Chapter 29 Child Health Nursing Partnering With Children & Families, 3rd Edition

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

Chapter 29

Question 1

Type: MCSA

A child has been diagnosed with a Wilms’ tumor and is being treated with chemotherapy. Prior to administering the chemotherapy, what will the nurse monitor to determine if the child has any capability of fighting infection?

1. Hemoglobin
2. Red blood cell count
3. Platelets
4. Absolute neutrophil count (ANC)

Correct Answer: 4

Rationale 1: Hemoglobin indicates oxygen-carrying capacity, not immune response.

Rationale 2: Red blood cell count has no correlation with immune function.

Rationale 3: Platelets are associated with clotting, not immune function.

Rationale 4: The absolute neutrophil count uses both the segmented (mature) and bands (immature) neutrophils as a measure of the body’s infection-fighting capability.

Global Rationale:

Cognitive Level: Analyzing

Client Need:

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 29-2

Question 2

Type: MCMA

Manifestations of cancer in the pediatric patient vary by type and location but typically include which of the following general manifestations?

Standard Text: Select all that apply.

1. Infection
2. Weight gain
3. Polycythemia
4. Neurologic symptoms
5. Pain
6. Cachexia

Correct Answer: 1,4,5,6

Rationale 1: Infection related to decreased immune function is common.

Rationale 2: Weight gain is incorrect; children with cancer are generally anorexic, have nausea and vomiting, and have early satiety.

Rationale 3: Anemia occurs rather than polycythemia.

Rationale 4: Neurologic symptoms can occur from impingement on the brain or nervous system.

Rationale 5: Pain results from neoplasms directly or indirectly affecting nerve receptors.

Rationale 6: Cachexia occurs secondarily to anorexia and nausea and vomiting.

Global Rationale:

Cognitive Level: Applying

Client Need:

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 29-1

Question 3

Type: MCSA

The parent of a child newly diagnosed with cancer verbalizes regret to the nurse for not seeking earlier medical attention for the child’s symptoms. Which response would be most therapeutic?

1. “You may feel guilty, but you should not blame yourself.”
2. “Most cancers can be treated easily.”
3. “Many types of cancer are difficult to diagnose and might not show early symptoms.”
4. “Early diagnosis is not significant in the diagnosis and management of cancer.”

Correct Answer: 3

Rationale 1: This is not a therapeutic response. It is not appropriate for the nurse to tell the family how they should feel.

Rationale 2: This answer is not accurate, as cancer is generally prolonged and difficult for both the child and family.

Rationale 3: Many cancers do not present significant findings until late and can progress rapidly. Giving such information is a communication tool.

Rationale 4: Outcomes for many cancers are improved with early diagnosis.

Global Rationale:

Cognitive Level: Analyzing

Client Need:

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 29-1

Question 4

Type: MCSA

A child has cancer and has been treated with chemotherapy. The most recent lab value indicates that the white blood cell count is very low. Based on this result, which would the nurse expect to administer?

1. Epoetin alfa (Epogen)
2. Ondansetron (Zofran)
3. Oprelvekin (Neumega)
4. Filgrastim (Neupogen)

Correct Answer: 4

Rationale 1: Epoetin alfa (human recombinant erythropoietin) stimulates red blood cell (RBC) production.

Rationale 2: Ondansetron (Zofran) is an antiemetic.

Rationale 3: Oprelvekin (Neumega) increases platelets.

Rationale 4: Filgrastim (Neupogen) increases production of neutrophils by the bone marrow.

Global Rationale:

Cognitive Level: Analyzing

Client Need:

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 29-2