Chapter 36: The Child with Cancer

Chapter 36: The Child with Cancer

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. Which of the following childhood cancers may demonstrate patterns of inheritance that suggest a familial basis?

a.	Leukemia
b.	Retinoblastoma
c.	Rhabdomyosarcoma
d.	Osteogenic sarcoma

 

 

ANS:  B

Retinoblastoma is an example of a pediatric cancer that demonstrates inheritance. The absence of the retinoblastoma gene allows for abnormal cell growth and the development of retinoblastoma. Chromosome abnormalities are present in many malignancies. They do not indicate a familial pattern of inheritance. The Philadelphia chromosome is observed in almost all individuals with chronic myelogenous leukemia. There is no evidence of a familial pattern of inheritance for rhabdomyosarcoma or osteogenic sarcoma cancers.

 

DIF:    Cognitive Level: Comprehension     REF:   p. 1463

TOP:   Nursing Process: Assessment

MSC:  Client Needs: Physiological Integrity: Physiologic Adaptation

 

2. As part of the diagnostic evaluation of a child with cancer, biopsies are important for staging. Which of the following 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 and/or lymph nodes
d.	Abnormal, unrestricted growth of cancer cells producing organ damage

 

 

ANS:  A

Staging is a description of the extent of the disease at the time of diagnosis. Staging criteria exist for most tumors. The stage usually relates directly to the prognosis; the higher the stage, the poorer the prognosis. The rate that normal cells are being replaced by cancer cells is not a definition of staging. Classification of the tumor refers to the biologic characteristics of the tumor and/or lymph nodes. Abnormal, unrestricted growth of cancer cells producing organ damage describes how cancer cells grow and can cause damage to an organ.

 

DIF:    Cognitive Level: Comprehension     REF:   p. 1486           TOP:   Nursing Process: Planning

MSC:  Client Needs: Physiological Integrity: Physiologic Adaptation

 

3. Clinical trials developed for pediatric cancers:

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.

 

 

ANS:  C

Most clinical trials have a control group where the patients receive the best available therapy currently known. The experimental group(s) receives treatment that is thought to be even better. The protocol outlines the therapy plan. Protocols are developed for many pediatric cancers. They can be accessed by pediatric oncologists throughout the United States. Consent is always required in treatment of children, especially for research protocols. The protocol is designed to optimize therapy for children based on disease type and stage.

 

DIF:    Cognitive Level: Comprehension     REF:   p. 1465

TOP:   Nursing Process: Implementation

MSC:  Client Needs: Physiological Integrity: Pharmacological and Parenteral Therapies

 

4. Chemotherapeutic agents are classified according to:

a.	side effects.
b.	effectiveness.
c.	mechanism of action.
d.	route of administration.

 

 

ANS:  C

Chemotherapeutic agents are classified according to mechanism of action. For example, antimetabolites resemble essential metabolic elements needed for growth, but are different enough to block further deoxyribonucleic acid (DNA) synthesis. Although the side effect profiles may be similar for drugs within a classification, they are not the basis for classification. Most chemotherapeutic regimens contain combinations of drugs. The effectiveness of any one drug is relative to the cancer type, combination therapy, and protocol for administration. The route of administration is determined by the pharmacodynamics and pharmacokinetics of each drug.

 

DIF:    Cognitive Level: Comprehension     REF:   p. 1465

TOP:   Nursing Process: Implementation

MSC:  Client Needs: Physiological Integrity: Pharmacological and Parenteral Therapies