Pediatric Oncology Nursing Test Bank – Practice
Exam (Questions 1–150)
1. A 5-year-old child is diagnosed with acute lymphoblastic leukemia
(ALL). Which is the most common presenting symptom?
A. Fever and pallor
B. Hematuria
C. Weight gain
D. Headache
A. Fever and pallor
Rationale: Fever and pallor are common initial manifestations of
ALL due to bone marrow suppression causing anemia and
increased infection risk.
2. Which laboratory finding is most consistent with leukemia?
A. Hypercalcemia
B. Pancytopenia
C. Polycythemia
D. Thrombocytosis
B. Pancytopenia
Rationale: Pancytopenia (reduced RBCs, WBCs, and platelets) is
characteristic of leukemia due to marrow infiltration by
malignant cells.
3. The nurse is caring for a child receiving chemotherapy. Which
intervention is priority to prevent infection?
A. Provide high-fiber diet
B. Limit visitors and maintain strict hand hygiene
C. Encourage physical activity
D. Administer antipyretics regularly
B. Limit visitors and maintain strict hand hygiene
, Rationale: Children receiving chemotherapy are
immunocompromised; infection prevention is critical.
4. A child with lymphoma reports painless swelling in the neck.
Which type of lymphoma is most likely?
A. Burkitt lymphoma
B. Hodgkin lymphoma
C. Non-Hodgkin lymphoma
D. ALL
B. Hodgkin lymphoma
Rationale: Hodgkin lymphoma often presents with painless
lymphadenopathy, commonly in the cervical region.
5. What is the primary goal of cancer treatment in children?
A. Palliation only
B. Cure while minimizing long-term effects
C. Symptom control without aggressive therapy
D. Focus on quality of life exclusively
B. Cure while minimizing long-term effects
Rationale: Pediatric oncology aims for cure while reducing
therapy-related toxicities and preserving growth and
development.
6. A child receiving chemotherapy develops mucositis. Which is the
best nursing intervention?
A. Encourage acidic beverages
B. Provide soft, bland foods and maintain oral hygiene
C. Limit fluid intake
D. Apply topical corticosteroids routinely
B. Provide soft, bland foods and maintain oral hygiene
Rationale: Mucositis requires gentle oral care and soft diet to
reduce pain and prevent infection.
,7. Which side effect is most commonly associated with doxorubicin
(Adriamycin)?
A. Neurotoxicity
B. Cardiotoxicity
C. Nephrotoxicity
D. Pulmonary fibrosis
B. Cardiotoxicity
Rationale: Doxorubicin can cause dose-dependent cardiotoxicity;
cardiac monitoring is essential.
8. A child with Wilms tumor presents for surgery. Which
preoperative nursing consideration is priority?
A. Avoid palpating the abdomen
B. Encourage ambulation
C. Administer antipyretics
D. Provide high-protein diet
A. Avoid palpating the abdomen
Rationale: Palpating the abdomen can disrupt a Wilms tumor,
increasing risk of metastasis.
9. Which symptom is most indicative of tumor lysis syndrome?
A. Hyperkalemia, hyperuricemia, hyperphosphatemia
B. Hypokalemia and metabolic alkalosis
C. Hypernatremia and hypocalcemia
D. Hyponatremia only
A. Hyperkalemia, hyperuricemia, hyperphosphatemia
Rationale: Tumor lysis syndrome occurs when rapid cell
destruction releases intracellular electrolytes and nucleic acids,
leading to these imbalances.
10. A nurse is teaching a family about administering oral
chemotherapy at home. Which instruction is most important?
, A. Mix the medication with food
B. Wear gloves when handling medication
C. Allow the child to chew the tablet
D. Store in the refrigerator only
B. Wear gloves when handling medication
Rationale: Chemotherapy agents are cytotoxic; proper PPE
prevents accidental exposure.
11. A 7-year-old child is receiving cisplatin. What is the priority
nursing intervention?
A. Monitor liver function
B. Monitor hearing and renal function
C. Encourage high-sodium diet
D. Limit fluid intake
B. Monitor hearing and renal function
Rationale: Cisplatin can cause nephrotoxicity and ototoxicity;
monitoring is essential.
12. Which laboratory value indicates neutropenia?
A. WBC 12,000/mm³
B. Absolute neutrophil count <500/mm³
C. Platelets 250,000/mm³
D. Hemoglobin 12 g/dL
B. Absolute neutrophil count <500/mm³
Rationale: Severe neutropenia is defined as ANC <500, placing
the child at high risk for infection.
13. A child receiving chemotherapy develops alopecia. What is
the best nursing action?
A. Provide a wig or head covering
B. Recommend a special shampoo to prevent hair loss
C. Encourage daily hair brushing
Exam (Questions 1–150)
1. A 5-year-old child is diagnosed with acute lymphoblastic leukemia
(ALL). Which is the most common presenting symptom?
A. Fever and pallor
B. Hematuria
C. Weight gain
D. Headache
A. Fever and pallor
Rationale: Fever and pallor are common initial manifestations of
ALL due to bone marrow suppression causing anemia and
increased infection risk.
2. Which laboratory finding is most consistent with leukemia?
A. Hypercalcemia
B. Pancytopenia
C. Polycythemia
D. Thrombocytosis
B. Pancytopenia
Rationale: Pancytopenia (reduced RBCs, WBCs, and platelets) is
characteristic of leukemia due to marrow infiltration by
malignant cells.
3. The nurse is caring for a child receiving chemotherapy. Which
intervention is priority to prevent infection?
A. Provide high-fiber diet
B. Limit visitors and maintain strict hand hygiene
C. Encourage physical activity
D. Administer antipyretics regularly
B. Limit visitors and maintain strict hand hygiene
, Rationale: Children receiving chemotherapy are
immunocompromised; infection prevention is critical.
4. A child with lymphoma reports painless swelling in the neck.
Which type of lymphoma is most likely?
A. Burkitt lymphoma
B. Hodgkin lymphoma
C. Non-Hodgkin lymphoma
D. ALL
B. Hodgkin lymphoma
Rationale: Hodgkin lymphoma often presents with painless
lymphadenopathy, commonly in the cervical region.
5. What is the primary goal of cancer treatment in children?
A. Palliation only
B. Cure while minimizing long-term effects
C. Symptom control without aggressive therapy
D. Focus on quality of life exclusively
B. Cure while minimizing long-term effects
Rationale: Pediatric oncology aims for cure while reducing
therapy-related toxicities and preserving growth and
development.
6. A child receiving chemotherapy develops mucositis. Which is the
best nursing intervention?
A. Encourage acidic beverages
B. Provide soft, bland foods and maintain oral hygiene
C. Limit fluid intake
D. Apply topical corticosteroids routinely
B. Provide soft, bland foods and maintain oral hygiene
Rationale: Mucositis requires gentle oral care and soft diet to
reduce pain and prevent infection.
,7. Which side effect is most commonly associated with doxorubicin
(Adriamycin)?
A. Neurotoxicity
B. Cardiotoxicity
C. Nephrotoxicity
D. Pulmonary fibrosis
B. Cardiotoxicity
Rationale: Doxorubicin can cause dose-dependent cardiotoxicity;
cardiac monitoring is essential.
8. A child with Wilms tumor presents for surgery. Which
preoperative nursing consideration is priority?
A. Avoid palpating the abdomen
B. Encourage ambulation
C. Administer antipyretics
D. Provide high-protein diet
A. Avoid palpating the abdomen
Rationale: Palpating the abdomen can disrupt a Wilms tumor,
increasing risk of metastasis.
9. Which symptom is most indicative of tumor lysis syndrome?
A. Hyperkalemia, hyperuricemia, hyperphosphatemia
B. Hypokalemia and metabolic alkalosis
C. Hypernatremia and hypocalcemia
D. Hyponatremia only
A. Hyperkalemia, hyperuricemia, hyperphosphatemia
Rationale: Tumor lysis syndrome occurs when rapid cell
destruction releases intracellular electrolytes and nucleic acids,
leading to these imbalances.
10. A nurse is teaching a family about administering oral
chemotherapy at home. Which instruction is most important?
, A. Mix the medication with food
B. Wear gloves when handling medication
C. Allow the child to chew the tablet
D. Store in the refrigerator only
B. Wear gloves when handling medication
Rationale: Chemotherapy agents are cytotoxic; proper PPE
prevents accidental exposure.
11. A 7-year-old child is receiving cisplatin. What is the priority
nursing intervention?
A. Monitor liver function
B. Monitor hearing and renal function
C. Encourage high-sodium diet
D. Limit fluid intake
B. Monitor hearing and renal function
Rationale: Cisplatin can cause nephrotoxicity and ototoxicity;
monitoring is essential.
12. Which laboratory value indicates neutropenia?
A. WBC 12,000/mm³
B. Absolute neutrophil count <500/mm³
C. Platelets 250,000/mm³
D. Hemoglobin 12 g/dL
B. Absolute neutrophil count <500/mm³
Rationale: Severe neutropenia is defined as ANC <500, placing
the child at high risk for infection.
13. A child receiving chemotherapy develops alopecia. What is
the best nursing action?
A. Provide a wig or head covering
B. Recommend a special shampoo to prevent hair loss
C. Encourage daily hair brushing
