CPHON Nurse Builders Book Exam Review 96 Questions with Verified Answers
In what age group is conscience beginning to develop?
a. toddlers
b.
... [Show More] preschoolers
c. school age
d. adolescents - CORRECT ANSWER b. preschoolers
What age group learns that gratification sometimes needs to be delayed?
a. infants
b. toddlers
c. preschoolers
d. adolescents - CORRECT ANSWER b. toddlers
Which of the following statements by teenagers is an example of the concept of personal fable?
a. "I know I could have a seizure, but it won't happen while I'm driving"
b. "You have no idea what it's like for me to go to school looking like this!"
c. "I don't care what's going on with the rest of my family, I deserve extra for having to deal with cancer!"
d. "When I'm not at school, everyone is talking about me!" - CORRECT ANSWER a. "I know I could have a seizure, but it won't happen while I'm driving"
A child asks the nurse why everyone keeps talking about her 'counts'. The nurse replies that her counts are her white blood cells that are like superheroes whose job it is to protect her against germs. For what age group would this explanation be best?
a. toddler
b. preschool
c. school aged
d. adolescent - CORRECT ANSWER c. school aged
A month after the death of a sibling, a child states "I know my brother died, but I hope he'll come back this summer." This statement is typical of what age group?
a. toddler
b. preschooler
c. school aged
d. adolescent - CORRECT ANSWER b. preschooler
The sibling of a child with end stage neuroblastoma has been acting out in school and refusing to help her sibling at home. Her parents describe her play as having a death theme. This behavior is characteristic of what age?
a. 5-year-old
b. 8-year-old
c. 10-year-old
d. 12-year-old - CORRECT ANSWER b. 8-year-old
A group of oncology nurses are setting up a program to help with school re-entry. Which of the following is not a necessary component of the program?
a. obtaining permission from the parents to contact the school
b. gathering information regarding the child's classwork and homework
c. coordinating with the school nurse and faculty
d. allowing the child to participate in a presentation to peers and faculty - CORRECT ANSWER b. gathering information regarding the child's classwork and homework
The nurse is discussing legacy making with an adolescent who has terminal cancer. Which of the following is not an intention of legacy making?
a. it helps the child decide how they will be remembered
b. it helps the child attend to unfinished business
c. it gives the child the ability to comfort family members
d. it keeps the child busy, decreasing the fear of death - CORRECT ANSWER d. it keeps the child busy, decreasing the fear of death
The parents of a 12-year-old with AML have asked the nurse ways to help the child's healthy fraternal twin. Which of the following is an appropriate suggestion?
a. have the child create a presentation for classmates and teachers
b. avoid talking about future plans that may be uncertain
c. avoid having the sibling attend any appointments
d. set expectations for the sibling to help care for his twin. - CORRECT ANSWER a. have the child create a presentation for classmates and teachers
What is the recommended minimum timeframe that a flu vaccine should be administered before chemotherapy?
a. 1 week
b. 2 weeks
c. 1 month
d. 3 months - CORRECT ANSWER b. 2 weeks
The oncology clinic nurse knows that healthcare teaching to an adolescent cancer survivor has been effective when she says?
a. "I never smoke cigarettes and only occasionally vape"
b. "I love hanging out with friends and going for shakes and hot dogs"
c. "I walk my dog twice a week and go for a run on the weekends"
d. "I love to eat fish tacos with avocado" - CORRECT ANSWER d. "I love to eat fish tacos with avocado"
The nurse is caring for a child with acute lymphoblastic leukemia and notes that the child has new onset stridor. What is the priority?
a. notify the provider and prepare for intubation
b. notify the provider and anticipate steroid administration
c. notify RT and anticipate the administration of racemic epinephrine
d. assist the child to a supine or side lying position and apply oxygen - CORRECT ANSWER b. notify the provider and anticipate steroid administration
The nurse is preparing a presentation on lymphomas. Which of the following is accurate concerning the incidence of lymphomas?
a. in children of all ages, hodgkin's lymphoma is more common than non-hodgkin's lymphoma
b. in developed countries, lymphomas comprise less than 1% of pediatric cancers
c. in children under 15 years, non-hodgkin's lymphoma is more common in males than in females
d. non-hodgkins lymphoma is more common in children under the age of 5 than in older children - CORRECT ANSWER c. in children under 15 years, non-hodgkin's lymphoma is more common in males than in females
What is the most common type of non-hodgkin's lymphoma?
a. lymphoblastic lymphoma
b. burkitt and burkitt-like lymphoma
c. diffuse large b-cell lymphoma
d. anaplastic large cell lymphoma - CORRECT ANSWER b. burkitt and burkitt-like lymphoma
Which of the following is accurate concerning medulloblastoma?
a. it is the most common benign central nervous system tumor
b. it is a slow growing tumor
c. it usually arises from the cerebellum or 4th ventricle
d. it rarely metastasizes - CORRECT ANSWER c. it usually arises from the cerebellum or 4th ventricle
Which of the following is classified as an infratentorial brain tumor?
a. medulloblastoma
b. hypothalamic tumor
c. optic pathway tumor
d. craniopharyngioma - CORRECT ANSWER a. medulloblastoma
Which of the following is true concerning Wilms anaplastic tumor?
a. it is the most common type of Wilms tumor
b. it is more common in older children
c. it is more common in caucasian than african american children
d. anaplasia respondss well to chemotherapy - CORRECT ANSWER b. it is more common in older children
Which lab result is consistent with autoimmune hemolytic anemia?
a. negative direct Coombs test
b. decreased reticulocyte count
c. increased LDH
d. increased hemoglobin - CORRECT ANSWER c. increased LDH
The nurse is providing counseling to a couple who both carry the genes for sickle cell disease. Which of the following is accurate regarding an inheritance pattern with each pregnancy?
a. there is a 50% chance the child will be a carrrier
b. there is a 75% chance the child will not be a carrier or have the disease
c. there is a 25% chance the child will be a carrier
d. there is a 50% chance the child will have the disease - CORRECT ANSWER a. there is a 50% chance the child will be a carrrier
What is the most common cause of death in children with sickle cell disease?
a. acute chest syndrome
b. splenic sequestration
c. aplastic crisis
d. sepsis - CORRECT ANSWER d. sepsis
The nurse is caring for a child admitted with a vaso-occlusive crisis. Which of the following is the priority intervention?
a. administer oxygen
b. administer IV antibiotics
c. administer IV fluids
d. apply a heating pad to painful areas - CORRECT ANSWER c. administer IV fluids
The nurse is caring for a 6 year old child with hereditary spherocytosis who is scheduled for a splenectomy. Prior to the splenectomy, the child is usually evaluated for the presence of:
a. gallstones
b. insulin deficiency
c. hypocalcemia
d. thrombocytopenia - CORRECT ANSWER a. gallstones
What organism is the most common cause of aplastic anemia in children with sickle cell disease?
a. parvovirus B19
b. epstein barr virus
c. cytomegalovirus
d. hepatitis B - CORRECT ANSWER a. parvovirus b19
A child has been diagnosed with severe aplastic anemia. Which of the following results corresponds with the severe classification?
a. ANC <200
b. platelet count <20,000
c. bone marrow cellularity < 50%
d. one cell line is severely depressed - CORRECT ANSWER b. platelet count <20,000
The nurse is obtaining the history of a child with Schwachman-Diamond Syndrome (SDS). The nurse expects the parents to describe the child's stool as:
a. long and thin, like a ribbon
b. clay colored
c. fatty and foul-smelling
d. small, round, and hard - CORRECT ANSWER c. fatty and foul-smelling
Which of the following are risk factors for the development of hemolytic uremic syndrome (HUS) after colitis?
a. male gender
b. administration of antibiotics or anti-peristaltic agents
c. low leukocyte count
d. low grade fever - CORRECT ANSWER b. administration of antibiotics or anti-peristaltic agents
A nurse is admitting a toddler with severe dehydration secondary to gastroenteritis. The child is noted to have bloody diarrhea and severe oliguria. When reviewing the orders, the nurse questions which of the following?
a. IV antibiotics
b. normal saline IV
c. acetaminophen
d. transfusion of pRBCs - CORRECT ANSWER a. IV antibiotics
(don't give w/HUS)
Which of the following lab results would be anticipated in a child with hemolytic uremic syndrome (HUS)?
a. hypernatremia
b. hyperkalemia
c. neutropenia
d. polycythemia - CORRECT ANSWER b. hyperkalemia
Which of the following is true concerning the use of desmopressin (DDAVP) for hemophilia?
a. it is used for mild to moderate factor IX deficiency
b. it can lead to hyponatremia
c. children should be encouraged to increase fluid intake after administration
d. it must be given IV to be effective - CORRECT ANSWER b. it can lead to hyponatremia
Which of the following is true concerning Von Willebrand Disease?
a. it is a very rare bleeding disorder
b. although seen in both genders, it tends to be detected more commonly among males
c. the majority of individuals with von willebrand disease are asymptomatic
d. symptoms are more apparent in children with blood type AB - CORRECT ANSWER c. the majority of individuals with von willebrand disease are asymptomatic
A committee of experienced oncology nurses meet to develop an orientation program for new nurses. They look at best practice and develop a didactic and skills program to meet the needs of new nurses. Preceptor guidelines are also formed. What standard of professional performance does this best reflect?
a. quality of practice
b. education
c. collegiality
d. collaboration - CORRECT ANSWER c. collegiality
After analyzing data regarding the last quarter's increase in central line infxns, a committee of nurses provide education and develop a tracking system for hand hygiene. Which standard of professional practice does this best reflect?
a. collaboration
b. ethics
c. leadership
d. resource utilization - CORRECT ANSWER c. leadership
The nurse is caring for a child receiving hydroxyurea. This medication is effective at decreasing vaso-occlusive crises associated w/sickle cell disease by:
a. decreasing fetal hemoglobin
b. increasing nitrous oxide level
c. increasing platelet count
d. increasing reticulocyte count - CORRECT ANSWER b. increasing nitrous oxide level
When is serum sickness likely to occur after receiving antithymocyte globulin?
a. within the first 12 hours
b. 12-24 hours
c. 7-14 days
d. there is no predictability to the occurrence of serum sickless - CORRECT ANSWER c. 7-14 days
AntiRho(D) immunoglobulin is prescribed for a child with ITP. Which of the following is an accurate statement?
a. it is most effective for children without a spleen
b. it is recommended for children who are not actively bleeding because the increase in platelet count is slow
c. it is only effective in children who are Rh negative
d. it can lead to severe anemia secondary to intravascular hemolysis - CORRECT ANSWER d. it can lead to severe anemia secondary to intravascular hemolysis
Why has the use of AntiRho(D) immunoglobulin decreased?
a. there are less expensive alternative therapies
b. the risk of bloodborne illness is high
c. there is a risk of intravascular hemolysis
d. it is not as effective as alternative therapies - CORRECT ANSWER c. there is a risk of intravascular hemolysis
A child with immune thrombocytopenic purpura (ITP) is being evaluated in the hematology clinic. The child's platelet count is 38,000. There are no signs of active bleeding such as petechiae, bruising, or mouth ulcers. The nurse anticipates that the child's treatment plan will include:
a. corticosteroid administration
b. IVIg adminstration
c. AntiRho(D) immunoglobulin
d. emergency splenectomy - CORRECT ANSWER a. corticosteroid administration
While reviewing a list of children coming to the hematology/oncology clinic, the nurse knows that rituximab would not be used for:
a. a teenager with ITP and history of hepatitis B
b. a child with ITP, non responsive to other therapies
c. a child with non-hodgkins lymphoma
d. a child with graft-vs-host disease - CORRECT ANSWER a. a teenager with ITP and history of hepatitis B
The nurse is providing education to the parents of a child receiving rituximab. the most common adverse effect the nurse should tell the parents about is:
a. the risk of infection
b. the risk of thrombosis
c. the risk of intravascular hemolysis
d. the risk of stroke - CORRECT ANSWER a. the risk of infection
Which of the following is true concerning IVIg?
a. it should be administered directly from the fridge and not allowed to warm to room temp
b. in order to avoid fluid overload, fluids should be restricted prior to administration
c. it has been associated with neutropenia
d. the most common adverse effects include headache and hypertension - CORRECT ANSWER c. it has been associated with neutropenia
The parents of a young child, who ahs just received IVIg tell the nurse that they have scheduled his MMR vaccine for the following week. How should the nurse advise the parents?
a. it is acceptable to administer the vaccine as long as they wait a full week
b. it is acceptable to administer the vaccine as long as it is the second dose of MMR
c. the vaccine will need to be delayed 8-9 months
d. the vaccine should be administered immediately - CORRECT ANSWER c. the vaccine will need to be delayed 8-9 months
Which of the following is accurate concerning immunizations in relation to a scheduled splenectomy?
a. pneumococcal, meningococcal, and h. influenza should be given before the splenectomy
b. pneumococcal, meningococcal, and h. influenza should be held until after the splenectomy
c. live vaccines can never be adminstered
d. the annual influenza vaccine is contra-indicated - CORRECT ANSWER a. pneumococcal, meningococcal, and h. influenza should be given before the splenectomy
A child will be receiving erythropoietin. The parents ask how often it is typically administered. The nurse knows that most often it is given:
a. subcutaneously, monthly
b. subcutaneously, 3x/week
c. subcutaneously, weekly
d. subcutaneously, daily - CORRECT ANSWER b. subcutaneously, 3x/week
During an exchange transfusion, the nurse monitors for signs of electrolyte imbalances. Which of the following is the most common electrolyte imbalance associated with an exchange transfusion?
a. hypercalcemia
b. hyperglycemia
c. hyponatremia
d. hypomagnesemia - CORRECT ANSWER b. hyperglycemia
One hour after the completion of a transfusion of packed red blood cells, a 4 year old child is noted to have the following vital signs: temp 39.1, heart rate 110, resp rate 38, and blood pressure 82/42. Auscultation of the lungs reveal crackles bilaterally. The nurse notifies the provider as the following is suspected:
a. acute hemolytic transfusion reaction
b. hypotensive transfusion reaction
c. transfusion associated circulatory overload
d. transfusion related acute lung injury - CORRECT ANSWER d. transfusion related acute lung injury
Which of the following is accurate concerning peripheral stem cell collection?
a. it can be collected through an existing peripheral IV
b. there continues to be a risk of bone pain
c. engraftment is slower
d. there are no associated risks w/donation - CORRECT ANSWER b. there continues to be a risk of bone pain
A child is receiving an infusion of fresh stem cells. Which of the following is a likely effect?
a. fluid overload
b. bradycardia
c. hypertension
d. complaints of a bad taste - CORRECT ANSWER a. fluid overload
The parents of a child with Hemophilia A report that they have given their child desmopressin (DDAVP). What instructions should the nurse provide?
a. decrease oral intake of fluids
b. monitor for increased urine output
c. report any facial flushing
d. report abdominal cramping and headaches - CORRECT ANSWER a. decrease oral intake of fluids
The nurse is caring for a child in the infusion clinic who is receiving chemotherapy prior to the surgical excision of a tumor. This type of therapy is referred to as:
a. multimodal
b. adjuvant
c. combination
d. neoadjuvant - CORRECT ANSWER d. neoadjuvant
The parents of a child receiving Bactrim call the after-hours clinic to report that their child has a blister type rash to his body including his mouth. The nurse should advise them to:
a. administer an oral dose of benadryl
b. discontinue the medication and see if the symptoms improve
c. apply hydrocortisone cream to the blisters and increase oral intake of fluids
d. immediately discontinue the medication and go to the emergency department - CORRECT ANSWER d. immediately discontinue the medication and go to the emergency department
The nurse is administering the first dose of GMCSF. For which of the following should the nurse monitor as part of the "first dose" phenomena?
a. oxygen desaturation
b. palor
c. bardycardia
d. hypertension - CORRECT ANSWER a. oxygen desaturation
Which of the following is true of brachytherapy?
a. a two-dimensional beam is aimed toward the tumor
b. it can involve temporary or permanent radiation
c. it is only effective in large tumors
d. it can only be used in children over 14 - CORRECT ANSWER b. it can involve temporary or permanent radiation
Radiation therapy that delivers varying levels of radiation with a maximum dose to the target area, while sparing healthy tissue, is referred to as:
a. brachytherapy
b. proton radiation therapy
c. external beam therapy
d. intensity-modulated therapy - CORRECT ANSWER d. intensity-modulated therapy
A child receiving radiation has experienced hair loss and desquamation of the skin. What is the minimum dose of radiation associated with this?
a. 10 Gy
b. 20 Gy
c. 30 Gy
d. 40 Gy - CORRECT ANSWER d. 40 Gy
A survivor of childhood cancer who received cyclophosphamide is most at risk for which of the following secondary cancers?
a. acute myeloid leukemia
b. bladder cancer
c. breast cancer
d. colorectal cancer - CORRECT ANSWER b. bladder cancer
The starting dose of an investigational agent is usually __ of an adult MTD?
a. 50%
b. 60%
c. 75%
d. 80% - CORRECT ANSWER d. 80%
How long do the medical records need to be kept after a new drug has been filed with the FDA?
a. 5 years
b. 7 years
c. 12 years
d. indefinitely - CORRECT ANSWER b. 7 years
A child with sickle cell anemia is admitted with a vaso-occlusive crisis. The child is complaining of extreme pain in the leg and rapidly withdraws the limb when the nurse assesses the leg. This pain is classified as:
a. somatic
b. centrally generated
c. visceral
d. sympathetically maintained - CORRECT ANSWER d. sympathetically maintained
(all vaso occlusive crisis pain classified as this; due to a dysregulation of the autonomic nervous system)
A child experiencing persistent pain is to receive adjuvant medications. The nurse would anticipate which medication?
a. fentanyl
b. ibuprofen
c. hydrocodone and acetaminophen
d. amitriptyline - CORRECT ANSWER d. amitriptyline
It is recommended that opioids are tapered if a child receives them for longer than:
a. 3 days
b. 5 days
c. 7 days
d. 10 days - CORRECT ANSWER c. 7 days
A child with ALL is receiving corticosteroids as part of his care. What effect does this have on sleep and fatigue
a. increases the time needed to fall asleep but does not cause nighttime awakening
b. increase in fatigue, leading to increased need for daytime naps
c. increases REM sleep
d. increases the total sleep time and delays morning awakening - CORRECT ANSWER b. increase in fatigue, leading to increased need for daytime naps.
Which of the following are characteristics of depression in children?
a. not wanting to be alone, playing in groups of children only
b. changes in appetite and diarrhea
c. self blame for negative events
d. inability to sit still, jitteriness - CORRECT ANSWER c. self blame for negative events
The nurse is assessing an implanted port to administer antibiotics. It is noted that there is no blood return and resistance is met when the port is accessed. How should the nurse proceed?
a. administer antibiotic as long as the child does not express discomfort
b. do not attempt to flush and notify the provider
c. assess for redness and swelling before attempting to flush
d. have the child change positions and apply a gentle force while flushing - CORRECT ANSWER b. do not attempt to flush and notify the provider
The nurse is obtaining a blood sample from an implanted port. The nurse disinfects the connection surface and sides of the needleless connector. If using chlorhexidine, what is the dry time?
a. 5 seconds
b. 10 seconds
c. 15 seconds
d. 20 seconds - CORRECT ANSWER d. 20 seconds
The nurse notes that the flow of IV solutions through the central line has become increasingly sluggish during the shift. The most common cause of catheter occlusion is:
a. lipid infusion
b. drug incompatibility
c. thrombus formation
d. diminished coagulation factors - CORRECT ANSWER c. thrombus formation
A 4 year old with a VP shunt is being evaluated for possible shunt malfunction. What would be most helpful in assessing for increased ICP?
a. assessing the fontanel
b. asking the child to look up
c. counting an apical pulse
d. asking the child to describe how his head feels - CORRECT ANSWER b. asking the child to look up
A preceptor is observing a new nurse taking care of a child receiving enteral feeds by NG tube. The nurse intervenes and provides more education when the following is observed:
a. the nurse flushes the tube with sterile water every 4 hours
b. the nurse elevates the bed to 30 degrees during the feeding
c. after the child pulls out the tube, the nurse replaces it and verifies the placement by auscultating for an air bolus
d. after determining the residual volume was more than 2 hours worth of feeding, the nurse holds the feeding and notifies the provider - CORRECT ANSWER c. after the child pulls out the tube, the nurse replaces it and verifies the placement by auscultating for an air bolus
Which of the following is true of refeeding syndrome?
a. it develops within 12 hours after initiation of nutritional supplementation
b. it is associated with slow and delayed nutritional correction
c. it is associated with fluid shifts an hyperphosphatemia
d. it is associated with electrolyte imbalances such as hypokalemia and hypophosphatemia - CORRECT ANSWER d. it is associated with electrolyte imbalances such as hypokalemia and hypophosphatemia
A mother tells the nurse that she has started using complementary therapies including herbs. What supplement is effective for oral ulcers?
a. chamomile
b. cloves
c. cinnamon
d. fennel - CORRECT ANSWER c. cinnamon
An adolescent has been admitted with pericarditis. Which manifestations are consistent with this diagnosis?
a. insomnia
b. loud echoing heart sounds
c. hypertension
d. ascites - CORRECT ANSWER d. ascites
A survivor of pediatric cancer was diagnosed with GI strictures. Which of the following manifestations are associated with GI strictures?
a. projectile non-bilious vomiting
b. hypoactive bowel sounds
c. nontender hepatomegaly
d. dysphagia - CORRECT ANSWER d. dysphagia
Which of the following is accurate concerning precocious puberty as a long-term effect to a child who has received alkylating agents for cancer treatment?
a. manifestations include breast development before the age of 10 in females
b. it can be more challenging to diagnose in males
c. it is associated with an increased final height
d. it is associated with delayed epiphyseal closure - CORRECT ANSWER b. it can be more challenging to diagnose in males
The parents of a child who had radiation to the legs and pelvis ask about growth hormone supplementation. The nurse bases the response on the fact that:
a. bones that have radiation may be resistant to growth hormones
b. growth hormones are given orally over several years
c. the best effects are associated with hormones that are begun within 3 months of the completion of cancer therapy
d. nutritional status does not play a role in growth when hormones are given - CORRECT ANSWER a. bones that have radiation may be resistant to growth hormones
An adolescent has developed Graves' disease several years after the completion of cancer therapy. Which manifestations would the nurse expect to see?
a. constipation
b. muscle weakness
c. decreased appetite
d. fatigue - CORRECT ANSWER b. muscle weakness
A 9 year old child, who was treated for cancer with radiation and chemotherapy as a toddler, is being evaluated for decreased peripheral vision. She also has complained of a headache and eye pain. This is characteristic of:
a. cataracts
b. glaucoma
c. uveitis
d. conjunctivitis - CORRECT ANSWER b. glaucoma
Which of the following is true concerning the general effects of chemo and radiation to the male reproductive system?
a. the cells that produce testosterone are more sensitive to the effects of therapy than the cells that produce sperm
b. most males will have normal pubertal development
c. adult sexual function is usually impaired
d. if an erection can be maintained, fertility is not impacted - CORRECT ANSWER b. most males will have normal pubertal development
The nurse is providing education to an adolescent male who is to receive testosterone supplementation. The nurse knows the teenager understands the education when he states:
a. "this medicine will increase my chances of breaking bones"
b. "I may feel lightheaded and dizzy since it can cause low blood pressure"
c. "I will report any joint and muscle pain"
d. "I will need to have daily injections - CORRECT ANSWER c. "I will report any joint and muscle pain"
Secondary neoplasms are most likely to occur ____ after radiation?
a. 1 year
b. 3 years
c. 5 years
d. 10 years - CORRECT ANSWER d. 10 years
A child, who received chemotherapy and radiation to the chest, asks the nurse why she has areas of darker skin. Which of the following is true regarding hyperpigmentation?
a. there is an association with bleomycin and methotrexate
b. it only occurs on the skin
c. it is important to mark the margins and observe over time
d. it is a permanent discoloration - CORRECT ANSWER a. there is an association with bleomycin and methotrexate
The nurse is caring for a child who has asplenia secondary to radiation. What is the most common pathogen responsible for bacterial sepsis in this child?
a. escheria coli
b. pseudomonas aeruginosa
c. staphylococcus aureus
d. streptococcus pneumoniae - CORRECT ANSWER d. streptococcus pneumoniae
What is the most common location of secondary cancer in individuals who have chronic graft-vs-host disease?
a. brain
b. oral cavity
c. rectum
d. breast - CORRECT ANSWER b. oral cavity
A child who is being managed with L-asparaginase for ALL is admitted with acute abdominal pain. The pain is located in the right upper abdomen and is worse after eating. It is also unrelieved with vomiting. Which of the following orders would the nurse question?
a. abdominal ultrasound
b. obtain serum amylase and lipase
c. increase ambulation as tolerated
d. IV fluids to infuse at maintenance rate - CORRECT ANSWER c. increase ambulation as tolerated
(this is describing pancreatitis)
A 7 year old child with a CNS tumor has been diagnosed with SIADH. Which of the following orders does the nurse question?
a. administration of hypertonic saline
b. administration of a loop diuretic
c. administration of DDAVP
d. fluid restrictions - CORRECT ANSWER c. administration of DDAVP
--DDAVP replaced ADH and there is PLENTY of this in SIADH; DDAVP would be used for patient in DI
An adolescent has been admitted to the oncology unit with a suspected diagnosis of superior vena cava syndrome. Which manifestations are consistent with this diagnosis?
a. difficulty swallowing
b. bounding pulses in the lower extremities
c. collateral veins noted on right leg
d. flank pain that increases with movement - CORRECT ANSWER a. difficulty swallowing
(SVC syndrome is when there is an obstruction of blood flow through the SVC. leads to upper body manifestations)
Spontaneous bleeding is associated with a platelet count of ___ or less
a. 20,000
b. 10,000
c. 5000
d. 2500 - CORRECT ANSWER c. 5000
Which of the following children are at highest risk for hyperleukocytosis?
a. a child with ALL
b. a child with AML
c. a child with CML
d. a child with osteosarcoma - CORRECT ANSWER c. a child with CML
Which of the following is accurate concerning vascular-sinusoidal obstructive syndrome (veno-occlusive disease)?
a. it is associated with depletion of bilirubin
b. massive dilation of the vessels of the liver leads to decreased hepatic perfusion
c. an enlarged, non-tender liver can be palpated
d. it can be accompanied with kidney dysfunction and encephalopathy - CORRECT ANSWER d. it can be accompanied with kidney dysfunction and encephalopathy
Which of the following is accurate concerning spinal cord compression?
a. it is a very common emergency, affecting approximately 25% of children with malignancies
b. it is most commonly associated with neuroblastomas
c. loss of sensation is the most common presenting symptom
d. if untreated, paralysis and sphincter dysfunction can result - CORRECT ANSWER d. if untreated, paralysis and sphincter dysfunction can result
A child with a pineal tumor has been diagnosed with Parinaud syndrome. When assessing the child, the nurse would expect:
a. reddened sclera
b. ptosis
c. upward gaze paralysis
d. miosis - CORRECT ANSWER c. upward gaze paralysis
The nurse is caring for a child who is post-op for a craniotomy. When stimulated, the child flexes her arms and extends her legs. The nurse correctly documents this as:
a. decerebrate posturing
b. extension reflex
c. decorticate posturing
d. irritability - CORRECT ANSWER c. decorticate posturing
Which of the following is seen in splenic sequestration?
a. gradual abdominal enlargement
b. painless mass upon abdominal palpation
c. hemoconcentration revealing no immediate changes in hemoglobin
d. sudden weakness, dyspnea, and tachycardia - CORRECT ANSWER d. sudden weakness, dyspnea, and tachycardia
A 4 month old infant has been admitted with a diagnosis of splenic sequestration. The nurse anticipates the treatment plan will include:
a. splenectomy once hemodynamically stable
b. fluid resuscitation
c. oxygen supplementation
d. rapid blood administration - CORRECT ANSWER c. oxygen supplementation
-splenectomy ideally done after age 2
-blood not rapidly given (want to avoid autotransfusion)
Which of the following is true of autotransfusion associated with the management of splenic sequestration?
a. it can increase the viscosity of the blood
b. it increases the amount of blood trapped in the spleen
c. it occurs when blood administration is delayed or given too slowly
d. it is associated with decreased circulating volume - CORRECT ANSWER a. it can increase the viscosity of the blood
The infant is providing teaching to the parents of an infant with sickle cell disease. The parents ask how to recognize signs of a vaso-occlusive crisis. How should the nurse respond?
a. "your baby will likely be irritable and not move the part that is hurting"
b. "your baby will be irritable and want to increase comfort measures such as feeding"
c. "your baby will be irritable and have very cool hands and feet"
d. "your baby will be irritable and flail all extremities" - CORRECT ANSWER a. "your baby will likely be irritable and not move the part that is hurting"
Which of the following is accurate concerning acute cerebral infarction among children with sickle cell disease?
a. it occurs in less than 2% of all children with sickle cell disease
b. it is associated with lifelong consequences
c. it occurs as vessels lose elasticity and are chronically dilated
d. it is more likely to occur in the teenage years - CORRECT ANSWER b. it is associated with lifelong consequences
which of the following is responsible for the majority of thromboembolisms in children?
a. arterial and venous access devices
b. immobility
c. presence of malignancy
d. increasing incidence of childhood obesity - CORRECT ANSWER a. arterial and venous access devices [Show Less]