EAQ CHAPTER 44: COMPREHENSIVE PEDIATRIC ONCOLOGY
EXAM REVIEW & PRACTICE QUESTIONS (PERRY’S MATERNAL
CHILD NURSING CARE, 7TH EDITION)
Table of Contents
SECTION DOMAIN APPROX. PAGE
QUESTIONS REFERENCE
SECTION Hematologic Malignancies 15 p. 1290-1300
1 (Leukemia and Lymphoma)
SECTION Solid Tumors (Wilms, 20 p. 1300-1315
2 Neuroblastoma, Bone, Soft
Tissue)
SECTION Central Nervous System 10 p. 1315-1320
3 Tumors and
Retinoblastoma
SECTION Treatment Modalities and 20 p. 1300-1310
4 Chemotherapy Side Effects
SECTION Oncologic Emergencies and 15 p. 1310-1325
5 Supportive Nursing Care
,SECTION 1: HEMATOLOGIC MALIGNANCIES (LEUKEMIA AND
LYMPHOMA)
1. A peripheral white blood cell (WBC) count greater than which value
defines hyperleukocytosis?
A. 25,000/mm3
B. 50,000/mm3
C. 75,000/mm3
D. 100,000/mm3
Correct Answer: D
Rationale: Hyperleukocytosis is defined as a peripheral WBC count
greater than 100,000/mm3. Laboratory values of 25,000, 50,000, or
75,000/mm3 are not high enough to indicate hyperleukocytosis. (p.
1308)
2. Which type of leukemia is characterized by the presence of Reed-
Sternberg cells?
A. Acute lymphoblastic leukemia (ALL)
B. Acute myelogenous leukemia (AML)
C. Hodgkin lymphoma
D. Non-Hodgkin lymphoma
Correct Answer: C
Rationale: Hodgkin lymphoma is characterized by the presence of Reed-
Sternberg cells, which are large, abnormal lymphocytes. ALL and AML
are leukemias, and Non-Hodgkin lymphoma does not typically present
with Reed-Sternberg cells. (p. 1298)
3. What is the peak age of incidence for acute lymphoblastic leukemia
(ALL) in children?
A. 2 to 5 years
,B. 6 to 10 years
C. 11 to 14 years
D. 15 to 18 years
Correct Answer: A
Rationale: Acute lymphoblastic leukemia (ALL) is the most common
childhood cancer, with a peak incidence occurring between 2 and 5
years of age. (p. 1292)
4. Which chemotherapeutic phase is designed to eradicate the bulk of
leukemia cells and achieve remission?
A. Consolidation
B. Maintenance
C. Induction
D. Intensification
Correct Answer: C
Rationale: Induction therapy is the first phase of chemotherapy, aimed
at eradicating the majority of leukemic cells and achieving complete
remission. Consolidation and maintenance follow to eliminate residual
disease and prevent relapse. (p. 1294)
5. A child with acute lymphoblastic leukemia (ALL) is scheduled for
intrathecal methotrexate. What is the primary purpose of this route of
administration?
A. To prevent testicular relapse
B. To treat central nervous system (CNS) disease
C. To reduce systemic side effects
D. To improve bone marrow function
Correct Answer: B
Rationale: Intrathecal administration delivers the chemotherapy directly
into the cerebrospinal fluid to treat or prevent central nervous system
, (CNS) involvement, as systemic chemotherapy often cannot cross the
blood-brain barrier effectively. (p. 1295)
6. Which clinical manifestation is most commonly associated with
hyperleukocytosis in a child with leukemia?
A. Severe anemia
B. Increased risk of bleeding
C. Pulmonary leukostasis
D. Hypercalcemia
Correct Answer: C
Rationale: Hyperleukocytosis can cause leukostasis, where excessive
white blood cells clump together and obstruct blood vessels, leading to
pulmonary distress, neurologic deficits, and other organ damage. (p.
1308)
7. A child is diagnosed with Non-Hodgkin lymphoma (NHL). Which
characteristic distinguishes NHL from Hodgkin lymphoma?
A. Presence of Reed-Sternberg cells
B. More localized presentation
C. Higher incidence of bone marrow involvement
D. Slower progression rate
Correct Answer: C
Rationale: Non-Hodgkin lymphoma in children often presents with
widespread disease and has a higher incidence of bone marrow and
CNS involvement compared to Hodgkin lymphoma, which typically
presents with localized lymphadenopathy. (p. 1299)
8. Which nursing intervention is a priority for a child with leukemia
who has a neutrophil count of 200/mm3?
A. Encourage a high-fiber diet.
EXAM REVIEW & PRACTICE QUESTIONS (PERRY’S MATERNAL
CHILD NURSING CARE, 7TH EDITION)
Table of Contents
SECTION DOMAIN APPROX. PAGE
QUESTIONS REFERENCE
SECTION Hematologic Malignancies 15 p. 1290-1300
1 (Leukemia and Lymphoma)
SECTION Solid Tumors (Wilms, 20 p. 1300-1315
2 Neuroblastoma, Bone, Soft
Tissue)
SECTION Central Nervous System 10 p. 1315-1320
3 Tumors and
Retinoblastoma
SECTION Treatment Modalities and 20 p. 1300-1310
4 Chemotherapy Side Effects
SECTION Oncologic Emergencies and 15 p. 1310-1325
5 Supportive Nursing Care
,SECTION 1: HEMATOLOGIC MALIGNANCIES (LEUKEMIA AND
LYMPHOMA)
1. A peripheral white blood cell (WBC) count greater than which value
defines hyperleukocytosis?
A. 25,000/mm3
B. 50,000/mm3
C. 75,000/mm3
D. 100,000/mm3
Correct Answer: D
Rationale: Hyperleukocytosis is defined as a peripheral WBC count
greater than 100,000/mm3. Laboratory values of 25,000, 50,000, or
75,000/mm3 are not high enough to indicate hyperleukocytosis. (p.
1308)
2. Which type of leukemia is characterized by the presence of Reed-
Sternberg cells?
A. Acute lymphoblastic leukemia (ALL)
B. Acute myelogenous leukemia (AML)
C. Hodgkin lymphoma
D. Non-Hodgkin lymphoma
Correct Answer: C
Rationale: Hodgkin lymphoma is characterized by the presence of Reed-
Sternberg cells, which are large, abnormal lymphocytes. ALL and AML
are leukemias, and Non-Hodgkin lymphoma does not typically present
with Reed-Sternberg cells. (p. 1298)
3. What is the peak age of incidence for acute lymphoblastic leukemia
(ALL) in children?
A. 2 to 5 years
,B. 6 to 10 years
C. 11 to 14 years
D. 15 to 18 years
Correct Answer: A
Rationale: Acute lymphoblastic leukemia (ALL) is the most common
childhood cancer, with a peak incidence occurring between 2 and 5
years of age. (p. 1292)
4. Which chemotherapeutic phase is designed to eradicate the bulk of
leukemia cells and achieve remission?
A. Consolidation
B. Maintenance
C. Induction
D. Intensification
Correct Answer: C
Rationale: Induction therapy is the first phase of chemotherapy, aimed
at eradicating the majority of leukemic cells and achieving complete
remission. Consolidation and maintenance follow to eliminate residual
disease and prevent relapse. (p. 1294)
5. A child with acute lymphoblastic leukemia (ALL) is scheduled for
intrathecal methotrexate. What is the primary purpose of this route of
administration?
A. To prevent testicular relapse
B. To treat central nervous system (CNS) disease
C. To reduce systemic side effects
D. To improve bone marrow function
Correct Answer: B
Rationale: Intrathecal administration delivers the chemotherapy directly
into the cerebrospinal fluid to treat or prevent central nervous system
, (CNS) involvement, as systemic chemotherapy often cannot cross the
blood-brain barrier effectively. (p. 1295)
6. Which clinical manifestation is most commonly associated with
hyperleukocytosis in a child with leukemia?
A. Severe anemia
B. Increased risk of bleeding
C. Pulmonary leukostasis
D. Hypercalcemia
Correct Answer: C
Rationale: Hyperleukocytosis can cause leukostasis, where excessive
white blood cells clump together and obstruct blood vessels, leading to
pulmonary distress, neurologic deficits, and other organ damage. (p.
1308)
7. A child is diagnosed with Non-Hodgkin lymphoma (NHL). Which
characteristic distinguishes NHL from Hodgkin lymphoma?
A. Presence of Reed-Sternberg cells
B. More localized presentation
C. Higher incidence of bone marrow involvement
D. Slower progression rate
Correct Answer: C
Rationale: Non-Hodgkin lymphoma in children often presents with
widespread disease and has a higher incidence of bone marrow and
CNS involvement compared to Hodgkin lymphoma, which typically
presents with localized lymphadenopathy. (p. 1299)
8. Which nursing intervention is a priority for a child with leukemia
who has a neutrophil count of 200/mm3?
A. Encourage a high-fiber diet.
