The Oncology Nursing Certification Corporation – Certified Pediatric Oncology Nurse (ONCC – CPON) exam is a comprehensive and challenging assessment for men and women looking to enter this rewarding and fast-paced field of health care.
The ONCC – CPON exam is arranged into nine content domains:
- Psychosocial dimensions of care (10 percent of the exam) includes questions regarding the principles of growth and development; the effects of acute and chronic illness on the child and family; patient and family support; psychosocial adaptation of the child and family; cultural and spiritual beliefs and rituals; reintegration issues related to daily life; loss, grief, and bereavement; and family systems theory and community resources.
- The section on disease-related biology (10 percent) covers types of childhood cancers, types of hematology disorders, pathophysiology, staging and grading, microbiology, cell cycle, hematopoiesis, anatomy and physiology, immunology, carcinogenesis, genetics, epidemiology, clinical manifestations, infectious diseases, laboratory values, prognostic indicators, and diagnostic procedures.
- The treatment domain of the ONCC – CPON exam (23 percent) includes questions about principles and side effects.
- The supportive care and symptom management domain (22 percent) addresses supportive care measures, pain management, fatigue management, palliative care, interventions for symptom management, central venous access, nutritional alterations, system-specific alterations, and discharge planning.
- The section on pediatric oncology and hematology emergencies (13 percent) covers emergency management, risk factors, prevention, and management.
- Long-term follow-up and survivorship (8 percent) addresses the impact of diagnosis and treatment, physical effects, psychosocial adaptation, cognitive function, and socioeconomic issues.
- The health maintenance domain of the ONCC – CPON exam (2 percent) reviews immunizations, health promotion and injury prevention, well child and anticipatory guidance, and the transition to primary health care.
- The end-of-life care section (6 percent) covers loss, grief, and bereavement; the physical and psychosocial care of the dying child and family; and hospice.
- Professional performance (6 percent) addresses ethics, cultural competence, therapeutic communication and relationships, regulatory standards and guidelines, healthcare legislation, principles of teaching and learning, professional boundaries, risk management, research and evidence-based practices, and professional self-care strategies.
ONCC-CPON Exam Practice Questions
1. Among the fears experienced by infants hospitalized for cancer or blood disorders are:
a. separation from parents
b. loud noises
c. bright lights
d. all of the above
2. Hospitalized preschoolers require all of the following EXCEPT:
a. assessment of normal behavior
b. encouragement to play
c. separation from other children
d. brief, simple explanations of treatment
3. Teenagers with cancer or other serious diseases often fear all of the following EXCEPT:
a. loss of body image
b. rebellious behavior
c. rejection by peers
d. loss of independence
4. Nursing interventions for the hospitalized toddler age-group (1–3 years of age) include:
a. providing and encouraging mobility
b. assisting with toilet training
c. both A and B
d. neither A nor B
5. The psychosocial factors influencing school-age children with cancer are:
a. absence from school
b. loss of peer-group acceptance
c. inability to carry out previously acquired skills
d. all of the above
1. D: Infants have many fears, including separation from parents, strangers, loud noises, sudden movements, animals, and heights. Any of these can be exacerbated by hospitalization and disease. Hospitalized infants need caring, nutrition, and support from caregivers. Thus, parents are encouraged to spend as much time as possible with their child, maintaining feeding and tactile stimulation as close to normal as possible. Examinations should not be prolonged, especially if they cause discomfort for the patient. Having a parent hold the child during examinations, if possible, is comforting to the infant. Assessment of the developmental level, using charts and guidebooks, is an essential nursing task for sick infants.
2. C: Preschoolers in the 4–6-year-old age-group have a sense of their identity and less fear of strangers than younger children. They have a more complete understanding of body parts and functions as well as the concepts of appropriate behavior and social interaction. Obtaining the pattern of normal routines and behavior from the parents is quite helpful in distinguishing hospital- or disease-acquired regressive behaviors. Preschoolers should be encouraged to play, by themselves and with other children, barring dangerous exposures; however, viewing other children in pain is discouraged since it generates fear and anxiety. It is usually possible to explain medical procedures and treatments in an age-appropriate way to preschoolers that may reassure the anxious child.
3. B: Teenagers with serious diseases often fear the loss of peer acceptance more than the disease itself. They tend to exaggerate other’s poor opinion of them and often become embarrassed by minor flaws. Privacy is especially important. Risky or rebellious behavior may follow a serious diagnosis often in an effort to deny their disease and be more inviting to their peer group. They are caught in the classic conflict of the desire for independence and the loss of control of their own bodies. A poor self-image is often a problem. The nurse should encourage frank discussions of their care. Self-care as much as possible is encouraged. However, the nurse should explain that dependence on others during an illness is a sign of strength and maturity.
4. C: Nursing interventions in toddlers should start with an assessment of the child’s normal behavior and routine as well as an evaluation of developmental stages. A conference with the parents or other guardian is always advisable. Such items as fears, sleep patterns, security items and stage of toilet training are important in the evaluation of the patient and offer clues as to management of an ill child in an unfamiliar, even scary environment, such as the hospital or outpatient clinic. Evaluation of the influence that the disease and its treatment play in modifying behavior and attitude is especially important. This is of particular concern if there is disease of the nervous system (e.g., stroke, intracerebral infection or bleeding) or treatment-induced abnormalities (e.g., drugs that influence the brain, intrathecal therapy, radiation effects). Pain is, of course, a major issue and must be addressed individually.
5. D: School-age children have already begun to develop some independence from their parents, at least for certain periods of time. This may change in a hospital environment so that the child may regress to a needier stage and may be unable or unwilling to perform previously acquired skills and habits. Absence from school and loss of peer group contact and acceptance are strong influences in modifying behavior. There are programs for school re-entry and maintenance of self-esteem and socialization that are useful despite changes in physical appearance (e.g., hair loss, prosthetic devices) or habits (e.g., enuresis, emotional control). Positive reinforcement of normal behavior and parent counseling are helpful in re-establishing usual patterns of acceptable behavior.