Nokea
After chemotherapy is begun for a child with acute leukemia, prophylaxis to prevent acute tumor lysis syndrome includes which therapeutic intervention?
- A. Hydration
- B. Oxygenation
- C. Corticosteroids
- D. Pain management
Correct Answer: A
Rationale: Hydration prevents acute tumor lysis syndrome by reducing metabolic complications (e.g., hyperuricemia, hyperkalemia) from cell breakdown during leukemia treatment. Oxygenation, corticosteroids, and pain management don?t address this syndrome directly.
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What childhood cancer may demonstrate patterns of inheritance that suggest a familial basis?
- A. Leukemia
- B. Retinoblastoma
- C. Rhabdomyosarcoma
- D. Osteogenic sarcoma
Correct Answer: B
Rationale: Retinoblastoma is inherited due to mutations in the retinoblastoma gene, promoting abnormal cell growth. Leukemia may involve chromosomal abnormalities like the Philadelphia chromosome, but not familial patterns. Rhabdomyosarcoma and osteogenic sarcoma lack evidence of familial inheritance.
What chemotherapeutic agent is classified as an antitumor antibiotic?
- A. Cisplatin (Platinol AQ)
- B. Vincristine (Oncovin)
- C. Methotrexate (Texall)
- D. Daunorubicin (Cerubidine)
Correct Answer: D
Rationale: Daunorubicin is an antitumor antibiotic that disrupts DNA replication. Cisplatin is an alkylating agent, vincristine is a plant alkaloid, and methotrexate is an antimetabolite, each with distinct mechanisms of action.
What pain management approach is most effective for a child who is having a bone marrow test?
- A. Relaxation techniques
- B. Administration of an opioid
- C. EMLA cream applied over site
- D. Conscious or unconscious sedation
Correct Answer: D
Rationale: Conscious or unconscious sedation is most effective for managing pain during bone marrow tests, with relaxation, opioids, and EMLA as adjuncts. Sedation ensures comfort and minimizes distress during this invasive procedure.
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
Correct Answer: C
Rationale: Alkylating agents replace a hydrogen atom with an alkyl group, disrupting DNA and causing cell death. Plant alkaloids block spindle formation, antimetabolites mimic metabolic elements to halt DNA synthesis, and antitumor antibiotics interfere with DNA replication and transcription.
Chemotherapeutic agents are classified according to what feature?
- A. Side effects
- B. Effectiveness
- C. Mechanism of action
- D. Route of administration
Correct Answer: C
Rationale: Chemotherapeutic agents are classified by mechanism of action (e.g., antimetabolites block DNA synthesis). Side effects may be similar within classes but aren?t the basis for classification, effectiveness varies by cancer type and protocol, and route depends on pharmacokinetics.