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Chapter 29. The Child with Cancer Questions and Answers 2024
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Chapter 29. The Child with Cancer
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Chapter 29. The Child with CancerWhat childhood cancer may demonstrate patterns of inheritance that suggest a familial
basis?
a. Leukemia
b. Retinoblastoma
c. Rhabdomyosarcoma
d. Osteogenic sarcoma - answerb. Retinoblastoma
Retinoblastoma is an example of a pediatric cancer that demonstrates inheritance. The
absence of the retinoblastoma gene allows for abnormal cell growth and the
development of retinoblastoma. Chromosome
abnormalities are present in many malignancies. They do not indicate a familial pattern
of inheritance. The Philadelphia chromosome is observed in almost all individuals with
chronic myelogenous leukemia. There is no evidence of a familial pattern of inheritance
for rhabdomyosarcoma or osteogenic sarcoma cancers
As part of the diagnostic evaluation of a child with cancer, biopsies are important for
staging. What statement explains what staging means?
a. Extent of the disease at the time of diagnosis
b. Rate normal cells are being replaced by cancer cells
c. Biologic characteristics of the tumor or lymph nodes
d. Abnormal, unrestricted growth of cancer cells producing organ damage - answera.
Extent of the disease at the time of diagnosis
Staging is a description of the extent of the disease at the time of diagnosis. Staging
criteria exist for most
tumors. The stage usually relates directly to the prognosis; the higher the stage, the
poorer the prognosis. The rate that normal cells are being replaced by cancer cells is
not a definition of staging. Classification of the
tumor refers to the biologic characteristics of the tumor or lymph nodes. Abnormal,
unrestricted growth of
cancer cells producing organ damage describes how cancer cells grow and can cause
damage to an organ.
What statement related to clinical trials developed for pediatric cancers is most
accurate?
a. Are accessible only in major pediatric centers
b. Do not require consent for standard therapy
,c. Provide the best available therapy compared with an expected improvement
d. Are standardized to provide the same treatment to all children with the disease -
answerc. Provide the best available therapy compared with an expected improvement
Most clinical trials have a control group in which the patients receive the best available
therapy currently known. The experimental group(s) receives treatment that is thought
to be even better. The protocol outlines the therapy plan. Protocols are developed for
many pediatric cancers. They can be accessed by pediatric oncologists throughout the
United States. Consent is always required in treatment of children, especially for
research protocols. The protocol is designed to optimize therapy for children based on
disease type and stage
Chemotherapeutic agents are classified according to what feature?
a. Side effects
b. Effectiveness
c. Mechanism of action
d. Route of administration - answerc. Mechanism of action
Chemotherapeutic agents are classified according to mechanism of action. For
example, antimetabolites resemble essential metabolic elements needed for growth but
are different enough to block further deoxyribonucleic acid (DNA) synthesis. Although
the side effect profiles may be similar for drugs within a classification, they are not the
basis for classification. Most chemotherapeutic regimens contain combinations of drugs.
The effectiveness of any one drug is relative to the cancer type, combination therapy,
and protocol for administration. The route of administration is determined by the
pharmacodynamics and pharmacokinetics of each drug
What type of chemotherapeutic agent alters the function of cells by replacing a
hydrogen atom of a
molecule?
a. Plant alkaloids
b. Antimetabolites
c. Alkylating agents
d. Antitumor antibiotics - answerc. Alkylating agents
Alkylating agents replace a hydrogen atom with an alkyl group. The irreversible
combination of alkyl groups with nucleotide chains, particularly deoxyribonucleic acid
(DNA), causes unbalanced growth of unaffected cell constituents so that the cell
eventually dies. Plant alkaloids arrest the cell in metaphase by binding to proteins
needed for spindle formation. Antimetabolites resemble essential metabolic elements
needed for growth but
are different enough to block further DNA synthesis. Antitumor antibiotics are natural
substances that interfere with cell division by reacting with DNA in such a way as to
prevent further replication of DNA and
, transcription of ribonucleic acid (RNA)
What side effect commonly occurs with corticosteroid (prednisone) therapy?
a. Alopecia
b. Anorexia
c. Nausea and vomiting
d. Susceptibility to infection - answerd. Susceptibility to infection
Corticosteroids have immunosuppressive effects. Children who are taking prednisone
are susceptible to infections. Hair loss is not a side effect of corticosteroid therapy.
Children taking corticosteroids have increased appetites. Gastric irritation, not nausea
and vomiting, is a potential side effect. The medicine should be given with food
What chemotherapeutic agent is classified as an antitumor antibiotic?
a. Cisplatin (Platinol AQ)
b. Vincristine (Oncovin)
c. Methotrexate (Texall)
d. Daunorubicin (Cerubidine) - answerd. Daunorubicin (Cerubidine)
Daunorubicin is an antitumor antibiotic. Cisplatin is classified as an alkylating agent.
Vincristine is a plant
alkaloid. Methotrexate is an antimetabolite
The nurse is administering an intravenous chemotherapeutic agent to a child with
leukemia. The child
suddenly begins to wheeze and have severe urticaria. What nursing action is most
appropriate to initiate?
a. Recheck the rate of drug infusion.
b. Stop the drug infusion immediately.
c. Observe the child closely for next 10 minutes.
d. Explain to the child that this is an expected side effect. - answerb. Stop the drug
infusion immediately
When an allergic reaction is suspected, the drug is immediately discontinued. Any drug
in the line should be
withdrawn, and a normal saline infusion begun to keep the line open. The intravenous
infusion is stopped to
minimize the amount of drug that infuses. The infusion rate can be confirmed at a later
time. Observation of
the child for 10 minutes is essential, but it is done after the infusion is stopped. These
signs are indicative of an allergic reaction, not an expected response
Total-body irradiation is indicated for what reason?
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