: The Child with Cancer
Hockenberry: Wong’s Essentials of Pediatric Nursing, 10th Edition
MULTIPLE CHOICE
1. The school nurse is discussing testicular self-examination with adolescent boys. Why is this
important?
a. Epididymitis is common during adolescence.
b. Asymptomatic sexually transm...
WONGS ESSENTIALS OF PEDIATRIC NURSING 10TH EDITION HOCKENBERRY TEST BANK
Chapter 25: The Child with Cancer
Hockenberry: Wong’s Essentials of Pediatric Nursing, 10th Edition
MULTIPLE CHOICE
1. The school nurse is discussing testicular self-examination with adolescent boys. Why is this
important?
a. Epididymitis is common during adolescence.
b. Asymptomatic sexually transmitted diseases may be present.
c. Testicular tumors during adolescence are generally malignant.
d. Testicular tumors, although usually benign, are common during adolescence.
ANS: C
Tumors of the testes are not common, but when manifested in adolescence, they are generally
malignant and demand immediate evaluation. Epididymitis is not common in adolescence.
Asymptomatic sexually transmitted disease would not be evident during testicular
self-examination. The focus of this examination is on testicular cancer. Testicular tumors are
most commonly malignant.
DIF: Cognitive Level: Apply REF: p. 842
TOP: Integrated Process: Teaching/Learning
MSC: Area of Client Needs: Physiologic Integrity: Reduction of Risk Potential
2. Which is the usual presenting symptom for testicular cancer?
a. Hard, painful mass
b. Hard, painless mass
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c. Epididymis easily palpated
d. Scrotal swelling and pain
ANS: B
The usual presenting symptom for testicular cancer is a heavy, hard, painless mass that is
either smooth or nodular and palpated on the testes. A hard, painful mass, an epididymis
easily palpated, and scrotal swelling and pain are not the clinical presentations of testicular
cancer.
DIF: Cognitive Level: Understand REF: p. 842
TOP: Integrated Process: Nursing Process: Assessment
MSC: Area of Client Needs: Physiologic Integrity: Physiologic Adaptation
3. Which is most descriptive of the pathophysiology of leukemia?
a. Increased blood viscosity occurs.
b. Thrombocytopenia (excessive destruction of platelets) occurs.
c. Unrestricted proliferation of immature white blood cells (WBCs) occurs.
d. First stage of coagulation process is abnormally stimulated.
ANS: C
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, WONGS ESSENTIALS OF PEDIATRIC NURSING 10TH EDITION HOCKENBERRY TEST BANK
Leukemia is a group of malignant disorders of the bone marrow and lymphatic system. It is
defined as an unrestricted proliferation of immature WBCs in the blood-forming tissues of the
body. Increased blood viscosity may occur secondary to the increased number of WBCs.
Thrombocytopenia may occur secondary to the overproduction of WBCs in the bone marrow.
The coagulation process is unaffected by leukemia.
DIF: Cognitive Level: Understand REF: p. 826
TOP: Integrated Process: Nursing Process: Assessment
MSC: Area of Client Needs: Physiologic Integrity: Physiologic Adaptation
4. A boy with leukemia screams whenever he needs to be turned or moved. Which is the most
probable cause of this pain?
a. Edema
b. Bone involvement
c. Petechial hemorrhages
d. Changes within the muscles
ANS: B
The invasion of the bone marrow with leukemic cells gradually causes a weakening of the
bone and a tendency toward fractures. As leukemic cells invade the periosteum, increasing
pressure causes severe pain. Edema, petechial hemorrhages, and changes within the muscles
would not cause severe pain.
DIF: Cognitive Level: Analyze REF: p. 826
TOP: Integrated Process: Nursing Process: Planning
MSC: Area of Client Needs: Physiologic Integrity: Physiologic Adaptation
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5. Myelosuppression, associated with chemotherapeutic agents or some malignancies such as
leukemia, can cause bleeding tendencies because of a(n):
a. decrease in leukocytes.
b. increase in lymphocytes.
c. vitamin C deficiency.
d. decrease in blood platelets.
ANS: D
The decrease in blood platelets secondary to the myelosuppression of chemotherapy can cause
an increase in bleeding. The child and family should be alerted to avoid risk of injury.
Decrease in leukocytes, increase in lymphocytes, and vitamin C deficiency would not affect
bleeding tendencies.
DIF: Cognitive Level: Apply REF: p. 828
TOP: Integrated Process: Nursing Process: Planning
MSC: Area of Client Needs: Physiologic Integrity: Physiologic Adaptation
6. A child with leukemia is receiving triple intrathecal chemotherapy consisting of methotrexate,
cytarabine, and hydrocortisone. What will the triple intrathecal chemotherapy prevent?
a. Infection
b. Brain tumor
c. Drug side effects
d. Central nervous system (CNS) disease
ANS: D
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