Ricci Ch. 46: Nursing Care of the Child with an Alteration in
Cellular Regulation/Hematologic or Neoplastic Disorders ||
100% Valid Answers.
The school nurse is providing information to parents of adolescents about prevention of cervical
cancer. Which information is included in the teaching?
Papanicolaou tests for adolescent girls
abstinence from sexual intercourse
vaccine against human papillomavirus (HPV)
use of condoms for sexually active teens correct answers vaccine against human papillomavirus
(HPV)
Reminding parents that both boys and girls should receive the vaccine against HPV is an
important preventive measure to reduce the incidence of cervical cancer. Papanicolaou tests are
not recommended until age 21. Abstinence from intercourse and use of condoms will help, but
do not prevent exposure through other sexual contact.
A 4-year-old child diagnosed with Wilms tumor is admitted for surgery. What information would
be most important for the nurse to include in the child's preoperative plan of care?
Avoiding further abdominal palpation
Performing dressing changes to the affected area
Administering analgesics for pain
Preparing the child for amputation correct answers Avoiding further abdominal palpation
After the initial assessment is performed on a child with Wilms tumor, further palpation of the
abdomen should be avoided because the tumor is highly vascular and soft. Therefore, excessive
handling of the tumor may result in tumor seeding and metastasis. Preoperatively, the child with
Wilms tumor does not have a wound; therefore, dressing changes are not necessary. Although
the child may experience abdominal pain, avoiding further abdominal palpation would be the
priority. Surgical removal of the tumor and affected kidney is the treatment of choice for Wilms
tumor. Amputation would be more likely for a child with osteosarcoma.
The nurse develops a meal plan for a child with iron-deficiency anemia. Which meal would the
nurse teach the parent has the highest amount of iron?
red meat, eggs, oatmeal, and dried fruit
chicken, corn, brown rice, and oranges
pork, broccoli, white rice, and strawberries
tuna salad with eggs, whole wheat crackers, and blueberries correct answers red meat, eggs,
oatmeal, and dried fruit
Iron-deficiency anemia occurs when the blood does not have enough iron to produce
hemoglobin. The anemia can be corrected via iron supplementation, nutrition, and even blood
,transfusion if the anemia is severe. Foods that have the highest sources of iron include red meat,
tuna, eggs, tofu, enriched grains, dried beans and peas, dried fruits, green leafy vegetables and
iron-fortified breakfast cereals. The nurse should teach the meal containing red meat, eggs,
oatmeal, and dried fruit has the highest amount of iron. Chicken has less iron than red meat, and
corn has only a small amount. All the fruits listed have iron, but when dried, the iron levels
increase. Pork has a limited amount of iron, and white rice contains almost no iron. Brown rice
and whole grains contain higher iron amounts.
The parent of a child with Down syndrome calls the nurse and reports 3 weeks of a lack of
energy, limping, and weight loss in the young child. What is the most appropriate response by
the nurse?
"If symptoms persist, your child needs to be seen within the week."
"Bring your child to the primary health care provider to be examined."
"Give your child acetaminophen every 4 hours for a day. If no improvement, call back."
"Limit active play and offer frequent small snacks and meals." correct answers "Bring your child
to the primary health care provider to be examined."
Symptoms could indicate acute lymphoblastic leukemia (ALL). Compared with other children,
children with Down syndrome have 15 times the risk of developing ALL. The nurse would
recommend the child come in for further assessment to determine what, if any, treatment is
needed for this child. Stating the child needs to be seen within the week if symptoms continue is
doing nothing for the child at this time. The child's symptoms are not appropriate for
acetaminophen; this choice is also a "do nothing" option. It is appropriate to limit the child's play
to conserve energy and provide frequent snacks; however, it is most important for the child to be
assessed.
The nurse is providing preoperative care for a 7-year-old boy with a brain tumor, as well as his
parents. Which intervention is a priority?
Assessing the child's level of consciousness.
Providing a tour of the intensive care unit.
Educating the child and parents about shunts.
Having the child talk to another child who has had this surgery. correct answers Assessing the
child's level of consciousness.
The priority intervention is to monitor for increases in intracranial pressure because brain tumors
may block cerebral fluid flow or cause edema in the brain. A change in the level of
consciousness is just one of several subtle changes that can occur indicating a change in
intracranial pressure. Lower priority interventions include providing a tour of the ICU to prepare
the child and parents for after the surgery, and educating the child and parents about shunts.
The parent contacts the health care provider because their preschool-age child has a temperature
of 101.5°F (38.6°C). The child received outpatient chemotherapy 1 week ago. Which is the most
appropriate response by the nurse?
,Instruct the parent to administer acetaminophen every 4 hours until the fever dissipates.
Ask whether any family members or other close associates are ill.
Have the parent bring the child to the pediatric oncology clinic as soon as possible.
Instruct the parent to immediately obtain and give the antibiotic that the oncologist calls in to the
pharmacy. correct answers Have the parent bring the child to the pediatric oncology clinic as
soon as possible.
The preschool-age child is considered immunosuppressed following recent chemotherapy. A
fever can mean sepsis, which would require immediate investigation of blood and other body
fluids to identify the organism, plus prompt treatment with an IV antibiotic. This can be
accomplished only by seeing the pediatric oncologist and is likely to result in hospitalization.
The other responses may be implemented after the child arrives at the clinic.
A hospice nurse is providing at-home care to a child with end-stage cancer. The nurse is
developing a plan of care to manage the child's pain. Which medications will the nurse likely
include?
mild analgesics
topical anesthetics
opioids
sedatives correct answers opioids
Chronic or terminal pain may be managed in the home with continuous administration of
opioids, orally or intravenously, as a bolus injection or infusion. Both pharmacologic and
nonpharmacologic interventions are important in managing pediatric pain. Mild analgesics,
topical anesthetics, and opioids can be used to treat pain. Sedatives such as midazolam or
anesthetic medications such as ketamine or propofol may be used to assist children undergoing
painful procedures that are required routinely during their cancer treatment.
Parents ask why their child just diagnosed with leukemia needs a "spinal tap." Which is the best
response by the nurse?
"It will help rule out a second malignancy."
"Checking the cerebrospinal fluid will reveal whether leukemic cells have entered the central
nervous system."
"The spinal tap will help relieve pressure and headache for your child."
"A sample of cerebrospinal fluid is needed to check for possible central nervous system
infection." correct answers "Checking the cerebrospinal fluid will reveal whether leukemic cells
have entered the central nervous system."
The cerebrospinal fluid is checked so the clinician can determine whether leukemic cells have
invaded the central nervous system. It is common for a chemotherapy medication, usually
methotrexate, to be administered immediately following lumbar puncture as treatment for
potential infiltration.
, The nurse is teaching the parents of a 15-year-old boy who is being treated for acute myeloid
leukemia about the side effects of chemotherapy. For which symptoms should the parents seek
medical care immediately?
earache, stiff neck, or sore throat
blisters, ulcers, or a rash appear
temperature of 101°F (38.3°C) or greater
difficulty or pain when swallowing correct answers temperature of 101°F (38.3°C) or greater
The parents should seek medical care immediately if the child has a temperature of 101°F (38.3°
C) or greater. This is because many chemotherapeutic drugs cause bone marrow suppression; the
parents must be directed to take action at the first sign of infection in order to prevent
overwhelming sepsis. The appearance of earache, stiff neck, sore throat, blisters, ulcers, or rashes
(or difficulty/pain when swallowing) are reasons to seek medical care, but are not as grave as the
risk of infection.
A child is receiving chemotherapy and develops stomatitis. The nurse identifies a nursing
diagnosis of Impaired oral mucous membranes related to the effects of chemotherapy. What
instructions would the nurse include in the child's plan of care? Select all that apply.
Vigorously rub the child's gums with gauze to clean them.
Provide various soft and bland foods to minimize further irritation.
Have the child rinse the mouth with lukewarm water three times a day.
Give the child acidic foods (e.g., orange juice) to cleanse the mouth.
Apply a lip balm or petroleum jelly to prevent cracking. correct answers Provide various soft and
bland foods to minimize further irritation.
Have the child rinse the mouth with lukewarm water three times a day.
Apply a lip balm or petroleum jelly to prevent cracking.
For the child with stomatitis, the nurse should provide soft foods to prevent further abrasions,
have the child rinse the mouth three times a day with lukewarm water to promote comfort and
healing, avoid giving the child acidic foods that would further irritate the tissue, and apply a lip
balm or petroleum jelly to prevent cracking of the lips. The nurse should offer a soft toothbrush
to minimize discomfort.
The nurse will use a special needle to start intravenous (IV) fluids through which central venous
access device?
A peripherally inserted central catheter
An implanted port
A tunneled central catheter
A multilumen catheter correct answers An implanted port
An implanted port requires a special (Huber) needle placed through the skin into the port, which
is implanted surgically under the skin and over a bony prominence. The peripherally inserted
Cellular Regulation/Hematologic or Neoplastic Disorders ||
100% Valid Answers.
The school nurse is providing information to parents of adolescents about prevention of cervical
cancer. Which information is included in the teaching?
Papanicolaou tests for adolescent girls
abstinence from sexual intercourse
vaccine against human papillomavirus (HPV)
use of condoms for sexually active teens correct answers vaccine against human papillomavirus
(HPV)
Reminding parents that both boys and girls should receive the vaccine against HPV is an
important preventive measure to reduce the incidence of cervical cancer. Papanicolaou tests are
not recommended until age 21. Abstinence from intercourse and use of condoms will help, but
do not prevent exposure through other sexual contact.
A 4-year-old child diagnosed with Wilms tumor is admitted for surgery. What information would
be most important for the nurse to include in the child's preoperative plan of care?
Avoiding further abdominal palpation
Performing dressing changes to the affected area
Administering analgesics for pain
Preparing the child for amputation correct answers Avoiding further abdominal palpation
After the initial assessment is performed on a child with Wilms tumor, further palpation of the
abdomen should be avoided because the tumor is highly vascular and soft. Therefore, excessive
handling of the tumor may result in tumor seeding and metastasis. Preoperatively, the child with
Wilms tumor does not have a wound; therefore, dressing changes are not necessary. Although
the child may experience abdominal pain, avoiding further abdominal palpation would be the
priority. Surgical removal of the tumor and affected kidney is the treatment of choice for Wilms
tumor. Amputation would be more likely for a child with osteosarcoma.
The nurse develops a meal plan for a child with iron-deficiency anemia. Which meal would the
nurse teach the parent has the highest amount of iron?
red meat, eggs, oatmeal, and dried fruit
chicken, corn, brown rice, and oranges
pork, broccoli, white rice, and strawberries
tuna salad with eggs, whole wheat crackers, and blueberries correct answers red meat, eggs,
oatmeal, and dried fruit
Iron-deficiency anemia occurs when the blood does not have enough iron to produce
hemoglobin. The anemia can be corrected via iron supplementation, nutrition, and even blood
,transfusion if the anemia is severe. Foods that have the highest sources of iron include red meat,
tuna, eggs, tofu, enriched grains, dried beans and peas, dried fruits, green leafy vegetables and
iron-fortified breakfast cereals. The nurse should teach the meal containing red meat, eggs,
oatmeal, and dried fruit has the highest amount of iron. Chicken has less iron than red meat, and
corn has only a small amount. All the fruits listed have iron, but when dried, the iron levels
increase. Pork has a limited amount of iron, and white rice contains almost no iron. Brown rice
and whole grains contain higher iron amounts.
The parent of a child with Down syndrome calls the nurse and reports 3 weeks of a lack of
energy, limping, and weight loss in the young child. What is the most appropriate response by
the nurse?
"If symptoms persist, your child needs to be seen within the week."
"Bring your child to the primary health care provider to be examined."
"Give your child acetaminophen every 4 hours for a day. If no improvement, call back."
"Limit active play and offer frequent small snacks and meals." correct answers "Bring your child
to the primary health care provider to be examined."
Symptoms could indicate acute lymphoblastic leukemia (ALL). Compared with other children,
children with Down syndrome have 15 times the risk of developing ALL. The nurse would
recommend the child come in for further assessment to determine what, if any, treatment is
needed for this child. Stating the child needs to be seen within the week if symptoms continue is
doing nothing for the child at this time. The child's symptoms are not appropriate for
acetaminophen; this choice is also a "do nothing" option. It is appropriate to limit the child's play
to conserve energy and provide frequent snacks; however, it is most important for the child to be
assessed.
The nurse is providing preoperative care for a 7-year-old boy with a brain tumor, as well as his
parents. Which intervention is a priority?
Assessing the child's level of consciousness.
Providing a tour of the intensive care unit.
Educating the child and parents about shunts.
Having the child talk to another child who has had this surgery. correct answers Assessing the
child's level of consciousness.
The priority intervention is to monitor for increases in intracranial pressure because brain tumors
may block cerebral fluid flow or cause edema in the brain. A change in the level of
consciousness is just one of several subtle changes that can occur indicating a change in
intracranial pressure. Lower priority interventions include providing a tour of the ICU to prepare
the child and parents for after the surgery, and educating the child and parents about shunts.
The parent contacts the health care provider because their preschool-age child has a temperature
of 101.5°F (38.6°C). The child received outpatient chemotherapy 1 week ago. Which is the most
appropriate response by the nurse?
,Instruct the parent to administer acetaminophen every 4 hours until the fever dissipates.
Ask whether any family members or other close associates are ill.
Have the parent bring the child to the pediatric oncology clinic as soon as possible.
Instruct the parent to immediately obtain and give the antibiotic that the oncologist calls in to the
pharmacy. correct answers Have the parent bring the child to the pediatric oncology clinic as
soon as possible.
The preschool-age child is considered immunosuppressed following recent chemotherapy. A
fever can mean sepsis, which would require immediate investigation of blood and other body
fluids to identify the organism, plus prompt treatment with an IV antibiotic. This can be
accomplished only by seeing the pediatric oncologist and is likely to result in hospitalization.
The other responses may be implemented after the child arrives at the clinic.
A hospice nurse is providing at-home care to a child with end-stage cancer. The nurse is
developing a plan of care to manage the child's pain. Which medications will the nurse likely
include?
mild analgesics
topical anesthetics
opioids
sedatives correct answers opioids
Chronic or terminal pain may be managed in the home with continuous administration of
opioids, orally or intravenously, as a bolus injection or infusion. Both pharmacologic and
nonpharmacologic interventions are important in managing pediatric pain. Mild analgesics,
topical anesthetics, and opioids can be used to treat pain. Sedatives such as midazolam or
anesthetic medications such as ketamine or propofol may be used to assist children undergoing
painful procedures that are required routinely during their cancer treatment.
Parents ask why their child just diagnosed with leukemia needs a "spinal tap." Which is the best
response by the nurse?
"It will help rule out a second malignancy."
"Checking the cerebrospinal fluid will reveal whether leukemic cells have entered the central
nervous system."
"The spinal tap will help relieve pressure and headache for your child."
"A sample of cerebrospinal fluid is needed to check for possible central nervous system
infection." correct answers "Checking the cerebrospinal fluid will reveal whether leukemic cells
have entered the central nervous system."
The cerebrospinal fluid is checked so the clinician can determine whether leukemic cells have
invaded the central nervous system. It is common for a chemotherapy medication, usually
methotrexate, to be administered immediately following lumbar puncture as treatment for
potential infiltration.
, The nurse is teaching the parents of a 15-year-old boy who is being treated for acute myeloid
leukemia about the side effects of chemotherapy. For which symptoms should the parents seek
medical care immediately?
earache, stiff neck, or sore throat
blisters, ulcers, or a rash appear
temperature of 101°F (38.3°C) or greater
difficulty or pain when swallowing correct answers temperature of 101°F (38.3°C) or greater
The parents should seek medical care immediately if the child has a temperature of 101°F (38.3°
C) or greater. This is because many chemotherapeutic drugs cause bone marrow suppression; the
parents must be directed to take action at the first sign of infection in order to prevent
overwhelming sepsis. The appearance of earache, stiff neck, sore throat, blisters, ulcers, or rashes
(or difficulty/pain when swallowing) are reasons to seek medical care, but are not as grave as the
risk of infection.
A child is receiving chemotherapy and develops stomatitis. The nurse identifies a nursing
diagnosis of Impaired oral mucous membranes related to the effects of chemotherapy. What
instructions would the nurse include in the child's plan of care? Select all that apply.
Vigorously rub the child's gums with gauze to clean them.
Provide various soft and bland foods to minimize further irritation.
Have the child rinse the mouth with lukewarm water three times a day.
Give the child acidic foods (e.g., orange juice) to cleanse the mouth.
Apply a lip balm or petroleum jelly to prevent cracking. correct answers Provide various soft and
bland foods to minimize further irritation.
Have the child rinse the mouth with lukewarm water three times a day.
Apply a lip balm or petroleum jelly to prevent cracking.
For the child with stomatitis, the nurse should provide soft foods to prevent further abrasions,
have the child rinse the mouth three times a day with lukewarm water to promote comfort and
healing, avoid giving the child acidic foods that would further irritate the tissue, and apply a lip
balm or petroleum jelly to prevent cracking of the lips. The nurse should offer a soft toothbrush
to minimize discomfort.
The nurse will use a special needle to start intravenous (IV) fluids through which central venous
access device?
A peripherally inserted central catheter
An implanted port
A tunneled central catheter
A multilumen catheter correct answers An implanted port
An implanted port requires a special (Huber) needle placed through the skin into the port, which
is implanted surgically under the skin and over a bony prominence. The peripherally inserted
