Advance Oncology Nursing Flashcards

A patient receiving cisplatin-based chemotherapy develops tinnitus and decreased high-frequency hearing. Which intervention is most appropriate?

Answer: Discontinue cisplatin and notify the oncologist immediately

Tinnitus and high-frequency hearing loss are signs of cisplatin-induced ototoxicity, which requires immediate discontinuation and oncologist notification.

Which grading tool is most appropriate for evaluating chemotherapy-induced peripheral neuropathy (CIPN) severity in clinical oncology practice?

Answer: NCI Common Terminology Criteria for Adverse Events (CTCAE)

The NCI CTCAE provides standardized grading (1–4) for peripheral neuropathy and is the standard tool used in oncology clinical trials and practice.

A patient on pembrolizumab develops a skin rash covering 35% of body surface area with mucosal involvement. What is the FIRST priority action?

Answer: Permanently discontinue pembrolizumab and initiate IV corticosteroids

Grade 3 immune-mediated dermatitis with mucosal involvement requires permanent discontinuation of the checkpoint inhibitor and systemic high-dose corticosteroids.

When counseling a premenopausal woman with hormone receptor-positive breast cancer about fertility preservation, which option is safest prior to chemotherapy?

Answer: Embryo or oocyte cryopreservation before chemotherapy

Embryo or oocyte cryopreservation before chemotherapy is the most established and effective fertility preservation method for premenopausal women.

A patient with multiple myeloma receiving bortezomib develops new-onset tingling and burning pain in bilateral feet. The MOST appropriate next step is to:

Answer: Switch to carfilzomib and initiate gabapentin

Bortezomib causes peripheral neuropathy; switching to subcutaneous carfilzomib (less neurotoxic) and initiating neuropathic pain management with gabapentin is appropriate.

Which parameter is MOST critical to monitor in a patient receiving high-dose methotrexate therapy?

Answer: Serum creatinine and urine pH

Methotrexate is renally cleared and crystallizes in acidic urine; monitoring renal function and maintaining urine pH above 7 prevents nephrotoxicity and delayed clearance.

A patient with non-small cell lung cancer develops new-onset confusion, hypercalcemia (Ca 13.5 mg/dL), and polyuria. This presentation is MOST consistent with which oncologic emergency?

Answer: Hypercalcemia of malignancy

Confusion, elevated serum calcium, and polyuria (nephrogenic diabetes insipidus from hypercalcemia) are classic features of hypercalcemia of malignancy.