8-Week Preparation Guide

Certifying Body: Oncology Nursing Certification Corporation (ONCC)

Exam: Certified Pediatric Hematology Oncology Nurse (CPHON)

Format: 165 multiple-choice questions (125 scored, 40 unscored pretest)

Time: 3 hours

Cost: $300 (ONS/APHON member) or $420 (non-member)

Passing Score: Scaled score of 55 on a 25–75 scale

Eligibility: Active RN license + 2,000 hours pediatric heme/onc practice in past 4 years + 10 CE hours in oncology (past 3 years)

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About the Exam

The CPHON validates specialized knowledge in pediatric hematology and oncology nursing. Certified nurses work in children’s hospitals, pediatric oncology units, hematology clinics, and bone marrow transplant programs. The exam covers six content domains weighted by clinical importance.

Exam Content Domains

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Week-by-Week Study Plan

Weeks 1–2: Foundations — Pediatric Oncology & Hematology Basics

Goal: Build core knowledge of pediatric cancers and hematologic disorders

Key Topics — Pediatric Cancers:

• •Leukemia: ALL (most common childhood cancer), AML — clinical presentation, lab findings, treatment protocols
• •Brain tumors: posterior fossa tumors (medulloblastoma, ependymoma), optic pathway gliomas, craniopharyngioma
• •Solid tumors: Wilms tumor, neuroblastoma, hepatoblastoma, rhabdomyosarcoma, Ewing sarcoma, osteosarcoma
• •Lymphoma: Hodgkin and Non-Hodgkin lymphoma in pediatric patients
• •Retinoblastoma: genetics (RB1 gene), staging, treatment

Key Topics — Pediatric Hematology:

• •Sickle cell disease: pathophysiology, vaso-occlusive crises, acute chest syndrome, stroke risk, hydroxyurea therapy
• •Hemophilia: types A (factor VIII) and B (factor IX), bleeding management, factor replacement therapy, inhibitor development
• •Thalassemia: alpha and beta types, transfusion therapy, iron chelation
• •Aplastic anemia: etiology, immunosuppressive therapy, HSCT
• •ITP: diagnosis, management, when to treat vs. observe

Study Activities:

• •Read ONCC CPHON Test Content Outline thoroughly
• •Create flashcards for each cancer type: presentation, staging, treatment, nursing considerations
• •Focus on the differences between pediatric and adult cancer presentations
• •Study 2–3 hours daily, emphasizing Domain II (18%) content

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Weeks 3–4: Treatment Modalities & Side Effects

Goal: Master chemotherapy, biotherapy, immunotherapy, and cellular therapies in pediatric patients

Key Topics:

• •Chemdrug classes: alkylating agents, antimetabolites, vinca alkaloids, anthracyclines, platinum agents
• •Weight-based dosing: BSA calculations, dose adjustments for pediatric patients
• •Side effects by system: mucositis, nausea/vomiting, myelosuppression, cardiotoxicity (doxorubicin), nephrotoxicity (cisplatin), ototoxicity, peripheral neuropathy
• •Immunotherapy: CAR-T cell therapy (tisagenlecleucel), checkpoint inhibitors, cytokine release syndrome management
• •HSCT: autologous vs. allogeneic, conditioning regimens, graft-versus-host disease (acute and chronic)
• •Radiation therapy: proton beam, total body irradiation, late effects
• •Blood product therapy: transfusion support, irradiated products, CMV-negative for immunocompromised

Study Activities:

• •Create a drug table: class, mechanism, key side effects, nursing implications
• •Study the top 20 chemotherapy agents used in pediatric oncology
• •Practice calculating BSA-based dosing
• •Review CAR-T cell therapy process: collection, manufacturing, infusion, monitoring

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Weeks 5–6: Symptom Management, Emergencies & Supportive Care

Goal: Master Domain IV (26%) and Domain V (21%) — the two highest-weighted domains

Key Topics — Symptom Management (26%):

• •Pain assessment in pediatric patients: age-appropriate scales (FLACC, Wong-Baker FACES, numeric)
• •System-specific complications: neurological, respiratory, cardiovascular, GI, renal, musculoskeletal, integumentary
• •Neutropenic precautions and infection prevention
• •Venous access devices: ports, PICCs, tunneled catheters — care, troubleshooting, complications
• •Colony-stimulating factors: G-CSF, dosing, monitoring
• •Palliative care and end-of-life considerations in pediatrics

Key Topics — Emergencies (21%):

• •Tumor lysis syndrome: risk factors, prevention (rasburicase, allopurinol), monitoring (uric acid, potassium, phosphorus, calcium)
• •Sepsis in immunocompromised children: recognition, initial management, antibiotic timing
• •Cytokine release syndrome: grading, tocilizumab, supportive care
• •Hyperleukocytosis: leukostasis risks, emergent management
• •Increased ICP: signs in children (bulging fontanelle in infants, morning headache, vomiting), management
• •Extravasation: immediate response, antidotes, documentation
• •DIC, hemorrhage, and coagulation emergencies

Study Activities:

• •Create emergency algorithm flowcharts for each pediatric oncology emergency
• •Practice NCLEX-style questions focusing on priority/nursing interventions
• •Study oncologic emergencies: tumor lysis syndrome, sepsis, increased ICP, CRS
• •Review age-appropriate pain assessment tools and developmental considerations

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Week 7: Psychosocial Care & Care Continuum

Goal: Master Domains I (6%) and VI (8%)

Key Topics:

• •Developmental considerations: how cancer affects each stage (infant, toddler, school-age, adolescent, young adult)
• •Family-centered care: parent education, sibling support, family dynamics
• •School reintegration: IEP/504 plans, educational liaisons
• •Grief and bereavement: anticipatory grief, cultural considerations, palliative care
• •Survivorship: long-term follow-up care, late effects screening, health promotion
• •Transition of care: pediatric to adult healthcare systems
• •Cultural competence and diversity in pediatric oncology care
• •Community resources: Camp Sunshine, Make-A-Wish, Leukemia & Lymphoma Society

Study Activities:

• •Review growth and development milestones for each age group
• •Study the impact of hospitalization on children at different developmental stages
• •Review survivorship care guidelines (COG long-term follow-up guidelines)

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Week 8: Practice Exams & Final Review

Goal: Simulate exam conditions and identify weak areas

Activities:

• •Take ONCC’s official CPHON practice test (50 questions free, 100 questions for $75)
• •Review the ONCC Test Reference List for 2026 — focus on any sources you haven’t read
• •Time yourself: complete 165 questions in 3 hours to build pacing skills
• •Review all missed questions and revisit those content areas
• •Focus extra time on Domains IV and V (combined 47% of exam)
• •The night before: light review only — no cramming. Get rest.

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Recommended Study Resources

• •ONCC CPHON Test Content Outline — the official blueprint of what’s tested
• •ONCC Test Reference List — updated annually with recommended reading
• •Capra Academy CPHON Study Guide — comprehensive review with practice questions and rationales
• •ONCC Practice Tests — 50 questions free, 100 for $75
• •APHON (Association of Pediatric Hematology/Oncology Nurses) — professional development resources
• •ONS (Oncology Nursing Society) — clinical resources and CE opportunities