Chapter 25, The Child with Cancer Video Solutions, Wong’s Essentials of Pediatric Nursing

Problem 1

At a visit to the pediatric clinic, a mother is concerned by her 4-year-old's symptoms over the last few weeks. Which of the following symptoms described by the mother would lead the nurse to be concerned about an oncologic disorder? Select all that apply.
a. Bruising in various stages, mainly on the legs
b. Frequent complaints of respiratory infections, while siblings remain healthy
c. Enlarged, firm lymph nodes
d. Asthma symptoms with increase in wheezing
e. Fever for more than 1 week

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Problem 2

The nurse taking care of a 5-year-old cancer patient with ulcerative stomatitis is getting ready to perform mouth care. Which of the following principles should be followed? Select all that apply.
a. Due to pain of the stomatitis, viscous lidocaine should be used to swish the mouth three times per day.
b. A soft, bland diet, although not the favorite of the child, will help with the pain.
c. Lemon glycerin swabs are helpful because they remind children of lemon drops.
d. Using a soft sponge-type toothbrush will decrease the tendency for gums to bleed.
e. A solution of $1 \mathrm{tsp}$ of baking soda and tsp of table salt in 1 quart of water is helpful for mouth rinse.

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Problem 3

You are working with a new graduate and explaining prevention of infection for a child with acute lymphocytic leukemia. Which statement by this new nurse indicates understanding?
a. "Prophylaxis against Pneumocystis pneumonia is routinely given to most children during treatment for cancer."
b. "If blood is drawn, firm pressure should be applied to the area for a minimum of 10 minutes."
c. "Having a roommate with a routine surgery would be acceptable for this child."
d. "The child should be vaccinated completely to avoid childhood diseases."

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Problem 4

The parents of a child with Hodgkin disease ask how the physician will know what type of cancer their child has. Which of the following definitive signs and symptoms should the nurse describe? Select all that apply.
a. The most common finding is enlarged, firm, nontender, movable nodes in the supraclavicular or cervical area.
b. Tests include complete blood count, prothrombin time and glucose-6-phosphate dehydrogenase (G6PD), erythropoietin, and sedimentation rate.
c. Generally a bone marrow biopsy is done to look for the presence of blast cells.
d. The presence of Sternberg-Reed cells is considered diagnostic of Hodgkin disease.
e. The presence of a white reflection as opposed to the normal red pupillary reflex in the pupil of a child's eye is a classic sign.

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Problem 5

You are caring for a child on the pediatric unit with a suspected abdominal tumor. Which criteria would lead you to determine this tumor is a neuroblastoma rather than a Wilms tumor?
a. Most children present with neuroblastoma around age 4 .
b. Neuroblastoma is a firm, nontender, irregular mass confined to one side, generally deep in the flank.
c. Hypertension is often noted due to secretion of excess amounts of rennin by the tumor.
d. Most tumors develop in the adrenal gland or the retroperitoneal sympathetic chain.

Rabeya Zahid

Numerade Educator