CPHON Exam Prep: Certified Pediatric Hematology Oncology Nurse (ONCC) Study Guide + 2,100+ Practice Questions

A 4-year-old patient with a mediastinal tumor is experiencing respiratory distress and facial cyanosis. The medical team is preparing for emergency radiation to shrink the mass and alleviate the Superior Vena Cava Syndrome. Which nursing consideration is most important during the preparation for this procedure?

A 4-year-old child with a recent diagnosis of a hematologic malignancy is being evaluated for anemia. The nurse notes the child is a “picky eater” who consumes large amounts of cow’s milk. Which laboratory value would most specifically indicate that the anemia is due to nutritional deficiency rather than chronic disease?

A 12-year-old child with a chronic hematologic disorder presents with a height that has dropped from the 25th to the 5th percentile over the last year. The patient is currently at Tanner Stage 1 for puberty. What is the most appropriate initial nursing action to address this growth pattern?

A 10-year-old patient who is severely immunocompromised following intensive therapy is being discharged. The nurse is providing education regarding food safety and the prevention of foodborne illnesses. Which instruction should be included as a primary evidence-based recommendation?

A 5-year-old child who has experienced a 15% unintentional weight loss over the last month is starting intensive nutritional rehabilitation. Within the first 48 hours of increased caloric intake, the nurse should prioritize monitoring for which laboratory abnormality associated with metabolic shifts?

A 14-year-old patient experiencing severe oral mucositis and grade 3 esophagitis is unable to tolerate oral intake due to pain. The clinical exam reveals active bowel sounds, no abdominal distension, and regular bowel movements. Which nutritional intervention is most appropriate for this patient to maintain mucosal integrity?

An 8-year-old child with a large mediastinal mass and superior vena cava syndrome is admitted for treatment. The nurse notes the child has visible muscle wasting in the extremities but maintains a stable weight and has significant facial and upper body edema. Which assessment method provides the most accurate evaluation of this patient’s nutritional status?

A family living in a rural area must travel three hours each way for their child’s weekly outpatient infusions. The father recently lost his job, and the mother is the primary caregiver for three other young children. The nurse notices the family has missed two consecutive appointments. What is the most effective nursing intervention?

A 12-year-old patient is preparing to return to school after a prolonged hospitalization for intensive therapy. The patient is anxious about classmates’ reactions to hair loss and weight changes. The family is concerned about the patient’s social reintegration and potential bullying. Which action should the nurse prioritize?

The parents of a toddler recently diagnosed with a hematologic malignancy express intense guilt, questioning if environmental exposures or their delay in seeking care caused the illness. They are now hovering over the staff and questioning every minor adjustment in the care plan. What is the most appropriate nursing response?

A 4-year-old patient becomes extremely combative and tearful whenever the medical team approaches for routine physical assessments or vital signs. The parents report feeling helpless and are considering staying away during procedures to avoid seeing their child in distress. Which strategy should the nurse implement?

A 15-year-old patient expresses a desire to discuss the impact of treatment on future reproductive health. The parents pull the nurse aside and request that this information be withheld to avoid causing the patient unnecessary distress during an already difficult induction phase. How should the nurse proceed to balance these conflicting needs?

An 8-year-old sibling of a patient receiving intensive medical therapy begins experiencing nocturnal enuresis and academic decline. The parents are currently spending most nights at the hospital and feel overwhelmed by the patient’s complex care requirements. Which intervention should the nurse suggest to best support the sibling’s adjustment?

A 10-year-old with a mediastinal mass is displaying signs of Superior Vena Cava Syndrome. The nurse identifies that the child has developed a persistent headache and blurred vision since the morning assessment. Which nursing intervention should be prioritized to manage these symptoms?

A 17-year-old female with Hodgkin lymphoma presents with a feeling of fullness in her neck and visible collateral venous circulation across her chest wall. She requires blood draws and intravenous supportive care. Which nursing action is most appropriate for managing her vascular access?

A 6-year-old child with a tunneled central venous catheter experiences significant resistance when the nurse attempts to flush the line while the child is sitting upright. However, the catheter flushes easily when the child leans back and raises the ipsilateral arm. The nurse suspects a mechanical complication related to the catheter’s anatomical path.

A 12-year-old girl with an anterior mediastinal mass is being monitored for worsening Superior Vena Cava Syndrome. During the shift assessment, the nurse observes new-onset swelling of the upper extremities and a dusky hue to the skin above the waist. Which assessment is the most critical for the nurse to perform next?

A 6-year-old child with a suspected T-cell malignancy exhibits distended neck veins and a plethoric facial appearance. The nurse notes that the child is increasingly restless and prefers to sit leaning forward on an overbed table. Which approach should the nurse take regarding the child’s positioning?

A 15-year-old male with a newly diagnosed mediastinal mass presents with periorbital edema and a persistent non-productive cough. While lying supine for a chest radiograph, he reports sudden lightheadedness and increased difficulty breathing. Which action should the nurse take to address these clinical changes?

A 12-year-old child with a chronic condition is experiencing significant physical changes, including hair loss and weight fluctuations, due to the ongoing treatment regimen. The child has started wearing oversized clothing and refuses to participate in video calls with friends. What is the most effective nursing action to support this child’s social development?

A 5-year-old child is preparing for a scheduled diagnostic procedure. During the assessment, the child tells the nurse, “I got sick because I was mean to my little brother yesterday.” Which response by the nurse best addresses the child’s cognitive and developmental understanding of their illness?

A 7-month-old infant requires a prolonged hospitalization for the management of a chronic condition. The nurse observes that the infant has become increasingly withdrawn, rarely makes eye contact, and does not cry when the parents leave the room. Which nursing intervention is most appropriate to support the infant’s primary developmental task?

A 15-year-old adolescent with a chronic illness is becoming increasingly non-adherent with the daily supportive care regimen. The adolescent states, “I just want to be a normal teenager and not have to think about being sick all the time.” When planning care, how should the nurse best incorporate the developmental needs of this patient?

An 8-year-old child with a chronic blood disorder has missed significant amounts of school due to frequent medical appointments and fatigue. During a clinic visit, the child expresses feeling “stupid” because classmates are learning multiplication while the child is struggling to keep up. Which approach by the nurse most effectively addresses this child’s developmental stage?

A 3-year-old child who has been hospitalized for several weeks for a chronic hematologic condition begins to experience regression, specifically refusing to use the toilet and demanding a bottle. The parents express significant frustration and concern regarding this loss of previously mastered milestones. Which intervention should the nurse implement to best support the developmental needs of this child?

A 17-year-old with a tunneled central venous catheter is sitting upright in a chair while the nurse performs a routine needleless connector change. Suddenly, the patient develops acute shortness of breath, becomes tachycardic, and reports feeling a sense of impending doom.

A 2-year-old child has a 3-French neonatal peripherally inserted central catheter. The nurse notes the line is slightly sluggish. To maintain catheter integrity and avoid excessive intraluminal pressure during the patency assessment, the nurse selects specific supplies.

A 9-year-old oncology patient with a double-lumen tunneled catheter develops sudden rigors and a temperature of 38.8°C approximately fifteen minutes after the nurse begins a saline flush of the distal lumen. The patient was previously afebrile and appearing well.

A 4-year-old with an implanted port is receiving a continuous intravenous hydration infusion. During the hourly assessment, the nurse observes new-onset edema and coolness at the needle insertion site, although the infusion pump is not currently alarming for high pressure.

A 12-year-old patient with a peripherally inserted central catheter reports a “gurgling” sound in the ear and a mild headache during a routine saline flush. The nurse notes that the external measurement of the catheter has increased by 3 centimeters since the previous assessment.