Nokea
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.
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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.
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.
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.
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.
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.