Question 1
Regular
What childhood cancer may demonstrate patterns of inheritance that suggest a familial basis?
Correct!
Incorrect
The correct answer is: B
Rationale
Retinoblastoma may demonstrate patterns of inheritance that suggest a familial basis. This cancer has well-documented genetic links, with mutations in the RB1 gene leading to increased risk in families, indicating a hereditary component.
A: Leukemia often arises sporadically without significant hereditary patterns, making its familial associations less pronounced compared to retinoblastoma's clear genetic ties.
C: Rhabdomyosarcoma does not exhibit a strong genetic predisposition, as its occurrence is primarily linked to environmental factors and specific syndromes rather than inherited traits.
D: Osteogenic sarcoma typically occurs randomly and is not significantly influenced by familial inheritance patterns, distinguishing it from the genetic basis seen in retinoblastoma.
Correct Answer: B
Rationale: Retinoblastoma may demonstrate patterns of inheritance that suggest a familial basis. This cancer has well-documented genetic links, with mutations in the RB1 gene leading to increased risk in families, indicating a hereditary component.
A: Leukemia often arises sporadically without significant hereditary patterns, making its familial associations less pronounced compared to retinoblastoma's clear genetic ties.
C: Rhabdomyosarcoma does not exhibit a strong genetic predisposition, as its occurrence is primarily linked to environmental factors and specific syndromes rather than inherited traits.
D: Osteogenic sarcoma typically occurs randomly and is not significantly influenced by familial inheritance patterns, distinguishing it from the genetic basis seen in retinoblastoma.
Question 2
Regular
As part of the diagnostic evaluation of a child with cancer, biopsies are important for staging. What statement explains what staging means?
Correct!
Incorrect
The correct answer is: A
Rationale
Staging refers to the extent of the disease at the time of diagnosis. This process is crucial for determining the appropriate treatment plan and understanding the prognosis for the child.
B: Rate normal cells are being replaced by cancer cells. This statement focuses on cellular dynamics rather than the overall extent of disease, which is the essence of staging.
C: Biologic characteristics of the tumor or lymph nodes. While biologic characteristics are important, they do not address the spread or extent of the disease, which staging specifically evaluates.
D: Abnormal, unrestricted growth of cancer cells producing organ damage. This describes the nature of cancer progression but does not convey the specific focus on disease extent at diagnosis that staging entails.
Correct Answer: A
Rationale: Staging refers to the extent of the disease at the time of diagnosis. This process is crucial for determining the appropriate treatment plan and understanding the prognosis for the child.
B: Rate normal cells are being replaced by cancer cells. This statement focuses on cellular dynamics rather than the overall extent of disease, which is the essence of staging.
C: Biologic characteristics of the tumor or lymph nodes. While biologic characteristics are important, they do not address the spread or extent of the disease, which staging specifically evaluates.
D: Abnormal, unrestricted growth of cancer cells producing organ damage. This describes the nature of cancer progression but does not convey the specific focus on disease extent at diagnosis that staging entails.
Question 3
Regular
What statement related to clinical trials developed for pediatric cancers is most accurate?
Correct!
Incorrect
The correct answer is: C
Rationale
C: Provide the best available therapy compared with an expected improvement. This statement accurately reflects the goal of pediatric clinical trials, which aim to offer optimal treatment options while assessing their effectiveness against standard therapies.
A: Are accessible only in major pediatric centers. Accessibility varies; many trials are conducted in diverse settings, not limited to large centers, expanding opportunities for participation among children.
B: Do not require consent for standard therapy. Informed consent is essential for all clinical trials, including those involving standard therapy, ensuring ethical considerations and patient rights are upheld.
D: Are standardized to provide the same treatment to all children with the disease. Treatments in clinical trials are often tailored to individual responses and needs, reflecting the complexity of pediatric cancers rather than a one-size-fits-all approach.
Correct Answer: C
Rationale: C: Provide the best available therapy compared with an expected improvement. This statement accurately reflects the goal of pediatric clinical trials, which aim to offer optimal treatment options while assessing their effectiveness against standard therapies.
A: Are accessible only in major pediatric centers. Accessibility varies; many trials are conducted in diverse settings, not limited to large centers, expanding opportunities for participation among children.
B: Do not require consent for standard therapy. Informed consent is essential for all clinical trials, including those involving standard therapy, ensuring ethical considerations and patient rights are upheld.
D: Are standardized to provide the same treatment to all children with the disease. Treatments in clinical trials are often tailored to individual responses and needs, reflecting the complexity of pediatric cancers rather than a one-size-fits-all approach.
Question 4
Regular
Chemotherapeutic agents are classified according to what feature?
Correct!
Incorrect
The correct answer is: C
Rationale
Chemotherapeutic agents are classified according to their mechanism of action. This classification is crucial as it determines how these agents target cancer cells, influencing treatment strategies and overall effectiveness in combating various malignancies.
A: Side effects. While side effects are important for patient management, they do not define the classification of chemotherapeutic agents, which focuses on their functional mechanisms rather than adverse effects.
B: Effectiveness. Effectiveness varies among agents and depends on multiple factors, such as tumor type and patient response, rather than serving as a basis for their classification in chemotherapy.
D: Route of administration. Although the route of administration can impact treatment logistics and patient experience, it does not delineate the fundamental pharmacological classification of chemotherapeutic agents based on their action.
Correct Answer: C
Rationale: Chemotherapeutic agents are classified according to their mechanism of action. This classification is crucial as it determines how these agents target cancer cells, influencing treatment strategies and overall effectiveness in combating various malignancies.
A: Side effects. While side effects are important for patient management, they do not define the classification of chemotherapeutic agents, which focuses on their functional mechanisms rather than adverse effects.
B: Effectiveness. Effectiveness varies among agents and depends on multiple factors, such as tumor type and patient response, rather than serving as a basis for their classification in chemotherapy.
D: Route of administration. Although the route of administration can impact treatment logistics and patient experience, it does not delineate the fundamental pharmacological classification of chemotherapeutic agents based on their action.
Question 5
Regular
What type of chemotherapeutic agent alters the function of cells by replacing a hydrogen atom of a molecule?
Correct!
Incorrect
The correct answer is: C
Rationale
Alkylating agents alter the function of cells by replacing a hydrogen atom of a molecule, which disrupts DNA and RNA synthesis, leading to cell death and inhibiting cancer growth.
A: Plant alkaloids Target specific cellular processes but do not primarily function by substituting hydrogen atoms in molecular structures. Their action often involves microtubule disruption or interference with metabolic pathways.
B: Antimetabolites Mimic natural metabolites but primarily interfere with DNA and RNA synthesis through structural similarity rather than substituting hydrogen atoms within molecules, thus not serving the specified function.
D: Antitumor antibiotics Act by interacting with DNA, typically through intercalation or free radical production, rather than replacing hydrogen atoms. Their mechanism is distinct from the hydrogen substitution process outlined.
Correct Answer: C
Rationale: Alkylating agents alter the function of cells by replacing a hydrogen atom of a molecule, which disrupts DNA and RNA synthesis, leading to cell death and inhibiting cancer growth.
A: Plant alkaloids Target specific cellular processes but do not primarily function by substituting hydrogen atoms in molecular structures. Their action often involves microtubule disruption or interference with metabolic pathways.
B: Antimetabolites Mimic natural metabolites but primarily interfere with DNA and RNA synthesis through structural similarity rather than substituting hydrogen atoms within molecules, thus not serving the specified function.
D: Antitumor antibiotics Act by interacting with DNA, typically through intercalation or free radical production, rather than replacing hydrogen atoms. Their mechanism is distinct from the hydrogen substitution process outlined.
Question 6
Regular
What side effect commonly occurs with corticosteroid (prednisone) therapy?
Correct!
Incorrect
The correct answer is: D
Rationale
Susceptibility to infection. Corticosteroids like prednisone can suppress the immune system, reducing the body’s ability to fight off infections. This side effect is especially significant during prolonged therapy, making patients more vulnerable.
A: Alopecia. While hair loss can occur in some patients, it is not a commonly reported side effect of corticosteroid therapy compared to the heightened risk of infections.
B: Anorexia. Although appetite changes can happen, anorexia is not a predominant side effect associated with corticosteroid use, overshadowed by more severe reactions, like immune suppression.
C: Nausea and vomiting. These symptoms may occasionally appear, but they are not typical side effects of corticosteroids, which primarily influence metabolic processes and immune function rather than gastrointestinal distress.
Correct Answer: D
Rationale: Susceptibility to infection. Corticosteroids like prednisone can suppress the immune system, reducing the body’s ability to fight off infections. This side effect is especially significant during prolonged therapy, making patients more vulnerable.
A: Alopecia. While hair loss can occur in some patients, it is not a commonly reported side effect of corticosteroid therapy compared to the heightened risk of infections.
B: Anorexia. Although appetite changes can happen, anorexia is not a predominant side effect associated with corticosteroid use, overshadowed by more severe reactions, like immune suppression.
C: Nausea and vomiting. These symptoms may occasionally appear, but they are not typical side effects of corticosteroids, which primarily influence metabolic processes and immune function rather than gastrointestinal distress.
Question 7
Regular
What chemotherapeutic agent is classified as an antitumor antibiotic?
Correct!
Incorrect
The correct answer is: D
Rationale
Daunorubicin (Cerubidine) is classified as an antitumor antibiotic. This classification stems from its ability to interfere with DNA synthesis and function, ultimately inhibiting the proliferation of cancer cells through its mechanism of action as an anthracycline antibiotic.
A: Cisplatin (Platinol AQ) Functions as a platinum-based chemotherapy drug, primarily acting through DNA cross-linking rather than exhibiting antibiotic properties.
B: Vincristine (Oncovin) Operates as a vinca alkaloid, disrupting microtubule formation, which is distinct from the antibiotic activity associated with daunorubicin.
C: Methotrexate (Texall) Acts as an antimetabolite that inhibits folate metabolism, differing significantly from the antibiotic classification, which targets bacterial cells rather than cancerous ones.
Correct Answer: D
Rationale: Daunorubicin (Cerubidine) is classified as an antitumor antibiotic. This classification stems from its ability to interfere with DNA synthesis and function, ultimately inhibiting the proliferation of cancer cells through its mechanism of action as an anthracycline antibiotic.
A: Cisplatin (Platinol AQ) Functions as a platinum-based chemotherapy drug, primarily acting through DNA cross-linking rather than exhibiting antibiotic properties.
B: Vincristine (Oncovin) Operates as a vinca alkaloid, disrupting microtubule formation, which is distinct from the antibiotic activity associated with daunorubicin.
C: Methotrexate (Texall) Acts as an antimetabolite that inhibits folate metabolism, differing significantly from the antibiotic classification, which targets bacterial cells rather than cancerous ones.
Question 8
Regular
The nurse is administering an intravenous chemotherapeutic agent to a child with leukemia. The child suddenly begins to wheeze and have severe urticaria. What nursing action is most appropriate to initiate?
Correct!
Incorrect
The correct answer is: B
Rationale
Stop the drug infusion immediately.
This action is critical in response to the child's wheezing and severe urticaria, indicating a potential allergic reaction. Halting the infusion prevents further exposure to the chemotherapeutic agent, ensuring the child's safety while allowing for appropriate medical intervention to be initiated swiftly.
A: Recheck the rate of drug infusion. Monitoring the infusion rate does not address the immediate danger posed by the child’s acute symptoms and delays necessary action.
C: Observe the child closely for next 10 minutes. While observation is important, it does not provide immediate relief or protection against the potential escalation of the child's allergic reaction.
D: Explain to the child that this is an expected side effect. This approach is inappropriate since the symptoms indicate a serious allergic response, not a typical side effect of the treatment.
Correct Answer: B
Rationale: Stop the drug infusion immediately.
This action is critical in response to the child's wheezing and severe urticaria, indicating a potential allergic reaction. Halting the infusion prevents further exposure to the chemotherapeutic agent, ensuring the child's safety while allowing for appropriate medical intervention to be initiated swiftly.
A: Recheck the rate of drug infusion. Monitoring the infusion rate does not address the immediate danger posed by the child’s acute symptoms and delays necessary action.
C: Observe the child closely for next 10 minutes. While observation is important, it does not provide immediate relief or protection against the potential escalation of the child's allergic reaction.
D: Explain to the child that this is an expected side effect. This approach is inappropriate since the symptoms indicate a serious allergic response, not a typical side effect of the treatment.
Question 9
Regular
Total-body irradiation is indicated for what reason?
Correct!
Incorrect
The correct answer is: D
Rationale
Total-body irradiation is indicated for preparation for bone marrow transplant. This treatment effectively eradicates malignant cells and suppresses the immune system, providing a conducive environment for transplant success and reducing the risk of rejection.
A: Palliative care does not typically require total-body irradiation, as this treatment focuses on curative approaches rather than symptom management in advanced illness stages.
B: Lymphoma therapy may utilize different treatment modalities such as chemotherapy or targeted therapies, rather than total-body irradiation, which is not a standard approach for lymphoma management.
C: Definitive therapy for leukemia often involves chemotherapy or targeted therapies; total-body irradiation is not primarily used as a first-line treatment for leukemia but rather for transplant preparation.
Correct Answer: D
Rationale: Total-body irradiation is indicated for preparation for bone marrow transplant. This treatment effectively eradicates malignant cells and suppresses the immune system, providing a conducive environment for transplant success and reducing the risk of rejection.
A: Palliative care does not typically require total-body irradiation, as this treatment focuses on curative approaches rather than symptom management in advanced illness stages.
B: Lymphoma therapy may utilize different treatment modalities such as chemotherapy or targeted therapies, rather than total-body irradiation, which is not a standard approach for lymphoma management.
C: Definitive therapy for leukemia often involves chemotherapy or targeted therapies; total-body irradiation is not primarily used as a first-line treatment for leukemia but rather for transplant preparation.
Question 10
Regular
The parents of a child with cancer tell the nurse that a bone marrow transplant (BMT) may be necessary. What information should the nurse recognize as important when discussing this with the family?
Correct!
Incorrect
The correct answer is: D
Rationale
Finding a suitable donor involves matching antigens from the human leukocyte antigen (HLA) system. This compatibility is crucial for the success of the bone marrow transplant, as mismatched donors can lead to complications such as graft-versus-host disease.
A: BMT should be done at the time of diagnosis. Timing can vary; BMT may not be immediately necessary and should be based on the child’s condition.
B: Parents and siblings of the child have a 25% chance of being a suitable donor. The probability of finding a match can differ significantly, often exceeding or falling below this percentage.
C: If BMT fails, chemotherapy or radiotherapy will need to be continued. Alternative treatments may vary based on individual circumstances and are not guaranteed to be the next step after a failed BMT.
Correct Answer: D
Rationale: Finding a suitable donor involves matching antigens from the human leukocyte antigen (HLA) system. This compatibility is crucial for the success of the bone marrow transplant, as mismatched donors can lead to complications such as graft-versus-host disease.
A: BMT should be done at the time of diagnosis. Timing can vary; BMT may not be immediately necessary and should be based on the child’s condition.
B: Parents and siblings of the child have a 25% chance of being a suitable donor. The probability of finding a match can differ significantly, often exceeding or falling below this percentage.
C: If BMT fails, chemotherapy or radiotherapy will need to be continued. Alternative treatments may vary based on individual circumstances and are not guaranteed to be the next step after a failed BMT.
Question 11
Regular
An adolescent will receive a bone marrow transplant (BMT). The nurse should explain that the bone marrow will be administered by which method?
Correct!
Incorrect
The correct answer is: B
Rationale
Bone marrow will be administered by intravenous infusion. This method allows the transplanted stem cells to quickly enter the bloodstream, facilitating their journey to the bone marrow for effective engraftment.
A: Bone grafting Involves the surgical placement of bone tissue to repair or reconstruct bone, which does not pertain to the administration of bone marrow for transplantation.
C: Bone marrow injection Refers to a direct injection into the bone, which is not the standard method used for delivering stem cells during a bone marrow transplant.
D: Intraabdominal infusion Involves delivering fluids directly into the abdominal cavity, which is irrelevant to the process of administering bone marrow for transplantation purposes.
Correct Answer: B
Rationale: Bone marrow will be administered by intravenous infusion. This method allows the transplanted stem cells to quickly enter the bloodstream, facilitating their journey to the bone marrow for effective engraftment.
A: Bone grafting Involves the surgical placement of bone tissue to repair or reconstruct bone, which does not pertain to the administration of bone marrow for transplantation.
C: Bone marrow injection Refers to a direct injection into the bone, which is not the standard method used for delivering stem cells during a bone marrow transplant.
D: Intraabdominal infusion Involves delivering fluids directly into the abdominal cavity, which is irrelevant to the process of administering bone marrow for transplantation purposes.
Question 12
Regular
After chemotherapy is begun for a child with acute leukemia, prophylaxis to prevent acute tumor lysis syndrome includes which therapeutic intervention?
Correct!
Incorrect
The correct answer is: A
Rationale
Hydration. Adequate hydration during chemotherapy is crucial for preventing acute tumor lysis syndrome, as it helps maintain kidney function and facilitates the excretion of metabolic byproducts resulting from tumor cell breakdown.
B: Oxygenation. While oxygenation is essential for overall health, it does not specifically address the metabolic disturbances caused by chemotherapy or the resulting tumor lysis syndrome.
C: Corticosteroids. Though corticosteroids can be used to manage inflammation and symptoms in leukemia, they do not play a direct role in preventing the metabolic complications associated with tumor lysis syndrome.
D: Pain management. Pain management focuses on alleviating discomfort related to cancer treatment but does not contribute to preventing the biochemical changes leading to acute tumor lysis syndrome.
Correct Answer: A
Rationale: Hydration. Adequate hydration during chemotherapy is crucial for preventing acute tumor lysis syndrome, as it helps maintain kidney function and facilitates the excretion of metabolic byproducts resulting from tumor cell breakdown.
B: Oxygenation. While oxygenation is essential for overall health, it does not specifically address the metabolic disturbances caused by chemotherapy or the resulting tumor lysis syndrome.
C: Corticosteroids. Though corticosteroids can be used to manage inflammation and symptoms in leukemia, they do not play a direct role in preventing the metabolic complications associated with tumor lysis syndrome.
D: Pain management. Pain management focuses on alleviating discomfort related to cancer treatment but does not contribute to preventing the biochemical changes leading to acute tumor lysis syndrome.
Question 13
Regular
Nursing care of the child with myelosuppression from leukemia or chemotherapeutic agents should include which therapeutic intervention?
Correct!
Incorrect
The correct answer is: C
Rationale
C: Use good hand-washing technique. Promoting hand hygiene is crucial for children with myelosuppression, as they have weakened immune systems and are at higher risk for infections. Effective hand-washing can significantly reduce this risk.
A: Restrict oral fluids. Limiting fluid intake can lead to dehydration and does not address the underlying infection risk associated with myelosuppression. Maintaining hydration is essential for overall health.
B: Institute strict isolation. While minimizing exposure to infection is important, strict isolation can lead to psychological distress and should be balanced with social interaction to promote emotional well-being.
D: Give immunizations appropriate for age. Administering live vaccines poses significant risks for immunocompromised children, as their bodies may not effectively respond, potentially leading to severe complications from the vaccine itself.
Correct Answer: C
Rationale: C: Use good hand-washing technique. Promoting hand hygiene is crucial for children with myelosuppression, as they have weakened immune systems and are at higher risk for infections. Effective hand-washing can significantly reduce this risk.
A: Restrict oral fluids. Limiting fluid intake can lead to dehydration and does not address the underlying infection risk associated with myelosuppression. Maintaining hydration is essential for overall health.
B: Institute strict isolation. While minimizing exposure to infection is important, strict isolation can lead to psychological distress and should be balanced with social interaction to promote emotional well-being.
D: Give immunizations appropriate for age. Administering live vaccines poses significant risks for immunocompromised children, as their bodies may not effectively respond, potentially leading to severe complications from the vaccine itself.
Question 14
Regular
In teaching parents how to minimize or prevent bleeding episodes when the child is myelosuppressed, the nurse includes what information?
Correct!
Incorrect
The correct answer is: A
Rationale
Meticulous mouth care is essential to avoid mucositis. Proper oral hygiene helps prevent inflammation and ulceration in the mouth, which can lead to bleeding episodes, especially in myelosuppressed children with weakened immune responses.
B: Rectal temperatures are necessary to monitor for infection. Monitoring rectal temperatures poses a risk of trauma and bleeding in myelosuppressed patients, making it an unsuitable method for assessing fever.
C: Intramuscular injections are preferred to intravenous ones. Intramuscular injections can cause more bleeding and discomfort, which is particularly hazardous for children with myelosuppression and low platelet counts.
D: Platelet transfusions are given to maintain a count greater than 50,000/mm3. Maintaining platelet counts above 50,000/mm3 is not the sole focus; transfusions are used as needed based on individual patient conditions and circumstances.
Correct Answer: A
Rationale: Meticulous mouth care is essential to avoid mucositis. Proper oral hygiene helps prevent inflammation and ulceration in the mouth, which can lead to bleeding episodes, especially in myelosuppressed children with weakened immune responses.
B: Rectal temperatures are necessary to monitor for infection. Monitoring rectal temperatures poses a risk of trauma and bleeding in myelosuppressed patients, making it an unsuitable method for assessing fever.
C: Intramuscular injections are preferred to intravenous ones. Intramuscular injections can cause more bleeding and discomfort, which is particularly hazardous for children with myelosuppression and low platelet counts.
D: Platelet transfusions are given to maintain a count greater than 50,000/mm3. Maintaining platelet counts above 50,000/mm3 is not the sole focus; transfusions are used as needed based on individual patient conditions and circumstances.
Question 15
Regular
A school-age child with leukemia experienced severe nausea and vomiting when receiving chemotherapy for the first time. What is the most appropriate nursing action to prevent or minimize these reactions with subsequent treatments?
Correct!
Incorrect
The correct answer is: B
Rationale
Give an antiemetic before chemotherapy begins.
Administering an antiemetic prior to chemotherapy is crucial for effectively managing nausea and vomiting. This proactive approach helps to mitigate the side effects associated with chemotherapy, enhancing the child's overall comfort and willingness to continue treatment. By addressing potential reactions in advance, the child can receive necessary care without the added stress of nausea.
A: Administer the chemotherapy between meals. Timing chemotherapy around meals does not address the physiological reactions caused by the treatment and may not significantly reduce nausea or vomiting.
C: Have the child bring favorite foods for snacks. While familiar foods may provide comfort, they do not prevent the adverse effects of chemotherapy and could exacerbate nausea if consumed during treatment.
D: Keep the child NPO (nothing by mouth) until nausea and vomiting subside. This approach can contribute to dehydration and does not address the underlying cause of nausea, leaving the child at risk for further discomfort.
Correct Answer: B
Rationale: Give an antiemetic before chemotherapy begins.
Administering an antiemetic prior to chemotherapy is crucial for effectively managing nausea and vomiting. This proactive approach helps to mitigate the side effects associated with chemotherapy, enhancing the child's overall comfort and willingness to continue treatment. By addressing potential reactions in advance, the child can receive necessary care without the added stress of nausea.
A: Administer the chemotherapy between meals. Timing chemotherapy around meals does not address the physiological reactions caused by the treatment and may not significantly reduce nausea or vomiting.
C: Have the child bring favorite foods for snacks. While familiar foods may provide comfort, they do not prevent the adverse effects of chemotherapy and could exacerbate nausea if consumed during treatment.
D: Keep the child NPO (nothing by mouth) until nausea and vomiting subside. This approach can contribute to dehydration and does not address the underlying cause of nausea, leaving the child at risk for further discomfort.
Question 16
Regular
A young child with leukemia has anorexia and severe stomatitis. What approach should the nurse suggest that the parents try?
Correct!
Incorrect
The correct answer is: A
Rationale
Relax any eating pressures.
This approach allows the child to regain a sense of control over food choices, reducing stress around mealtimes. It acknowledges their discomfort and encourages a more positive relationship with eating, which is crucial during treatment for leukemia.
B: Firmly insist that the child eat normally. This would likely create additional anxiety and resistance, potentially worsening the child’s relationship with food and exacerbating their anorexia in a challenging time.
C: Serve foods that are either hot or cold. Temperature preferences vary widely among children, and offering only extreme temperatures may not accommodate the child's sensitivity, especially with stomatitis impacting their ability to tolerate foods.
D: Provide only liquids because chewing is painful. Limiting diet solely to liquids could deprive the child of essential nutrients and variety, which are important for overall health, especially during leukemia treatment.
Correct Answer: A
Rationale: Relax any eating pressures.
This approach allows the child to regain a sense of control over food choices, reducing stress around mealtimes. It acknowledges their discomfort and encourages a more positive relationship with eating, which is crucial during treatment for leukemia.
B: Firmly insist that the child eat normally. This would likely create additional anxiety and resistance, potentially worsening the child’s relationship with food and exacerbating their anorexia in a challenging time.
C: Serve foods that are either hot or cold. Temperature preferences vary widely among children, and offering only extreme temperatures may not accommodate the child's sensitivity, especially with stomatitis impacting their ability to tolerate foods.
D: Provide only liquids because chewing is painful. Limiting diet solely to liquids could deprive the child of essential nutrients and variety, which are important for overall health, especially during leukemia treatment.
Question 17
Regular
The nurse is preparing a child for possible alopecia from chemotherapy. What information should the nurse include?
Correct!
Incorrect
The correct answer is: C
Rationale
Hair may have a slightly different color or texture when it regrows. This information is crucial for managing expectations, as children undergoing chemotherapy may experience changes in hair characteristics upon regrowth, which can be surprising for them and their families.
A: Wearing hats or scarves is preferable to a wig. While head coverings can provide comfort, wigs are often more natural-looking and may help children feel more confident during treatment.
B: Expose head to sunlight to stimulate hair regrowth. Sun exposure can actually damage the scalp and does not promote hair regrowth, making this advice potentially harmful and misleading.
D: Regrowth of hair usually begins 12 months after chemotherapy ends. While hair regrowth can vary, it typically starts within months, not a year, thus misrepresenting the timeline for recovery.
Correct Answer: C
Rationale: Hair may have a slightly different color or texture when it regrows. This information is crucial for managing expectations, as children undergoing chemotherapy may experience changes in hair characteristics upon regrowth, which can be surprising for them and their families.
A: Wearing hats or scarves is preferable to a wig. While head coverings can provide comfort, wigs are often more natural-looking and may help children feel more confident during treatment.
B: Expose head to sunlight to stimulate hair regrowth. Sun exposure can actually damage the scalp and does not promote hair regrowth, making this advice potentially harmful and misleading.
D: Regrowth of hair usually begins 12 months after chemotherapy ends. While hair regrowth can vary, it typically starts within months, not a year, thus misrepresenting the timeline for recovery.
Question 18
Regular
What pain management approach is most effective for a child who is having a bone marrow test?
Correct!
Incorrect
The correct answer is: D
Rationale
D: Conscious or unconscious sedation is the most effective pain management approach for a child undergoing a bone marrow test, as it minimizes anxiety and discomfort during the procedure, ensuring a smoother experience.
A: Relaxation techniques may help reduce anxiety but do not adequately address the physical pain experienced during invasive procedures like a bone marrow test.
B: Administration of an opioid provides significant pain relief, yet it may not be suitable for all children and could lead to unwanted side effects during the procedure.
C: EMLA cream applied over the site offers localized numbing but may not provide sufficient pain relief for the level of discomfort associated with a bone marrow test.
Correct Answer: D
Rationale: D: Conscious or unconscious sedation is the most effective pain management approach for a child undergoing a bone marrow test, as it minimizes anxiety and discomfort during the procedure, ensuring a smoother experience.
A: Relaxation techniques may help reduce anxiety but do not adequately address the physical pain experienced during invasive procedures like a bone marrow test.
B: Administration of an opioid provides significant pain relief, yet it may not be suitable for all children and could lead to unwanted side effects during the procedure.
C: EMLA cream applied over the site offers localized numbing but may not provide sufficient pain relief for the level of discomfort associated with a bone marrow test.
Question 19
Regular
The nurse is caring for a child receiving chemotherapy for leukemia. The childs granulocyte count is 600/mm3 and platelet count is 45,000/mm3. What oral care should the nurse recommend for this child?
Correct!
Incorrect
The correct answer is: B
Rationale
Daily toothbrushing and flossing is essential for maintaining oral hygiene in children undergoing chemotherapy, as they are at higher risk for infections due to low granulocyte and platelet counts.
A: Rinsing mouth with water provides minimal cleaning and fails to address plaque and bacteria, which could contribute to infection in an immunocompromised child.
C: Lemon glycerin swabs for cleansing can irritate mucous membranes and do not effectively remove plaque, posing a risk to oral health during chemotherapy treatment.
D: Wiping teeth with moistened gauze or Toothettes lacks the thoroughness of regular brushing and flossing, making it insufficient for optimal oral hygiene in a child with compromised immunity.
Correct Answer: B
Rationale: Daily toothbrushing and flossing is essential for maintaining oral hygiene in children undergoing chemotherapy, as they are at higher risk for infections due to low granulocyte and platelet counts.
A: Rinsing mouth with water provides minimal cleaning and fails to address plaque and bacteria, which could contribute to infection in an immunocompromised child.
C: Lemon glycerin swabs for cleansing can irritate mucous membranes and do not effectively remove plaque, posing a risk to oral health during chemotherapy treatment.
D: Wiping teeth with moistened gauze or Toothettes lacks the thoroughness of regular brushing and flossing, making it insufficient for optimal oral hygiene in a child with compromised immunity.
Question 20
Regular
What immunization should not be given to a child receiving chemotherapy for cancer?
Correct!
Incorrect
The correct answer is: D
Rationale
D. The measles, mumps, rubella (MMR) vaccine should not be administered to children undergoing chemotherapy for cancer due to their compromised immune systems, which cannot effectively respond to live attenuated viruses present in the vaccine.
A: Tetanus vaccine. This vaccine is inactivated and does not pose a risk to immunocompromised children, making it safe during chemotherapy.
B: Inactivated poliovirus vaccine. As an inactivated vaccine, it does not rely on a robust immune response, thus it is considered safe for children receiving chemotherapy.
C: Diphtheria, pertussis, tetanus (DPT). Similar to the tetanus vaccine, DPT is inactivated and does not present the same dangers as live vaccines for those on chemotherapy.
Correct Answer: D
Rationale: D. The measles, mumps, rubella (MMR) vaccine should not be administered to children undergoing chemotherapy for cancer due to their compromised immune systems, which cannot effectively respond to live attenuated viruses present in the vaccine.
A: Tetanus vaccine. This vaccine is inactivated and does not pose a risk to immunocompromised children, making it safe during chemotherapy.
B: Inactivated poliovirus vaccine. As an inactivated vaccine, it does not rely on a robust immune response, thus it is considered safe for children receiving chemotherapy.
C: Diphtheria, pertussis, tetanus (DPT). Similar to the tetanus vaccine, DPT is inactivated and does not present the same dangers as live vaccines for those on chemotherapy.