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CHAPTER 24:Nursing Care of the Child With
an Alteration in Cellular Regulation/
Hematologic or Neoplastic Disorder Verified
and Updated Questions and Answers (100%
Correct Answers)
1. The nurse is caring for a 16-year-old boy with acute myelogenous leukemia who is
having chemotherapy and who has incomplete records for varicella zoster
immunization. Which is the priority nursing diagnosis?
A) Pain related to adverse effects of treatment verbalized by the child
B) Nausea related to side effects of chemotherapy verbalized by the child
C) Constipation related to the use of opioid analgesics for pain
D) Risk for infection related to neutropenia and immunosuppression
Answer: Ans: D
Feedback: The priority nursing diagnosis is risk for infection related to neutropenia
and immunosuppression. The incomplete records for varicella zoster immunization
can cause a problem since exposure to chickenpox could cause sepsis, so the nurse
should contact the oncologist for approval to administer the vaccine. Certain
vaccines are not administered when the child is immunosuppressed, so timing is
crucial. Diagnoses for pain and nausea are valid for this child because he is
undergoing chemotherapy, but they are not a priority. Likewise, the need for
constipation management would not be necessary unless opioid use begins.
2. The nurse is caring for an 8-year-old girl who has been diagnosed with leukemia
and will have a variety of tests, including a lumbar puncture, before beginning
chemotherapy. What action would be the priority?
A) Applying EMLA to the lumbar puncture site
B) Educating the child and family about the testing procedures
C) Administering promethazine as ordered for nausea
D) Educating the family about chemotherapy and its side effects
Answer: Ans: B
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Feedback: The priority would be educating the child and family about the testing
procedures so they know what to expect and understand why the tests are being
performed. Applying EMLA to the lumbar puncture site will be done prior to the
procedure. The family will be educated about chemotherapy and its side effects prior
to the therapy beginning, and promethazine or other antiemetics will be
administered once chemotherapy has begun.
3. The nurse is caring for a 13-year-old boy with acute myelogenous leukemia who is
experiencing feelings of powerlessness due to the effects of chemotherapy. What
intervention will best help the teen's sense of control?
A) Involving the boy in decisions whenever possible
B) Acknowledging the boy's feelings of anger with the disease
C) Providing realistic expectations of treatments and outcomes
D) Recognizing abilities that are unaffected by the disease
Answer: Ans: A
Feedback: Involving the boy in the decision-making process will best help his sense
of control. Whether he is included in important decisions about therapy or minor
decisions like menus or dress, it will give him a sense of control over his situation.
Acknowledging feelings of anger, recognizing his abilities, and providing realistic
expectations will reduce body image disturbance and build self-esteem.
4. The nurse is caring for a 5-year-old girl with a disseminated medulloblastoma.
What intervention would be most appropriate for this situation?
A) Providing emotional support to the parents and siblings of the child
B) Recommending support groups for people whose children have cancer
C) Encouraging the family to cry and express feelings away from the child
D) Educating the family about the disease, its treatments, and side effects
Answer: Ans: C
Feedback: The outcome of this highly malignant medulloblastoma is often not
positive. Helping the family through anticipatory grieving by encouraging the family
to cry and express feelings away from the child would be unique to this child's
situation. Educating the family about the disease, its treatments, and side effects;
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recommending support groups; and providing emotional support to the parents and
siblings would be appropriate for any child with cancer.
5. The nurse is assessing a 3-year-old boy whose parents brought him to the clinic
when they noticed that the right side of his abdomen was swollen. What finding
would suggest this child has a neuroblastoma?
A) The child has a maculopapular rash on his palms.
B) The parents report that their son is vomiting and not eating well.
C) The parents report that their son is irritable and not gaining weight.
D) Auscultation reveals wheezing with diminished lung sounds.
Answer: Ans: B
Feedback: Along with the swollen abdomen on one side, the parents reporting that
the child is vomiting and anorexic points to the possibility of a neuroblastoma.
Observing a maculopapular rash on the child's palms is a sign of graft-versus-host
disease. The parents reporting that the child is irritable and not gaining weight
suggests a possible brain tumor as well as malabsorption problems. Auscultation
revealing wheezing with diminished lung sounds would suggest other problems, not
a neuroblastoma.
6. The nurse is educating the parents of a 4-year-old boy with a Wilms tumor who is
about to have chemotherapy prior to surgery. Which statement by the parents
indicates that the nurse should review the instructions about preventing infection?
A) "He takes his antibiotic twice a day."
B) "We check his temperature orally."
C) "We keep him away from crowds."
D) "He must be clean and his teeth brushed."
Answer: Ans: A
Feedback:
The parents have heard the instructions for the antibiotic administration incorrectly.
The
CHAPTER 24:Nursing Care of the Child With
an Alteration in Cellular Regulation/
Hematologic or Neoplastic Disorder Verified
and Updated Questions and Answers (100%
Correct Answers)
1. The nurse is caring for a 16-year-old boy with acute myelogenous leukemia who is
having chemotherapy and who has incomplete records for varicella zoster
immunization. Which is the priority nursing diagnosis?
A) Pain related to adverse effects of treatment verbalized by the child
B) Nausea related to side effects of chemotherapy verbalized by the child
C) Constipation related to the use of opioid analgesics for pain
D) Risk for infection related to neutropenia and immunosuppression
Answer: Ans: D
Feedback: The priority nursing diagnosis is risk for infection related to neutropenia
and immunosuppression. The incomplete records for varicella zoster immunization
can cause a problem since exposure to chickenpox could cause sepsis, so the nurse
should contact the oncologist for approval to administer the vaccine. Certain
vaccines are not administered when the child is immunosuppressed, so timing is
crucial. Diagnoses for pain and nausea are valid for this child because he is
undergoing chemotherapy, but they are not a priority. Likewise, the need for
constipation management would not be necessary unless opioid use begins.
2. The nurse is caring for an 8-year-old girl who has been diagnosed with leukemia
and will have a variety of tests, including a lumbar puncture, before beginning
chemotherapy. What action would be the priority?
A) Applying EMLA to the lumbar puncture site
B) Educating the child and family about the testing procedures
C) Administering promethazine as ordered for nausea
D) Educating the family about chemotherapy and its side effects
Answer: Ans: B
,Inquire through: | Professional | Confidential Support
Feedback: The priority would be educating the child and family about the testing
procedures so they know what to expect and understand why the tests are being
performed. Applying EMLA to the lumbar puncture site will be done prior to the
procedure. The family will be educated about chemotherapy and its side effects prior
to the therapy beginning, and promethazine or other antiemetics will be
administered once chemotherapy has begun.
3. The nurse is caring for a 13-year-old boy with acute myelogenous leukemia who is
experiencing feelings of powerlessness due to the effects of chemotherapy. What
intervention will best help the teen's sense of control?
A) Involving the boy in decisions whenever possible
B) Acknowledging the boy's feelings of anger with the disease
C) Providing realistic expectations of treatments and outcomes
D) Recognizing abilities that are unaffected by the disease
Answer: Ans: A
Feedback: Involving the boy in the decision-making process will best help his sense
of control. Whether he is included in important decisions about therapy or minor
decisions like menus or dress, it will give him a sense of control over his situation.
Acknowledging feelings of anger, recognizing his abilities, and providing realistic
expectations will reduce body image disturbance and build self-esteem.
4. The nurse is caring for a 5-year-old girl with a disseminated medulloblastoma.
What intervention would be most appropriate for this situation?
A) Providing emotional support to the parents and siblings of the child
B) Recommending support groups for people whose children have cancer
C) Encouraging the family to cry and express feelings away from the child
D) Educating the family about the disease, its treatments, and side effects
Answer: Ans: C
Feedback: The outcome of this highly malignant medulloblastoma is often not
positive. Helping the family through anticipatory grieving by encouraging the family
to cry and express feelings away from the child would be unique to this child's
situation. Educating the family about the disease, its treatments, and side effects;
, Inquire through: | Professional | Confidential Support
recommending support groups; and providing emotional support to the parents and
siblings would be appropriate for any child with cancer.
5. The nurse is assessing a 3-year-old boy whose parents brought him to the clinic
when they noticed that the right side of his abdomen was swollen. What finding
would suggest this child has a neuroblastoma?
A) The child has a maculopapular rash on his palms.
B) The parents report that their son is vomiting and not eating well.
C) The parents report that their son is irritable and not gaining weight.
D) Auscultation reveals wheezing with diminished lung sounds.
Answer: Ans: B
Feedback: Along with the swollen abdomen on one side, the parents reporting that
the child is vomiting and anorexic points to the possibility of a neuroblastoma.
Observing a maculopapular rash on the child's palms is a sign of graft-versus-host
disease. The parents reporting that the child is irritable and not gaining weight
suggests a possible brain tumor as well as malabsorption problems. Auscultation
revealing wheezing with diminished lung sounds would suggest other problems, not
a neuroblastoma.
6. The nurse is educating the parents of a 4-year-old boy with a Wilms tumor who is
about to have chemotherapy prior to surgery. Which statement by the parents
indicates that the nurse should review the instructions about preventing infection?
A) "He takes his antibiotic twice a day."
B) "We check his temperature orally."
C) "We keep him away from crowds."
D) "He must be clean and his teeth brushed."
Answer: Ans: A
Feedback:
The parents have heard the instructions for the antibiotic administration incorrectly.
The
