CPHON Pediatric Oncology Nursing Assessment and Care Planning 1 — Questions and Answers
Question 1: When performing a nursing assessment on a newly diagnosed pediatric oncology patient, which finding requires IMMEDIATE intervention?
- Blood pressure of 100/60 mmHg
- Respiratory distress with mediastinal mass on chest X-ray (Correct answer)
- Weight loss of 2 lbs over one month
- Mild pallor of mucous membranes
Correct answer: Respiratory distress with mediastinal mass on chest X-ray
A mediastinal mass can compress the trachea and superior vena cava, causing life-threatening airway obstruction or superior vena cava syndrome.
Question 2: Which nursing diagnosis has HIGHEST priority for a child with febrile neutropenia?
- Risk for imbalanced nutrition
- Risk for infection related to immune suppression (Correct answer)
- Disturbed body image
- Activity intolerance
Correct answer: Risk for infection related to immune suppression
Febrile neutropenia is a life-threatening emergency; preventing infection spread and initiating antibiotics are the primary nursing priorities.
Question 3: The CPHON nurse is caring for a child with superior vena cava (SVC) syndrome. Which position is MOST appropriate?
- Supine with legs elevated
- Prone
- High Fowler's (head of bed elevated 60–90°) (Correct answer)
- Left lateral decubitus
Correct answer: High Fowler's (head of bed elevated 60–90°)
Elevating the head of bed reduces venous pressure in the SVC, decreasing facial/neck swelling and improving venous return.
Question 4: A child with ALL is admitted with a fever and ANC of 200/mm³. Within how many minutes should empiric antibiotics be initiated?
- Within 60 minutes (Correct answer)
- Within 30 minutes
- Within 4 hours
- Within 24 hours
Correct answer: Within 60 minutes
Febrile neutropenia guidelines recommend initiating empiric broad-spectrum antibiotics within 60 minutes of triage to prevent septic shock.
Question 5: When developing a care plan for a child with terminal cancer, the nurse includes which priority goal?
- Cure the underlying malignancy
- Maintain comfort and quality of life (Correct answer)
- Maximize aggressive treatment
- Prevent all family visits
Correct answer: Maintain comfort and quality of life
For terminal pediatric cancer, palliative and comfort-focused goals center on maximizing quality of life, not curative intervention.
Question 6: A 10-year-old with leukemia refuses to take oral medication. The BEST nursing approach is to:
- Force the medication immediately
- Crush and hide medication in food without telling the child
- Collaborate with the child and family to problem-solve acceptability (Correct answer)
- Document refusal and skip the dose without further action
Correct answer: Collaborate with the child and family to problem-solve acceptability
A child-centered approach that involves the child and family in problem-solving increases adherence and respects developmental autonomy.
CPHON Pediatric Oncology Nursing Assessment and Care Planning 1
When performing a nursing assessment on a newly diagnosed pediatric oncology patient, which finding requires IMMEDIATE intervention?