2024 A+ GRADE NCLEX - PEDIATRICS –
ONCOLOGY WITH QUESTIONS AND ANSWERS FOR
REVISION. WELL RESEARCHED AND 100%
REVIEWED AND UPDATED.
1. The nurse is monitoring a child for bleeding after surgery for
removal of a brain tumor. The nurse checks the head dressing for
the presence of blood and notes a colorless drainage on the back
of the dressing. Which intervention should the nurse perform
immediately?
1. Reinforce the dressing.
2.Notify the health care provider (HCP).
3.Document the findings and continue to monitor.
4.CircIe the area of drainage and continue to monitor.: Correct
Answer: 2
Rationale: Colorless drainage on the dressing in a child after craniotomy
indicates the presence of cerebrospinal fluid and should be reported to
the HCP immediately. Options 1, 3, and 4 are not the immediate nursing
intervention because they do not address the need for immediate
intervention to prevent complications.
2. The mother of a 4-year-old child tells the pediatric nurse
that the child's abdomen seems to be swollen. During further
assessment, the mother tells the nurse that the child is eating
well and that the activity level of the child is unchanged. The
nurse, suspecting the possibility of Wilms' tumor, should avoid
which during the physical assessment?
1.PaIpating the abdomen for a mass
2.Assessing the urine for the presence of hematuria
3.Monitoring the temperature for the presence of fever
1/23
, 2024 A+ GRADE NCLEX - PEDIATRICS –
ONCOLOGY WITH QUESTIONS AND ANSWERS FOR
REVISION. WELL RESEARCHED AND 100%
REVIEWED AND UPDATED.
4.Monitoring the blood pressure for the presence of
hypertension: Correct
Answer: 1
Rationale: Wilms' tumor is the most common intraabdominal and
kidney tumor of childhood. If Wilms' tumor is suspected, the tumor
mass should not be palpated by the nurse. Excessive manipulation
can cause seeding of the tumor and spread of the cancerous cells.
Hematuria, fever, and hypertension are clinical manifestations
associated with Wilms' tumor.
3. The nurse provides a teaching session to the nursing staff
regarding osteosarcoma. Which statement by a member of the
nursing staff indicates a need for information?
1."The femur is the most common site of this sarcoma."
2."The child does not experience pain at the primary tumor site."
3."Limping, if a weight-bearing limb is affected, is a clinical
manifestation."
4." The symptoms of the disease in the early stage are almost
always attributed to normal growing pains.": Correct Answer: 2
Rationale: Osteosarcoma is the most common bone cancer in
children. Cancer usually is found in the metaphysis of long bones,
especially in the lower extremities, with most tumors occurring in
the femur. Osteosarcoma is manifested clinically by progressive,
insidious, and intermittent pain at the tumor site. By the time these
children receive medical attention, they may be in considerable pain
from the tumor.
2/23
, 2024 A+ GRADE NCLEX - PEDIATRICS –
ONCOLOGY WITH QUESTIONS AND ANSWERS FOR
REVISION. WELL RESEARCHED AND 100%
REVIEWED AND UPDATED.
Options 1, 3, and 4 are accurate regarding osteosarcoma.
4. The nurse analyzes the laboratory values of a child with
leukemia who is receiving chemotherapy. The nurse notes that
the platelet count is 19,500 mm3 (19.5 x 109/L). On the basis of
this laboratory result, which intervention should the nurse
include in the plan of care?
illiterate bleeding precautions.
2.Monitor closely for signs of infection.
3.Monitor the temperature every 4 hours.
4.1nitiate protective isolation precautions.: Correct Answer: 1
Rationale: Leukemia is a malignant increase in the number of leukocytes,
usually at an immature stage, in the bone marrow. It affects the bone
marrow, causing anemia from decreased erythrocytes, infection from
neutropenia, and bleeding from decreased platelet production
(thrombocytopenia). If a child is severely thrombocytopenic and has a
platelet count less than 20,000 mm3 (20.0 x 109/L), bleeding
precautions need to be initiated because of the increased risk of
bleeding or hemorrhage. Precautions include limiting activity that could
result in head injury, using soft toothbrushes, checking urine and stools
for blood, and administering stool softeners to prevent straining with
constipation. In addition, suppositories, enemas, and rectal
temperatures are avoided. Options 2, 3, and 4 are related to the
prevention of infection rather than bleeding.
5. The nurse is monitoring a 3-year-old child for signs and
symptoms of increased intracranial pressure (ICP) after a
3/23
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