Radiation Oncology Nursing Flashcards

A patient receiving whole-brain radiation therapy (WBRT) is at highest risk for which late cognitive effect?

Answer: Radiation-induced cognitive decline including memory and executive function deficits

WBRT damages white matter and the hippocampus, producing progressive neurocognitive decline, particularly affecting memory and processing speed months to years later.

Concurrent chemoradiation is superior to radiation alone in which cancers because chemotherapy acts as a:

Answer: Radiosensitizer that enhances tumor cell kill by radiation

Radiosensitizing chemotherapy (e.g., cisplatin, 5-FU) impairs the tumor cell's ability to repair radiation-induced DNA damage, increasing local control and survival.

Proton beam therapy offers a dosimetric advantage over photon (X-ray) radiation because protons:

Answer: Deposit most of their energy at a specific depth (Bragg peak) with minimal exit dose

The Bragg peak allows protons to release their energy at the tumor depth with virtually no exit dose, reducing radiation to tissues beyond the tumor.

Radiation-induced lymphedema after axillary irradiation for breast cancer is best prevented by:

Answer: Avoiding trauma, infection, venipuncture, and blood pressure measurement in the affected arm, combined with weight management

Protecting the at-risk limb from infection, trauma, and compressive procedures minimizes additional lymphatic damage in an already compromised system.

A patient who received mantle field radiation for Hodgkin lymphoma 15 years ago presents for a routine visit. Which surveillance is most critically indicated?

Answer: Annual mammography starting 8–10 years after radiation or at age 25 for breast cancer screening

Mantle field radiation dramatically increases breast cancer risk; NCCN recommends annual MRI and mammography beginning 8–10 years post-treatment or at age 25, whichever is later.

Which assessment finding requires the radiation oncology NP to immediately contact the treating physician during a course of pelvic radiation?

Answer: Gross hematuria, severe rectal bleeding, or signs of bowel perforation

Gross hematuria, significant rectal hemorrhage, or perforation signs indicate severe acute radiation toxicity requiring immediate evaluation and possible treatment interruption.