1. The school nurse is discussing testicular self-examination with adolescent boys. Why
is this important?
a. Epididymitis is common during
... [Show More] adolescence.
b. Asymptomatic sexually transmitted diseases may be present.
c. Testicular tumors during adolescence are generally malignant.
d. Testicular tumors, although usually benign, are common during adolescence.
ANS: C
Tumors of the testes are not common, but when manifested in adolescence, they are
generally malignant and demand immediate evaluation. Epididymitis is not common in
adolescence. Asymptomatic sexually transmitted disease would not be evident during
testicular self-examination. The focus of this examination is on testicular cancer.
Testicular tumors are most commonly malignant.
DIF: Cognitive Level: Apply REF: p. 842
2. Which is the usual presenting symptom for testicular cancer?
a. Hard, painful mass
b. Hard, painless mass
c. Epididymis easily palpated
d. Scrotal swelling and pain
ANS: B
The usual presenting symptom for testicular cancer is a heavy, hard, painless mass that
is either smooth or nodular and palpated on the testes. A hard, painful mass, an
epididymis easily palpated, and scrotal swelling and pain are not the clinical
presentations of testicular cancer.
DIF: Cognitive Level: Understand REF: p. 842
3. Which is most descriptive of the pathophysiology of leukemia?
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.
ANS: C
Leukemia is a group of malignant disorders of the bone marrow and lymphatic system.
It is defined as an unrestricted proliferation of immature WBCs in the blood-forming
tissues of the body. Increased blood viscosity may occur secondary to the increased
number of WBCs. Thrombocytopenia may occur secondary to the overproduction of
WBCs in the bone marrow. The coagulation process is unaffected by leukemia.
DIF: Cognitive Level: Understand REF: p. 826
4. A boy with leukemia screams whenever he needs to be turned or moved. Which is
the most probable cause of this pain?
a. Edema
b. Bone involvement
c. Petechial hemorrhages
d. Changes within the muscles
ANS: B
The invasion of the bone marrow with leukemic cells gradually causes a weakening of
the bone and a tendency toward fractures. As leukemic cells invade the periosteum,
increasing pressure causes severe pain. Edema, petechial hemorrhages, and changes
within the muscles would not cause severe pain.
DIF: Cognitive Level: Analyze REF: p. 826
5. Myelosuppression, associated with chemotherapeutic agents or some malignancies
such as leukemia, can cause bleeding tendencies because of a(n):
a. decrease in leukocytes.
b. increase in lymphocytes.
c. vitamin C deficiency
d. decrease in blood platelets
ANS: D
The decrease in blood platelets secondary to the myelosuppression of chemotherapy
can cause an increase in bleeding. The child and family should be alerted to avoid risk
of injury. Decrease in leukocytes, increase in lymphocytes, and vitamin C deficiency
would not affect bleeding tendencies.
DIF: Cognitive Level: Apply REF: p. 828
6. A child with leukemia is receiving triple intrathecal chemotherapy consisting of
methotrexate, cytarabine, and hydrocortisone. What will the triple intrathecal
chemotherapy prevent?
a. Infection
b. Brain tumor
c. Drug side effects
d. Central nervous system (CNS) disease
ANS: D
For certain children, CNS prophylactic therapy is indicated. This drug regimen is used to
prevent CNS leukemia and will not prevent infection or drug side effects. If the child has
a brain tumor in addition to leukemia, additional therapy would be indicated.
DIF: Cognitive Level: Analyze REF: p. 831
7. 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?
a. Syngeneic -twin
b. Allogeneic -another individual
c. Monoclonal -made up
d. Autologous -own marrow
ANS: B
Allogeneic transplants are from another individual. Because he and his sibling are
histocompatible, the BMT can be done. Syngeneic marrow is from an identical twin.
There is no such thing as a monoclonal BMT. Autologous refers to the individual's own
marrow. DIF: Cognitive Level: Understand REF: p. 824 [Show Less]