Certified Pediatric Oncology Nurse (CPON) Practice
Exam Questions And Correct Answers (Verified
Answers) Plus Rationales 2025/2026 Q&A | Instant
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1. Which symptom is most commonly associated with tumor lysis syndrome
(TLS)?
A. Metabolic alkalosis
B. Hypokalemia
C. Hyperphosphatemia
D. Hypouricemia
Italic rationale: TLS causes massive cell breakdown leading to elevated
phosphate, potassium, and uric acid.
2. The most critical nursing action when administering vincristine is to:
A. Use an infusion pump
B. Pre-medicate with antiemetics
C. Verify that the drug is given IV only, never intrathecally
D. Give with high-fat foods
Vincristine given intrathecally is fatal; ensuring correct route is essential.
3. A child receiving doxorubicin is at highest risk for which toxicity?
A. Renal impairment
B. Ototoxicity
C. Pulmonary fibrosis
D. Cardiomyopathy
Anthracyclines can cause dose-dependent cardiac damage.
4. Which lab value indicates neutropenia in a pediatric oncology patient?
,A. ANC 2000
B. ANC 1500
C. ANC 400
D. ANC 1200
ANC <500 = severe neutropenia.
5. A common early sign of increased intracranial pressure in children is:
A. Cushing’s triad
B. Headache upon waking
C. Irregular respirations
D. Dilated, fixed pupils
Early signs include morning headache, vomiting, irritability.
6. What is the priority nursing action for a child with suspected spinal cord
compression?
A. Start IV fluids
B. Insert NG tube
C. Notify provider immediately and prepare for MRI
D. Give antiemetics
Spinal cord compression is an oncologic emergency requiring immediate
imaging.
7. Which vaccine is contraindicated for an immunocompromised oncology
patient?
A. Hepatitis B
B. Tdap
C. MMR
D. Inactivated polio
Live vaccines are contraindicated.
8. A child on methotrexate therapy develops mucositis. Which intervention is
most appropriate?
, A. Alcohol-based mouthwash
B. Frequent saline mouth rinses
C. Tooth brushing avoided
D. High-acid juices
Gentle saline rinses reduce irritation and infection risk.
9. The purpose of leucovorin rescue is to:
A. Enhance chemotherapy absorption
B. Reduce nausea
C. Protect normal cells from methotrexate toxicity
D. Prevent hair loss
Leucovorin counteracts folate depletion.
10. Which lab abnormality is expected in a child with leukemia?
A. High RBC count
B. High platelet count
C. Low hemoglobin
D. Elevated TSH
Bone marrow crowding causes anemia.
11. The most common presenting symptom of leukemia is:
A. Hypertension
B. Tremors
C. Fatigue
D. Constipation
Anemia and systemic illness commonly cause fatigue.
12. For a child receiving cyclophosphamide, which complication requires
monitoring?
A. Ototoxicity
B. Retinopathy
C. Hemorrhagic cystitis
Exam Questions And Correct Answers (Verified
Answers) Plus Rationales 2025/2026 Q&A | Instant
Download Pdf
1. Which symptom is most commonly associated with tumor lysis syndrome
(TLS)?
A. Metabolic alkalosis
B. Hypokalemia
C. Hyperphosphatemia
D. Hypouricemia
Italic rationale: TLS causes massive cell breakdown leading to elevated
phosphate, potassium, and uric acid.
2. The most critical nursing action when administering vincristine is to:
A. Use an infusion pump
B. Pre-medicate with antiemetics
C. Verify that the drug is given IV only, never intrathecally
D. Give with high-fat foods
Vincristine given intrathecally is fatal; ensuring correct route is essential.
3. A child receiving doxorubicin is at highest risk for which toxicity?
A. Renal impairment
B. Ototoxicity
C. Pulmonary fibrosis
D. Cardiomyopathy
Anthracyclines can cause dose-dependent cardiac damage.
4. Which lab value indicates neutropenia in a pediatric oncology patient?
,A. ANC 2000
B. ANC 1500
C. ANC 400
D. ANC 1200
ANC <500 = severe neutropenia.
5. A common early sign of increased intracranial pressure in children is:
A. Cushing’s triad
B. Headache upon waking
C. Irregular respirations
D. Dilated, fixed pupils
Early signs include morning headache, vomiting, irritability.
6. What is the priority nursing action for a child with suspected spinal cord
compression?
A. Start IV fluids
B. Insert NG tube
C. Notify provider immediately and prepare for MRI
D. Give antiemetics
Spinal cord compression is an oncologic emergency requiring immediate
imaging.
7. Which vaccine is contraindicated for an immunocompromised oncology
patient?
A. Hepatitis B
B. Tdap
C. MMR
D. Inactivated polio
Live vaccines are contraindicated.
8. A child on methotrexate therapy develops mucositis. Which intervention is
most appropriate?
, A. Alcohol-based mouthwash
B. Frequent saline mouth rinses
C. Tooth brushing avoided
D. High-acid juices
Gentle saline rinses reduce irritation and infection risk.
9. The purpose of leucovorin rescue is to:
A. Enhance chemotherapy absorption
B. Reduce nausea
C. Protect normal cells from methotrexate toxicity
D. Prevent hair loss
Leucovorin counteracts folate depletion.
10. Which lab abnormality is expected in a child with leukemia?
A. High RBC count
B. High platelet count
C. Low hemoglobin
D. Elevated TSH
Bone marrow crowding causes anemia.
11. The most common presenting symptom of leukemia is:
A. Hypertension
B. Tremors
C. Fatigue
D. Constipation
Anemia and systemic illness commonly cause fatigue.
12. For a child receiving cyclophosphamide, which complication requires
monitoring?
A. Ototoxicity
B. Retinopathy
C. Hemorrhagic cystitis
