Oncology Study Questions

Question 1

Test for childhood cancer

Answer 1

• CT/MRI/PET/MRA to locate/stage tumors
• Bone marrow aspiration/biopsy to diagnose leukemia
• Lumbar puncture to assess CNS involvement
• CBC/Electrolytes/BUN/Cr for baseline and tumor impact
• Ultrasound for wilms tumor

Question 2

Nursing responsibilities for childhood cancer test

Answer 2

• Prepare child/family emotionally (age-appropriate explanation)
• Monitor for bleeding/infection post-biopsy
• Manage sedation, pain control
• Support positioning, observe for CSF leaks or neuro changes

Question 3

Leukemia definition

Answer 3

a type of cancer that effects the blood and bone marrow

Question 4

S/S of leukemia

Answer 4

Fever (61%)

Bleeding/petechiae/purpura (48%)

Bone pain, pallor, fatigue

Hepatosplenomegaly​

Question 5

Onset of leukemia

Answer 5

Peaks 2-3 years

Question 6

Patho of leukemia

Answer 6

• Immature WBCs (blasts) crowd out healthy cells → pancytopenia
• Creates dysfunctional immune system

Question 7

Diagnosis of leukemia

Answer 7

CBC: Abnormal counts (↑ blasts, ↓ Hgb, ↓ platelets)

Bone marrow aspiration: Confirms leukemia, % of blasts

LP: Rules out CNS involvement

Immunophenotyping: B-cell (more common) or T-cell (worse prognosis)​

Question 8

Treatment of leukemia

Answer 8

4 chemo phases: Induction, Consolidation, Delayed Intensification, Maintenance

Radiation: For CNS/testicular involvement or T-cell disease

Stem cell transplant: If relapse/chemo failure

Route: IV, PO, IM, IT​

Question 9

Treatment length of leukemia

Answer 9

2 years for girls, >3 years for boys

Question 10

Complications of leukemia

Answer 10

Infection, anemia, hemorrhage

Side effects from chemo: mucositis, N/V, alopecia

CNS toxicity, long-term growth delay

Relapse (15–20%)

Question 11

Worse prognosis in leukemia

Answer 11

High WBC count (>50,000)

T-cell leukemia

CNS/testicular involvement

Age <1 or >10​

Question 12

Types of brain tumors

Answer 12

Medulloblastoma

Astrocytoma

Ependymoma

Brainstem glioma

Question 13

S/S of brain tumor

Answer 13

Morning headache, vomiting, abnormal gait, vision changes, fatigue, behavior changes

Question 14

Diagnosis of brain tumor

Answer 14

CT, MRI, PET, MRA

LP for CSF cytology (if safe)​

Question 15

Treatment of brain tumor

Answer 15

Surgery: Remove/debulk tumor, relieve ICP

Radiation: Post-op, esp. medulloblastoma, ependymoma

Chemo: Limited efficacy due to blood-brain barrier

Monitor for: seizures, hydrocephalus, infection, growth/cognitive delay

Question 16

Post-op complications of brain tumor

Answer 16

Neuro checks: ↓ LOC, unequal pupils, posturing

Vital signs: bradycardia, widened pulse pressure, irregular respirations (Cushing’s triad)

Risk for seizures, SIADH, infection, bleeding

Question 17

Wilms tumor definition

Answer 17

rare kidney cancer

Question 18

S/S of wilms tumor

Answer 18

Asymptomatic abdominal mass (often found during bath)

May have hematuria or HTN (due to renin)

Question 19

Diagnosis of wilms tumor

Answer 19

Ultrasound (first), then CT/MRI

Lab: CBC, BUN/Cr, Electrolytes

Question 20

Diagnosis of wilms tumor

Answer 20

Surgery: Remove affected kidney

Chemo ± Radiation depending on stage

Do NOT palpate abdomen → risk of rupture!

Question 21

Complications of wilms tumor

Answer 21

Post-op liver damage (R-sided tumors), cirrhosis

Radiation → skeletal deformities

Remaining kidney: risk for glomerular damage

Question 22

Osteosarcoma definition

Answer 22

bone cancer

Question 23

Common age in osteosarcoma

Answer 23

Adolescents during growth spurts (13–17 yrs)

Question 24

S/S of osteosarcoma

Answer 24

Bone pain, swelling, limp

Night pain or referred hip/back pain

Question 25

Diagnosis of osteosarcoma

Answer 25

Bone scan, MRI, CT Labs: CBC, elevated LDH

Question 26

Treatment of osteosarcoma

Answer 26

Surgery (limb salvage or amputation) Chemo before and after surgery Watch for lung metastasis (20% risk)

Question 27

Complications of osteosarcoma

Answer 27

Phantom limb pain Lung metastasis Chemo side effects (n/v, myelosuppression)

Question 28

Psychosocial needs of childhood cancer

Answer 28

Body image concerns Peer support and counseling Functional limitations and grief support​

Question 29

Lymphoma (Hodgkin & Non-Hodgkin) risk/etiology

Answer 29

Teens (esp. Hodgkin), immunocompromised (NHL) Viral exposures (EBV), genetic predisposition

Question 30

S/S of lymphoma

Answer 30

Painless lymphadenopathy B symptoms: fever, night sweats, weight loss

Question 31

Diagnosis of lymphoma

Answer 31

Lymph node biopsy, imaging

Question 32

Retinoblastoma S/S

Answer 32

Often first noted as leukocoria ("white pupil"/absent red reflex) May also present with strabismus

Question 33

Treatment of retinoblastoma

Answer 33

Enucleation, radiation, chemotherapy depending on severity

Question 34

Febrile neutropenia

Answer 34

Medical emergency—Immediate eval and empiric broad-spectrum antibiotics Workup: CBC, cultures, possibly CXR/UA ANC <500 → high risk

Question 35

Hyperleukocytosis

Answer 35

WBC >100K, risk of leukostasis Causes ↓ perfusion, CNS or pulmonary failure Worse prognosis with WBC >300K

Question 36

Tumor Lysis Syndrome

Answer 36

Labs: ↑ K⁺, ↑ uric acid, ↑ phosphate, ↓ calcium Highest risk: large tumor burden (e.g., leukemia, lymphoma) Peaks 24–48 hrs after treatment starts Treat with hydration, allopurinol, rasburicase​

Question 37

Discharge considerations in childhood cancer

Answer 37

Infection prevention (hand hygiene, avoid sick contacts) Nutrition support Pain management Immunization guidance (no live vaccines during/after chemo) School reintegration Long-term follow-up for growth, cognition, and secondary malignancies​