Peds Hematology | Questions with 100% Verified Answers |
Latest Update 2026/2027
Question: 1. The nurse is caring for a 16-year-old boy with acute
myelogenous leukemia who is having chemotherapy and who has incomplete records for varicella zoster
immunization. Which is the priority nursing diagnosis?
A) Pain related to adverse effects of treatment verbalized by
the child
B) Nausea related to side effects of chemotherapy verbalized
by the child
C) Constipation related to the use of opioid analgesics for
pain
D) Risk for infection related to neutropenia and
immunosuppression
Answer: Ans: D Feedback: The priority nursing diagnosis is risk for infection related to neutropenia and
immunosuppression. The incomplete records for varicella zoster immunization can cause a problem since
exposure to chickenpox could cause sepsis, so the nurse should contact the oncologist for approval to
administer the vaccine. Certain vaccines are not administered when the child is immunosuppressed, so timing
is crucial. Diagnoses for pain and nausea are valid for this child because he is undergoing chemotherapy, but
they are not a priority. Likewise, the need for constipation management would not be necessary unless opioid
use begins.
Question: 2. The nurse is caring for an 8-year-old girl who has been
diagnosed with leukemia and will have a variety of tests, including a lumbar puncture, before beginning
chemotherapy. What action would be the priority?
A) Applying EMLA to the lumbar puncture site
B) Educating the child and family about the testing procedures
C) Administering promethazine as ordered for nausea
D) Educating the family about chemotherapy and its side
effects
Answer: Ans: B Feedback: The priority would be educating the child and family about the testing procedures so
they know what to expect and understand why the tests are being performed. Applying EMLA to the lumbar
puncture site will be done prior to the procedure. The family will be educated about chemotherapy and its side
effects prior to the therapy beginning, and promethazine or other antiemetics will be administered once
chemotherapy has begun.
Question: 3. The nurse is caring for a 13-year-old boy with acute
myelogenous leukemia who is experiencing feelings of powerlessness due to the effects of chemotherapy.
What intervention will best help the teen's sense of control?
A) Involving the boy in decisions whenever possible
B) Acknowledging the boy's feelings of anger with the disease
C) Providing realistic expectations of treatments and
outcomes
D) Recognizing abilities that are unaffected by the disease
Answer: Ans: A Feedback: Involving the boy in the decision-making process will best help his sense of control.
Whether he is included in important decisions about therapy or minor decisions like menus or dress, it will give
him a sense of control over his situation. Acknowledging feelings of anger, recognizing his abilities, and
providing realistic expectations will reduce body image disturbance and build self-esteem.
, Question: 4. The nurse is caring for a 5-year-old girl with a disseminated
medulloblastoma. What intervention would be most appropriate for this situation?
A) Providing emotional support to the parents and siblings of
the child
B) Recommending support groups for people whose children
have cancer
C) Encouraging the family to cry and express feelings away
from the child
D) Educating the family about the disease, its treatments, and
side effects
Answer: Ans: C Feedback: The outcome of this highly malignant medulloblastoma is often not positive. Helping
the family through anticipatory grieving by encouraging the family to cry and express feelings away from the
child would be unique to this child's situation. Educating the family about the disease, its treatments, and side
effects; recommending support groups; and providing emotional support to the parents and siblings would be
appropriate for any child with cancer.
Question: 9. The nurse is caring for a 7-year-old girl who is undergoing a
stem cell transplant. What information would the nurse include in the child's postoperative plan of care?
A) Assessing for petechiae, purpura, bruising, or bleeding
B) Limiting blood draws to the minimum volume required
C) Administering antiemetics around the clock as ordered
D) Monitoring for severe diarrhea and maculopapular rash
Answer: Ans: D Feedback: In the posttransplant phase, monitor closely for symptoms of graft-versus-host
disease (GVHD) such as severe diarrhea and maculopapular rash progressing to redness or desquamation of
the skin (especially on the palms of the hands or soles of the feet). During chemotherapy in the pretransplant
phase, assess for petechiae, purpura, bruising, or bleeding to prevent hemorrhage; administer antiemetics
around the clock as ordered to prevent the cycle of nausea, vomiting, and anorexia; and limit blood draws to
the minimum volume required to prevent anemia.
Question: 16. The parents bring their 4-year-old son to the emergency
department. The child is receiving chemotherapy for acute lymphoblastic leukemia. The parents report that the
child has become lethargic and has had significant episodes of vomiting and diarrhea. Why findings would lead
the nurse to suspect the child may be experiencing tumor lysis syndrome? Select all answers that apply.
A) Hyperkalemia
B) Hypophosphatemia
C) Polyuria
D) Hypocalcemia
E) Hyperuricemia
Answer: Ans: A, D, E Feedback: Tumor lysis syndrome is characterized by hyperuricemia, hyperkalemia,
hyperphosphatemia, decreased or absent urine output, and hypocalcemia.
Question: 24. A nurse is instituting neutropenic precautions for a child.
What information would the nurse most likely include? Select all that apply.
A) Placing the child in a semiprivate room
B) Avoiding rectal exams, suppositories, and enemas
C) Placing a mask on the child when outside the room
D) Encouraging an intake of raw fruits and vegetables
E) Discouraging fresh flowers in the child's room
Answer: Ans: B, C, E Feedback: Generally, neutropenic precautions include placing the child in a private room;
avoiding rectal suppositories, enemas, and examinations; placing a mask on the child when outside the room;
avoiding the intake of raw fruits and vegetables; and not permitting fresh flowers or live plants in the room.
Latest Update 2026/2027
Question: 1. The nurse is caring for a 16-year-old boy with acute
myelogenous leukemia who is having chemotherapy and who has incomplete records for varicella zoster
immunization. Which is the priority nursing diagnosis?
A) Pain related to adverse effects of treatment verbalized by
the child
B) Nausea related to side effects of chemotherapy verbalized
by the child
C) Constipation related to the use of opioid analgesics for
pain
D) Risk for infection related to neutropenia and
immunosuppression
Answer: Ans: D Feedback: The priority nursing diagnosis is risk for infection related to neutropenia and
immunosuppression. The incomplete records for varicella zoster immunization can cause a problem since
exposure to chickenpox could cause sepsis, so the nurse should contact the oncologist for approval to
administer the vaccine. Certain vaccines are not administered when the child is immunosuppressed, so timing
is crucial. Diagnoses for pain and nausea are valid for this child because he is undergoing chemotherapy, but
they are not a priority. Likewise, the need for constipation management would not be necessary unless opioid
use begins.
Question: 2. The nurse is caring for an 8-year-old girl who has been
diagnosed with leukemia and will have a variety of tests, including a lumbar puncture, before beginning
chemotherapy. What action would be the priority?
A) Applying EMLA to the lumbar puncture site
B) Educating the child and family about the testing procedures
C) Administering promethazine as ordered for nausea
D) Educating the family about chemotherapy and its side
effects
Answer: Ans: B Feedback: The priority would be educating the child and family about the testing procedures so
they know what to expect and understand why the tests are being performed. Applying EMLA to the lumbar
puncture site will be done prior to the procedure. The family will be educated about chemotherapy and its side
effects prior to the therapy beginning, and promethazine or other antiemetics will be administered once
chemotherapy has begun.
Question: 3. The nurse is caring for a 13-year-old boy with acute
myelogenous leukemia who is experiencing feelings of powerlessness due to the effects of chemotherapy.
What intervention will best help the teen's sense of control?
A) Involving the boy in decisions whenever possible
B) Acknowledging the boy's feelings of anger with the disease
C) Providing realistic expectations of treatments and
outcomes
D) Recognizing abilities that are unaffected by the disease
Answer: Ans: A Feedback: Involving the boy in the decision-making process will best help his sense of control.
Whether he is included in important decisions about therapy or minor decisions like menus or dress, it will give
him a sense of control over his situation. Acknowledging feelings of anger, recognizing his abilities, and
providing realistic expectations will reduce body image disturbance and build self-esteem.
, Question: 4. The nurse is caring for a 5-year-old girl with a disseminated
medulloblastoma. What intervention would be most appropriate for this situation?
A) Providing emotional support to the parents and siblings of
the child
B) Recommending support groups for people whose children
have cancer
C) Encouraging the family to cry and express feelings away
from the child
D) Educating the family about the disease, its treatments, and
side effects
Answer: Ans: C Feedback: The outcome of this highly malignant medulloblastoma is often not positive. Helping
the family through anticipatory grieving by encouraging the family to cry and express feelings away from the
child would be unique to this child's situation. Educating the family about the disease, its treatments, and side
effects; recommending support groups; and providing emotional support to the parents and siblings would be
appropriate for any child with cancer.
Question: 9. The nurse is caring for a 7-year-old girl who is undergoing a
stem cell transplant. What information would the nurse include in the child's postoperative plan of care?
A) Assessing for petechiae, purpura, bruising, or bleeding
B) Limiting blood draws to the minimum volume required
C) Administering antiemetics around the clock as ordered
D) Monitoring for severe diarrhea and maculopapular rash
Answer: Ans: D Feedback: In the posttransplant phase, monitor closely for symptoms of graft-versus-host
disease (GVHD) such as severe diarrhea and maculopapular rash progressing to redness or desquamation of
the skin (especially on the palms of the hands or soles of the feet). During chemotherapy in the pretransplant
phase, assess for petechiae, purpura, bruising, or bleeding to prevent hemorrhage; administer antiemetics
around the clock as ordered to prevent the cycle of nausea, vomiting, and anorexia; and limit blood draws to
the minimum volume required to prevent anemia.
Question: 16. The parents bring their 4-year-old son to the emergency
department. The child is receiving chemotherapy for acute lymphoblastic leukemia. The parents report that the
child has become lethargic and has had significant episodes of vomiting and diarrhea. Why findings would lead
the nurse to suspect the child may be experiencing tumor lysis syndrome? Select all answers that apply.
A) Hyperkalemia
B) Hypophosphatemia
C) Polyuria
D) Hypocalcemia
E) Hyperuricemia
Answer: Ans: A, D, E Feedback: Tumor lysis syndrome is characterized by hyperuricemia, hyperkalemia,
hyperphosphatemia, decreased or absent urine output, and hypocalcemia.
Question: 24. A nurse is instituting neutropenic precautions for a child.
What information would the nurse most likely include? Select all that apply.
A) Placing the child in a semiprivate room
B) Avoiding rectal exams, suppositories, and enemas
C) Placing a mask on the child when outside the room
D) Encouraging an intake of raw fruits and vegetables
E) Discouraging fresh flowers in the child's room
Answer: Ans: B, C, E Feedback: Generally, neutropenic precautions include placing the child in a private room;
avoiding rectal suppositories, enemas, and examinations; placing a mask on the child when outside the room;
avoiding the intake of raw fruits and vegetables; and not permitting fresh flowers or live plants in the room.
