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A school-age child with leukemia experienced severe nausea and vomiting when receiving chemotherapy for the first time. What is the most appropriate nursing action to prevent or minimize these reactions with subsequent treatments?
- A. Administer the chemotherapy between meals.
- B. Give an antiemetic before chemotherapy begins.
- C. Have the child bring favorite foods for snacks.
- D. Keep the child NPO (nothing by mouth) until nausea and vomiting subside.
Correct Answer: B
Rationale: Administering an antiemetic like ondansetron before chemotherapy prevents anticipatory nausea and vomiting. Giving chemotherapy between meals doesn?t prevent nausea, favorite foods may cause aversions, and NPO status risks dehydration and discomfort.
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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.
Correct Answer: B
Rationale: Wheezing and urticaria indicate an allergic reaction, requiring immediate cessation of the chemotherapeutic agent, withdrawal of remaining drug, and initiation of a saline infusion. Checking the rate, observing further, or dismissing as expected delays critical intervention.
A young child with leukemia has anorexia and severe stomatitis. What approach should the nurse suggest that the parents try?
- A. Relax any eating pressures.
- B. Firmly insist that the child eat normally.
- C. Serve foods that are either hot or cold.
- D. Provide only liquids because chewing is painful.
Correct Answer: A
Rationale: Relaxing eating pressures and offering soft, bland foods with mouthwashes and anesthetics support nutrition in children with stomatitis and anorexia. Insisting on normal eating creates conflict, hot/cold foods may irritate mucosa, and liquids alone are insufficient.
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
Correct Answer: C
Rationale: Pediatric cancer clinical trials compare the best current therapy (control group) with potentially better treatments (experimental group). They?re accessible beyond major centers, require consent for all therapies, and are tailored by disease type and stage, not standardized.
The nurse is preparing a child for possible alopecia from chemotherapy. What information should the nurse include?
- A. Wearing hats or scarves is preferable to a wig.
- B. Expose head to sunlight to stimulate hair regrowth.
- C. Hair may have a slightly different color or texture when it regrows.
- D. Regrowth of hair usually begins 12 months after chemotherapy ends.
Correct Answer: C
Rationale: Chemotherapy-induced alopecia may result in hair regrowing with a different color or texture. Children choose preferred head coverings, sunlight risks sunburn, and hair typically regrows within 3-6 months post-chemotherapy, not 12 months.
Total-body irradiation is indicated for what reason?
- A. Palliative care
- B. Lymphoma therapy
- C. Definitive therapy for leukemia
- D. Preparation for bone marrow transplant
Correct Answer: D
Rationale: Total-body irradiation destroys the immune system to prepare for bone marrow transplant, increasing complication risks until engraftment. It?s not used for palliative care, lymphoma, or leukemia as a primary treatment, which rely on other modalities.