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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
- C. Biologic characteristics of the tumor or lymph nodes
- D. Abnormal, unrestricted growth of cancer cells producing organ damage
Correct Answer: A
Rationale: Staging describes the extent of cancer at diagnosis, correlating with prognosis. It doesn?t measure cell replacement rates, describe tumor biology (which is classification), or define cancer growth mechanisms, but rather quantifies disease spread for treatment planning.
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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.
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.
What side effect commonly occurs with corticosteroid (prednisone) therapy?
- A. Alopecia
- B. Anorexia
- C. Nausea and vomiting
- D. Susceptibility to infection
Correct Answer: D
Rationale: Corticosteroids like prednisone cause immunosuppression, increasing infection risk. Alopecia is not a side effect, appetite increases rather than decreases, and gastric irritation occurs, not nausea and vomiting, which can be mitigated by taking with food.
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.
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.