT ANSWER Members of the healthcare team should begin discussing palliative care: it is not what you say, but rather how you say it - Parents need to be cognizent of verbal and nonverbal cues when discussing death with children. Information should be appropriately delivered in a factual but sensitive manner. - CORRECT ANSWER When discussing death with children who have cancer it is most important to remember: talks about beginning to plan family activities without the child who has died - Rebuilding a life with the living family members demonstrates a healthy acceptance of the loss of a child. - CORRECT ANSWER Which of the following actions demonstrates a parent's healthy response to the death of a child? The parent: The student's death should be discussed in an open and honest manner - Teachers should be open and honest with classmates regarding a students death from cancer. - CORRECT ANSWER Which of the following is an appropriate action for a teacher to take with the classmates of a student who has died from cancer? evidence-based practice - Most models of EBP incorporate five main activities which are often referred to with the acronym the five A's (ask, acquire, appraise, apply and assess.) - CORRECT ANSWER Ask, acquire, appraise, apply and assess are activities incorporated into most models of: Fidelity - The ethical principle of fidelity applies to keeping the patient's best interests first when providing care. - CORRECT ANSWER A patient requests pain medication which the nurse administers, despite the parents requests to hold the medication. What ethical principle is the nurse demonstrating? A hospital conducts interdisciplinary meetings to discuss a patient's and parents' treatment decision - Strategies for addressing moral distress include healthcare institutions providing open discussions with staff regarding specific clinical decisions that have occurred with patients and families and developing policies and procedures to address situation that cause moral distress. - CORRECT ANSWER Which of the following is a positive strategy for addressing moral distress? [Show Less]
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CPHON Practice C Exam 50 Questions with Verified Answers,100% CORRECT
CPHON Practice C Exam 50 Questions with Verified Answers Participating in risk taking behavior- Adolescents can exhibit risk-taking behavior in response... [Show More] to a terminal diagnosis. - CORRECT ANSWER A 12-year-old patient with metastatic osteosarcoma has been told that his prognosis is poor. The nurse knows that which of the following would be a normal display of grief in this age group? 4-year-olds have increased fine motor skills which includes drawing pictures rather than scribbles. - CORRECT ANSWER A 4-year-old child with acute lymphoblastic leukemia has had a regression of several developmental milestones. The nurse assesses the patient and determines which of the following to be inappropriate for age? Discuss the importance of having the sibling visit the patient - Loved ones should be encouraged to visit the dying patient. - CORRECT ANSWER The mother of a child near the end-of-life voices concerns about the 8-year-old sibling visiting the patient, stating that it would be "traumatizing". What is the most appropriate response from the nurse? Herbs and supplements increase the risk of side effects and medication interactions. - CORRECT ANSWER The mother of a patient with acute lymphoblastic leukemia asks if she can give her child natural herbs to supplement the immune system. Which of the following is the most appropriate response from the nurse? "Inactivated immunizations are safe but may be ineffective." All family members and household contacts should be immunized with routinely recommended vaccines. - CORRECT ANSWER Which of the following statements indicates parents' understanding about immunizations while their child is being treated with chemotherapy? Identity versus identity confusion - CORRECT ANSWER A 16-year-old patient diagnosed with acute myeloid leukemia expresses concerns about graduation. Which of the following developmental stages does this represent? Itraconazole increases the risks for medication reactions - CORRECT ANSWER Which of the following can increase the risk of a medication interaction for a patient scheduled to receive vincristine? The goal of a phase 3 trial is to determine if new treatment is better than existing treatment - CORRECT ANSWER A patient with cancer tells the nurse that she is enrolled in a clinical trial to see if combination chemotherapy is more effective than single agent chemotherapy. Which phase of the trial is the patient enrolled? Intravenous immunoglobulins - IVIG is preferred over corticosteroids for treatment of ITP - CORRECT ANSWER A 13-month-old infant presents with a continuous nose bleed. The patient's laboratory values reveal hemoglobin 13g/dL; absolute neutrophil count 1545/mm3; and platelets 8/mm3. Which of the following will be the most likely initial treatment? Capillary leak syndrome is an early complication associated with HSCT - CORRECT ANSWER Which of the following complications would the nurse expect during the early phase of a hematopoietic stem cell transplant? Ferritin 875ng/mL - Iron overload can occur with repeated transfusions - CORRECT ANSWER A patient with beta-thalassemia requires blood transfusions every two weeks. Which of the following laboratory results would cause the nurse to be concerned? "I will need to shower several times a day after I receive the medication." Patients receiving thiotepa for HSCT conditioning should shower several times daily for 24 hours after treatment - CORRECT ANSWER Which statement by a patient receiving thiotepa for HSCT conditioning indicates an understanding of potential side effects? 9-year-old boy with an astrocytoma - Bevacizumab is used for refractory solid tumors - CORRECT ANSWER Which of the following patients would most likely be treated with bevacizumab? how well the body can fight off infection." Neutrophils fight infection - CORRECT ANSWER The mother of a child with acute lymphoblastic leukemia asks the nurse to explain the absolute neutrophil count. What is the nurse's best response? "The absolute neutrophil count measures: Doxorubicin increases hepatic radiosensitivty - CORRECT ANSWER Which of the following medications can increase radiosensitivity of the liver? Stereotactic radiosurgery - Stereotactic radiation is delivered via a focused beam to a small, well- circumscribed area of the tumor. - CORRECT ANSWER Which of the following is defined as radiation delivered via a focused beam to a small, well- cirumscribed area of the tumor? Infuse the frozen cells over 3 hours - Rapid infusion of frozen cells is recommended - CORRECT ANSWER Which of the following orders for a frozen stem cell transfusion should the nurse question? volume depleting the unit of packed red blood cells - Prevention of circulatory overload is accomplished by volume depleting the packed red blood cells. - CORRECT ANSWER Transfusion related circulatory overload can be prevented by: Acyclovir should be given prior to HSCT if a patient is positive for CMV - CORRECT ANSWER Prior to an HSCT, a patient tests positive for CMV. The nurse would expect which of the following medications to be administered the day before transplant? Fluorouracil causes diarhea. - CORRECT ANSWER After a four day course of chemotherapy, a patient is experiencing diarrhea. Which of the following medications most likely caused the diarrhea? Deferoxamine administration used to treat iron overload. - CORRECT ANSWER Which of the following orders would the nurse expect to receive for a patient with major beta- thalassemia who has laboratory results of hemoglobin 10g/dL, platelets 120/mm3 and serum ferritin greater than 1000ng/mL? Platelets - Platelet count should be greater than 50,000/mm3 for surgery. - CORRECT ANSWER Pre-operative laboratory results for a patient scheduled to receive an implanted port reveal hemoglobin 9g/dL, platelets 30,000/mm3, absolute neutrophil count 2500/mm3 and international normalized ratio 0.9. Which of the following products will the patient most likely receive before surgery? Dexamethasone - Osteopenia is associated with corticosteroid treatments - CORRECT ANSWER An 18-year-old patient with acute lymphoblastic leukemia reports severe, bilateral knee joint pain during a follow-up appointment. Which of the following medications most likely is the cause for the pain? • Tell me more about why you feel this way." - It is important to explore parents feelings when dealing with difficult diagnoses. - CORRECT ANSWER A patient with end stage leukemia is enrolled in hospice care. The mother states "You are wrong. My baby is going to live." Which of the following is the most therapeutic response from the nurse? Cisplatin causes delayed nausea and vomiting - CORRECT ANSWER A patient should be given instructions regarding delayed nausea and vomiting after receiving which of the following medications? Monitor strict intake and output - must be monitored following ifosfamide treatment. - CORRECT ANSWER The nurse caring for a patient who received ifosfamide prior to change of shift would expect orders for which of the following interventions? Swollen gums with moderate bleeding - CORRECT ANSWER Which of the following findings indicates grade 3 mucositis? Bone age study - Precociuos puberty symptoms include early breast development and advanced bone age - CORRECT ANSWER A 6-year-old female has breast development after completing radiation therapy for a brain tumor. Which of the following diagnostic studies would the nurse anticipate an order for? APL differentiation syndrome - APL differentiation syndrome is a complication from arsenic administration - CORRECT ANSWER Which of the following is a complication from arsenic trioxide? Limit outside activities between 11am and 3pm - Instruct patients to avoid being outside during extreme sun times - CORRECT ANSWER What instructions should the nurse provide to a patient starting weekly oral methotrexate? Glutamine can reduce the severity of mucositis - CORRECT ANSWER Which of the following complementary medicines has been used to reduce the severity of mucositis? Dexamethasone - Long term administration of corticosteriods can lead to cataract development - CORRECT ANSWER Which of the following medications does the nurse suspect caused cataract development in a 40-year-old pediatric cancer survivor? Musculoskeletal pain is described as sharp, throbbing and worse with movement - CORRECT ANSWER What type of pain is described as sharp, throbbing, and worse with movement or weight bearing? Non-rearranged germlines have improved outcomes - CORRECT ANSWER Which of the following cytogenetic abnormalities of acute lymphoblastic leukemia is associated with a poor prognosis? Hodgkin lymphoma - Clinical presentation of Hodgkin lymphoma includes: painless adenopathy, fatigue, night sweats. - CORRECT ANSWER A patient presents to the hospital with painless adenopathy, fatigue, fever, weight loss, and night sweats. The nurse anticipates a work up for which of the following diagnoses? Anaplastic astrocytomas are classified as grade 3 - CORRECT ANSWER According to the WHO classification system, an anaplastic astrocytoma is which grade of tumor? Renal tumor - CORRECT ANSWER A patient with Beckwith- Wiedemann syndrome is at an increased risk of developing: Increased unconjugated bilirubin a finding consistent with AHA - CORRECT ANSWER Which of the following findings is consistent witha diagnosis of autoimmune hemolytic anemia? Elevated urine catecholamines - Blue nodules are a clinical presentation for neuroblastoma - CORRECT ANSWER A 2-month-old infant has blue nodules along the abdomen. Which of the following laboratory values would make the nurse suspect a diagnosis of neuroblastoma? Down syndrome is a favorable prognostic factor for AML - CORRECT ANSWER Which of the following is considered a favorable prognostic factor for acute myeloid leukemia? Phosphorous 12 mg/dL - Hyperphosphatemia is associated with TLS - CORRECT ANSWER A patient with flank pain, nausea, and vomiting arrives to the Emergency Department. Which of the following laboratory values would make the nurse suspect a diagnosis of tumor lysis syndrome? Applying a warm compress to chest - Warm packs are used for a vincristine extravasation. - CORRECT ANSWER A patient receiving vincristine reports pain and redness at the implanted port site. After discontinuing the infusion, the nurse's next intervention would be: Nothing by mouth - Patients with pancreatitis should be on complete bowel rest - CORRECT ANSWER A 14-year-old patient with acute lymphoblastic leukemia in delayed intensification presents with abdominal pain, vomiting, and elevated serum amylase. Which of the following is the most appropriate dietary order? Dexamethasone administration - Dexamethasone is the initial treatment for spinal cord compression - CORRECT ANSWER A patient reports back pain for several weeks with a sudden onset of lower extremity weakness. A magnetic resonance image reveals a paravertebral spinal tumor and spinal edema. The nurse anticipates an initial order for which of the following? An abdominal ultrasound - Abdominal ultrasound is used to diagnose pancreatitis; side effect of PEG- asparaginase is pancreatitis. - CORRECT ANSWER A patient with leukemia who recently received PEG- asparaginase presents with flank pain, vomiting, and a fever. The nurse anticipates an order for: Hypersensitivity reaction - Urticaria and pruritis are symptoms of hypersensitivity reactions - CORRECT ANSWER A patient receiving a blood transfusion develops urticaria and reports pruritis. What does the nurse suspect? Intravenous methylprednisolone - Corticosteroids are the current standard treatment for SVCS - CORRECT ANSWER A patient presents with difficulty breathing and an audible wheezing. A chest x-ray reveals a mediastinal mass with tracheal deviation. What is the most appropriate initial intervention? Oxygen supplementation - Oxygen delivery in the least invasive way is one of the first treatments for shock. - CORRECT ANSWER Which of the following is the most appropriate initial nursing intervention for a patient who is lethargic, hypotensive and febrile? Initiate IV antibiotics - Antibiotics are the first treatment for typhlitis - CORRECT ANSWER Which of the following initial orders would the nurse expect when a patient presents with fever, bloody diarrhea, and right lower quadrant pain? "90% of children recover within 12 months." - 90% of children with ITP recover within 12 months - CORRECT ANSWER A patient diagnosed with idiopathic thrombocytopenic purpura (ITP) asks the nurse if this will affect him for the rest of his life. What should the nurse tell the patient? [Show Less]
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