A 4-year-old child presents with bone pain, fatigue, pallor, and petechiae. CBC shows WBC 45,000/microL with 80% blasts. What is the MOST likely diagnosis?
Cphon Scientific Basis Pathophysiology
Question · Easy
CPHON Exam Guide 2026: Pediatric Hematology Oncology Nursing Prep by Domain
Prepare for the 2026 ONCC CPHON exam with the 165-question, 3-hour format, RN eligibility, treatment and symptom-management priorities, pediatric oncology traps, and free CPHON practice questions.
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Which chromosomal abnormality in childhood ALL is associated with the BEST prognosis?
Question · Hard
Introduction & Exam Overview
1.1 Current Exam Facts
Study guide
Neuroblastoma most commonly arises from which embryonic tissue?
Question · Medium
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Which tumor marker is elevated in neuroblastoma and used for diagnosis and monitoring?
Wilms tumor (nephroblastoma) typically presents in which age group?
Which genetic syndrome significantly increases the risk of developing childhood cancer and requires cancer surveillance?
Cphon Health Promotion Disease Prevention
1.2 Eligibility, Application, and Testing Logistics
A child with sickle cell disease is at increased risk of which neurological complication that requires routine screening?
Which immunization is contraindicated in a child who is actively receiving chemotherapy?
What is the MOST important cancer screening recommendation for children with Down syndrome?
Which phase of ALL treatment is specifically designed to eliminate residual leukemia cells in the central nervous system?
Cphon Treatment Modalities
1.3 Test Content Outline and Study Strategy
A child receiving high-dose methotrexate develops delayed methotrexate clearance (level >1 micromol/L at 48 hours). What is the priority nursing intervention?
Which chemotherapy agent requires cardiac monitoring with echocardiogram before and during treatment due to cumulative cardiotoxicity?
What is the mechanism of action of vincristine, a vinca alkaloid commonly used in pediatric cancer protocols?
A nurse prepares to administer chemotherapy to a pediatric patient. Which safety measure is essential?
Care Continuum
2.1 Transition of Care: Primary Care and Levels of Care
L-asparaginase is a key component of ALL treatment. Which adverse reaction requires immediate intervention?
What is the primary purpose of maintenance therapy in the treatment of childhood ALL?
A child receiving radiation therapy to the brain for a CNS tumor is at risk for which late endocrine effect?
Blinatumomab is a bispecific T-cell engager (BiTE) used in pediatric ALL. What is its mechanism of action?
2.2 End-of-Life Care
During administration of a blood transfusion to a pediatric oncology patient, the child develops fever, chills, and back pain within the first 15 minutes. What should the nurse do FIRST?
Which surgical principle is unique to Wilms tumor management?
A 3-year-old child with ALL develops a temperature of 38.4 degrees C and an ANC of 300. The child appears well but has a central line. What is the priority action?
Cphon Symptom Management
Which pain assessment tool is MOST appropriate for a non-verbal 2-year-old receiving chemotherapy?
2.3 Health Promotion and Maintenance
A child receiving cisplatin-based chemotherapy should receive which prophylactic assessment to prevent a significant long-term toxicity?
What is the MOST effective approach to managing chemotherapy-induced nausea and vomiting (CINV) in pediatric patients?
A child on dexamethasone for ALL maintenance develops increased appetite, weight gain, mood swings, and hyperglycemia. What should the nurse explain to the family?
A child undergoing chemotherapy develops oral mucositis. Which oral care intervention is recommended?
2.4 Survivorship
Tumor lysis syndrome (TLS) is most likely to occur with which pediatric malignancy?
Rasburicase is used in tumor lysis syndrome prevention/treatment to address which metabolic abnormality?
A 6-year-old child with a medulloblastoma develops symptoms of increased intracranial pressure. Which sign is the MOST concerning?
What is the MOST common type of central venous access device used for long-term chemotherapy administration in pediatric oncology?
Leukemias and Lymphomas
3.1 Acute Lymphoblastic Leukemia
Which childhood cancer has the HIGHEST overall survival rate with current treatment protocols?
Sickle cell disease causes chronic hemolytic anemia. Which complication requires emergency intervention with exchange transfusion?
Which staging system is used for pediatric Hodgkin lymphoma?
What is the MOST common brain tumor in children?
3.2 Acute Myeloid Leukemia and Related Myeloid Disease
What is the primary mechanism causing anemia in children with chronic kidney disease who also have a hematologic condition?
A child with hemophilia A has a factor VIII level of 2%. What severity classification is this?
Retinoblastoma is associated with mutation of which tumor suppressor gene?
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