NFDN 2005 LATEST EXAMS PAPER QUESTIONS
AND ANSWERS SET A+
✔✔Acute Lymphoid Leukemia (ALL) - ✔✔most common cancer in children
✔✔How is leukemia diagnosed? - ✔✔Clinical presentation
Bruising
Pain
Fever
Pale
Liver/spleen enlargement felt on palpation
Blood tests
Blood count
Blood smear
Bone marrow aspiration
Will determine what blast cells involved
Lumbar puncture (LP) (spinal tap)
Check for metastasis
Bed rest after tests
✔✔How is leukemia treated? - ✔✔Chemotherapy
Radiation
Stem-cell transplant
✔✔Nursing care for cancer - ✔✔Preparation for diagnostic and therapeutic procedures
Pain management
Preventing complications of Myelosuppression
Child has be to careful about activities/contact sports they do
Chemo can attack healthy cells
Precautions in administering and handling chemo (glove, gown, mask)
Emotional support
Family prep - side effects, infections
be honest about procedures/tests, what to anticipate/expect
,Alopecia - starts to grow back after about 3 months - can be thicker/curlier/different
color
doesn't always happen immediately
wigs/ scarfs/ hats
Medication prescribed to deal with pain & side effects
May not get results back = no news is good news
✔✔What types of side effects could occur from chemo? - ✔✔Nausea - given before
treatment
Alopecia
Mucosal ulcers - mouth & rectal most common
Anorexia - offer variety of foods, soft/bland food
Neuropathy - nerve/jaw pain - soft or liquid diet
Mood changes
Hemorrhagic cystitis - give extra fluids - flush out bladder
✔✔Hodgkin's Lymphoma - ✔✔Type of lymphoma (cancer of the lymph nodes)
Usually the first sign is a painless, enlarged axillary or cervical lymph node
Fever, weight loss about 10% within first 6 months, night sweats, cough, abd
discomfort, n/v, anxorexia
✔✔Hodgkin's lymphoma diagnosis - ✔✔Lymph node biopsy
Symptom history
Blood work
CT scans (neck, chest, abdomen, pelvis
PET scan - assess for metastisis or recurrence of disease
CXR - chest x-ray
✔✔Hodgkin's lymphoma treatment - ✔✔Chemotherapy
Radiation - need a mask to stabilize head & control where radiation hits
Prognosis is usually very good
Not often that it recurs
✔✔What type of support is necessary for children with hodgkins lymphoma? -
✔✔Similar to children with other cancers
Typically affects adolescents, so consider their psychological needs
Ensure good hand hygiene and avoidance of infection
Sexual maturity may be delayed
✔✔Non-Hodgkin's Lymphoma - ✔✔Any form of lymphoma that is not Hodgkin's
disease****
More common in children than Hodgkin's disease
Diverse group of cancers
Similar manifestations a Hodgkin's, including organ symptoms related to pressure from
enlargement
, Can be quick to appear
More difuse
Cells undifferentiated/poorly differentiated
Invades meninges, mediastinal
✔✔Wilms tumor - ✔✔Form of kidney cancer
Most common malignant renal & intra-abdominal tumor of childhood
Can be born with it
Goes into surgery within 24-48 hrs after diagnosis
✔✔What is an important consideration for wilms tumor? - ✔✔Do NOT palpate the
abdomen (may cause spread)
✔✔How is wilms tumor treated treated? - ✔✔Chemotherapy/radiation
Can cause a ilius - get up & walk, fluids
Surgery
✔✔What are the signs and symptoms of brain tumours? - ✔✔Headaches
Neurological changes
Seizures
✔✔How are brain tumours treated? - ✔✔Chemotherapy
Radiation
Surgery - if possible
✔✔brain tumors - ✔✔2nd most common childhood cancer
s/s directly related to anatomical location & size & some extent the child's age
✔✔Neuroblastoma - ✔✔Most common extracranial solid tumour in children
Diagnosis: locate primary site
And areas of metastasis
Therapy: surgery, radiation, chemotherapy
Symptoms - lump in abdomen or chest, bone/back pain, bruising around eyes
✔✔What types of sarcomas are common in children? - ✔✔Osteogenic sarcoma - bone -
amputation above tumor, most common in femurs
Ewing sarcoma - joint, most common in marrow spaces, usually don't need amputation
Rhabdomyosarcoma (muscle)
✔✔How are Sarcomas treated? - ✔✔Chemotherapy
Surgery (may include amputation)
Radiation
✔✔sarcoma diagnosis - ✔✔CT, MRI, bone scan, biopsies
AND ANSWERS SET A+
✔✔Acute Lymphoid Leukemia (ALL) - ✔✔most common cancer in children
✔✔How is leukemia diagnosed? - ✔✔Clinical presentation
Bruising
Pain
Fever
Pale
Liver/spleen enlargement felt on palpation
Blood tests
Blood count
Blood smear
Bone marrow aspiration
Will determine what blast cells involved
Lumbar puncture (LP) (spinal tap)
Check for metastasis
Bed rest after tests
✔✔How is leukemia treated? - ✔✔Chemotherapy
Radiation
Stem-cell transplant
✔✔Nursing care for cancer - ✔✔Preparation for diagnostic and therapeutic procedures
Pain management
Preventing complications of Myelosuppression
Child has be to careful about activities/contact sports they do
Chemo can attack healthy cells
Precautions in administering and handling chemo (glove, gown, mask)
Emotional support
Family prep - side effects, infections
be honest about procedures/tests, what to anticipate/expect
,Alopecia - starts to grow back after about 3 months - can be thicker/curlier/different
color
doesn't always happen immediately
wigs/ scarfs/ hats
Medication prescribed to deal with pain & side effects
May not get results back = no news is good news
✔✔What types of side effects could occur from chemo? - ✔✔Nausea - given before
treatment
Alopecia
Mucosal ulcers - mouth & rectal most common
Anorexia - offer variety of foods, soft/bland food
Neuropathy - nerve/jaw pain - soft or liquid diet
Mood changes
Hemorrhagic cystitis - give extra fluids - flush out bladder
✔✔Hodgkin's Lymphoma - ✔✔Type of lymphoma (cancer of the lymph nodes)
Usually the first sign is a painless, enlarged axillary or cervical lymph node
Fever, weight loss about 10% within first 6 months, night sweats, cough, abd
discomfort, n/v, anxorexia
✔✔Hodgkin's lymphoma diagnosis - ✔✔Lymph node biopsy
Symptom history
Blood work
CT scans (neck, chest, abdomen, pelvis
PET scan - assess for metastisis or recurrence of disease
CXR - chest x-ray
✔✔Hodgkin's lymphoma treatment - ✔✔Chemotherapy
Radiation - need a mask to stabilize head & control where radiation hits
Prognosis is usually very good
Not often that it recurs
✔✔What type of support is necessary for children with hodgkins lymphoma? -
✔✔Similar to children with other cancers
Typically affects adolescents, so consider their psychological needs
Ensure good hand hygiene and avoidance of infection
Sexual maturity may be delayed
✔✔Non-Hodgkin's Lymphoma - ✔✔Any form of lymphoma that is not Hodgkin's
disease****
More common in children than Hodgkin's disease
Diverse group of cancers
Similar manifestations a Hodgkin's, including organ symptoms related to pressure from
enlargement
, Can be quick to appear
More difuse
Cells undifferentiated/poorly differentiated
Invades meninges, mediastinal
✔✔Wilms tumor - ✔✔Form of kidney cancer
Most common malignant renal & intra-abdominal tumor of childhood
Can be born with it
Goes into surgery within 24-48 hrs after diagnosis
✔✔What is an important consideration for wilms tumor? - ✔✔Do NOT palpate the
abdomen (may cause spread)
✔✔How is wilms tumor treated treated? - ✔✔Chemotherapy/radiation
Can cause a ilius - get up & walk, fluids
Surgery
✔✔What are the signs and symptoms of brain tumours? - ✔✔Headaches
Neurological changes
Seizures
✔✔How are brain tumours treated? - ✔✔Chemotherapy
Radiation
Surgery - if possible
✔✔brain tumors - ✔✔2nd most common childhood cancer
s/s directly related to anatomical location & size & some extent the child's age
✔✔Neuroblastoma - ✔✔Most common extracranial solid tumour in children
Diagnosis: locate primary site
And areas of metastasis
Therapy: surgery, radiation, chemotherapy
Symptoms - lump in abdomen or chest, bone/back pain, bruising around eyes
✔✔What types of sarcomas are common in children? - ✔✔Osteogenic sarcoma - bone -
amputation above tumor, most common in femurs
Ewing sarcoma - joint, most common in marrow spaces, usually don't need amputation
Rhabdomyosarcoma (muscle)
✔✔How are Sarcomas treated? - ✔✔Chemotherapy
Surgery (may include amputation)
Radiation
✔✔sarcoma diagnosis - ✔✔CT, MRI, bone scan, biopsies
