CPHON Pediatric Hematology Oncology Nurse 2

Question 1

A child with ALL is receiving intrathecal methotrexate. Which adverse effect is most specific to this route of administration?

Accepted Answer

Arachnoiditis

Answer

Intrathecal methotrexate can cause chemical arachnoiditis, presenting with headache, fever, and meningismus shortly after administration.

Question 2

When caring for a child receiving high-dose cytarabine (Ara-C), which ocular prophylaxis is routinely administered?

Accepted Answer

Steroid eye drops

Answer

Steroid (dexamethasone) eye drops are given prophylactically to prevent cytarabine-induced conjunctivitis and keratitis.

Question 3

A 9-year-old with Hodgkin lymphoma has a mediastinal mass. Which pre-anesthesia concern is most critical?

Accepted Answer

Risk of airway compression under anesthesia

Answer

Mediastinal masses can compress the trachea or great vessels, making general anesthesia extremely dangerous due to loss of airway tone.

Question 4

Which hematologic finding is most consistent with disseminated intravascular coagulation (DIC) in a pediatric oncology patient?

Accepted Answer

Elevated D-dimer with prolonged PT/PTT and low fibrinogen

Answer

DIC is characterized by simultaneous clotting and bleeding, resulting in elevated D-dimer, prolonged clotting times, and consumed fibrinogen.

Question 5

A toddler with Wilms tumor is post-nephrectomy. Which blood pressure parameter requires close monitoring?

Accepted Answer

Hypertension due to remaining kidney compensation

Answer

After unilateral nephrectomy, the remaining kidney may produce excess renin, leading to hypertension that requires close monitoring.

CPHON Exam Practice Test