Chapter 31. Neoplastic Disease
1. The nurse notes that a childs gums bleed easily and bruising and petechiae are evident on
the extremities. Which laboratory value would be consistent with these symptoms?
a. Platelet count of 19,000/mm3
b. Prothrombin time of 11 to 15
seconds c. Hematocrit of 34
d. Leukocyte count of 14,000/mm3
ANS: A
The normal platelet count is 150,000 to 400,000/mm3. This finding is very low, indicating an
increased bleeding potential. The prothrombin time of 11 to 15 seconds is within normal
limits. The normal hematocrit is 35 to 45 and, although this finding is low, it would not create
the symptoms presented. A leukocyte count of 14,000/mm3 indicates the probable presence of
infection but is not a reflection of bleeding tendency.
2. The nurse understands that the type of precautions needed for children
receiving chemotherapy is based on which action of chemotherapeutic agents?
a. Gastrointestinal upset
b. Bone marrow suppression
c. Decreased creatinine level
d. Alopecia
ANS: B
Chemotherapy agents cause bone marrow suppression, which creates the need to institute
precautions related to reduced white blood cell, red blood cell, and platelet counts. These
precautions focus on preventing infection and bleeding. Although gastrointestinal upset may
be an adverse effect of chemotherapy, it is not caused by all chemotherapeutic agents. No
special precautions are instituted for gastrointestinal upset. A decreased creatinine level is
consistent with renal pathological conditions, not chemotherapy. Not all chemotherapeutic
agents cause alopecia. No precautions are taken to prevent alopecia.
, 3. The nurse should base a response to a parents question about the prognosis of
acute lymphoblastic leukemia (ALL) on which information?
a. Leukemia is a fatal disease although chemotherapy provides increasingly
longer periods of remission.
b. Research to find a cure for childhood cancers is very active.
1. The nurse notes that a childs gums bleed easily and bruising and petechiae are evident on
the extremities. Which laboratory value would be consistent with these symptoms?
a. Platelet count of 19,000/mm3
b. Prothrombin time of 11 to 15
seconds c. Hematocrit of 34
d. Leukocyte count of 14,000/mm3
ANS: A
The normal platelet count is 150,000 to 400,000/mm3. This finding is very low, indicating an
increased bleeding potential. The prothrombin time of 11 to 15 seconds is within normal
limits. The normal hematocrit is 35 to 45 and, although this finding is low, it would not create
the symptoms presented. A leukocyte count of 14,000/mm3 indicates the probable presence of
infection but is not a reflection of bleeding tendency.
2. The nurse understands that the type of precautions needed for children
receiving chemotherapy is based on which action of chemotherapeutic agents?
a. Gastrointestinal upset
b. Bone marrow suppression
c. Decreased creatinine level
d. Alopecia
ANS: B
Chemotherapy agents cause bone marrow suppression, which creates the need to institute
precautions related to reduced white blood cell, red blood cell, and platelet counts. These
precautions focus on preventing infection and bleeding. Although gastrointestinal upset may
be an adverse effect of chemotherapy, it is not caused by all chemotherapeutic agents. No
special precautions are instituted for gastrointestinal upset. A decreased creatinine level is
consistent with renal pathological conditions, not chemotherapy. Not all chemotherapeutic
agents cause alopecia. No precautions are taken to prevent alopecia.
, 3. The nurse should base a response to a parents question about the prognosis of
acute lymphoblastic leukemia (ALL) on which information?
a. Leukemia is a fatal disease although chemotherapy provides increasingly
longer periods of remission.
b. Research to find a cure for childhood cancers is very active.
