Nokea
In teaching parents how to minimize or prevent bleeding episodes when the child is myelosuppressed, the nurse includes what information?
- A. Meticulous mouth care is essential to avoid mucositis.
- B. Rectal temperatures are necessary to monitor for infection.
- C. Intramuscular injections are preferred to intravenous ones.
- D. Platelet transfusions are given to maintain a count greater than 50,000/mm3.
Correct Answer: A
Rationale: Meticulous mouth care prevents gingival bleeding and mucositis in myelosuppressed children with low platelets. Rectal temperatures and intramuscular injections risk bleeding and infection, and platelet transfusions are typically given below 10,000/mm3 or with active bleeding.
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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.
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.
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.
Nursing care of the child with myelosuppression from leukemia or chemotherapeutic agents should include which therapeutic intervention?
- A. Restrict oral fluids.
- B. Institute strict isolation.
- C. Use good hand-washing technique.
- D. Give immunizations appropriate for age.
Correct Answer: C
Rationale: Good hand-washing reduces infection risk in myelosuppressed children by minimizing exposure to pathogens. Oral fluids are encouraged, strict isolation isn?t needed, and immunizations are ineffective or risky during immunosuppression.