Q.1 Which of the following is the most common childhood cancer?
Neuroblastoma
Leukemia
Lymphoma
Wilms' tumor
Explanation - Leukemia, specifically acute lymphoblastic leukemia (ALL), is the most common cancer in children, accounting for about 25% of all childhood cancers.
Correct answer is: Leukemia
Q.2 A child receiving chemotherapy develops oral mucositis. Which is the priority nursing intervention?
Provide bland diet
Administer opioid analgesics
Encourage oral hygiene with soft brush
Apply topical antibiotics
Explanation - Maintaining oral hygiene with a soft toothbrush helps prevent infection and reduces the severity of mucositis.
Correct answer is: Encourage oral hygiene with soft brush
Q.3 Which symptom is an early sign of neutropenia in a child undergoing chemotherapy?
Fever
Bruising
Fatigue
Hair loss
Explanation - Fever is often the first sign of infection in neutropenic children, as low neutrophil count reduces the inflammatory response.
Correct answer is: Fever
Q.4 Which lab finding is most indicative of leukemia?
Elevated WBC count with blasts
Decreased hemoglobin only
Low platelets only
Elevated ESR only
Explanation - Leukemia often presents with an elevated white blood cell count containing immature blast cells.
Correct answer is: Elevated WBC count with blasts
Q.5 Which immunization is contraindicated in children receiving chemotherapy?
Influenza (inactivated)
MMR (live attenuated)
Hepatitis B
Tdap
Explanation - Live attenuated vaccines like MMR are contraindicated in immunocompromised children due to risk of causing infection.
Correct answer is: MMR (live attenuated)
Q.6 A child with Hodgkin lymphoma is receiving radiation therapy. What is the most important long-term nursing consideration?
Prevent obesity
Monitor for secondary malignancies
Increase calcium intake
Limit physical activity
Explanation - Radiation therapy increases the risk of developing secondary cancers later in life; regular monitoring is essential.
Correct answer is: Monitor for secondary malignancies
Q.7 Which symptom is characteristic of nephrotic syndrome in pediatric oncology patients?
Edema
Fever
Cough
Vomiting
Explanation - Edema, particularly periorbital edema, is a hallmark symptom of nephrotic syndrome due to protein loss in urine.
Correct answer is: Edema
Q.8 Which is the priority nursing assessment for a child with suspected anaphylaxis after immunotherapy?
Blood pressure
Skin rash
Heart rate
Respiratory status
Explanation - Airway compromise is life-threatening; assessing respiratory status is the top priority.
Correct answer is: Respiratory status
Q.9 A child with aplastic anemia requires which precaution?
Contact isolation
Neutropenic precautions
Droplet precautions
Standard precautions only
Explanation - Children with aplastic anemia are highly susceptible to infection due to low neutrophil counts, necessitating neutropenic precautions.
Correct answer is: Neutropenic precautions
Q.10 Which is the most common site for a Wilms' tumor?
Kidney
Liver
Bone marrow
Lymph nodes
Explanation - Wilms' tumor, or nephroblastoma, typically originates in the kidney in children.
Correct answer is: Kidney
Q.11 Which nursing intervention reduces the risk of infection in immunocompromised pediatric oncology patients?
Frequent handwashing
Administering vitamins
Encouraging exercise
Limiting fluids
Explanation - Hand hygiene is the most effective way to prevent infection transmission in immunocompromised children.
Correct answer is: Frequent handwashing
Q.12 Which sign may indicate tumor lysis syndrome in a child receiving chemotherapy?
Hyperkalemia
Bradycardia
Hypoglycemia
Hyponatremia
Explanation - Tumor lysis syndrome releases intracellular potassium, leading to hyperkalemia, which is a medical emergency.
Correct answer is: Hyperkalemia
Q.13 A child with immune deficiency develops recurrent sinopulmonary infections. Which lab test is most relevant?
Immunoglobulin levels
Liver function tests
Serum electrolytes
CBC only
Explanation - Measuring immunoglobulin levels helps detect humoral immune deficiencies that cause recurrent infections.
Correct answer is: Immunoglobulin levels
Q.14 Which dietary recommendation is appropriate for a child with chemotherapy-induced nausea?
Small, frequent meals
High-fat meals
Avoid fluids
Large, protein-rich meals
Explanation - Small, frequent meals reduce nausea and improve nutritional intake in children receiving chemotherapy.
Correct answer is: Small, frequent meals
Q.15 Which complication is most common in children with bone marrow transplantation?
Graft-versus-host disease
Pulmonary embolism
Diabetic ketoacidosis
Epilepsy
Explanation - Graft-versus-host disease is a frequent and serious complication after allogeneic bone marrow transplantation.
Correct answer is: Graft-versus-host disease
Q.16 A child with Hodgkin lymphoma presents with painless neck swelling. Which lymph node is most commonly affected?
Cervical
Axillary
Inguinal
Mediastinal
Explanation - Painless cervical lymphadenopathy is a hallmark early sign of Hodgkin lymphoma.
Correct answer is: Cervical
Q.17 Which lab value indicates a child is at risk for bleeding due to thrombocytopenia?
Platelet count 15,000/mm³
Hemoglobin 12 g/dL
WBC 6,000/mm³
ESR 10 mm/hr
Explanation - A platelet count below 20,000/mm³ increases the risk of spontaneous bleeding and requires intervention.
Correct answer is: Platelet count 15,000/mm³
Q.18 Which is a common side effect of corticosteroid therapy in pediatric oncology?
Weight gain
Diarrhea
Hair loss
Bradycardia
Explanation - Corticosteroids often cause fluid retention and increased appetite, leading to weight gain in children.
Correct answer is: Weight gain
Q.19 Which sign is most suggestive of immune thrombocytopenic purpura (ITP) in a child?
Petechiae and easy bruising
Fever and cough
Abdominal pain
Jaundice
Explanation - ITP causes a low platelet count, leading to petechiae, ecchymosis, and easy bruising.
Correct answer is: Petechiae and easy bruising
Q.20 A child receiving chemotherapy should be taught to avoid which over-the-counter medication?
Acetaminophen
Ibuprofen
Diphenhydramine
Loperamide
Explanation - NSAIDs like ibuprofen can worsen thrombocytopenia and increase bleeding risk in children receiving chemotherapy.
Correct answer is: Ibuprofen
Q.21 Which therapy is considered first-line treatment for acute lymphoblastic leukemia (ALL) in children?
Chemotherapy
Surgery
Radiation alone
Immunotherapy only
Explanation - Chemotherapy is the primary treatment for ALL, often combined with other therapies depending on risk factors.
Correct answer is: Chemotherapy
Q.22 Which symptom indicates hypersensitivity reaction to immunotherapy in children?
Rash, itching, and facial swelling
Hair loss
Fever
Fatigue
Explanation - Allergic or hypersensitivity reactions commonly present with rash, urticaria, and facial or lip swelling.
Correct answer is: Rash, itching, and facial swelling
Q.23 Which is the primary nursing goal for a child with severe combined immunodeficiency (SCID)?
Prevent infection
Promote weight gain
Encourage physical activity
Increase cognitive stimulation
Explanation - Children with SCID are extremely vulnerable to infections; infection prevention is the top nursing priority.
Correct answer is: Prevent infection
Q.24 Which laboratory test monitors kidney function in a child receiving chemotherapy?
Serum creatinine
CBC
Liver enzymes
Blood glucose
Explanation - Serum creatinine and BUN are used to monitor renal function, which may be affected by certain chemotherapeutic drugs.
Correct answer is: Serum creatinine
Q.25 Which is the most appropriate action when a child develops alopecia during chemotherapy?
Provide emotional support and coping strategies
Discontinue chemotherapy
Apply medicated shampoo
Isolate the child
Explanation - Alopecia is a common side effect; supporting the child’s emotional well-being is crucial rather than stopping therapy.
Correct answer is: Provide emotional support and coping strategies