AOCNP Surgical Oncology and Perioperative Care 3

Question 1

Prehabilitation in the preoperative period for cancer surgery focuses on which intervention?

Accepted Answer

Optimizing physical fitness, nutrition, and psychological readiness before surgery

Answer

Administering preoperative chemotherapy exclusively

Answer

Initiating radiation therapy to shrink the tumor before resection

Answer

Completing all staging workup within 72 hours

Question 2

A patient undergoes abdominoperineal resection (APR) for rectal cancer and requires a permanent colostomy. Postoperative colostomy education should emphasize which priority?

Accepted Answer

Proper pouching system management, skin care, and expected output characteristics

Answer

Restricting all dietary intake for 6 weeks

Answer

Irrigation of the colostomy daily as the only management

Answer

Avoiding all physical activity permanently

Question 3

In breast-conserving surgery (lumpectomy) for breast cancer, which additional procedure is performed to assess locoregional lymph node involvement with minimal morbidity?

Accepted Answer

Sentinel lymph node biopsy (SLNB)

Answer

Complete axillary lymph node dissection (ALND) in all patients

Answer

CT-guided fine-needle aspiration of palpable nodes only

Answer

No nodal assessment — imaging suffices

Question 4

Milking or stripping surgical drains placed after oncologic surgery is now generally discouraged because:

Accepted Answer

It creates excessive negative pressure that can damage healing tissue and increase drainage volume

Answer

It causes immediate patient discomfort during dressing changes

Answer

Drains should never be touched by nurses

Answer

It reduces the risk of infection by maintaining suction

Question 5

Which lab value change in the immediate postoperative period after major cancer surgery most warrants notification of the surgical team?

Accepted Answer

Serum lactate >2 mmol/L with tachycardia and hypotension

Answer

Hemoglobin decrease of 0.5 g/dL from preoperative baseline

Answer

WBC increase from 7,000 to 9,000 post-surgery

Answer

Mild hyperglycemia (140–160 mg/dL) in a diabetic patient

Question 6

Intraoperative blood salvage (cell saver) use is CONTRAINDICATED in which oncologic surgery scenario?

Accepted Answer

Surgery for active infection or bacterial contamination

Answer

Hepatic resection for colorectal liver metastases

Answer

Radical cystectomy with urinary diversion

Answer

Major vascular reconstruction during cancer resection