2026 GRADED A+ EXAM
NUR 254 Exam 4: Pediatric Hematology, Oncology, and Neurosensory Nursing
Care 2025 [4 VERSIONS]
NUR 254 Exam 4 Review – Hematology & Oncology
1. A patient with leukemia has a WBC count of 2,000/mm³. What is the primary nursing concern?
A) Risk for bleeding
B) Risk for infection
C) Fluid overload
D) Hyperkalemia
Answer: B) Risk for infection
Rationale: Leukopenia increases susceptibility to infections; strict infection precautions are
essential.
2. True or False: Thrombocytopenia increases the risk of bleeding.
Answer: True
Rationale: Low platelet counts impair clotting, increasing the risk of spontaneous or traumatic
bleeding.
3. Scenario: A patient receiving chemotherapy reports fatigue, pallor, and shortness of breath.
Which lab value should the nurse review first?
Answer: Hemoglobin and hematocrit
Rationale: These symptoms suggest anemia, a common side effect of chemotherapy.
4. Which is a common side effect of radiation therapy?
A) Alopecia
B) Hypertension
,2026 GRADED A+ EXAM
C) Hyperglycemia
D) Bradycardia
Answer: A) Alopecia
Rationale: Radiation targets rapidly dividing cells, including hair follicles, causing hair loss.
5. True or False: Neutropenic patients should avoid fresh flowers and raw fruits.
Answer: True
Rationale: These items may harbor bacteria or fungi, increasing infection risk.
6. Which intervention is appropriate for a patient with anemia from chemotherapy?
A) Encourage high-protein diet
B) Administer prescribed iron or erythropoietin
C) Limit fluids
D) Restrict activity completely
Answer: B) Administer prescribed iron or erythropoietin
Rationale: Supports RBC production; activity may need modification, but not total restriction.
7. Scenario: A patient with lymphoma reports new bruising and nosebleeds. What is the priority
nursing action?
Answer: Assess platelet count
Rationale: Symptoms suggest thrombocytopenia; monitoring platelets guides interventions.
8. Which lab value indicates neutropenia?
A) ANC 1,500/mm³
B) ANC 800/mm³
C) ANC 3,000/mm³
D) ANC 5,000/mm³
Answer: B) ANC 800/mm³
Rationale: Absolute neutrophil count <1,000/mm³ indicates neutropenia; <500/mm³ is severe.
,2026 GRADED A+ EXAM
9. True or False: A patient with multiple myeloma is at risk for hypercalcemia.
Answer: True
Rationale: Bone breakdown releases calcium, increasing serum calcium levels.
10. Which symptom is most concerning in a patient receiving chemotherapy?
A) Mild nausea
B) Persistent fever of 101.5°F
C) Fatigue
D) Hair loss
Answer: B) Persistent fever of 101.5°F
Rationale: Fever may indicate infection in an immunocompromised patient and requires urgent
attention.
11. Scenario: A patient with anemia is prescribed a blood transfusion. Which pre-transfusion
intervention is critical?
Answer: Verify blood type and crossmatch, assess vitals, and obtain informed consent
Rationale: Prevents hemolytic reactions and ensures patient safety.
12. True or False: Platelet transfusions are typically indicated when platelets fall below
20,000/mm³.
Answer: True
Rationale: Transfusions reduce risk of spontaneous bleeding in severe thrombocytopenia.
13. Which medication is commonly used to manage hyperuricemia in leukemia patients
undergoing chemotherapy?
A) Allopurinol
B) Furosemide
C) Metoprolol
D) Insulin
Answer: A) Allopurinol
Rationale: Prevents uric acid buildup from tumor lysis syndrome.
, 2026 GRADED A+ EXAM
14. Scenario: A patient with cancer reports severe nausea and vomiting after chemotherapy.
What is the most effective nursing intervention?
Answer: Administer antiemetic prior to chemotherapy and as scheduled
Rationale: Prophylactic antiemetics reduce severity and improve patient comfort.
15. True or False: Fatigue in oncology patients is usually relieved by rest alone.
Answer: False
Rationale: Fatigue is multifactorial (anemia, treatment effects, nutrition) and may require
multiple interventions.
16. Which lab value is most important to monitor in a patient at risk for tumor lysis syndrome?
A) Serum potassium
B) Hemoglobin
C) Platelets
D) INR
Answer: A) Serum potassium
Rationale: Rapid cell breakdown can cause hyperkalemia, which is life-threatening.
17. Scenario: A patient with leukemia has ANC of 400/mm³. What precautions should the nurse
implement?
Answer: Neutropenic precautions, including strict hand hygiene, private room, limited visitors,
and no fresh flowers or raw foods
Rationale: Reduces risk of severe infection in severely immunocompromised patients.
18. True or False: Alopecia caused by chemotherapy is usually permanent.
Answer: False
Rationale: Hair loss is usually temporary; hair often regrows after treatment ends.
NUR 254 Exam 4: Pediatric Hematology, Oncology, and Neurosensory Nursing
Care 2025 [4 VERSIONS]
NUR 254 Exam 4 Review – Hematology & Oncology
1. A patient with leukemia has a WBC count of 2,000/mm³. What is the primary nursing concern?
A) Risk for bleeding
B) Risk for infection
C) Fluid overload
D) Hyperkalemia
Answer: B) Risk for infection
Rationale: Leukopenia increases susceptibility to infections; strict infection precautions are
essential.
2. True or False: Thrombocytopenia increases the risk of bleeding.
Answer: True
Rationale: Low platelet counts impair clotting, increasing the risk of spontaneous or traumatic
bleeding.
3. Scenario: A patient receiving chemotherapy reports fatigue, pallor, and shortness of breath.
Which lab value should the nurse review first?
Answer: Hemoglobin and hematocrit
Rationale: These symptoms suggest anemia, a common side effect of chemotherapy.
4. Which is a common side effect of radiation therapy?
A) Alopecia
B) Hypertension
,2026 GRADED A+ EXAM
C) Hyperglycemia
D) Bradycardia
Answer: A) Alopecia
Rationale: Radiation targets rapidly dividing cells, including hair follicles, causing hair loss.
5. True or False: Neutropenic patients should avoid fresh flowers and raw fruits.
Answer: True
Rationale: These items may harbor bacteria or fungi, increasing infection risk.
6. Which intervention is appropriate for a patient with anemia from chemotherapy?
A) Encourage high-protein diet
B) Administer prescribed iron or erythropoietin
C) Limit fluids
D) Restrict activity completely
Answer: B) Administer prescribed iron or erythropoietin
Rationale: Supports RBC production; activity may need modification, but not total restriction.
7. Scenario: A patient with lymphoma reports new bruising and nosebleeds. What is the priority
nursing action?
Answer: Assess platelet count
Rationale: Symptoms suggest thrombocytopenia; monitoring platelets guides interventions.
8. Which lab value indicates neutropenia?
A) ANC 1,500/mm³
B) ANC 800/mm³
C) ANC 3,000/mm³
D) ANC 5,000/mm³
Answer: B) ANC 800/mm³
Rationale: Absolute neutrophil count <1,000/mm³ indicates neutropenia; <500/mm³ is severe.
,2026 GRADED A+ EXAM
9. True or False: A patient with multiple myeloma is at risk for hypercalcemia.
Answer: True
Rationale: Bone breakdown releases calcium, increasing serum calcium levels.
10. Which symptom is most concerning in a patient receiving chemotherapy?
A) Mild nausea
B) Persistent fever of 101.5°F
C) Fatigue
D) Hair loss
Answer: B) Persistent fever of 101.5°F
Rationale: Fever may indicate infection in an immunocompromised patient and requires urgent
attention.
11. Scenario: A patient with anemia is prescribed a blood transfusion. Which pre-transfusion
intervention is critical?
Answer: Verify blood type and crossmatch, assess vitals, and obtain informed consent
Rationale: Prevents hemolytic reactions and ensures patient safety.
12. True or False: Platelet transfusions are typically indicated when platelets fall below
20,000/mm³.
Answer: True
Rationale: Transfusions reduce risk of spontaneous bleeding in severe thrombocytopenia.
13. Which medication is commonly used to manage hyperuricemia in leukemia patients
undergoing chemotherapy?
A) Allopurinol
B) Furosemide
C) Metoprolol
D) Insulin
Answer: A) Allopurinol
Rationale: Prevents uric acid buildup from tumor lysis syndrome.
, 2026 GRADED A+ EXAM
14. Scenario: A patient with cancer reports severe nausea and vomiting after chemotherapy.
What is the most effective nursing intervention?
Answer: Administer antiemetic prior to chemotherapy and as scheduled
Rationale: Prophylactic antiemetics reduce severity and improve patient comfort.
15. True or False: Fatigue in oncology patients is usually relieved by rest alone.
Answer: False
Rationale: Fatigue is multifactorial (anemia, treatment effects, nutrition) and may require
multiple interventions.
16. Which lab value is most important to monitor in a patient at risk for tumor lysis syndrome?
A) Serum potassium
B) Hemoglobin
C) Platelets
D) INR
Answer: A) Serum potassium
Rationale: Rapid cell breakdown can cause hyperkalemia, which is life-threatening.
17. Scenario: A patient with leukemia has ANC of 400/mm³. What precautions should the nurse
implement?
Answer: Neutropenic precautions, including strict hand hygiene, private room, limited visitors,
and no fresh flowers or raw foods
Rationale: Reduces risk of severe infection in severely immunocompromised patients.
18. True or False: Alopecia caused by chemotherapy is usually permanent.
Answer: False
Rationale: Hair loss is usually temporary; hair often regrows after treatment ends.
