Oncology/ blood Exam Questions and Answers |Complete Solutions Graded A+
|100% Correct
A child with myelosuppression is at risk for infection. Good hand washing technique is
necessary to prevent the spread of infection. Restricting oral fluids would not be an
intervention to reduce the risk of infection and could actually be harmful to the child. Live virus
vaccines are not given when the child is myelosuppressed, so assessment of the child's immune
status should be done before administration of immunizations appropriate for age. Strict
isolation without visitors is not warranted, although visitors should wear a mask and gloves
while in the child's room.
The pediatric nurse clinician is discussing the pathophysiology related to childhood leukemia
with a class of nursing students. Which statement made by a nursing student indicates a lack of
understanding of the pathophysiology of this disease?
1. The platelet count is decreased.
2. Red blood cell production is affected.
3. Reed-Sternberg cells are found on biopsy.
4. Normal bone marrow is replaced by blast cells. 3. Reed-Sternberg cells are found on
biopsy.
In leukemia, normal bone marrow is replaced by malignant blast cells. As the blast cells take
over the bone marrow, eventually red blood cell and platelet production is affected, and the
child becomes anemic and thrombocytopenic. The Reed-Sternberg cell is found in Hodgkin's
disease.
A nurse is caring for a 9-year-old child with leukemia who is hospitalized for the administration
of chemotherapy. The nurse would monitor the child specifically for central nervous system
(CNS) involvement by checking which item?
1. Pupillary reaction
2. Level of consciousness (LOC)
3. The presence of petechiae in the sclera
,4. Color, motion, and sensation of the extremities 2. Level of consciousness (LOC)
The CNS status is monitored in the child with leukemia because of the risk of infiltration of blast
cells into the CNS. The nurse should check the child's LOC and should also monitor for signs of
irritability, vomiting, and lethargy. Changes in pupillary reaction are specific to conditions
related to increased intracranial pressure. The presence of petechiae in the sclera is an
objective sign that may be noted in leukemia but is not specifically related to the CNS. Color,
motion, and sensation of the extremities relate to a neurovascular assessment and are not
specifically related to CNS status.
The pediatric nurse assists the health care provider in performing a lumbar puncture (LP) on a
3-year-old child with leukemia and suspected central nervous system metastasis. The nurse
should place the child in which position for this procedure?
1. Lithotomy position
2. Modified Sims position
3. Prone, with the knees flexed to the abdomen and the head bent, the chin resting on the
chest
4. Lateral recumbent, with the knees flexed to the abdomen and the head bent, the chin resting
on the chest 4. Lateral recumbent, with the knees flexed to the abdomen and the head
bent, the chin resting on the chest
A lateral recumbent position, with the knees flexed to the abdomen and the head bent with the
chin resting on the chest, is assumed for a lumbar puncture. This position separates the spinal
processes and facilitates needle insertion into the subarachnoid space. The remaining options
are incorrect positions.
A 6-year-old child has just been diagnosed with localized Hodgkin's disease, and chemotherapy
is planned to begin immediately. The mother of the child asks the nurse why radiation therapy
was not prescribed as a part of the treatment. Which is the appropriate and supportive
response to the mother?
1. "The child is too young to have radiation therapy."
, 2. "It's very costly, and chemotherapy works just as well."
3. "I'm not sure. I'll discuss it with the health care provider."
4. "The health care provider (HCP) would prefer that you discuss treatment options with the
oncologist." 1. "The child is too young to have radiation therapy."
Radiation therapy is usually delayed until a child is 8 years of age, if possible to prevent
retardation of bone growth and soft tissue development. The remaining options are
inappropriate responses to the mother.
A diagnostic workup is being performed on a 1-year-old child with suspected neuroblastoma.
The nurse reviews the results of the diagnostic tests and understands that which finding is most
specifically related to this type of tumor?
1. Positive Babinski's sign
2. Presence of blast cells in the bone marrow
3. Projectile vomiting, usually in the morning
4. Elevated vanillylmandelic acid (VMA) urinary levels 4. Elevated vanillylmandelic acid
(VMA) urinary levels
Neuroblastoma is a solid tumor found only in children. It arises from neural crest cells that
develop into the sympathetic nervous system and the adrenal medulla. Typically, the tumor
compresses adjacent normal tissue and organs. Neuroblastoma cells may excrete
catecholamines and their metabolites. Urine samples will indicate elevated VMA levels. The
presence of blast cells in the bone marrow occurs in leukemia. Projectile vomiting occurring
most often in the morning and a positive Babinski's sign are clinical manifestations of a brain
tumor.
The nurse is collecting data on a 9-year-old child suspected of having a brain tumor. Which
question should the nurse ask to elicit data related to the classic symptoms of a brain tumor?
1. "Do you have trouble seeing?"
|100% Correct
A child with myelosuppression is at risk for infection. Good hand washing technique is
necessary to prevent the spread of infection. Restricting oral fluids would not be an
intervention to reduce the risk of infection and could actually be harmful to the child. Live virus
vaccines are not given when the child is myelosuppressed, so assessment of the child's immune
status should be done before administration of immunizations appropriate for age. Strict
isolation without visitors is not warranted, although visitors should wear a mask and gloves
while in the child's room.
The pediatric nurse clinician is discussing the pathophysiology related to childhood leukemia
with a class of nursing students. Which statement made by a nursing student indicates a lack of
understanding of the pathophysiology of this disease?
1. The platelet count is decreased.
2. Red blood cell production is affected.
3. Reed-Sternberg cells are found on biopsy.
4. Normal bone marrow is replaced by blast cells. 3. Reed-Sternberg cells are found on
biopsy.
In leukemia, normal bone marrow is replaced by malignant blast cells. As the blast cells take
over the bone marrow, eventually red blood cell and platelet production is affected, and the
child becomes anemic and thrombocytopenic. The Reed-Sternberg cell is found in Hodgkin's
disease.
A nurse is caring for a 9-year-old child with leukemia who is hospitalized for the administration
of chemotherapy. The nurse would monitor the child specifically for central nervous system
(CNS) involvement by checking which item?
1. Pupillary reaction
2. Level of consciousness (LOC)
3. The presence of petechiae in the sclera
,4. Color, motion, and sensation of the extremities 2. Level of consciousness (LOC)
The CNS status is monitored in the child with leukemia because of the risk of infiltration of blast
cells into the CNS. The nurse should check the child's LOC and should also monitor for signs of
irritability, vomiting, and lethargy. Changes in pupillary reaction are specific to conditions
related to increased intracranial pressure. The presence of petechiae in the sclera is an
objective sign that may be noted in leukemia but is not specifically related to the CNS. Color,
motion, and sensation of the extremities relate to a neurovascular assessment and are not
specifically related to CNS status.
The pediatric nurse assists the health care provider in performing a lumbar puncture (LP) on a
3-year-old child with leukemia and suspected central nervous system metastasis. The nurse
should place the child in which position for this procedure?
1. Lithotomy position
2. Modified Sims position
3. Prone, with the knees flexed to the abdomen and the head bent, the chin resting on the
chest
4. Lateral recumbent, with the knees flexed to the abdomen and the head bent, the chin resting
on the chest 4. Lateral recumbent, with the knees flexed to the abdomen and the head
bent, the chin resting on the chest
A lateral recumbent position, with the knees flexed to the abdomen and the head bent with the
chin resting on the chest, is assumed for a lumbar puncture. This position separates the spinal
processes and facilitates needle insertion into the subarachnoid space. The remaining options
are incorrect positions.
A 6-year-old child has just been diagnosed with localized Hodgkin's disease, and chemotherapy
is planned to begin immediately. The mother of the child asks the nurse why radiation therapy
was not prescribed as a part of the treatment. Which is the appropriate and supportive
response to the mother?
1. "The child is too young to have radiation therapy."
, 2. "It's very costly, and chemotherapy works just as well."
3. "I'm not sure. I'll discuss it with the health care provider."
4. "The health care provider (HCP) would prefer that you discuss treatment options with the
oncologist." 1. "The child is too young to have radiation therapy."
Radiation therapy is usually delayed until a child is 8 years of age, if possible to prevent
retardation of bone growth and soft tissue development. The remaining options are
inappropriate responses to the mother.
A diagnostic workup is being performed on a 1-year-old child with suspected neuroblastoma.
The nurse reviews the results of the diagnostic tests and understands that which finding is most
specifically related to this type of tumor?
1. Positive Babinski's sign
2. Presence of blast cells in the bone marrow
3. Projectile vomiting, usually in the morning
4. Elevated vanillylmandelic acid (VMA) urinary levels 4. Elevated vanillylmandelic acid
(VMA) urinary levels
Neuroblastoma is a solid tumor found only in children. It arises from neural crest cells that
develop into the sympathetic nervous system and the adrenal medulla. Typically, the tumor
compresses adjacent normal tissue and organs. Neuroblastoma cells may excrete
catecholamines and their metabolites. Urine samples will indicate elevated VMA levels. The
presence of blast cells in the bone marrow occurs in leukemia. Projectile vomiting occurring
most often in the morning and a positive Babinski's sign are clinical manifestations of a brain
tumor.
The nurse is collecting data on a 9-year-old child suspected of having a brain tumor. Which
question should the nurse ask to elicit data related to the classic symptoms of a brain tumor?
1. "Do you have trouble seeing?"
