Situational Multiple Choice Quiz: Cellular Aberrations in Children

1. A child with acute lymphoblastic leukemia (ALL) presents with pallor, fatigue, and low-grade fever. What is the most likely cause of these symptoms?
a. Decreased thrombocytes
b. Low red blood cell production
c. CNS involvement
d. Chemotherapy side effects

2. A nurse is teaching the family of a child with leukemia about chemotherapy. Which statement indicates understanding?
a. "Chemotherapy works by destroying only cancerous cells."
b. "It will kill rapidly dividing cells, including healthy ones."
c. "It only affects cells in the resting phase of the cycle."
d. "We will need to avoid all sunlight exposure during chemotherapy."

3. A child undergoing radiation for Wilms' tumor presents with skin erythema and tenderness in the treatment area. What is the nurse’s best action?
a. Apply a cold compress
b. Use a gentle moisturizer
c. Encourage vigorous scrubbing to keep the area clean
d. Avoid touching the affected area

4. A patient diagnosed with osteogenic sarcoma has been started on chemotherapy. What complication should the nurse monitor for?
a. Nephrotoxicity
b. Pathologic fractures
c. Immune suppression
d. Hearing loss

5. A nurse is assessing a child for side effects during induction therapy for ALL. Which of the following is a common side effect to monitor for?
a. Severe headache
b. Immunosuppression
c. Increased appetite
d. Weight gain

6. A child with leukemia is receiving intrathecal chemotherapy. Why is this method used?
a. To treat brain and spinal cord leukemia
b. To avoid gastrointestinal side effects
c. To increase the speed of drug absorption
d. To decrease pain during administration

7. The parents of a child with chronic myeloid leukemia (CML) ask why their child does not need treatment immediately. What is the correct response?
a. "The disease progresses slowly, and treatment is delayed until symptoms appear."
b. "Treatment will not be effective at this stage."
c. "Your child’s immune system is still functioning properly."
d. "Immediate treatment increases the risk of drug resistance."

8. Which complication should a nurse expect in a child with bone metastasis secondary to osteosarcoma?
a. Thrombocytopenia
b. Pathologic fractures
c. Petechiae
d. Neutropenia

9. A child with leukemia is being prepared for a bone marrow biopsy. What is the nurse’s priority intervention?
a. Encouraging fluid intake
b. Applying local anesthetic to the biopsy site
c. Obtaining informed consent
d. Administering antiemetics before the procedure

10. A child undergoing chemotherapy for ALL has developed mucositis. What diet is most appropriate?
a. High-fiber diet
b. Spicy foods to stimulate appetite
c. Soft, bland foods
d. Regular diet as tolerated

11. A patient with nephroblastoma (Wilms' tumor) has surgery scheduled to remove the kidney and tumor. What is a priority nursing action preoperatively?
a. Encourage ambulation to prevent DVT
b. Avoid palpation of the abdomen
c. Administer diuretics
d. Provide a high-protein diet

12. During the assessment of a child with Wilms' tumor, the nurse notices a sudden increase in abdominal girth. What is the nurse's priority action?
a. Notify the healthcare provider immediately
b. Measure the abdominal circumference
c. Reposition the child for comfort
d. Ask the parents about dietary changes

13. Which nursing diagnosis is appropriate for a child undergoing chemotherapy for leukemia?
a. Impaired gas exchange related to pleural effusion
b. Risk for infection related to immunosuppressive therapy
c. Fluid volume excess related to chemotherapy
d. Hypothermia related to decreased activity

14. A child is receiving radiation therapy for osteogenic sarcoma. What side effect should the nurse prioritize monitoring for?
a. Fever
b. Bone deformities
c. Skin irritation
d. Seizures

15. A child with acute myelogenous leukemia (AML) presents with bleeding gums and petechiae. What is the likely cause of these symptoms?
a. Thrombocytopenia
b. Infection
c. Hypercalcemia
d. Anemia

16. During chemotherapy, a child with leukemia reports severe nausea. What is the most effective nursing intervention?
a. Provide small, frequent meals
b. Encourage deep breathing exercises
c. Administer antiemetic medication before meals
d. Limit fluid intake to prevent vomiting

17. What is a key difference between acute and chronic leukemias?
a. Acute leukemia progresses rapidly and requires immediate treatment
b. Chronic leukemia often affects children under 5 years old
c. Chronic leukemia has a higher survival rate than acute leukemia
d. Acute leukemia only affects adults

18. A child with osteosarcoma is experiencing increased pain. What non-pharmacological method can the nurse implement to provide comfort?
a. Deep tissue massage
b. Warm compresses
c. Physical activity
d. Aromatherapy

19. A child with leukemia has a high fever and is suspected of developing sepsis. What is the nurse’s priority intervention?
a. Administer antipyretics
b. Increase fluid intake
c. Start broad-spectrum antibiotics
d. Apply cold compresses to reduce fever

20. A child is diagnosed with osteogenic sarcoma. What is the most definitive diagnostic test to confirm this diagnosis?
a. MRI
b. Bone biopsy
c. CT scan
d. Bone scan

21. What phase of chemotherapy focuses on preventing leukemia cells from invading the central nervous system?
a. Induction phase
b. Maintenance phase
c. Consolidation phase
d. Palliative phase

22. A child with leukemia is being treated with a combination of chemotherapy drugs. What is the advantage of using combination chemotherapy?
a. It increases the speed of treatment
b. It targets the cancer at different phases of the cell cycle
c. It reduces the need for radiation therapy
d. It decreases the risk of drug toxicity

23. A nurse is providing discharge education to the family of a child who has undergone stem cell transplantation. Which of the following is the most important teaching point?
a. "Your child will need lifelong immunosuppressive therapy."
b. "Monitor for signs of infection closely during the first few months."
c. "Avoid all vaccinations for the next five years."
d. "Limit physical activity to prevent injury."

24. During chemotherapy, a child with leukemia develops severe neutropenia. Which intervention should the nurse prioritize?
a. Encouraging increased fluid intake
b. Administering antibiotics prophylactically
c. Placing the child in protective isolation
d. Monitoring for signs of bleeding

25. A child with Wilms' tumor is undergoing chemotherapy. What specific nursing intervention is crucial during this treatment?
a. Monitoring blood sugar levels
b. Checking for increased blood pressure
c. Assessing for signs of neuropathy
d. Monitoring liver function tests

26. A child with osteogenic sarcoma reports night pain and swelling at the tumor site. What is the most likely reason for these symptoms?
a. Inflammation of surrounding tissues
b. Tumor growth and pressure on adjacent structures
c. Radiation therapy side effects
d. Increased physical activity

27. In managing a child with acute lymphoblastic leukemia (ALL), which intervention helps address the child's risk for infection?
a. Administering prophylactic antibiotics
b. Encouraging the use of fresh fruits and vegetables
c. Implementing strict hand hygiene
d. Avoiding vaccinations during chemotherapy

28. A nurse is preparing to administer radiation therapy to a child with leukemia. What is an important safety measure for the nurse to take?
a. Ensure the patient is in isolation to prevent infection
b. Use shielding to protect themselves and the patient
c. Limit fluid intake during radiation
d. Apply a heating pad to the radiation site after therapy

29. A child diagnosed with Wilms' tumor undergoes a nephrectomy. Postoperatively, what should the nurse closely monitor?
a. Respiratory function
b. Fluid and electrolyte balance
c. Blood glucose levels
d. Neurological status

30. A nurse is caring for a child with leukemia experiencing alopecia due to chemotherapy. What is the best intervention to support the child’s psychosocial needs?
a. Offer the child a wig or scarf
b. Encourage the child to avoid mirrors
c. Avoid discussing hair loss unless the child brings it up
d. Focus on discussing treatment progress instead of appearance

Answer Key:

1. b

2. b

3. b

4. d

5. b

6. a

7. a

8. b

9. c

10. c

11. b

12. a

13. b

14. c

15. a

16. c

17. a

18. b

19. c

20. b

21. c

22. b

23. b

24. c

25. b

26. b

27. c

28. b

29. b

30. a