AOCNP Advance Oncology Nursing 5

Question 1

A patient with metastatic melanoma on ipilimumab develops diarrhea with 7 stools above baseline per day and cramping. The MOST appropriate management is:

Accepted Answer

Hold ipilimumab and initiate high-dose systemic corticosteroids (prednisone 1–2 mg/kg/day)

Answer

Grade 3 immune-mediated colitis (≥7 stools above baseline) requires drug hold and high-dose systemic corticosteroids; infliximab is reserved for steroid-refractory cases.

Question 2

The oncology NP is reviewing a patient's DECIPHER genomic risk score after radical prostatectomy. This score MOST directly informs decisions about:

Accepted Answer

The need for adjuvant or salvage radiation therapy

Answer

The DECIPHER score predicts metastasis risk after radical prostatectomy and guides shared decision-making about adjuvant or salvage radiation.

Question 3

A patient with head and neck cancer completing radiation therapy reports severe odynophagia and is unable to maintain adequate oral intake. Which intervention is MOST appropriate to address nutritional needs?

Accepted Answer

Place a percutaneous endoscopic gastrostomy (PEG) tube for enteral feeding

Answer

A PEG tube provides reliable enteral nutrition for patients with severe radiation-induced mucositis-related dysphagia and is preferred over TPN when the gut is functional.

Question 4

Which nursing assessment finding would MOST strongly suggest superior vena cava (SVC) syndrome in a patient with lung cancer?

Accepted Answer

Facial plethora, neck vein distension, and worsening dyspnea when supine

Answer

SVC syndrome causes impaired venous return from the upper body, resulting in facial plethora, neck vein distension, and positional dyspnea (worse when lying flat).

Question 5

A patient asks about the difference between adjuvant and neoadjuvant chemotherapy. The BEST explanation is:

Accepted Answer

Neoadjuvant is given before primary treatment to downstage disease; adjuvant is given after to reduce recurrence risk

Answer

Neoadjuvant chemotherapy is administered before primary treatment (surgery/radiation) to reduce tumor size, while adjuvant chemotherapy is given afterward to eliminate micrometastatic disease.

AOCNP - Advanced Oncology Certified Nurse Practitioner Practice Test

AOCNP - Advanced Oncology Certified Nurse Practitioner Practice Test

AOCNP Advance Oncology Nursing 5