Neuroblastoma arises from neural crest-derived sympathetic cells. These cells normally mature into parts of the sympathetic nervous system and adrenal medulla. When maturation fails and malignant transformation occurs, tumour growth may occur along the sympathetic chain. Common primary sites include: Site Clinical relevance Adrenal gland / abdomen Most common; abdominal mass, distention, pain, feeding issues Chest / mediastinum Cough, respiratory distress, dysphagia Neck Visible mass, Horner syndrome Paraspinal area Spinal cord compression risk Bone / bone marrow metastasis Bone pain, limp, anemia, thrombocytopenia, infection risk For NCLEX-RN (Canada), items rarely announce the topic in the first sentence. Anchor to objective data, trajectory, and the safest next step for the role named in the stem before distractors compete. On the exam, writers often pair stable-sounding options with unstable data—notice the mismatch before you commit. If the stem names a license or role, reread that line; scope errors are classic trap answers even when the clinical topic is familiar. Run a 60-second scan: breathing work and oxygenation, perfusion and end organs, neuro baseline, likely infection sources, and devices that can fail quietly.