Page 1 of 63
PEDS - EXAM #3 (CH. 25, 26, 27) WONG 10TH EDITION
QUESTIONS COMPREHENSIVE 2026 QUESTIONS EXAM
LATEST VERSION SOLVED QUESTIONS & ANSWERS
VERIFIED 100 %
Chapter 25: The Child with Cancer
What childhood cancer may demonstrate patterns of inheritance that suggest
a familial basis?
a. Leukemia
b. Retinoblastoma
c. Rhabdomyosarcoma
d. Osteogenic sarcoma
B
Retinoblastoma is an example of a pediatric cancer that demonstrates inheritance.
The absence of the retinoblastoma gene allows for abnormal cell growth and the
development of retinoblastoma. Chromosome abnormalities are present in many
malignancies. They do not indicate a familial pattern of inheritance. The Philadelphia
chromosome is observed in almost all individuals with chronic myelogenous
leukemia. There is no evidence of a familial pattern of inheritance for
rhabdomyosarcoma or osteogenic sarcoma cancers.
As part of the diagnostic evaluation of a child with cancer, biopsies are
important for staging. What statement explains what staging means?
a. Extent of the disease at the time of diagnosis
b. Rate normal cells are being replaced by cancer cells
, Page 2 of 63
c. Biologic characteristics of the tumor or lymph nodes
d. Abnormal, unrestricted growth of cancer cells producing organ damage
A
Staging is a description of the extent of the disease at the time of diagnosis. Staging
criteria exist for most tumors. The stage usually relates directly to the prognosis; the
higher the stage, the poorer the prognosis. The rate that normal cells are being
replaced by cancer cells is not a definition of staging. Classification of the tumor
refers to the biologic characteristics of the tumor or lymph nodes. Abnormal,
unrestricted growth of cancer cells producing organ damage describes how cancer
cells grow and can cause damage to an organ.
What statement related to clinical trials developed for pediatric cancers is
most accurate?
a. Are accessible only in major pediatric centers
b. Do not require consent for standard therapy
c. Provide the best available therapy compared with an expected improvement
d. Are standardized to provide the same treatment to all children with the
disease
C
Most clinical trials have a control group in which the patients receive the best
available therapy currently known. The experimental group(s) receives treatment that
is thought to be even better. The protocol outlines the therapy plan. Protocols are
developed for many pediatric cancers. They can be accessed by pediatric
oncologists throughout the United States. Consent is always required in treatment of
children, especially for research protocols. The protocol is designed to optimize
therapy for children based on disease type and stage.
Chemotherapeutic agents are classified according to what feature?
a. Side effects
b. Effectiveness
, Page 3 of 63
c. Mechanism of action
d. Route of administration
C
Chemotherapeutic agents are classified according to mechanism of action. For
example, antimetabolites resemble essential metabolic elements needed for growth
but are different enough to block further deoxyribonucleic acid (DNA) synthesis.
Although the side effect profiles may be similar for drugs within a classification, they
are not the basis for classification. Most chemotherapeutic regimens contain
combinations of drugs. The effectiveness of any one drug is relative to the cancer
type, combination therapy, and protocol for administration. The route of
administration is determined by the pharmacodynamics and pharmacokinetics of
each drug.
What type of chemotherapeutic agent alters the function of cells by replacing a
hydrogen atom of a molecule?
a. Plant alkaloids
b. Antimetabolites
c. Alkylating agents
d. Antitumor antibiotics
C
Alkylating agents replace a hydrogen atom with an alkyl group. The irreversible
combination of alkyl groups with nucleotide chains, particularly deoxyribonucleic acid
(DNA), causes unbalanced growth of unaffected cell constituents so that the cell
eventually dies. Plant alkaloids arrest the cell in metaphase by binding to proteins
needed for spindle formation. Antimetabolites resemble essential metabolic elements
needed for growth but are different enough to block further DNA synthesis. Antitumor
antibiotics are natural substances that interfere with cell division by reacting with
DNA in such a way as to prevent further replication of DNA and transcription of
ribonucleic acid (RNA).
What side effect commonly occurs with corticosteroid (prednisone) therapy?
a. Alopecia
, Page 4 of 63
b. Anorexia
c. Nausea and vomiting
d. Susceptibility to infection
D
Corticosteroids have immunosuppressive effects. Children who are taking
prednisone are susceptible to infections. Hair loss is not a side effect of
corticosteroid therapy. Children taking corticosteroids have increased appetites.
Gastric irritation, not nausea and vomiting, is a potential side effect. The medicine
should be given with food.
What chemotherapeutic agent is classified as an antitumor antibiotic?
a. Cisplatin (Platinol AQ)
b. Vincristine (Oncovin)
c. Methotrexate (Texall)
d. Daunorubicin (Cerubidine)
D
Daunorubicin is an antitumor antibiotic. Cisplatin is classified as an alkylating agent.
Vincristine is a plant alkaloid. Methotrexate is an antimetabolite.
The nurse is administering an intravenous chemotherapeutic agent to a child
with leukemia. The child suddenly begins to wheeze and have severe urticaria.
What nursing action is most appropriate to initiate?
a. Recheck the rate of drug infusion.
b. Stop the drug infusion immediately.
c. Observe the child closely for next 10 minutes.
d. Explain to the child that this is an expected side effect.
B
When an allergic reaction is suspected, the drug is immediately discontinued. Any
drug in the line should be withdrawn, and a normal saline infusion begun to keep the
line open. The intravenous infusion is stopped to minimize the amount of drug that
infuses. The infusion rate can be confirmed at a later time. Observation of the child
PEDS - EXAM #3 (CH. 25, 26, 27) WONG 10TH EDITION
QUESTIONS COMPREHENSIVE 2026 QUESTIONS EXAM
LATEST VERSION SOLVED QUESTIONS & ANSWERS
VERIFIED 100 %
Chapter 25: The Child with Cancer
What childhood cancer may demonstrate patterns of inheritance that suggest
a familial basis?
a. Leukemia
b. Retinoblastoma
c. Rhabdomyosarcoma
d. Osteogenic sarcoma
B
Retinoblastoma is an example of a pediatric cancer that demonstrates inheritance.
The absence of the retinoblastoma gene allows for abnormal cell growth and the
development of retinoblastoma. Chromosome abnormalities are present in many
malignancies. They do not indicate a familial pattern of inheritance. The Philadelphia
chromosome is observed in almost all individuals with chronic myelogenous
leukemia. There is no evidence of a familial pattern of inheritance for
rhabdomyosarcoma or osteogenic sarcoma cancers.
As part of the diagnostic evaluation of a child with cancer, biopsies are
important for staging. What statement explains what staging means?
a. Extent of the disease at the time of diagnosis
b. Rate normal cells are being replaced by cancer cells
, Page 2 of 63
c. Biologic characteristics of the tumor or lymph nodes
d. Abnormal, unrestricted growth of cancer cells producing organ damage
A
Staging is a description of the extent of the disease at the time of diagnosis. Staging
criteria exist for most tumors. The stage usually relates directly to the prognosis; the
higher the stage, the poorer the prognosis. The rate that normal cells are being
replaced by cancer cells is not a definition of staging. Classification of the tumor
refers to the biologic characteristics of the tumor or lymph nodes. Abnormal,
unrestricted growth of cancer cells producing organ damage describes how cancer
cells grow and can cause damage to an organ.
What statement related to clinical trials developed for pediatric cancers is
most accurate?
a. Are accessible only in major pediatric centers
b. Do not require consent for standard therapy
c. Provide the best available therapy compared with an expected improvement
d. Are standardized to provide the same treatment to all children with the
disease
C
Most clinical trials have a control group in which the patients receive the best
available therapy currently known. The experimental group(s) receives treatment that
is thought to be even better. The protocol outlines the therapy plan. Protocols are
developed for many pediatric cancers. They can be accessed by pediatric
oncologists throughout the United States. Consent is always required in treatment of
children, especially for research protocols. The protocol is designed to optimize
therapy for children based on disease type and stage.
Chemotherapeutic agents are classified according to what feature?
a. Side effects
b. Effectiveness
, Page 3 of 63
c. Mechanism of action
d. Route of administration
C
Chemotherapeutic agents are classified according to mechanism of action. For
example, antimetabolites resemble essential metabolic elements needed for growth
but are different enough to block further deoxyribonucleic acid (DNA) synthesis.
Although the side effect profiles may be similar for drugs within a classification, they
are not the basis for classification. Most chemotherapeutic regimens contain
combinations of drugs. The effectiveness of any one drug is relative to the cancer
type, combination therapy, and protocol for administration. The route of
administration is determined by the pharmacodynamics and pharmacokinetics of
each drug.
What type of chemotherapeutic agent alters the function of cells by replacing a
hydrogen atom of a molecule?
a. Plant alkaloids
b. Antimetabolites
c. Alkylating agents
d. Antitumor antibiotics
C
Alkylating agents replace a hydrogen atom with an alkyl group. The irreversible
combination of alkyl groups with nucleotide chains, particularly deoxyribonucleic acid
(DNA), causes unbalanced growth of unaffected cell constituents so that the cell
eventually dies. Plant alkaloids arrest the cell in metaphase by binding to proteins
needed for spindle formation. Antimetabolites resemble essential metabolic elements
needed for growth but are different enough to block further DNA synthesis. Antitumor
antibiotics are natural substances that interfere with cell division by reacting with
DNA in such a way as to prevent further replication of DNA and transcription of
ribonucleic acid (RNA).
What side effect commonly occurs with corticosteroid (prednisone) therapy?
a. Alopecia
, Page 4 of 63
b. Anorexia
c. Nausea and vomiting
d. Susceptibility to infection
D
Corticosteroids have immunosuppressive effects. Children who are taking
prednisone are susceptible to infections. Hair loss is not a side effect of
corticosteroid therapy. Children taking corticosteroids have increased appetites.
Gastric irritation, not nausea and vomiting, is a potential side effect. The medicine
should be given with food.
What chemotherapeutic agent is classified as an antitumor antibiotic?
a. Cisplatin (Platinol AQ)
b. Vincristine (Oncovin)
c. Methotrexate (Texall)
d. Daunorubicin (Cerubidine)
D
Daunorubicin is an antitumor antibiotic. Cisplatin is classified as an alkylating agent.
Vincristine is a plant alkaloid. Methotrexate is an antimetabolite.
The nurse is administering an intravenous chemotherapeutic agent to a child
with leukemia. The child suddenly begins to wheeze and have severe urticaria.
What nursing action is most appropriate to initiate?
a. Recheck the rate of drug infusion.
b. Stop the drug infusion immediately.
c. Observe the child closely for next 10 minutes.
d. Explain to the child that this is an expected side effect.
B
When an allergic reaction is suspected, the drug is immediately discontinued. Any
drug in the line should be withdrawn, and a normal saline infusion begun to keep the
line open. The intravenous infusion is stopped to minimize the amount of drug that
infuses. The infusion rate can be confirmed at a later time. Observation of the child
