Chapter 31: The Child with Cancer

Chapter 31: The Child with Cancer

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. What childhood cancer 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: Understanding       REF:   p. 1379

TOP:   Nursing Process: Assessment           MSC:  Client Needs: Physiological Integrity

 

2. 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

 

 

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 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: Understanding       REF:   p. 1400           TOP:   Nursing Process: Planning

MSC:  Client Needs: Physiological Integrity

 

3. 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

 

 

ANS:  C

Most clinical trials have a control group in which 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: Understanding       REF:   p. 1382           TOP:   Nursing Process: Evaluation

MSC:  Client Needs: Physiological Integrity

 

4. Chemotherapeutic agents are classified according to what feature?

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: Understanding       REF:   p. 1383

TOP:   Nursing Process: Assessment           MSC:  Client Needs: Physiological Integrity

 

5. 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

 

 

ANS:  C

Alkylating agents replace a hydrogen atom with an alkyl group. The irreversible combination of alkyl groups with nucleotide chains, particularly deoxyribonucleic acid (DNA), causes unbalanced growth of unaffected cell constituents so that the cell eventually dies. Plant alkaloids arrest the cell in metaphase by binding to proteins needed for spindle formation. Antimetabolites resemble essential metabolic elements needed for growth but are different enough to block further DNA synthesis. Antitumor antibiotics are natural substances that interfere with cell division by reacting with DNA in such a way as to prevent further replication of DNA and transcription of ribonucleic acid (RNA).

 

DIF:    Cognitive Level: Understanding       REF:   p. 1383

TOP:   Nursing Process: Assessment           MSC:  Client Needs: Physiological Integrity