21. The nurse is conducting a staff in-service on childhood blood disorders. Which describes the pathology of idiopathic thrombocytopenic purpura?

a. Bone marrow failure in which all elements are suppressed

b. Deficiency in the production rate of globin chains

c. Diffuse fibrin deposition in the microvasculature

d. An excessive destruction of platelets

22. 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.

23. 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

24. 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.

25. A child with leukemia is receiving triple intrathecal chemotherapy consisting of methotrexate, cytarabine, and hydrocortisone. The purpose of this is to prevent:

a. infection.

b. brain tumor.

c. drug side effects.

d. central nervous system (CNS) disease.

26. A young boy will receive a bone marrow transplant (BMT). This is possible because one of his older siblings is a histocompatible donor. Which is this type of BMT called?

a. Syngeneic

b. Allogeneic

c. Monoclonal

d. Autologous

27. Which is the most effective pain-management approach for a child who is having a bone marrow aspiration?

a. Relaxation techniques

b. Administration of an opioid

c. EMLA cream applied over site

d. Conscious or unconscious sedation

28. Which immunization should not be given to a child receiving chemotherapy for cancer?

a. Tetanus vaccine

b. Inactivated poliovirus vaccine

c. Diphtheria, pertussis, tetanus (DPT)

d. Measles, rubella, mumps

29. Which is often administered to prevent or control hemorrhage in a child with cancer?

a. Nitrosoureas

b. Platelets

c. Whole blood

d. Corticosteroids

30. The nurse is administering an IV chemotherapeutic agent to a child with leukemia. The child suddenly begins to wheeze and have severe urticaria. Which is the most appropriate nursing action?

a. Stop drug infusion immediately.

b. Recheck rate of drug infusion.

c. Observe child closely for next 10 minutes.

d. Explain to child that this is an expected side effect.