Multiple Choice
Identify the choice that best completes the statement or answers the question.
1. A 12-year-old patient is experiencing pain in the abdomen after receiving chemotherapy.
When developing a care plan, for which interventions will the nurse plan for pain
management?
a. Application of heating pads to the abdomen
b. Application of cold packs to the chest area
c. Alternative therapy such as aromatherapy
d. Administration of antacids for alleviation of abdominal pain
ANS: C
Chapter: Chapter 20 Hematological, Immunological, and Neoplastic Disorders
Chapter Learning Objective: 5. Develop a nursing care plan for the child with cancer
who is experiencing pain.
Page: 503
Heading: Safe and Effective Nursing Care: Promoting Safety—Nursing Care
Priorities for Complex Pediatric Hematology and Oncology Patients
Integrated Processes: Nursing Process
Cognitive Level: Synthesis [Creating]
Client Need: Safe and Effective Care Environment: Management of Care
Concept: Cellular Regulation
Difficulty: Difficult
Feedback
A. This is incorrect. Applying heating pads will increase circulation to the area and
increase pain.
B. This is incorrect. Cold packs to the abdomen may resolve abdominal issues but
will not be effective if applied to the chest.
C. This is correct. Aromatherapy is the therapeutic use of essential oils from plants
(flowers, herbs, or trees) for the improvement of physical, emotional, and
spiritual well-being.
D. This is incorrect. Antacids neutralize acids, which are not the direct cause of the
patient’s abdominal pain.
PTS: 1 CON: Cellular Regulation
2. An 8-year-old child arrives at the emergency department with abdominal pain and fever.
The child has a medical history of leukemia in remission. The nurse receives medical
, orders for the child. Which order does the nurse recognize as the priority?
a. Draw blood work for a CBC and blood culture.
b. Complete a thorough physical assessment.
c. Set up neutropenic precautions for the child.
d. Prepare the child to be transported to radiology.
ANS: C
Chapter: Chapter 20 Hematological, Immunological, and Neoplastic Disorders
Chapter Learning Objective: 3. Identify the major pathophysiology associated with
the care of a child with cancer.
Page: 503
Heading: Safe and Effective Nursing Care: Promoting Safety—Nursing Care
Priorities for Complex Pediatric Hematology and Oncology Patients
Integrated Processes: Nursing Process
Client Need: Safe and Effective Care Environment: Safety and Infection Control
Cognitive Level: Analysis [Analyzing]
Concept: Cellular Regulation
Difficulty: Moderate
Feedback
A. This is incorrect. The nurse will avoid invasive procedures and use aseptic
technique to draw from central lines if present. Laboratory outcomes are
important, but this action is not the priority.
B. This is incorrect. The nurse will complete a thorough physical assessment. Vital
signs, duration of current symptoms, and systems evaluations are of special
interest. This information is important and will guide the physician for additional
orders; however, this action is not the priority.
C. This is correct. Patients with a history of leukemia need to be triaged quickly and
placed in a treatment room as soon as possible. Neutropenic precautions
(protective isolation) need to be initiated. The cancer cells, along with the cancer
treatments, place a burden on the child’s immune system. The disease
pathophysiology makes observation and prevention of infection a priority.
D. This is incorrect. Radiological studies may be in order after the initial
assessments and antibiotics have begun. The administration of antibiotics within
60 minutes of assessment for the presence of fever is of greater importance.
PTS: 1 CON: Cellular Regulation
3. A 19-year-old college student is being treated for nonmetastatic Hodgkin’s lymphoma
with chemotherapy. Which recommendation by the nurse was made prior to beginning
chemotherapy to promote a level of health?
a. Gain weight before treatment to offset weight loss.
b. Consider sperm banking because of expected sterilization.
c. Move in with parents to initiate quarantine protocols.
, d. Withdraw from all college courses because of fatigue.
ANS: B
Chapter: Chapter 20 Hematological, Immunological, and Neoplastic Disorders
Chapter Learning Objective: 4. Identify nursing assessments and interventions that
promote health during the care of children with cancer and their families.
Page: 508
Heading: Oncological Disorders > Lymphomas > Caregiver Education
Integrated Processes: Nursing Process
Client Need: Physiological Integrity: Reduction of Risk Potential
Cognitive Level: Analysis [Analyzing]
Concept: Cellular Regulation
Difficulty: Moderate
Feedback
A. This is incorrect. The patient is likely to be experiencing weight loss from
anorexia triggered by the disease process. Weight gain is unlikely; other nutrition
recommendations are needed.
B. This is correct. Treatment with chemotherapy is likely to cause sterilization; the
nurse needs to recommend sperm banking. Patients may not be able to think
about a future and children; the nurse will explain the importance of having
sperm at a future time.
C. This is incorrect. If the patient is living independently, there is no need to move
in with parents unless care assistance is needed. The patient can initiate
quarantine measures if necessary, which may be easier in an independent
environment. However, other care needs may be met if living with caregivers.
D. This is incorrect. It is likely the patient will experience fatigue from
chemotherapy. However, the patient may benefit from activities focused on
something other than the illness and treatment. The patient may want to consider
one class a term and the availability of online courses.
PTS: 1 CON: Cellular Regulation
4. The nurse in a pediatric clinic is assessing an infant who is 6 months of age. The infant is
pale with poor muscle tone. Auscultation reveals tachycardia; in addition, the infant is at
the 35th percentile for both height and weight. The physician orders laboratory testing.
Which laboratory value does the nurse expect?
a. Erythropoietin level of 1.9 mIU
b. Serum iron 24 mcg/dL
c. Normal red blood cell count (RBC) index in complete blood count (CBC)
d. RBCs small in size and pale
ANS: D
Chapter: Chapter 20 Hematological, Immunological, and Neoplastic Disorders
Identify the choice that best completes the statement or answers the question.
1. A 12-year-old patient is experiencing pain in the abdomen after receiving chemotherapy.
When developing a care plan, for which interventions will the nurse plan for pain
management?
a. Application of heating pads to the abdomen
b. Application of cold packs to the chest area
c. Alternative therapy such as aromatherapy
d. Administration of antacids for alleviation of abdominal pain
ANS: C
Chapter: Chapter 20 Hematological, Immunological, and Neoplastic Disorders
Chapter Learning Objective: 5. Develop a nursing care plan for the child with cancer
who is experiencing pain.
Page: 503
Heading: Safe and Effective Nursing Care: Promoting Safety—Nursing Care
Priorities for Complex Pediatric Hematology and Oncology Patients
Integrated Processes: Nursing Process
Cognitive Level: Synthesis [Creating]
Client Need: Safe and Effective Care Environment: Management of Care
Concept: Cellular Regulation
Difficulty: Difficult
Feedback
A. This is incorrect. Applying heating pads will increase circulation to the area and
increase pain.
B. This is incorrect. Cold packs to the abdomen may resolve abdominal issues but
will not be effective if applied to the chest.
C. This is correct. Aromatherapy is the therapeutic use of essential oils from plants
(flowers, herbs, or trees) for the improvement of physical, emotional, and
spiritual well-being.
D. This is incorrect. Antacids neutralize acids, which are not the direct cause of the
patient’s abdominal pain.
PTS: 1 CON: Cellular Regulation
2. An 8-year-old child arrives at the emergency department with abdominal pain and fever.
The child has a medical history of leukemia in remission. The nurse receives medical
, orders for the child. Which order does the nurse recognize as the priority?
a. Draw blood work for a CBC and blood culture.
b. Complete a thorough physical assessment.
c. Set up neutropenic precautions for the child.
d. Prepare the child to be transported to radiology.
ANS: C
Chapter: Chapter 20 Hematological, Immunological, and Neoplastic Disorders
Chapter Learning Objective: 3. Identify the major pathophysiology associated with
the care of a child with cancer.
Page: 503
Heading: Safe and Effective Nursing Care: Promoting Safety—Nursing Care
Priorities for Complex Pediatric Hematology and Oncology Patients
Integrated Processes: Nursing Process
Client Need: Safe and Effective Care Environment: Safety and Infection Control
Cognitive Level: Analysis [Analyzing]
Concept: Cellular Regulation
Difficulty: Moderate
Feedback
A. This is incorrect. The nurse will avoid invasive procedures and use aseptic
technique to draw from central lines if present. Laboratory outcomes are
important, but this action is not the priority.
B. This is incorrect. The nurse will complete a thorough physical assessment. Vital
signs, duration of current symptoms, and systems evaluations are of special
interest. This information is important and will guide the physician for additional
orders; however, this action is not the priority.
C. This is correct. Patients with a history of leukemia need to be triaged quickly and
placed in a treatment room as soon as possible. Neutropenic precautions
(protective isolation) need to be initiated. The cancer cells, along with the cancer
treatments, place a burden on the child’s immune system. The disease
pathophysiology makes observation and prevention of infection a priority.
D. This is incorrect. Radiological studies may be in order after the initial
assessments and antibiotics have begun. The administration of antibiotics within
60 minutes of assessment for the presence of fever is of greater importance.
PTS: 1 CON: Cellular Regulation
3. A 19-year-old college student is being treated for nonmetastatic Hodgkin’s lymphoma
with chemotherapy. Which recommendation by the nurse was made prior to beginning
chemotherapy to promote a level of health?
a. Gain weight before treatment to offset weight loss.
b. Consider sperm banking because of expected sterilization.
c. Move in with parents to initiate quarantine protocols.
, d. Withdraw from all college courses because of fatigue.
ANS: B
Chapter: Chapter 20 Hematological, Immunological, and Neoplastic Disorders
Chapter Learning Objective: 4. Identify nursing assessments and interventions that
promote health during the care of children with cancer and their families.
Page: 508
Heading: Oncological Disorders > Lymphomas > Caregiver Education
Integrated Processes: Nursing Process
Client Need: Physiological Integrity: Reduction of Risk Potential
Cognitive Level: Analysis [Analyzing]
Concept: Cellular Regulation
Difficulty: Moderate
Feedback
A. This is incorrect. The patient is likely to be experiencing weight loss from
anorexia triggered by the disease process. Weight gain is unlikely; other nutrition
recommendations are needed.
B. This is correct. Treatment with chemotherapy is likely to cause sterilization; the
nurse needs to recommend sperm banking. Patients may not be able to think
about a future and children; the nurse will explain the importance of having
sperm at a future time.
C. This is incorrect. If the patient is living independently, there is no need to move
in with parents unless care assistance is needed. The patient can initiate
quarantine measures if necessary, which may be easier in an independent
environment. However, other care needs may be met if living with caregivers.
D. This is incorrect. It is likely the patient will experience fatigue from
chemotherapy. However, the patient may benefit from activities focused on
something other than the illness and treatment. The patient may want to consider
one class a term and the availability of online courses.
PTS: 1 CON: Cellular Regulation
4. The nurse in a pediatric clinic is assessing an infant who is 6 months of age. The infant is
pale with poor muscle tone. Auscultation reveals tachycardia; in addition, the infant is at
the 35th percentile for both height and weight. The physician orders laboratory testing.
Which laboratory value does the nurse expect?
a. Erythropoietin level of 1.9 mIU
b. Serum iron 24 mcg/dL
c. Normal red blood cell count (RBC) index in complete blood count (CBC)
d. RBCs small in size and pale
ANS: D
Chapter: Chapter 20 Hematological, Immunological, and Neoplastic Disorders
