Nursing Care of Children Principles and Practice 3rd edition by Susan R. James
Nursing Care of Children Principles and Practice 3rd edition by Susan R. James
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Chapter 24: The Child with Cancer
Complete Chapter Questions With Answers
Sample Questions Are Posted Below
| a. | Platelet count of 19,000/mm3 |
| b. | Prothrombin time of 11 to 15 seconds |
| c. | Hematocrit of 34 |
| d. | Leukocyte count of 14,000/mm3 |
ANS: A
| Feedback | |
| A | The normal platelet count is 150,000 to 400,000/mm3. This finding is very low, indicating an increased bleeding potential. |
| B | The prothrombin time of 11 to 15 seconds is within normal limits. |
| C | The normal hematocrit is 35 to 45 and, although this finding is low, it would not create the symptoms presented. |
| D | This value indicates the probable presence of infection, but it is not a reflection of bleeding tendency. |
DIF: Cognitive Level: Analysis REF: Text Reference: pg 764
OBJ: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity
| a. | Gastrointestinal upset |
| b. | Bone marrow suppression |
| c. | Decreased creatinine level |
| d. | Alopecia |
ANS: B
| Feedback | |
| A | Although gastrointestinal upset may be an adverse effect of chemotherapy, it is not caused by all chemotherapeutic agents. No special precautions are instituted for gastrointestinal upset. |
| B | Chemotherapy agents cause bone marrow suppression, which creates the need to institute precautions related to reduced white blood cell, red blood cell, and platelet counts. These precautions focus on preventing infection and bleeding. |
| C | A decreased creatinine level is consistent with renal pathologic conditions, not chemotherapy. |
| D | Not all chemotherapeutic agents cause alopecia. No precautions are taken to prevent alopecia. |
DIF: Cognitive Level: Comprehension REF: Text Reference: pgs 755, 757
OBJ: Nursing Process Step: Assessment
MSC: NCLEX: Safe Effective Care Environment
| a. | Leukemia is a fatal disease although chemotherapy provides increasingly longer periods of remission. |
| b. | Research to find a cure for childhood cancers is very active. |
| c. | The majority of children go into remission and remain symptom free when treatment is completed. |
| d. | It usually takes several months of chemotherapy to achieve a remission. |
ANS: C
| Feedback | |
| A | With the majority of children surviving 5 years or longer, it is inappropriate to refer to leukemia as a fatal disease. |
| B | This statement is true, but it does not address the parent’s concern. |
| C | Children diagnosed with the most common form of leukemia, ALL, can almost always achieve remission, with a 5-year disease-free survival rate approaching 85%. |
| D | About 95% of children achieve remission within the first month of chemotherapy. If a significant number of blast cells are still present in the bone marrow after a month of chemotherapy, a new and stronger regimen is begun. |
DIF: Cognitive Level: Knowledge REF: Text Reference: pg 760
OBJ: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity
| a. | Acute lymphoblastic leukemia (ALL) |
| b. | Non-Hodgkin’s lymphoma |
| c. | Wilms’ tumor |
| d. | Acute myeloblastic leukemia (AML) |
ANS: D
| Feedback | |
| A | The standard treatment for ALL is combination chemotherapy. |
| B | Standard treatment for non-Hodgkin’s lymphoma is chemotherapy. Bone marrow transplantation is used to treat non-Hodgkin’s lymphoma that is resistant to conventional chemotherapy and radiation. |
| C | The treatment for Wilms’ tumor consists of surgery and chemotherapy alone or in combination with radiation therapy. |
| D | Bone marrow transplantation is currently standard treatment for children in their first remission with AML. |
DIF: Cognitive Level: Knowledge REF: Text Reference: pg 759
OBJ: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity
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