CPHON Radiation Therapy in Pediatric Oncology 2 — Questions and Answers
Question 1: Regarding radiation safety, which statement is correct about pregnant nurses and patients receiving internal brachytherapy implants?
- Pregnant nurses may care for these patients if they stand at least 1 foot away
- Pregnant nurses may care for these patients as long as contact is under 30 minutes
- Pregnant nurses should avoid caring for patients with active brachytherapy implants entirely (Correct answer)
- Pregnant nurses only need to wear a lead apron during direct care
Correct answer: Pregnant nurses should avoid caring for patients with active brachytherapy implants entirely
Pregnant nurses should not care for patients with active brachytherapy implants because ionizing radiation poses a risk of harm to the developing fetus at any exposure level.
Question 2: A child who received cranial radiation therapy at age 4 is most at risk for which long-term neurocognitive deficit?
- Expressive aphasia and language loss
- Decline in processing speed and working memory (Correct answer)
- Bilateral hearing loss
- Visual field deficits requiring glasses
Correct answer: Decline in processing speed and working memory
Cranial irradiation commonly damages developing white matter pathways, leading to deficits in processing speed, attention, and working memory, particularly when administered to young children.
Question 3: Which skin care instruction should the nurse provide to parents of a child receiving radiation therapy to the chest?
- Apply any commercial moisturizer generously to the treated area twice daily
- Use heating pads to soothe discomfort in the treated area
- Gently cleanse the area with mild, unscented soap and lukewarm water (Correct answer)
- Apply petroleum jelly to the skin immediately before each treatment session
Correct answer: Gently cleanse the area with mild, unscented soap and lukewarm water
Gentle cleansing with mild, unscented soap and lukewarm water maintains skin hygiene without causing additional irritation to radiation-sensitized skin.
Question 4: Radiation therapy directed to the thorax in a pediatric oncology patient most commonly causes which acute pulmonary complication?
- Pulmonary fibrosis
- Radiation pneumonitis (Correct answer)
- Spontaneous pneumothorax
- Massive pleural effusion
Correct answer: Radiation pneumonitis
Radiation pneumonitis typically develops 4–12 weeks after thoracic irradiation and presents with cough, dyspnea, and low-grade fever due to acute inflammatory injury.
Question 5: What is the priority nursing assessment for a child who has received total body irradiation (TBI) as part of a bone marrow transplant conditioning regimen?
- Monitor for hair loss and scalp irritation
- Assess for signs of hepatic veno-occlusive disease only
- Monitor for acute radiation syndrome including nausea, vomiting, diarrhea, and mucositis (Correct answer)
- Evaluate for weight gain and fluid retention
Correct answer: Monitor for acute radiation syndrome including nausea, vomiting, diarrhea, and mucositis
TBI causes systemic acute radiation syndrome, manifesting as nausea, vomiting, diarrhea, and mucositis that require intensive monitoring and aggressive supportive care.
Question 6: Which dietary recommendation is most appropriate for a child experiencing radiation-induced mucositis affecting the mouth and throat?
- High-fiber foods to promote bowel motility and comfort
- Spicy, highly seasoned foods to stimulate appetite
- Soft, bland, cool foods that minimize irritation and are easy to swallow (Correct answer)
- Carbonated beverages to keep the oral cavity moist
Correct answer: Soft, bland, cool foods that minimize irritation and are easy to swallow
Soft, bland, and cool foods minimize mechanical and chemical irritation to inflamed mucous membranes and reduce pain during swallowing.
Question 7: A pediatric patient receiving abdominal radiation reports sudden onset of severe, worsening abdominal pain with a board-like rigid abdomen. What is the nurse's priority action?
- Administer the scheduled antiemetic and continue monitoring
- Document loose stools as an expected radiation side effect
- Notify the physician immediately as this may indicate bowel perforation or obstruction (Correct answer)
- Apply a warm compress to the abdomen for comfort
Correct answer: Notify the physician immediately as this may indicate bowel perforation or obstruction
Sudden severe abdominal pain with rigidity is a potential sign of bowel perforation or obstruction—a rare but life-threatening complication of abdominal radiation requiring immediate medical evaluation.
CPHON Radiation Therapy in Pediatric Oncology 2
Regarding radiation safety, which statement is correct about pregnant nurses and patients receiving internal brachytherapy implants?