Mixed Deck — All CPHON Topics Flashcards
100 cards from real CPHON practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 20 Mixed Deck — All CPHON Topics flashcards as text
What is the correct syringe size to use when flushing a pediatric central line, and why?
Answer: 10 mL or larger, because smaller syringes generate dangerously high pressure that can rupture the catheter
Smaller syringes generate much higher pressures per unit force applied because the plunger area is smaller. Using syringes smaller than 10 mL (especially 1 mL or 3 mL) can exceed catheter pressure tolerances and cause rupture or catheter fracture.
What is the primary advantage of a tunneled central venous catheter (e.g., Broviac or Hickman) over a non-tunneled central line in pediatric oncology?
Answer: The subcutaneous tunnel reduces CLABSI risk and allows long-term use over months to years
Tunneling the catheter under the skin creates a mechanical barrier to bacterial migration from the skin exit site to the bloodstream, reduces CLABSI rates, and makes the catheter suitable for long-term use (months to years) compared to non-tunneled devices.
A mother of a child receiving cancer treatment tells the nurse she feels guilty that she 'gave' her child cancer. Which response is most therapeutic?
Answer: Acknowledge her feelings, then gently educate that childhood cancer is not caused by anything parents did, and refer to the social worker
Parental guilt is extremely common following a child's cancer diagnosis. Therapeutic response involves first acknowledging the emotional experience, then offering evidence-based reassurance that most childhood cancers have no known parental cause, and connecting the family with psychosocial support.
A child undergoing allogeneic stem cell transplant develops a new rash, diarrhea, and elevated bilirubin on day +30. The nurse suspects:
Answer: Graft-versus-host disease (GVHD)
Classic acute GVHD presents with the triad of skin rash, diarrhea, and liver dysfunction (elevated bilirubin) after allogeneic transplant.
A child with cancer has not urinated in 8 hours and is receiving IV hydration. The nurse should:
Answer: Notify the provider and assess for bladder distension or obstruction
No urine output for 8 hours despite IV hydration is abnormal and may indicate urinary retention or renal dysfunction requiring immediate evaluation.
A child's tumor pathology report shows translocation t(8;14). This finding is characteristic of:
Answer: Burkitt lymphoma
Translocation t(8;14) involves the MYC oncogene and the immunoglobulin heavy chain locus, and is the hallmark translocation of Burkitt lymphoma.
The nurse notes a child with sickle cell disease has a spleen that is markedly enlarged and the hemoglobin dropped from 9 to 5 g/dL acutely. This presentation suggests:
Answer: Splenic sequestration crisis
Splenic sequestration crisis involves rapid pooling of blood in the spleen causing acute anemia, splenomegaly, and circulatory compromise.
Radiation therapy directed to the thorax in a pediatric oncology patient most commonly causes which acute pulmonary complication?
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.
A child undergoing stem cell transplant is on neutropenic precautions. Which food should the nurse instruct the family to AVOID?
Answer: Fresh salads and raw fruits
Raw fruits, vegetables, and salads can harbor bacteria and fungi that are dangerous to severely immunocompromised patients.
Which chemotherapy agent is classified as a topoisomerase II inhibitor and requires cardiac monitoring?
Answer: Etoposide
Etoposide inhibits topoisomerase II, which can cause secondary leukemia and requires monitoring for hypotension during infusion.
A pediatric oncology patient has fatigue rated as severe (7/10). Which intervention is MOST evidence-based for cancer-related fatigue?
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.
Which food should be avoided by a neutropenic pediatric oncology patient?
Answer: Fresh salad bar items, unpasteurized dairy, raw eggs, and undercooked meats
Neutropenic diet restrictions aim to minimize exposure to pathogens; raw produce (especially salad bars with shared utensils), unpasteurized products, raw eggs, and undercooked meats harbor bacteria and fungi that healthy immune systems handle but neutropenic patients cannot.
Which of the following is an acute side effect of radiation therapy directed to the head and neck region in a pediatric patient?
Answer: Mucositis
Mucositis is an acute side effect of head and neck radiation that typically appears within the first 1–2 weeks of treatment due to injury to rapidly dividing mucosal cells.
Which action best demonstrates the nurse's role in pediatric oncology survivorship care?
Answer: Educating families about long-term follow-up needs and potential late effects based on treatment received
Survivorship nursing involves comprehensive education about monitoring for late effects of treatment, psychosocial support, and coordination of long-term follow-up care.
A child with hemophilia B is bleeding after a fall. The appropriate treatment is replacement with:
Answer: Factor IX concentrate
Hemophilia B is caused by deficiency of factor IX ('Christmas disease'); factor IX concentrate is the specific replacement therapy.
Which staging classification is used for childhood non-Hodgkin lymphoma?
Answer: St. Jude (Murphy) staging system
The St. Jude (Murphy) staging system is specifically designed for pediatric NHL, based on tumor location and extent of disease.
A 9-year-old with osteosarcoma asks the nurse: 'Am I going to die?' The most therapeutically appropriate response is:
Answer: Acknowledge the question with honesty and gentleness, explore what prompted it, and involve the appropriate team member for the discussion
Children with cancer have a right to honest, age-appropriate information. Dismissing or avoiding the question destroys trust. Exploring the question ('What made you think of that?'), acknowledging the reality of the illness, and involving the appropriate team (social work, child psychiatry) is the therapeutic approach.
A child on high-dose methotrexate has a serum methotrexate level of 10 micromol/L at 24 hours. The nurse should anticipate administering:
Answer: Leucovorin rescue
Leucovorin (folinic acid) is the rescue agent for methotrexate toxicity, bypassing the enzyme methotrexate inhibits.
The nurse informs the parent that the child's food should consist of the following for the preceding 12 hours in order to prepare for a PET scan:
Answer: low carbohydrate.
The youngster should consume low carbohydrate foods over the preceding 12 hours in order to prepare for a PET scan. A high-carbohydrate diet or receiving glucose intravenously (IV) could cause false-positive results. Prior to the test, patients must fast for six hours. Depending on the organ being scanned, the radioactive tracer used in the PET scan may be given orally, intravenously, or both. Because the tracer builds up in regions with a high level of chemical activity, such tumors, PET scans can detect malignancies.
A child with a newly placed PICC line develops erythema, warmth, and tenderness along the arm vein pathway 48 hours after insertion. The nurse suspects:
Answer: Phlebitis or thrombophlebitis of the accessed vein
Erythema, warmth, and tenderness tracking along the vein indicate phlebitis or thrombophlebitis — inflammation of the vein wall, a known complication of peripherally inserted central catheters.