CPHON Practice Exam 50 Questions A with Verified Answers
BEARS - The BEARS tools assesses the child's sleep history with respect to Bedtime, Excessive
... [Show More] daytime sleepiness, Awakenings, Regularity and Snoring. - CORRECT ANSWER Parents report that their school- aged child with leukemia is not sleeping well at home. Which tool is used to assess for sleep disturbance?
Autonomy versus doubt - Psychosocial autonomy versus doubt is the developmental task of a toddler. - CORRECT ANSWER Which of the following describes the developmental stage of a toddler?
Denial allows the patient to maintain hope in order to function productively. - CORRECT ANSWER The nurse notices that a 13-year- old has been cheerful since learning of her cancer diagnosis, avoids discussing her illness and treatment, and allows her parents ask all the questions. The best interpretation of her behavior is that the patient is:
Be emotionally involved and available to the teen. - CORRECT ANSWER The parent of an adolescent with cancer seeks advice on how to best promote the emotional well- being of the child while receiving therapy. The nurse's best advice to the parent is to?
Translocation of B-cell immunoglobulin genes - Burkitt lymphoma and Burkitt-like lymphoma are characterized by the chromosomal translocation of B-cell immunoglobulin - CORRECT ANSWER Which of the following is a cytogenetic feature for a patient diagnosed with Burkitt lymphoma?
Localized nodal disease - Involvement of a single lymph node is a favorable prognostic indicator. The presence of B symptoms, male gender, and an elevated sedimentation rate are considered unfavorable prognostic indicators. - CORRECT ANSWER What is a favorable prognostic indicator for a child diagnosed with Hodgkin lymphoma?
Langerhans cell histiocytosis - CORRECT ANSWER Which of the following is a disorder of dendritic cells?
Vagus - Brainstem gliomas effect cranial nerves V-X, and are located below the tentorium cerebelli. - CORRECT ANSWER Which nerve will most likely be compromised for a child diagnosed witha brainstem glioma?
Oncogenes promote cell growth and prevent apoptosis. - CORRECT ANSWER Oncogenes transform normal cells in to cancer cells by which of the following actions?
Abdominal lymphomas are at increased risk for tumor lysis syndrome and bowel obstruction - CORRECT ANSWER A patient with non-Hodgkin lymphoma with abdominal involvement is at greatest risk for which of the following complications?
Leukocyte-reduction prevents the transmission of cytomegalovirus - CORRECT ANSWER Blood products are leukocyte- reduced to prevent which of the following?
50GY - CORRECT ANSWER Moist desquamation of the skin occurs with radiation doses of:
1000 mg/m2 of intravenous cytarabine - CORRECT ANSWER Which of the following doses of medication is most likely associated with neurocognitive sequelae?
Signs of precocious puberty include advanced bone age, early onset breast development, early epiphyseal fusion, short stature. - CORRECT ANSWER Which of the following is an indication that a child is experiencing precocious puberty?
"Which therapies have you looked in to?" Nurses should encourage open communication with families about complementary therapies. Nurses should assess which therapies the patient would like to have more information about. - CORRECT ANSWER After receiving treatment information, the parents of a child recently diagnosed with cancer ask if complementary and alternative treatments are an option. What is the nurse's best response?
The mechanism of action determines how the medication is classified. - CORRECT ANSWER Chemotherapy medications are either cell-cycle specific or nonspecific as determined by the medication's?
Verify that the product is leukocyte-reduced - CORRECT ANSWER Which of the following is the most important action for the nurse to take prior to beginning the first platelet transfusion for a patient with leukemia?
Decreased incidence of graft-versus-host disease - The potential for a low incidence of graft-versus-host-disease (GVHD) may be one of the most important advantages for using umbilical cord blood - CORRECT ANSWER Which of the following is an advantage of cord blood transplantation?
"It is contraindicated with your child's treatment plan." Echinacea, antioxidants and immune-enhancing herbal therapies are contraindicated during bone marrow transplant. - CORRECT ANSWER Parents ask the nurse if echinacea supplements can be administered prior to their child's allogeneic stem transplant. What is the nurse's best response?
Nephrotoxicity - Cisplatin intensifies aminoglycoside toxicity and should be used in caution when administered concurrently with gentamicin. - CORRECT ANSWER What is a potential risk for patients receiving gentamicin concurrently with cisplatin?
The current treatment plan will provide the best possible outcome. "What concerns do you have?" Parents should verbalize the understanding of the primary diagnosis and treatment plan. - CORRECT ANSWER A patient with cancer has just completed scans to evaluate the response to treatment. The patient's mother states, "Now that the tumor is almost gone, can we switch to a less aggressive protocol?" Which of the following is the nurse's best response?
Anemia - The clinical presentation of anemia includes: behavioral changes, skin color changes, dyspnea, and tachycardia - CORRECT ANSWER A child presents to the clinic with malaise, dizziness, jaundice, dyspnea, and tachycardia. What does the nurse anticipate the laboratory results will reveal?
a bolus of isotonic fluids- Septic shock can quickly lead to decreased tissue perfusion, cellular hypoxia, and death. Volume resuscitation is critical for management of patients experiencing septic shock. - CORRECT ANSWER What is the initial intervention for a patient with neutropenia who develops fever and hypotension? Administer:
Pneumocystis jiroveci is a yeast- like fungus that cause pneumocystis jiroveci pneumonia (PCP) in immunocompromised patients. - CORRECT ANSWER What protozoal organism is responsible for causing respiratory distress, tachypnea, and fever?
The patient has adequate caloric intake- Patients are discharged from inpatient care when they meet specific criteria after a hematopoietic stem cell transplant, including evidence of engraftment, absence of fever, controlled graft-versus-host disease, adequate calorie intake, and completion of discharge education. - CORRECT ANSWER Caregivers ask when their child can be discharged after a stem cell transplant. A child can go home following transplant when:
Intravenous opioids are recommended for severe pain. A patient- controlled-analgesia (PCA) device is recommended for complex and multimodal pain management. - CORRECT ANSWER An adolescent with osteosarcoma who recently had surgery reports his pain as a 9 out of 10. What is the best choice for his pain management?
Cytomegalovirus - Ganciclovir, foscarnet, cidofovir, or high-dose immunoglobulin therapy may be administered to patients with an active cytomegalovirus pneumonitis infection. - CORRECT ANSWER Ganciclovir is used to treat pneumonia caused by which of the following organisms?
Ondansetron is a serotonin receptor antagonist that is used to prevent and treat nausea and vomiting - CORRECT ANSWER Which anti-emetic is used for patients receiving highly emetogenic chemotherapy?
The development of an inhibitor to factor VIII requires the use of a bypassing agent to stop bleeding, such as Recombinant factor VIlla. - CORRECT ANSWER A patient with a history of severe hemophilia A and an inhibitor presents with a swollen, painful elbow. The nurse anticipates administering which medication?
Neuropathic pain results from nerve damage, such as after an injury to the peripheral nervous system following an amputation. - CORRECT ANSWER Phantom limb pain following a surgical amputation is an example of what type of pain?
There are 5 stages of mucositis - CORRECT ANSWER How many stages of mucositis are there?
Children with medulloblastoma are at an increased risk of developing increased intracranial pressure. - CORRECT ANSWER Which type of cancer places a patient at a higher risk for developing increased intracranial pressure?
Administration of L-asparaginase is considered a risk factor for anaphylaxis. If a patient begins to complain of difficulty swallowing, the first thing the nurse must do is stop the infusion. - CORRECT ANSWER A child receiving L-asparaginase reports, "It is hard to swallow." What should the nurse's initial action be?
Cyclophosphamide and vincristine both can cause the syndrome of inappropriate antidiuretic hormone which results in decreased urine output and low sodium. The treatment for SIADH is furosemide. - CORRECT ANSWER A child receiving cyclophosphamide and vincristine develops decreased urine output and sodium level 108 mEg/L. What does the nurse anticipate an order for?
Serum sodium of 126 mEq/L. Syndrome of inappropriater antidiuretic hormone (SIADH) is associated with a decrease in urine output and increase in weight gain without edema, which leads to hyponatremia - CORRECT ANSWER A patient with the syndrome of inappropriate antidiuretic hormone would most likely have which of the following laboratory values?
increased intracranial pressure - The classic triad of symptom that result from elevated intracranial pressure are morning headaches, lethargy, and nausea and/or vomiting. In younger children irritability is a common symptom of increased intracranial pressure. - CORRECT ANSWER A 5-year-old patient presents with irritability, lethargy, and vomiting. The nurse recognizes these may be symptoms of:
Superior vena cava syndrome - Superior vena cava syndrome can occur when there is an occlusion from central venous catheter thrombosis. - CORRECT ANSWER A child with a central venous access device presents with flushed cheeks and facial swelling. What does the nurse suspect?
Posterior fossa syndrome presents within 48 hours of posterior fossa surgery and can persist for six months. - CORRECT ANSWER A patient develops restlessness, ataxia, and progressive mental status changes following resection of a brain tumor. Which of the following oncologic complications is this patient experiencing?
Nursing interventions for typhlitis include hyperhydration, broad-spectrum antibiotics coverage, pain management, and vasopressors when clinically indicated. - CORRECT ANSWER Which of the following interventions should be included in the treatment of typhlitis for a pediatric oncology patient?
checking for child care assistance in the community - Nurses need to facilitate social support connections for families, and help families identify resources to help them at home. - CORRECT ANSWER The parents of a child diagnosed with cancer preparing for discharge are concerned that they will not be able to handle the care and activities of their two younger children, as well as their child with cancer. The nurse suggests?
School age - Ophthalmologic examinations should be started at school age and repeated every few years due to the high risk for the development of retinopathy. - CORRECT ANSWER The initial ophthalmology exam for a child with sickle cell disease should be scheduled during which of the following developmental ages?
Create a medication calendar to travel with the child - Tools such as home medication schedules, calendars, and pill boxes are recommended to assure medication adherence. - CORRECT ANSWER Which of the following interventions is the most appropriate to ensure medication adherence for a patient who's parents are divorced and sharing custody of the patient?
"My pediatrician told me it was time to stop giving my child penicillin." Penicillin prophylaxis for children with sickle cell disease should continue until the child is between three and five years of age depending on the type of sickle cell disease. - CORRECT ANSWER Which of the following comments by the father of a 12-month-old child with sickle cell disease indicates the need for further teaching?
Suggest that the parent be genuine and sincere - Children at this age have a limited understanding of death and it is best to be truthful and to answer the child's questions. School-age children may take words literally and develop a fear of sleeping. This child is old enough to understand some of the concepts of death. Although it may be appropriate to involve a trained professional, a parent should be the one to answer the questions the child has directly. Reference: Baggott, - CORRECT ANSWER The parent of a 7-year-old child with end-stage disease asks the nurse, "My child has been asking questions about death, what do I say?" What would be the most appropriate response from the nurse?
There are 5 types of complicated grief: exaggerated, masked, delayed, chronic, and disenfranchised - CORRECT ANSWER Which of the following is a type of complicated grief?
Medulloblastoma - Survivors of CNS tumors have the highest risk of poor quality of life. - CORRECT ANSWER Survivors of which of the following cancer diagnoses generally report the poorest quality of life?
Following the death of a child, the grief of a parent will plateau between 12 - 18 months - CORRECT ANSWER Parental grief following the death of a child from cancer generally plateau's at what point in time?
Maintain well-defined boundaries between self and the patient and family - According to the American Nurse Association's position statement on professional boundaries; the nurse must recognize and maintain boundaries when caring for patients and families. - CORRECT ANSWER Which of the following nursing actions is the most appropriate for fostering therapeutic relationships with patients?
Phase 2 trials investigate the effectiveness of medication on a specific cancer. - CORRECT ANSWER The goal of a phase 2 clinical trial is to determine the:
Veracity is the ethical duty to tell the truth - CORRECT ANSWER The ethical duty to tell the truth is known as: [Show Less]