AOCNP Radiation Oncology Nursing 2 — Questions and Answers
Question 1: Radiation pneumonitis typically presents within which timeframe after thoracic radiation?
- 1–6 months after completion of radiation (Correct answer)
- Within the first week of treatment
- More than 2 years after treatment
- Only during active treatment fractions
Correct answer: 1–6 months after completion of radiation
Radiation pneumonitis presents 1–6 months after thoracic irradiation with dyspnea, cough, and low-grade fever as inflammatory cytokines accumulate in irradiated lung.
Question 2: The principal long-term complication of radiation to the head and neck that impairs nutrition is:
- Xerostomia and dysphagia from salivary gland and pharyngeal muscle damage (Correct answer)
- Peripheral neuropathy
- Hepatic fibrosis
- Bone marrow suppression
Correct answer: Xerostomia and dysphagia from salivary gland and pharyngeal muscle damage
Radiation damages the parotid glands causing permanent dry mouth (xerostomia) and fibroses pharyngeal muscles causing dysphagia, both profoundly affecting nutrition.
Question 3: Brachytherapy involves:
- Placement of radioactive sources directly into or adjacent to the tumor (Correct answer)
- External beam radiation from a linear accelerator
- Oral administration of radioactive iodine
- Intravenous infusion of a radioactive antibody
Correct answer: Placement of radioactive sources directly into or adjacent to the tumor
Brachytherapy positions radioactive sources (seeds, needles, or catheters) inside or near the tumor, delivering high local doses while rapidly sparing surrounding tissues.
Question 4: Radiation-induced hypothyroidism is a common late effect of radiation to which anatomic region?
- Neck, including fields used for head and neck cancers or lymphoma (Correct answer)
- Pelvis
- Chest only below the clavicles
- Abdomen below the diaphragm
Correct answer: Neck, including fields used for head and neck cancers or lymphoma
The thyroid gland sits in the neck and receives significant dose during radiation for head and neck cancers, Hodgkin lymphoma, and medulloblastoma, leading to hypothyroidism in up to 50% of patients.
Question 5: Which nursing intervention is most important for a patient with high-dose rate (HDR) brachytherapy applicators in place?
- Monitor applicator position, assess pain, and maintain bed rest per protocol (Correct answer)
- Encourage ambulation every 2 hours
- Remove and reinsert applicators for comfort
- Administer prophylactic chemotherapy
Correct answer: Monitor applicator position, assess pain, and maintain bed rest per protocol
Applicator displacement changes the radiation dose distribution; pain and immobility must be managed while the patient remains in bed to prevent migration.
Question 6: Radiation-induced secondary malignancy risk is greatest for which patient population?
- Children and young adults treated with radiation at a young age (Correct answer)
- Adults over 70 years treated for prostate cancer
- Patients receiving palliative radiation only
- Patients with brain metastases
Correct answer: Children and young adults treated with radiation at a young age
Younger patients have greater remaining lifespan for secondary cancers to develop, and growing tissues are more radiosensitive, making pediatric and young adult survivors highest risk.
AOCNP Radiation Oncology Nursing 2
Radiation pneumonitis typically presents within which timeframe after thoracic radiation?