A 4-year-old has developed acute lymphocytic leukemia (ALL). Nursing care for the child with ALL involves taking axillary, rather than rectal,
... [Show More] temperatures because the child
A) is anemic.
B) has a low white blood count.
C) has a low platelet count.
D) is prone to diarrhea.
2. Children with ALL may need periodic lumbar punctures. You would teach the mother this is done to assess for
A) platelets.
B) leukemic cells.
C) early meningitis.
D) early development of septicemia.
3. When planning care for a child with ALL undergoing treatment, which nursing intervention would be most important?
A) Handling the head gently to prevent leukemic brain infiltration.
B) Providing the child with play materials that stimulate cognitive development.
C) Protecting the child from a sibling with an upper respiratory infection.
D) Encouraging the child to eat a high-protein diet.
4. A child with ALL is receiving methotrexate for therapy. Which nursing diagnosis below would best apply to him during therapy?
A) Risk for impaired skin integrity related to oral ulcerations associated with chemotherapy.
B) Risk for impaired mobility related to depressant effects of methotrexate.
C) Excess fluid volume related to effect of methotrexate on aldosterone secretion.
D) Risk for self-directed violence related to effect of methotrexate on central nervous system.
5. A child with ALL is beginning treatment with methotrexate in an attempt to eradicate the leukemic cells. The stage of therapy represents which of the following?
A) Induction phase.
B) Sanctuary phase.
C) Consolidation phase
D) Delayed intensive therapy phase.
6. A child with ALL is given leucovorin, a folinic acid, after high-dose methotrexate therapy. It is important to administer this drug because leucovorin
A) prevents methotrexate that is not incorporated into leukemia cells from entering normal cells.
B) helps methotrexate enter leukemia cells the same as insulin helps glucose enter cells.
C) is an experimental drug to ensure resistance to infection during methotrexate therapy.
D) will encourage bone marrow to build new cells after methotrexate therapy.
7. A child with cancer is receiving vincristine. It is most important to observe this child for which of the following side effects?
A) Constipation.
B) Diarrhea.
C) Flatulence.
D) Rectal bleeding.
8. Which of the following symptoms would lead you to suspect that a child is developing a common side effect of vincristine?
A) His cheeks are turning bright red.
B) He says his fingertips feel numb.
C) He says his teeth “ache.”
D) His hearing seems to be altered.
9. When explaining the procedure of bone marrow aspiration to a child with leukemia, the best explanation would be
A) “You will need to lie still afterward to prevent a headache.”
B) “You will feel pressure on your hip from the needle.”
C) “You will have to lie on your back and hold your breath.”
D) “You won't feel any pain at all, because you will be asleep.”
10. When discussing a diagnosis of ALL with parents, what is the most factual advice you could give them?
A) Children who are free of the disease for 4 years are considered cured.
B) The prognosis remains grave despite some advances in treatment.
C) Periods of remission and exacerbation are likely to occur throughout the child's life.
D) Because there is no cure for leukemia, despite recent advances, there is no hope.
11. A 6-month-old girl is seen with retinoblastoma. When taking a health history from her father, which symptom would you expect him to report he has noticed?
A) The infant always keeps her eyes tightly closed.
B) He has noticed one pupil appears white.
C) His daughter tugs and pulls at one ear.
D) His daughter's eye appears to be protruding.
12. Which of the following diagnoses would be most appropriate for an infant with a large retinoblastoma after surgery?
A) Anticipatory grieving related to change in body image.
B) Fear related to loss of normal vision.
C) Pain related to retinal removal.
D) Disturbed sensory perception related to enucleation.
13. A school-age child with cancer is receiving chemotherapy. Which nursing action would best promote the oral comfort of a child receiving chemotherapy?
A) Asking the child to rinse the mouth with salt water.
B) Encouraging the use of acidic fruit juices to decrease mouth organisms.
C) Keeping the child's lips moist with Vaseline to prohibit cracking.
D) Vigorously brushing the teeth and gums to remove secretions.
14. Which of the following would be most helpful in preventing kidney stones from high uric acid levels in a child receiving chemotherapy?
A) Encouraging fluids.
B) Administering prescribed acetaminophen.
C) Encouraging the intake of fruits.
D) Keeping the child active.
15. When planning long-term care for an infant with retinoblastoma, which of the following teaching points would be most important to plan?
A) She should know that retinoblastoma might be inherited.
B) She should know to avoid all corticosteroid therapy.
C) It would never be advisable for her to wear contact lenses.
D) She needs to learn to think of herself as lucky.
16. A high-school football player has been diagnosed as having osteosarcoma of the femur. His mother is angry because she told him not to play football. Which of the following health teaching points would you include in the teaching plan for the boy and his mother?
A) Osteosarcoma often follows trauma, such as a football injury.
B) He can expect some discoloration of his leg following chemotherapy.
C) Football injuries do not contribute to the development of a tumor.
D) Tumor growth is more related to his dislike of milk.
17. An adolescent has a portion of his femur removed and an artificial bone transplant put in its place because of osteosarcoma. Which of the following approaches to his care would be appropriate postsurgically?
A) Discouraging him from contacting peers until he is able to fully ambulate.
B) Discouraging him from talking about his body image until healing is complete.
C) Encouraging him to release any anger he feels about his condition.
D) Urging him to stop thinking about sports.
18. A 2-year-old has a nephroblastoma (Wilms' tumor). The first symptom of a Wilms' tumor you would expect his parents most likely to have reported is
A) blood in urine.
B) chronic cough.
C) abdominal mass.
D) oliguria.
19. An important nursing intervention to institute with an infant before surgery for a Wilms' tumor is to place a sign over his crib that reads
A) “do not palpate abdomen.”
B) “no milk or milk products allowed.”
C) “no blood sampling in lower extremities.”
D) “no intramuscular injections.”
20. A child is to receive radiation therapy this morning. A drug you would expect to see prescribed for him before this would be
A) an analgesic.
B) an antiemetic.
C) an antipyretic.
D) an antineoplastic.
21. As you bathe an infant receiving radiation therapy, you notice that there are ink marks at the site where the radiation will be directed. Which nursing action is indicated?
A) Cleanse the marks well with soap and water.
B) Remove the ink marks with acetone or alcohol.
C) Leave the ink marks alone.
D) Apply lotion to the area to keep the skin moist.
22. An infant received radiation to his right kidney for treatment for cancer. At health maintenance visits for the next 5 years, which assessment is most important in detecting the long-term effects of radiation?
A) Palpation of his back for a recurring tumor.
B) Assessment of his spine for scoliosis.
C) Assessment for petechiae over lower extremities.
D) Examination of his retina for retinoblastoma.
23. A school-age child receiving chemotherapy has experienced alopecia. What intervention by the nurse may be most helpful?
A) Letting the child choose a wig to play with.
B) Providing a doll without hair to play with.
C) Encourage the parents to not discuss it.
D) Give the child a book to read about it.
24. A 6-year-old child receiving chemotherapy develops stomatitis. The physician prescribes Xylocaine to be used to decrease the discomfort associated with this. The nurse must first teach the child:
A) To drink the solution with his favorite beverage.
B) To use the solution after eating.
C) Not to swallow the solution.
D) To use the solution after brushing their teeth. [Show Less]