Practice Question
A nurse is planning care for a preschooler.
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Correct Answer:
Alopecia
Rationale:
🔷 Alopecia is a common side effect of chemotherapy, especially agents like vincristine and doxorubicin, which target rapidly dividing cells.
🔷 These agents damage hair follicle cells, leading to hair loss typically within 1–2 weeks of treatment initiation.
🔷 The psychosocial impact of alopecia is significant in pediatric clients and must be addressed through therapeutic support.
🔷 Scalp cooling or discussions about hair coverings can help reduce distress.
🔷 Parents should be educated that hair typically regrows after the treatment phase.
Tumor Lysis Syndrome (TLS)
🔷 TLS is a potentially life-threatening emergency associated with rapid destruction of malignant cells, particularly in leukemia during induction therapy.
🔷 The breakdown of tumor cells releases potassium, phosphate, and uric acid, leading to electrolyte imbalances and renal failure.
🔷 This child is in the induction phase of chemotherapy, which is the highest risk period for TLS.
🔷 Prophylactic measures like hydration and allopurinol may be implemented to reduce risk.
🔷 Nurses must monitor for signs like nausea, vomiting, lethargy, and cardiac arrhythmias.
Hemorrhage
🔷 The child’s platelet count is 120,000/mm³, below the normal range (150,000–400,000), placing them at risk for bleeding.
🔷 Thrombocytopenia is a common complication of chemotherapy due to bone marrow suppression.
🔷 The nurse should monitor for signs of bleeding gums, petechiae, hematuria, and bruising.
🔷 Injury prevention measures are critical, including soft toothbrush use and avoiding IM injections.
🔷 The nurse should ensure availability of platelet transfusion if levels fall further.
Peripheral Neuropathy
🔷 Vincristine, a chemotherapy drug used in this client’s treatment, commonly causes peripheral neuropathy.
🔷 Neuropathy results from nerve damage, leading to tingling, numbness, or weakness, often in the hands and feet.
🔷 In children, this may manifest as difficulty walking, decreased reflexes, or constipation due to autonomic involvement.
🔷 Nurses must assess for gait disturbances, loss of fine motor skills, and report findings promptly.
🔷 Dose adjustment may be required if neuropathy is severe.
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This question is from RN Comprehensive Predictor-2025 Exam 3 which contains 150 questions.
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Question Details
- Category: RN Nursing Exam(s)
- Subcategory: ATI EXIT Exam(s)
- Domain: RN ATI Comprehensive Predictor Exam(s)~2025
- Answer Choices: 8