CPHON Symptom Management and Supportive Care 2 — Questions and Answers
Question 1: A child with cancer develops cachexia. Which intervention should the nurse prioritize?
- Enforce strict calorie restriction
- Consult a registered dietitian and consider enteral nutrition (Correct answer)
- Encourage only high-sugar foods
- Restrict all protein intake
Correct answer: Consult a registered dietitian and consider enteral nutrition
Cancer cachexia requires collaboration with a dietitian to optimize nutrition; enteral support may be needed if oral intake is inadequate.
Question 2: A child on high-dose corticosteroids for ALL treatment shows mood swings and increased appetite. The nurse explains these are:
- Signs of disease progression
- Expected side effects of steroid therapy (Correct answer)
- Symptoms of hypoglycemia
- Indicators of opioid toxicity
Correct answer: Expected side effects of steroid therapy
Corticosteroids commonly cause mood lability, increased appetite, and weight gain as predictable pharmacologic side effects.
Question 3: When caring for a child with severe mucositis, which oral care intervention is recommended?
- Use alcohol-based mouthwash four times daily
- Rinse with normal saline or sodium bicarbonate solution (Correct answer)
- Brush vigorously with a firm toothbrush
- Avoid all oral care to prevent pain
Correct answer: Rinse with normal saline or sodium bicarbonate solution
Normal saline or sodium bicarbonate rinses are gentle and help maintain oral pH, promoting healing without irritating damaged mucosa.
Question 4: A pediatric oncology patient has fatigue rated as severe (7/10). Which intervention is MOST evidence-based for cancer-related fatigue?
- Complete bed rest throughout treatment
- Aerobic exercise tailored to the child's capacity (Correct answer)
- High-dose vitamin C supplementation
- Caffeine supplementation
Correct answer: Aerobic exercise tailored to the child's capacity
Evidence supports moderate aerobic exercise as effective in reducing cancer-related fatigue in children and adolescents.
Question 5: A child with a central venous catheter develops a temperature of 38.5°C. The nurse should FIRST:
- Administer acetaminophen and recheck in 2 hours
- Draw blood cultures from the central line and a peripheral site (Correct answer)
- Remove the central catheter immediately
- Increase IV fluid rate
Correct answer: Draw blood cultures from the central line and a peripheral site
Blood cultures from both the central line and a peripheral vein are necessary before antibiotics to identify the source of the infection.
Question 6: The nurse is assessing for peripheral neuropathy in a child receiving vincristine. Which assessment is MOST appropriate?
- Auscultate for abnormal breath sounds
- Test deep tendon reflexes and ask about tingling or weakness (Correct answer)
- Check serum electrolytes
- Perform a fundoscopic examination
Correct answer: Test deep tendon reflexes and ask about tingling or weakness
Vincristine neuropathy is best assessed by testing deep tendon reflexes (often diminished or absent) and asking the patient about paresthesias.
CPHON Symptom Management and Supportive Care 2
A child with cancer develops cachexia.
Which intervention should the nurse prioritize?