Chapter 14: Cancer in Children MULTIPLE MULTIPLE CHOICE
1. What congenital malformation is commonly linked to acute leukemia in children? a. Down syndrome c. Retinoblastoma b. Wilms tumor d. Neuroblastoma ANS: A
risomy !1 "Down syndrome# is the most common genetic defect linked to the de$elo%ment of acute leukemia. &hildren with Down syndrome ha$e a 1'( to !'(fold increased risk of de$elo%ing acute lym%hoblastic and myelogenous leukemia and a higher risk for de$elo%ing acute megakaryocytic leukemia. No current research su%%orts a link between the other stated congenital malformations and acute leukemia. )S: 1
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!. When are childhood cancers most often diagnosed? a. During infancy c. After diagnosis of a chronic illness b. At %eak times of %hysical growth d. After an acute illness ANS: -
&hildhood cancers are most often diagnosed during %eak times of %hysical growth. No current research su%%orts the other o%tions. )S: 1
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. )renatal e/%osure to diethylstilbestrol "D*S# can result in which ty%e of can cer? a. -reast cancer c. 0aginal cancer b. eukemia d. ym%homa ANS: &
D*S has been identified as a trans%lacental chemical carcinogen2 a small %ercentage of the daughters of women who took D*S during %regnancy de$elo%ed adenocarcinomas of the $agina. No current research su%%orts a link between the drug and other cancers. )S: 1
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,. &urrently4 what %ercentage of children with cancer can be cured? a. ,'5 c. 6'5 b. 3'5 d. 7'5 ANS: D
&urrently4 more than 7'5 of children diagnosed with cancer are cured. )S: 1
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3. 8ost childhood cancers arise from the: a. *%ithelium b. 8esodermal germ layer ANS: -
c. *mbryologic ectodermal layer d. 0iscera
8ost childhood cancers originate from the mesodermal germ la yer that gi$es rise to connecti$e tissue4 bone4 cartilage4 muscle4 blood4 blood $essels4 gonads4 kidney4 and the lym%hatic system. he other o%tions are not common sites from which canc ers originate. )S: 1
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6. Which form of cancer is linked to congenital c ongenital malformation syndromes? a. Wilms tumor c. 9steosarcoma b. Retinoblastoma d. Rhabdomyosarcoma ANS: A
Wilms Wilms tumors are linked with other genetically linked childhood cancers. t is the only form among the a$ailable o%tions that is associated with co ngenital malformation syndromes. )S: 1
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<. Research data su%%ort a carcinogenic relationshi% in children resulting from e/%osure to
which $irus? a. =er%es sim%le/ $irus b. nfluen>a
c. 0aricella >oster $irus d. *%stein(-arr $irus
ANS: D
he strongest association between $iruses and the de$elo% ment of cancer in children has been b een the *%stein(-arr $irus "*-0#4 -urkitt lym%homa4 naso%haryngeal carcinoma4 and =odgkin disease. No current research su%%orts a link between the remaining o%tions and childhood cancer. )S: 1
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7. A child diagnosed with acuired immunodeficiency syndrome "ADS# has an increased risk of
de$elo%ing: a. Non(=odgkin lym%homa b. Retinoblastoma
c. *%stein(-arr d. eukemia
ANS: A
&hildren with ADS ha$e an increased risk of de$elo%ing non(=odgkin lym%homa and @a%osi sarcoma. eukemia is linked to retinoblastoma. *%stein(-arr has been linked to the de$elo%ment of some cancers4 whereas no known link has been found between ADS and the de$elo%ment of leukemia. )S: 1
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. Which inter$ention has the greatest affect on a childBs mortality rate when diagnosed with
cancer? a. Age at the time of diagnosis b. )artici%ation in clinical trials c. )ro/imity to a maCor cancer treatment center d. )arental in$ol$ement in the treatment %lanning ANS: -
8ortality rates ha$e significantly declined in the %ast ,' yea rs largely as a result of ad$ances in treatment and %artici%ation in clinical trials. Although im%ortant4 the other o%tions are not belie$ed to ha$e an affect on the decline of the mortality rate of childhood cancer. )S: 1
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1'. Which statement is likely true regarding true regarding children being treated for cancer with radiation
thera%y? a. hey will most likely ha$e a successful remission of tumor growth. b. hey seldom reuire follow(u% maintenance treatments. c. hey are %rone to e/%erience se$ere de$elo%mental delays. d. hey are at increased risk for de$elo%ing adult cancers. ANS: D
Although the need e/ists for long(term studies4 research has shown a correlation between radiation(induced malignancies from radiothera%y "as in cancer treatment# or radiation e/%osure from diagnostic imaging2 both ha$e shown to increase the risk of de$elo%ing cancer during adulthood. he other o%tions are not necessarily true regarding the outcomes of radiation thera%y for childhood cancers. )S: 1
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11. =ow should the nurse re%ly when a %arent uestions why a com%uted tomogra%hic "&# scan
of the head was not ordered o rdered for their 3(year(old child after a minor fall? )hysicians are cautious about ordering & scan on children younger than 1' years of age. b. & scans are seldom conclusi$e when used to diagnosis head inCuries in young children. c. he childBs sym%toms sym%toms will determine whether a & scan is necessary an d worth the e/%ense. d. Research suggests that re%eated & scans can increase the risk of de$elo%ing brain cancer. a.
ANS: D
+indings from a recent study of 1<6437< children suggest that those who ha$e two or three & scans of the head before the age of !! years are three times more likely to de$elo% brain cancer as those in the general %o%ulation4 and the risk of de$elo%ing leukemia is three times as great in those who recei$ed fi$e to ten & scans. he other o%tions do not re%resent the logic behind not ordering a & scan in relationshi% to minor head trauma. )S: 1
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MULTIPLE RESPONSE
1!. &hildhood e/%osure to which risk factors increases the susce%tibility for de$elo%ing can cers? cers?
(Select all that apply.) a. ow birth weight b. &hemothera%y c. oni>ing radiation d. &igarette smoke
e. =odgkin disease ANS: -4 &4 &4 *
&hildhood e/%osure to ioni>ing radiation4 drugs4 or e/isting cancer(causing $iruses has been associated with the risk of de$elo%ing cancer. Although unhealthy4 no current research identifies cigarette smoke or low birth weight as risk factors for childhood cance r. )S: 1
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1. Which statement is true concerning true concerning the difference between adult and childhood cancers?
(Select all that apply.) a. Numerous differences e/ist between these two categories of cancer. cancer. b. &hildhood cancers are far less likely to be associated with genetic mutations. c. *n$ironmental risks are strongly associated with childhood cancers. d. */%osure to %esticides is a minor risk for the de$elo% ment of adult cancers. e. 8aternal e/%osure to carcinogenic substances %resents little risk to the fetus. ANS: A4 -
9$erall4 cancers in children are $ery different d ifferent than adult cancers and are associated with far fewer genetic mutations. Research does not su%%ort the other o%tions. )S: 1
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1,. 8ost childhood cancers originate from the mesodermal germ layer that ultimately %roduces
which of the following? (Select all that apply.) a. &onnecti$e tissue b. Digesti$e system c. 8uscles d. @idneys e. -lood ANS: ANS: A4 &4 &4 D4 D4 *
8ost childhood cancers originate from the mesodermal germ layer4 which gi$es rise to connecti$e tissue4 bone cartilage4 muscle4 blood4 blood $essels4 gonads4 kidney4 and the lym%hatic system. &ancers of the digesti$e tract do not originate in the mesodermal germ layer. )S: 1
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13. Which statements are true regarding true regarding cancers that de$elo% in children? (Select all that apply.) ap ply.) a. &hildhood cancers tend to be fast growing. b. &hildhood cancers are diagnosed during d uring growth s%urts. c. &hildhood cancer generally metastasi>es by the time of diagnosis. d. &hildhood cancer is ty%ically at low risk for aggressi$e metastasis. e. &hildhood cancers res%ond well to standardi>ed treatment modalities. ANS: A4 -4 -4 &
&hildhood cancers are most often diagnosed during %eak times of %hysical growth. n gen eral4 they are e/tremely fast growing4 with 7'5 ha$ ing distant s%read "metastases# at diagnosis. he other o%tions are not true regarding childhood cancers. )S: 1
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ca ncer and its occurrence among college(aged students. 16. he nurse is %re%aring a discussion on cancer Which cancers will the nurse include in the discussion? (Select all that apply.) &olorectal esticular hyroid -reast ung
a. b. c. d. e.
ANS: ANS: A4 -4 -4 &4 &4 D
he most common cancers among the adolescent and young adult %o%ulation "13 to years of age# are =odgkin lym%homa4 leukemia4 germ(cell tumors "%articularly testicular#4 central ner$ous system tumors4 non(=odgkin lym%homa4 thyroid cancer4 melanoma4 sarcomas4 and breast4 cer$ical4 li$er4 thyroid thyroid and colorectal cancers. ung cancer generally de$elo%s after chronic inhalation of nicotine(containing %roducts. )S: 1
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