NCLEX - PEDIATRICS – ONCOLOGY EXAM QUESTIONS AND
ANSWERS 100% PASS!!
1. The nurse is monitoring a child Correct Answer: 2
for bleeding after surgery for
removal of a brain tumor. The Rationale: Colorless drainage on the dress-
nurse checks the head dress- ing in a child after craniotomy indicates the
ing for the presence of blood presence of cerebrospinal fluid and should
and notes a colorless drainage be reported to the HCP immediately. Op-
on the back of the dressing. tions 1, 3, and 4 are not the immediate
Which intervention should the nursing intervention because they do not
nurse perform immediately? address the need for immediate interven-
1.Reinforce the dressing. tion to prevent complications.
2. Notify the health care
provider (HCP).
3. Document the findings and
continue to monitor.
4. Circle the area of drainage
and continue to monitor.
2. The mother of a 4-year-old Correct Answer: 1
child tells the pediatric nurse
that the child's abdomen Rationale: Wilms' tumor is the most com-
seems to be swollen. During mon intraabdominal and kidney tumor of
further assessment, the mother childhood. If Wilms' tumor is suspected, the
tells the nurse that the child is tumor mass should not be palpated by the
eating well and that the activity nurse. Excessive manipulation can cause
level of the child is unchanged. seeding of the tumor and spread of the
The nurse, suspecting the pos- cancerous cells. Hematuria, fever, and hy-
sibility of Wilms' tumor, should pertension are clinical manifestations asso-
avoid which during the physi- ciated with Wilms' tumor.
cal assessment?
1. Palpating the abdomen for a
mass
2. Assessing the urine for the
presence of hematuria
3.Monitoring the temperature
for the presence of fever
4.Monitoring the blood pres-
sure for the presence of hyper-
tension
, NCLEX - PEDIATRICS – ONCOLOGY EXAM QUESTIONS AND
ANSWERS 100% PASS!!
3. The nurse provides a teaching Correct Answer: 2
session to the nursing staff re-
garding osteosarcoma. Which Rationale: Osteosarcoma is the most com-
statement by a member of the mon bone cancer in children. Cancer usual-
nursing staff indicates a need ly is found in the metaphysis of long bones,
for information? especially in the lower extremities, with
1. "The femur is the most com- most tumors occurring in the femur. Os-
mon site of this sarcoma." teosarcoma is manifested clinically by pro-
2. "The child does not expe- gressive, insidious, and intermittent pain
rience pain at the primary at the tumor site. By the time these chil-
tumor site." 3."Limping, if a dren receive medical attention, they may
weight-bearing limb is affected, be in considerable pain from the tumor.
is a clinical manifestation." Options 1, 3, and 4 are accurate regarding
4."The symptoms of the dis- osteosarcoma.
ease in the early stage are al-
most always attributed to nor-
mal growing pains."
4. The nurse analyzes the labo- Correct Answer: 1
ratory values of a child with
leukemia who is receiving Rationale: Leukemia is a malignant in-
chemotherapy. The nurse notes crease in the number of leukocytes, usu-
that the platelet count is 19,500 ally at an immature stage, in the bone
mm3 (19.5 × 109/L). On the ba- marrow. It affects the bone marrow, caus-
sis of this laboratory result, ing anemia from decreased erythrocytes,
which intervention should the infection from neutropenia, and bleeding
nurse include in the plan of from decreased platelet production (throm-
care? bocytopenia). If a child is severely throm-
1. Initiate bleeding precau- bocytopenic and has a platelet count less
tions. than 20,000 mm3 (20.0 × 109/L), bleeding
2. Monitor closely for signs of precautions need to be initiated because
infection. of the increased risk of bleeding or hemor-
3. Monitor the temperature rhage. Precautions include limiting activity
every 4 hours. that could result in head injury, using soft
4. Initiate protective isolation toothbrushes, checking urine and stools for
precautions. blood, and administering stool softeners to
prevent straining with constipation. In ad-
dition, suppositories, enemas, and rectal
temperatures are avoided. Options 2, 3,
, NCLEX - PEDIATRICS – ONCOLOGY EXAM QUESTIONS AND
ANSWERS 100% PASS!!
and 4 are related to the prevention of infec-
tion rather than bleeding.
5. The nurse is monitoring a Correct Answer: 1
3-year-old child for signs and
symptoms of increased in- Rationale: The brain, although well pro-
tracranial pressure (ICP) after a tected by the solid bony cranium, is high-
craniotomy. The nurse plans to ly susceptible to pressure that may ac-
monitor for which early sign or cumulate within the enclosure. Volume
symptom of increased ICP? and pressure must remain constant with-
1. Vomiting in the brain. A change in the size of the
2. Bulging anterior fontanel brain, such as occurs with edema or in-
3.Increasing head circumfer- creased volume of intracranial blood or
ence cerebrospinal fluid without a compensato-
4.Complaints of a frontal ry change, leads to an increase in ICP,
headache which may be life-threatening. Vomiting,
an early sign of increased ICP, can be-
come excessive as pressure builds up and
stimulates the medulla in the brainstem,
which houses the vomiting center. Chil-
dren with open fontanels (posterior fontanel
closes at 2 to 3 months; anterior fontanel
closes at 12 to 18 months) compensate
for ICP changes by skull expansion and
subsequent bulging fontanels. When the
fontanels have closed, nausea, excessive
vomiting, diplopia, and headaches become
pronounced, with headaches becoming
more prevalent in older children.
6. A 4-year-old child is admitted Correct Answer: 2
to the hospital for abdominal
pain. The mother reports that Rationale: Leukemia is a malignant in-
the child has been pale and ex- crease in the number of leukocytes, usually
cessively tired and is bruising at an immature stage, in the bone marrow.
easily. On physical examina- The confirmatory test for leukemia is mi-
tion, lymphadenopathy and he- croscopic examination of bone marrow ob-
patosplenomegaly are noted. tained by bone marrow aspirate and biopsy,
Diagnostic studies are being which is considered positive if blast cells
ANSWERS 100% PASS!!
1. The nurse is monitoring a child Correct Answer: 2
for bleeding after surgery for
removal of a brain tumor. The Rationale: Colorless drainage on the dress-
nurse checks the head dress- ing in a child after craniotomy indicates the
ing for the presence of blood presence of cerebrospinal fluid and should
and notes a colorless drainage be reported to the HCP immediately. Op-
on the back of the dressing. tions 1, 3, and 4 are not the immediate
Which intervention should the nursing intervention because they do not
nurse perform immediately? address the need for immediate interven-
1.Reinforce the dressing. tion to prevent complications.
2. Notify the health care
provider (HCP).
3. Document the findings and
continue to monitor.
4. Circle the area of drainage
and continue to monitor.
2. The mother of a 4-year-old Correct Answer: 1
child tells the pediatric nurse
that the child's abdomen Rationale: Wilms' tumor is the most com-
seems to be swollen. During mon intraabdominal and kidney tumor of
further assessment, the mother childhood. If Wilms' tumor is suspected, the
tells the nurse that the child is tumor mass should not be palpated by the
eating well and that the activity nurse. Excessive manipulation can cause
level of the child is unchanged. seeding of the tumor and spread of the
The nurse, suspecting the pos- cancerous cells. Hematuria, fever, and hy-
sibility of Wilms' tumor, should pertension are clinical manifestations asso-
avoid which during the physi- ciated with Wilms' tumor.
cal assessment?
1. Palpating the abdomen for a
mass
2. Assessing the urine for the
presence of hematuria
3.Monitoring the temperature
for the presence of fever
4.Monitoring the blood pres-
sure for the presence of hyper-
tension
, NCLEX - PEDIATRICS – ONCOLOGY EXAM QUESTIONS AND
ANSWERS 100% PASS!!
3. The nurse provides a teaching Correct Answer: 2
session to the nursing staff re-
garding osteosarcoma. Which Rationale: Osteosarcoma is the most com-
statement by a member of the mon bone cancer in children. Cancer usual-
nursing staff indicates a need ly is found in the metaphysis of long bones,
for information? especially in the lower extremities, with
1. "The femur is the most com- most tumors occurring in the femur. Os-
mon site of this sarcoma." teosarcoma is manifested clinically by pro-
2. "The child does not expe- gressive, insidious, and intermittent pain
rience pain at the primary at the tumor site. By the time these chil-
tumor site." 3."Limping, if a dren receive medical attention, they may
weight-bearing limb is affected, be in considerable pain from the tumor.
is a clinical manifestation." Options 1, 3, and 4 are accurate regarding
4."The symptoms of the dis- osteosarcoma.
ease in the early stage are al-
most always attributed to nor-
mal growing pains."
4. The nurse analyzes the labo- Correct Answer: 1
ratory values of a child with
leukemia who is receiving Rationale: Leukemia is a malignant in-
chemotherapy. The nurse notes crease in the number of leukocytes, usu-
that the platelet count is 19,500 ally at an immature stage, in the bone
mm3 (19.5 × 109/L). On the ba- marrow. It affects the bone marrow, caus-
sis of this laboratory result, ing anemia from decreased erythrocytes,
which intervention should the infection from neutropenia, and bleeding
nurse include in the plan of from decreased platelet production (throm-
care? bocytopenia). If a child is severely throm-
1. Initiate bleeding precau- bocytopenic and has a platelet count less
tions. than 20,000 mm3 (20.0 × 109/L), bleeding
2. Monitor closely for signs of precautions need to be initiated because
infection. of the increased risk of bleeding or hemor-
3. Monitor the temperature rhage. Precautions include limiting activity
every 4 hours. that could result in head injury, using soft
4. Initiate protective isolation toothbrushes, checking urine and stools for
precautions. blood, and administering stool softeners to
prevent straining with constipation. In ad-
dition, suppositories, enemas, and rectal
temperatures are avoided. Options 2, 3,
, NCLEX - PEDIATRICS – ONCOLOGY EXAM QUESTIONS AND
ANSWERS 100% PASS!!
and 4 are related to the prevention of infec-
tion rather than bleeding.
5. The nurse is monitoring a Correct Answer: 1
3-year-old child for signs and
symptoms of increased in- Rationale: The brain, although well pro-
tracranial pressure (ICP) after a tected by the solid bony cranium, is high-
craniotomy. The nurse plans to ly susceptible to pressure that may ac-
monitor for which early sign or cumulate within the enclosure. Volume
symptom of increased ICP? and pressure must remain constant with-
1. Vomiting in the brain. A change in the size of the
2. Bulging anterior fontanel brain, such as occurs with edema or in-
3.Increasing head circumfer- creased volume of intracranial blood or
ence cerebrospinal fluid without a compensato-
4.Complaints of a frontal ry change, leads to an increase in ICP,
headache which may be life-threatening. Vomiting,
an early sign of increased ICP, can be-
come excessive as pressure builds up and
stimulates the medulla in the brainstem,
which houses the vomiting center. Chil-
dren with open fontanels (posterior fontanel
closes at 2 to 3 months; anterior fontanel
closes at 12 to 18 months) compensate
for ICP changes by skull expansion and
subsequent bulging fontanels. When the
fontanels have closed, nausea, excessive
vomiting, diplopia, and headaches become
pronounced, with headaches becoming
more prevalent in older children.
6. A 4-year-old child is admitted Correct Answer: 2
to the hospital for abdominal
pain. The mother reports that Rationale: Leukemia is a malignant in-
the child has been pale and ex- crease in the number of leukocytes, usually
cessively tired and is bruising at an immature stage, in the bone marrow.
easily. On physical examina- The confirmatory test for leukemia is mi-
tion, lymphadenopathy and he- croscopic examination of bone marrow ob-
patosplenomegaly are noted. tained by bone marrow aspirate and biopsy,
Diagnostic studies are being which is considered positive if blast cells
