CPHON Practice C questions
APL differentiation syndrome - APL differentiation syndrome is a complication from arsenic administration
Which of the following is a complication from arsenic trioxide?
Participating in risk taking behavior- Adolescents can exhibit risk-taking behavior in response to a terminal diagnosis.
A 12-year-old patient with metastatic osteosarcoma has been told that his prognosis is poor. The nurse knows that which of the following would be a normal display of grief in this age group?
Intravenous immunoglobulins - IVIG is preferred over corticosteroids for treatment of ITP
A 13-month-old infant presents with a continuous nose bleed. The patient's laboratory values reveal hemoglobin 13g/dL; absolute neutrophil count 1545/mm3; and platelets 8/mm3. Which of the following will be the most likely initial treatment?
Nothing by mouth - Patients with pancreatitis should be on complete bowel rest
A 14-year-old patient with acute lymphoblastic leukemia in delayed intensification presents with abdominal pain, vomiting, and elevated serum amylase. Which of the following is the most appropriate dietary order?
Identity versus identity confusion
A 16-year-old patient diagnosed with acute myeloid leukemia expresses concerns about graduation. Which of the following developmental stages does this represent?
Elevated urine catecholamines - Blue nodules are a clinical presentation for neuroblastoma
A 2-month-old infant has blue nodules along the abdomen. Which of the following laboratory values would make the nurse suspect a diagnosis of neuroblastoma?
4-year-olds have increased fine motor skills which includes drawing pictures rather than scribbles.
A 4-year-old child with acute lymphoblastic leukemia has had a regression of several developmental milestones. The nurse assesses the patient and determines which of the following to be inappropriate for age?
Bone age study - Precociuos puberty symptoms include early breast development and advanced bone age
A 6-year-old female has breast development after completing radiation therapy for a brain tumor. Which of the following diagnostic studies would the nurse anticipate an order for?
"90% of children recover within 12 months." - 90% of children with ITP recover within 12 months
A patient diagnosed with idiopathic thrombocytopenic purpura (ITP) asks the nurse if this will affect him for the rest of his life. What should the nurse tell the patient?
Hodgkin lymphoma - Clinical presentation of Hodgkin lymphoma includes: painless adenopathy, fatigue, night sweats.
A patient presents to the hospital with painless adenopathy, fatigue, fever, weight loss, and night sweats. The nurse anticipates a work up for which of the following diagnoses?
Intravenous methylprednisolone - Corticosteroids are the current standard treatment for SVCS
A patient presents with difficulty breathing and an audible wheezing. A chest x-ray reveals a mediastinal mass with tracheal deviation. What is the most appropriate initial intervention?
Hypersensitivity reaction - Urticaria and pruritis are symptoms of hypersensitivity reactions
A patient receiving a blood transfusion develops urticaria and reports pruritis. What does the nurse suspect?
Applying a warm compress to chest - Warm packs are used for a vincristine extravasation.
A patient receiving vincristine reports pain and redness at the implanted port site. After discontinuing the infusion, the nurse's next intervention would be:
Dexamethasone administration - Dexamethasone is the initial treatment for spinal cord compression
A patient reports back pain for several weeks with a sudden onset of lower extremity weakness. A magnetic resonance image reveals a paravertebral spinal tumor and spinal edema. The nurse anticipates an initial order for which of the following?
Cisplatin causes delayed nausea and vomiting
A patient should be given instructions regarding delayed nausea and vomiting after receiving which of the following medications?
Renal tumor
A patient with Beckwith- Wiedemann syndrome is at an increased risk of developing:
Ferritin 875ng/mL - Iron overload can occur with repeated transfusions
A patient with beta-thalassemia requires blood transfusions every two weeks. Which of the following laboratory results would cause the nurse to be concerned?
The goal of a phase 3 trial is to determine if new treatment is better than existing treatment
A patient with cancer tells the nurse that she is enrolled in a clinical trial to see if combination chemotherapy is more effective than single agent chemotherapy. Which phase of the trial is the patient enrolled?
• Tell me more about why you feel this way." - It is important to explore parents feelings when dealing with difficult diagnoses.
A patient with end stage leukemia is enrolled in hospice care. The mother states "You are wrong. My baby is going to live." Which of the following is the most therapeutic response from the nurse?
Phosphorous 12 mg/dL - Hyperphosphatemia is associated with TLS
A patient with flank pain, nausea, and vomiting arrives to the Emergency Department. Which of the following laboratory values would make the nurse suspect a diagnosis of tumor lysis syndrome?
An abdominal ultrasound - Abdominal ultrasound is used to diagnose pancreatitis; side effect of PEG- asparaginase is pancreatitis.
A patient with leukemia who recently received PEG- asparaginase presents with flank pain, vomiting, and a fever. The nurse anticipates an order for:
Anaplastic astrocytomas are classified as grade 3
According to the WHO classification system, an anaplastic astrocytoma is which grade of tumor?
Fluorouracil causes diarhea.
After a four day course of chemotherapy, a patient is experiencing diarrhea. Which of the following medications most likely caused the diarrhea?
Dexamethasone - Osteopenia is associated with corticosteroid treatments
An 18-year-old patient with acute lymphoblastic leukemia reports severe, bilateral knee joint pain during a follow-up appointment. Which of the following medications most likely is the cause for the pain?
Platelets - Platelet count should be greater than 50,000/mm3 for surgery.
Pre-operative laboratory results for a patient scheduled to receive an implanted port reveal hemoglobin 9g/dL, platelets 30,000/mm3, absolute neutrophil count 2500/mm3 and international normalized ratio 0.9. Which of the following products will the patient most likely receive before surgery?
Acyclovir should be given prior to HSCT if a patient is positive for CMV
Prior to an HSCT, a patient tests positive for CMV. The nurse would expect which of the following medications to be administered the day before transplant?
Discuss the importance of having the sibling visit the patient - Loved ones should be encouraged to visit the dying patient.
The mother of a child near the end-of-life voices concerns about the 8-year-old sibling visiting the patient, stating that it would be "traumatizing". What is the most appropriate response from the nurse?
how well the body can fight off infection." Neutrophils fight infection
The mother of a child with acute lymphoblastic leukemia asks the nurse to explain the absolute neutrophil count. What is the nurse's best response? "The absolute neutrophil count measures:
Herbs and supplements increase the risk of side effects and medication interactions.
The mother of a patient with acute lymphoblastic leukemia asks if she can give her child natural herbs to supplement the immune system. Which of the following is the most appropriate response from the nurse?
Monitor strict intake and output - must be monitored following ifosfamide treatment.
The nurse caring for a patient who received ifosfamide prior to change of shift would expect orders for which of the following interventions?
volume depleting the unit of packed red blood cells - Prevention of circulatory overload is accomplished by volume depleting the packed red blood cells.
Transfusion related circulatory overload can be prevented by:
Limit outside activities between 11am and 3pm - Instruct patients to avoid being outside during extreme sun times
What instructions should the nurse provide to a patient starting weekly oral methotrexate?
Musculoskeletal pain is described as sharp, throbbing and worse with movement
What type of pain is described as sharp, throbbing, and worse with movement or weight bearing?
Itraconazole increases the risks for medication reactions
Which of the following can increase the risk of a medication interaction for a patient scheduled to receive vincristine?
Glutamine can reduce the severity of mucositis
Which of the following complementary medicines has been used to reduce the severity of mucositis?
Capillary leak syndrome is an early complication associated with HSCT
Which of the following complications would the nurse expect during the early phase of a hematopoietic stem cell transplant?
Non-rearranged germlines have improved outcomes
Which of the following cytogenetic abnormalities of acute lymphoblastic leukemia is associated with a poor prognosis?
Swollen gums with moderate bleeding
Which of the following findings indicates grade 3 mucositis?
Increased unconjugated bilirubin a finding consistent with AHA
Which of the following findings is consistent witha diagnosis of autoimmune hemolytic anemia?
Initiate IV antibiotics - Antibiotics are the first treatment for typhlitis
Which of the following initial orders would the nurse expect when a patient presents with fever, bloody diarrhea, and right lower quadrant pain?
Down syndrome is a favorable prognostic factor for AML
Which of the following is considered a favorable prognostic factor for acute myeloid leukemia?
Stereotactic radiosurgery - Stereotactic radiation is delivered via a focused beam to a small, well- circumscribed area of the tumor.
Which of the following is defined as radiation delivered via a focused beam to a small, well- cirumscribed area of the tumor?
Oxygen supplementation - Oxygen delivery in the least invasive way is one of the first treatments for shock.
Which of the following is the most appropriate initial nursing intervention for a patient who is lethargic, hypotensive and febrile?
Doxorubicin increases hepatic radiosensitivty
Which of the following medications can increase radiosensitivity of the liver?
Dexamethasone - Long term administration of corticosteriods can lead to cataract development
Which of the following medications does the nurse suspect caused cataract development in a 40-year-old pediatric cancer survivor?
Infuse the frozen cells over 3 hours - Rapid infusion of frozen cells is recommended
Which of the following orders for a frozen stem cell transfusion should the nurse question?
Deferoxamine administration used to treat iron overload.
Which of the following orders would the nurse expect to receive for a patient with major beta- thalassemia who has laboratory results of hemoglobin 10g/dL, platelets 120/mm3 and serum ferritin greater than 1000ng/mL?
9-year-old boy with an astrocytoma - Bevacizumab is used for refractory solid tumors
Which of the following patients would most likely be treated with bevacizumab?
"Inactivated immunizations are safe but may be ineffective." All family members and household contacts should be immunized with routinely recommended vaccines.
Which of the following statements indicates parents' understanding about immunizations while their child is being treated with chemotherapy?
"I will need to shower several times a day after I receive the medication." Patients receiving thiotepa for HSCT conditioning should shower several times daily for 24 hours after treatment
Which statement by a patient receiving thiotepa for HSCT conditioning indicates an understanding of potential side effects?
