Nokea
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.
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The parents of a child with cancer tell the nurse that a bone marrow transplant (BMT) may be necessary. What information should the nurse recognize as important when discussing this with the family?
- A. BMT should be done at the time of diagnosis.
- B. Parents and siblings of the child have a 25% chance of being a suitable donor.
- C. If BMT fails, chemotherapy or radiotherapy will need to be continued.
- D. Finding a suitable donor involves matching antigens from the human leukocyte antigen (HLA) system.
Correct Answer: D
Rationale: HLA matching is critical for successful BMT, ensuring donor compatibility. BMT timing varies by disease, parents share only about 50% genetic material, and discussing post-failure treatments is premature during initial planning.
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 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.
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.
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.