PEDS Final-oncology
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What is the peak onset for Acute Lymphocytic Leukemia?
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3-5 years
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10-12 years
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3-5 months
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12-14 years
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About This Quiz
Practice test based on professor's power points and lectures.
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- 2.
A school age child who has suspected osteo sarcoma would have which elevated lab value?
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Alkaline Phosphate
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Blood Glucose
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Hematocrit
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Serum Potasium
Correct Answer
A. Alkaline PhosphateExplanation
Alkaline phosphate is an enzyme found in the liver, bones, and other tissues. An elevated level of alkaline phosphate in the blood can indicate bone or liver disease. In the case of a school-age child with suspected osteosarcoma, which is a type of bone cancer, an elevated level of alkaline phosphate may be observed. This is because osteosarcoma can cause the destruction of bone tissue, leading to the release of alkaline phosphate into the bloodstream. Therefore, an elevated lab value of alkaline phosphate would be expected in a child with suspected osteosarcoma.Rate this question:
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- 3.
What is not associated with Acute Lymphocytic Leukemia?
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Renomegaly
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Hepatomegaly
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Splenomegaly
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Lymphadenopathy
Correct Answer
A. RenomegalyExplanation
Renomegaly, which refers to the enlargement of the kidneys, is not associated with Acute Lymphocytic Leukemia (ALL). ALL is a type of cancer that affects the white blood cells, specifically the lymphocytes. It commonly leads to symptoms such as hepatomegaly (enlargement of the liver), splenomegaly (enlargement of the spleen), and lymphadenopathy (enlarged lymph nodes). However, it does not cause renomegaly.Rate this question:
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- 4.
What type of malignant cell replaces the functioning cells in the marrow?
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Blast
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Adenomatous
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Squamous
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Oesophagus
Correct Answer
A. BlastExplanation
The correct answer is Blast. Blast cells are immature cells that are found in the bone marrow and can develop into various types of blood cells. In the case of malignancy, these blast cells can multiply uncontrollably and replace the normal functioning cells in the marrow, leading to conditions such as leukemia. Adenomatous and squamous cells are not typically associated with the bone marrow, and the esophagus is not directly related to the question.Rate this question:
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- 5.
Which lab finding for a 10yr old male is not consistent with A.L.L?
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4.4 Calcium
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3.9 WBC
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182 Plts
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3.1 RBC
Correct Answer
A. 4.4 CalciumExplanation
The lab finding of 4.4 Calcium is not consistent with A.L.L (Acute Lymphoblastic Leukemia). In A.L.L, the calcium levels are typically normal or low due to the increased uptake of calcium by leukemic cells. Therefore, a calcium level of 4.4 is not consistent with the expected findings in A.L.L.Rate this question:
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- 6.
Which assessment finding is not consistent with A.L.L?
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Weight gain
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Nose Bleeds
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Unexplained Fevers
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Lethargy
Correct Answer
A. Weight gainExplanation
Weight gain is not a typical finding in Acute Lymphoblastic Leukemia (A.L.L). A.L.L is a type of cancer that affects the white blood cells, leading to symptoms such as nose bleeds, unexplained fevers, and lethargy. Weight loss or failure to thrive is more commonly associated with A.L.L due to the effects of the disease on the body. Therefore, weight gain would be inconsistent with A.L.L.Rate this question:
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- 7.
A 10yr old girl with newly diagnosed A.L.L. is experiencing papilledema, infrequent seizures, and preretinal hemorrhages. The nurse's first concern should be;
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Increased Intracranial Pressure
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Anemia
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Neutropenia
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Thrombocytopenia
Correct Answer
A. Increased Intracranial PressureExplanation
The nurse's first concern should be increased intracranial pressure. Papilledema, infrequent seizures, and preretinal hemorrhages are all signs of increased intracranial pressure, which can be a life-threatening condition. It is important for the nurse to address this concern promptly to prevent further complications and provide appropriate interventions to manage the elevated pressure in the brain. Anemia, neutropenia, and thrombocytopenia may be present in a patient with A.L.L., but they are not the immediate priority in this case.Rate this question:
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- 8.
A child with an infection that is active for _______ , should be tested for A.L.L.? (fill in the blank)
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16 days
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10 days
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2 days
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7 days
Correct Answer
A. 16 daysExplanation
If a child has an infection that has been active for 16 days, it is recommended to test them for Acute Lymphoblastic Leukemia (A.L.L.). A.L.L. is a type of cancer that affects the white blood cells, and it can present with symptoms similar to an infection. Testing for A.L.L. is important to ensure early detection and appropriate treatment for the child.Rate this question:
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- 9.
For a positive diagnosis, bone marrow aspiration must be performed on what site?
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Iliac Spine
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Lumbar Spine
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Femur
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Zygomatic bone
Correct Answer
A. Iliac SpineExplanation
Bone marrow aspiration is a procedure in which a small sample of bone marrow is taken for diagnostic purposes. The iliac spine, also known as the iliac crest, is a common site for bone marrow aspiration. It is easily accessible and provides a good representation of the bone marrow. The lumbar spine and femur are not typically used for bone marrow aspiration. The zygomatic bone, also known as the cheekbone, is not related to bone marrow aspiration.Rate this question:
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- 10.
Which lab value is not a positive result for A.L.L.?
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15% Blast cells
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25% Blast cells
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30% Blast cells
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50% Blast cells
Correct Answer
A. 15% Blast cellsExplanation
A.L.L. (Acute Lymphoblastic Leukemia) is a type of cancer that affects the white blood cells. In this condition, the bone marrow produces too many immature lymphocytes called blast cells. A positive result for A.L.L. would typically show a high percentage of blast cells in the blood or bone marrow. Therefore, a lower percentage of blast cells, such as 15%, would not be considered a positive result for A.L.L.Rate this question:
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- 11.
A child with hip, shoulder and abdominal pain is admitted to the ER. The parent does not understand why their child is being screened for A.L.L. The nurse should explain:
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Pain could be due to marrow expansion and an enlarged liver
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We just wanted time alone with the child to verify your story.
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I will get the doctor so they can explain this
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This is just a state mandated test, nothing to worry about.
Correct Answer
A. Pain could be due to marrow expansion and an enlarged liverExplanation
The correct answer suggests that the child is being screened for Acute Lymphoblastic Leukemia (A.L.L.) because their symptoms of hip, shoulder, and abdominal pain could potentially be caused by marrow expansion and an enlarged liver, which are commonly associated with A.L.L. This explanation helps the parent understand the reason behind the screening and provides insight into the potential causes of the child's pain.Rate this question:
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- 12.
Once a bone marrow aspiration results positive, which exam will check for CNS involvement?
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Lumbar Puncture
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PET
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CT
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MRI
Correct Answer
A. Lumbar PunctureExplanation
A bone marrow aspiration is a procedure used to diagnose and monitor certain blood disorders and cancers. If the results of a bone marrow aspiration are positive, meaning abnormal cells or cancerous cells are found, it indicates the possibility of systemic involvement. Since the question specifically asks about checking for central nervous system (CNS) involvement, a lumbar puncture would be the most appropriate exam. A lumbar puncture involves collecting cerebrospinal fluid (CSF) from the spinal canal, which can be analyzed for the presence of abnormal cells or other indicators of CNS involvement.Rate this question:
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- 13.
A 8yr old female undergoing treatment for A.L.L. is having her yearly physical. The nurse notices she has a puffy face and is below 5% on the growth charts. Which medication should the nurse suspect is contributing to the child's conditions?
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Prednisone
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Adriamycin
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Dactinomysin
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Blenoxane
Correct Answer
A. PrednisoneExplanation
The correct answer is Prednisone. Prednisone is a corticosteroid medication commonly used in the treatment of Acute Lymphoblastic Leukemia (A.L.L.). One of the side effects of prednisone is fluid retention, which can lead to a puffy face. Additionally, long-term use of prednisone can affect growth and development, causing a child to fall below the normal growth charts. Therefore, the nurse should suspect that prednisone is contributing to the child's puffy face and below-average growth.Rate this question:
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- 14.
A 8yr old female undergoing treatment for A.L.L. is having her yearly physical. The nurse notices she has a puffy face and is below 5% on the growth charts. What should the nurse also check for?
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Hyperglycemia
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Hyperthyroidism
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Hypoglycemia
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Hypoglycemia
Correct Answer
A. HyperglycemiaExplanation
The nurse should also check for hyperglycemia. The patient's puffy face and below 5% on the growth charts may indicate Cushing's syndrome, which can be caused by long-term steroid use in the treatment of A.L.L. Steroids can also cause hyperglycemia, so it is important for the nurse to assess the patient's blood glucose levels to determine if hyperglycemia is present.Rate this question:
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- 15.
Which of the following is not an appropriate intervention for A.L.L.?
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Treating headache with Ibuprofen
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Assess for petechiae
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Applying pressure to wounds for 10 minutes
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Testing for guiac
Correct Answer
A. Treating headache with IbuprofenExplanation
Treating headache with Ibuprofen is not an appropriate intervention for A.L.L. because A.L.L. (Acute Lymphoblastic Leukemia) is a type of cancer that affects the white blood cells. Headache is not a common symptom of A.L.L., and treating it with Ibuprofen would not address the underlying cause. Instead, the focus should be on assessing for petechiae (small red or purple spots on the skin), applying pressure to wounds to control bleeding, and testing for guiac (a test for blood in the stool). These interventions are more relevant to the management of A.L.L.Rate this question:
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- 16.
Which is the priority nursing diagnosis for a child with A.L.L.?
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Risk for infection
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Risk for injury
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Fatigue
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Imbalanced nutrition; less than body requirement
Correct Answer
A. Risk for infectionExplanation
For a child with Acute Lymphoblastic Leukemia (A.L.L.), the priority nursing diagnosis would be "Risk for infection." A.L.L. is a type of cancer that affects the white blood cells, which weakens the immune system and makes the child more susceptible to infections. Therefore, the nurse should prioritize assessing and managing the child's risk for infection to prevent complications and ensure their safety and well-being.Rate this question:
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- 17.
Occurs when large numbers of tumor cells are rapidly destroyed and released into blood stream faster than the body can eliminate;
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Tumor Lysis Syndrome
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Superior Vena Cava Syndrome
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Hypercalcemia
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Spinal Chord Compression
Correct Answer
A. Tumor Lysis SyndromeExplanation
Tumor lysis syndrome occurs when a large number of tumor cells are destroyed and released into the bloodstream at a faster rate than the body can eliminate them. This can lead to the release of various substances, such as potassium, phosphate, and uric acid, which can overwhelm the body's normal elimination mechanisms. This can result in electrolyte imbalances, kidney dysfunction, and other complications.Rate this question:
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- 18.
Management of TLS include the following except;
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Lasix
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Aggressive fluid resuscitation
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Osmotic diuretics
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Mannitol
Correct Answer
A. LasixExplanation
The management of TLS (Tumor Lysis Syndrome) involves various strategies to prevent and treat electrolyte imbalances caused by rapid cell breakdown during cancer treatment. This typically includes aggressive fluid resuscitation to maintain hydration, osmotic diuretics like Mannitol to enhance urine production and remove excess substances, and other interventions to manage electrolyte imbalances. Lasix, also known as furosemide, is a loop diuretic commonly used to treat conditions like edema and hypertension, but it is not typically used in the management of TLS.Rate this question:
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- 19.
6yr old female undergoing cancer treatment is at your office today to update her vaccinations for school. Due to he condition, which is the only vaccination the nurse can administer.
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Tdap
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LAIV
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MMR
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VAR
Correct Answer
A. TdapExplanation
The correct answer is Tdap. The Tdap vaccine is recommended for adolescents and adults to protect against tetanus, diphtheria, and pertussis (whooping cough). Since the 6-year-old female is undergoing cancer treatment, her immune system may be compromised, making her more susceptible to infections. The Tdap vaccine can help prevent these serious bacterial and viral infections, which could be especially harmful to her in her current condition. The other options (LAIV, MMR, VAR) may not be suitable for her due to her weakened immune system.Rate this question:
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- 20.
Select all that apply. When performing mouth care on a Chemo Patient, the nurse should not use;
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Malox/Benadryl/HO
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Listerine
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Tooothbrush
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Dental floss
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Cotton Swab
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Viscous Lidocaine
Correct Answer(s)
A. Listerine
A. Tooothbrush
A. Dental flossExplanation
When performing mouth care on a Chemo patient, the nurse should not use Listerine, toothbrush, or dental floss. Listerine contains alcohol which can irritate and dry out the mucous membranes in the mouth. A toothbrush and dental floss can cause trauma to the gums and increase the risk of bleeding and infection. It is important to use gentle methods of mouth care such as a soft toothbrush, saline solution, or a mouthwash specifically designed for chemotherapy patients.Rate this question:
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- 21.
A nurse is caring for a child with leukemia who is receiving his first round of chemotherapy. Which of the following assessments should the nurse report to the primary care provider immediately?
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Urticaria
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Fatigue
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Vomiting
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Anorexia
Correct Answer
A. UrticariaExplanation
Urticaria is a type of allergic reaction that presents as raised, itchy, and red welts on the skin. It can be a sign of an allergic reaction to the chemotherapy medication, which could potentially be life-threatening. Therefore, the nurse should report the presence of urticaria to the primary care provider immediately so that appropriate interventions can be taken to address the allergic reaction and ensure the child's safety.Rate this question:
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- 22.
A nurse is caring for a toddler with terminal cancer who is experiencing pain. Which of the following interventions is the most effective?
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Providing the toddler with analgesic medication
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Distracting the toddler with his favorite toy
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Frequently changing the toddlers position
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Giving the toddler food or fluids that he requests
Correct Answer
A. Providing the toddler with analgesic medicationExplanation
Providing the toddler with analgesic medication is the most effective intervention for managing the pain experienced by a toddler with terminal cancer. Analgesic medication helps to alleviate pain and improve the toddler's comfort. This intervention directly addresses the primary concern of the toddler's pain, providing relief and promoting a better quality of life. Distracting the toddler with his favorite toy may provide temporary relief, but it does not address the underlying cause of the pain. Frequently changing the toddler's position or giving him food or fluids that he requests may not have a significant impact on pain management.Rate this question:
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- 23.
When reviewing the medications for a cancer patient, the nurse knows the patient has not had a cardiac work up or PET scan. Which medication can the nurse administer for the patients bacterial infection?
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Bleomycin
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Actinomycin
Correct Answer
A. BleomycinExplanation
The nurse can administer Bleomycin for the patient's bacterial infection because it is an antibiotic that is commonly used to treat various types of infections, including bacterial infections. It is not contraindicated in patients who have not had a cardiac workup or PET scan. Actinomycin, on the other hand, is an antineoplastic medication that is used to treat certain types of cancer and not indicated for bacterial infections.Rate this question:
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- 24.
Which medication is used to protect the CNS during chemotherapy.
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Methotrexate
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Doxorubicin
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Oncovin
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Cisplantin
Correct Answer
A. MethotrexateExplanation
Methotrexate is a medication that is commonly used to protect the central nervous system (CNS) during chemotherapy. It is a type of chemotherapy drug known as an antimetabolite, which means it interferes with the growth and division of cancer cells. Methotrexate is able to cross the blood-brain barrier, allowing it to reach the CNS and target cancer cells that may have spread to the brain or spinal cord. By protecting the CNS, methotrexate helps prevent the spread of cancer to these vital areas and reduces the risk of neurological complications.Rate this question:
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- 25.
Which medication is used to inhibit the production of uric acid.
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Allopurinol
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Mesna
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Platinol
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Methotrexate
Correct Answer
A. AllopurinolExplanation
Allopurinol is used to inhibit the production of uric acid. Uric acid is a waste product that is produced when the body breaks down purines, which are found in certain foods and drinks. High levels of uric acid can lead to conditions such as gout, kidney stones, and uric acid nephropathy. Allopurinol works by blocking the enzyme xanthine oxidase, which is involved in the production of uric acid. By inhibiting this enzyme, allopurinol helps to reduce the levels of uric acid in the body and prevent the formation of uric acid crystals.Rate this question:
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- 26.
Which medication binds to toxic metabolites and prevents hemorrhagic cystitis.
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Mesna
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Allopurinol
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Methotrexate
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Plantinol
Correct Answer
A. MesnaExplanation
Mesna is a medication that is used to bind to and detoxify toxic metabolites, particularly those produced by certain chemotherapy drugs. One of the side effects of these drugs is hemorrhagic cystitis, which is inflammation and bleeding in the bladder. Mesna helps to prevent this side effect by binding to the toxic metabolites and reducing their harmful effects on the bladder. Allopurinol is a medication used to treat gout, Methotrexate is a chemotherapy drug, and Plantinol is not a medication.Rate this question:
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- 27.
Select all that apply. When educating a patient on the side effects of Vincristine, the nurse should mention the possibility of;
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Peripheral Neuropathy
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Severe Constipation
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Bowel Innervation
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Nausea and Vomiting
Correct Answer(s)
A. Peripheral Neuropathy
A. Severe Constipation
A. Bowel Innervation
A. Nausea and VomitingExplanation
When educating a patient on the side effects of Vincristine, the nurse should mention the possibility of peripheral neuropathy, severe constipation, bowel innervation, and nausea and vomiting. Vincristine is known to cause peripheral neuropathy, which is damage to the peripheral nerves that can result in symptoms such as tingling, numbness, and weakness in the extremities. Severe constipation is another potential side effect of Vincristine, as it can slow down the movement of the bowels. Bowel innervation refers to the regulation of bowel movements, and Vincristine can disrupt this process. Lastly, nausea and vomiting are common side effects of Vincristine treatment.Rate this question:
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- 28.
Patient education regarding radiation should include the following; (select all that apply)
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Side Effects after 7-10 days
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Dysphagia
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Alopecia
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Myleosuppression
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Pneumonitis
Correct Answer(s)
A. Side Effects after 7-10 days
A. Dysphagia
A. Alopecia
A. Myleosuppression
A. PneumonitisExplanation
Patient education regarding radiation should include information about the potential side effects that may occur after 7-10 days, such as fatigue, skin changes, and gastrointestinal symptoms. Dysphagia, which refers to difficulty swallowing, is another important side effect that patients should be aware of. Alopecia, or hair loss, can also occur as a result of radiation therapy. Myleosuppression, which is a decrease in the production of blood cells, and pneumonitis, which is inflammation of the lungs, are both potential complications of radiation therapy that patients should be educated about.Rate this question:
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- 29.
A nurse receives an order for a whole blood transfusion for a pediatric oncology patient that receives radiation therapy. The nurse should consider what before administering the order?
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The risk for fluid overload
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Increased Neutrophils
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Infection
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Erythema
Correct Answer
A. The risk for fluid overloadExplanation
When administering a whole blood transfusion to a pediatric oncology patient receiving radiation therapy, the nurse should consider the risk for fluid overload. This is because the patient may already have compromised fluid balance due to their underlying condition and radiation therapy. Administering a large volume of whole blood could potentially lead to fluid overload, which can cause complications such as pulmonary edema or heart failure. Therefore, it is important for the nurse to closely monitor the patient's fluid status and assess for any signs of fluid overload during and after the transfusion.Rate this question:
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- 30.
Your Pediatric oncology patient's dinner tray comes up. You notice which of the following items should be removed from his tray?
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Apple
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Steamed broccoli
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Chicken cutlet
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Chocolate pudding
Correct Answer
A. AppleExplanation
The correct answer is Apple. Pediatric oncology patients often have a weakened immune system due to their illness and treatment, making them more susceptible to infections. Apples are a common source of bacteria and should be avoided to reduce the risk of foodborne illnesses.Rate this question:
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- 31.
Which condition results in a change in gait, intermittent joint pain, and pathological starburst fractures?
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Osteogenic sarcoma
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Wilm's tumor
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Ewing's sarcoma
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Non-Hodgkins lymphoma
Correct Answer
A. Osteogenic sarcomaExplanation
Osteogenic sarcoma is a type of bone cancer that commonly affects teenagers and young adults. It can cause a change in gait, which refers to the way a person walks, due to pain and discomfort in the affected bone. Intermittent joint pain is also a common symptom of osteogenic sarcoma, as the cancer can spread to nearby joints. Pathological starburst fractures, which are fractures that radiate out from a central point, can occur as a result of the weakening of the bone by the tumor. Therefore, osteogenic sarcoma is the most likely condition to cause these symptoms.Rate this question:
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- 32.
When preparing a patient of surgical interventions r/t Osteosarcoma, what should be included in the patient/family teaching? (select all that apply)
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Exercise to strengthen upper arms
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Prepare for extensive physical therapy
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Discuss the importance for the patient to grieve the loss of the limb
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Introduce patient to support groups
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Focus on what the patient cannot do
Correct Answer(s)
A. Exercise to strengthen upper arms
A. Prepare for extensive physical therapy
A. Discuss the importance for the patient to grieve the loss of the limb
A. Introduce patient to support groupsExplanation
The patient/family teaching for a patient undergoing surgical interventions for Osteosarcoma should include the following: exercise to strengthen upper arms, preparing for extensive physical therapy, discussing the importance for the patient to grieve the loss of the limb, and introducing the patient to support groups. These interventions are important for the patient's physical recovery, emotional well-being, and adjustment to the changes in their body and lifestyle. Focusing on what the patient cannot do may have a negative impact on their mental health and overall recovery, so it should not be included in the teaching.Rate this question:
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- 33.
Post-op nursing considerations for Osteosarcoma limb removal would include what at the patient bedside
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Ambu bag
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Suction kit
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Tourniquet
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Restraint
Correct Answer
A. TourniquetExplanation
The correct answer for post-op nursing considerations for Osteosarcoma limb removal would include a tourniquet at the patient bedside. This is because a tourniquet may be needed in case of excessive bleeding or to control bleeding during the surgery. It is a device that applies pressure to the limb to restrict blood flow, allowing the surgeon to work more effectively and minimize blood loss. Having a tourniquet readily available at the patient's bedside ensures that it can be quickly applied if necessary, ensuring the patient's safety and preventing complications.Rate this question:
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- 34.
After a limb is removed, a pillow should be used to elevate the stump for;
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1st 24hrs
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After 24hrs
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1st 72hrs
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1st 8hrs
Correct Answer
A. 1st 24hrsExplanation
After a limb is removed, a pillow should be used to elevate the stump for the first 24 hours. Elevating the stump helps to reduce swelling and promote blood circulation in the area. This can aid in minimizing pain and discomfort, as well as prevent complications such as fluid accumulation. After the initial 24 hours, other measures may be taken to promote healing and prevent complications, but elevating the stump with a pillow is particularly important in the immediate aftermath of the limb removal.Rate this question:
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- 35.
Which of the following is a common bone tumor that infiltrates the soft tissue around the bone.
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Ewing's sarcoma
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Osteosarcoma
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Wilm's tumor
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Non-Hodgkin's lymphoma
Correct Answer
A. Ewing's sarcomaExplanation
Ewing's sarcoma is a common bone tumor that infiltrates the soft tissue around the bone. It is a type of cancer that primarily affects children and young adults. Ewing's sarcoma is characterized by the abnormal growth of cells in the bones or soft tissues, leading to the formation of tumors. These tumors often infiltrate the surrounding soft tissue, causing pain, swelling, and limited mobility. Early diagnosis and treatment are crucial for managing Ewing's sarcoma and improving patient outcomes.Rate this question:
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- 36.
Ewing's sarcoma is more invasive than Osteosarcoma and requires 6-8weeks of total body radiation?
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True
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False
Correct Answer
A. TrueExplanation
Ewing's sarcoma is a highly aggressive form of cancer that commonly affects children and young adults. It is known to be more invasive than Osteosarcoma, which is another type of bone cancer. Additionally, the treatment for Ewing's sarcoma often involves total body radiation, which typically lasts for a period of 6-8 weeks. Therefore, the statement that Ewing's sarcoma is more invasive than Osteosarcoma and requires 6-8 weeks of total body radiation is true.Rate this question:
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Aug 26, 2023Quiz Edited by
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May 12, 2013Quiz Created by
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