AOCNP Cancer and Oncology Nursing 2 — Questions and Answers
Question 1: A patient receiving cisplatin-based chemotherapy develops tinnitus and high-frequency hearing loss. Which intervention is the nurse's priority?
- Administer amifostine as ordered
- Notify the oncologist immediately and document findings (Correct answer)
- Schedule an audiologist referral for next week
- Reassure the patient this is a temporary side effect
Correct answer: Notify the oncologist immediately and document findings
Ototoxicity is a serious cisplatin toxicity that should be promptly reported to the oncologist as it may require dose modification or discontinuation.
Question 2: Which laboratory finding is most consistent with tumor lysis syndrome (TLS)?
- Hypercalcemia, hypokalemia, and hyperphosphatemia
- Hyperkalemia, hyperphosphatemia, hypocalcemia, and hyperuricemia (Correct answer)
- Hyponatremia, hypophosphatemia, and hypocalcemia
- Hypernatremia, hypercalcemia, and hyperuricemia
Correct answer: Hyperkalemia, hyperphosphatemia, hypocalcemia, and hyperuricemia
TLS is characterized by hyperkalemia, hyperphosphatemia, hypocalcemia, and hyperuricemia from rapid tumor cell lysis releasing intracellular contents.
Question 3: A nurse is caring for a patient with malignant hypercalcemia. Which symptom would the nurse expect to assess?
- Muscle twitching and positive Chvostek's sign
- Bradycardia, confusion, constipation, and polyuria (Correct answer)
- Tetany and seizures
- Hyperreflexia and diarrhea
Correct answer: Bradycardia, confusion, constipation, and polyuria
Malignant hypercalcemia presents with bradycardia, altered mental status, constipation, and polyuria (stones, bones, groans, moans).
Question 4: Which cancer has the highest association with paraneoplastic syndrome of inappropriate antidiuretic hormone secretion (SIADH)?
- Colorectal cancer
- Small cell lung cancer (Correct answer)
- Prostate cancer
- Breast cancer
Correct answer: Small cell lung cancer
Small cell lung cancer is the most common malignancy associated with SIADH due to ectopic ADH production by tumor cells.
Question 5: An oncology nurse is assessing a patient for superior vena cava (SVC) syndrome. Which early sign should prompt immediate action?
- Dependent edema in bilateral lower extremities
- Facial edema and arm swelling worse in the morning (Correct answer)
- Hypotension and tachycardia
- Fever and chills
Correct answer: Facial edema and arm swelling worse in the morning
Facial and arm edema that is worse upon awakening is an early hallmark of SVC syndrome due to venous obstruction.
Question 6: When administering a vesicant chemotherapy agent peripherally, the patient complains of burning and the nurse notes swelling at the IV site. What is the priority intervention?
- Flush the line with normal saline and slow the infusion rate
- Stop the infusion immediately, leave the needle in place, and aspirate residual drug (Correct answer)
- Apply warm compresses and notify the pharmacist
- Remove the IV immediately and apply ice to the site
Correct answer: Stop the infusion immediately, leave the needle in place, and aspirate residual drug
The priority is to stop the infusion and leave the needle in place to aspirate residual drug before applying antidote, per extravasation management protocol.
Question 7: Which grading scale is most widely used to classify chemotherapy-induced adverse effects in clinical oncology practice?
- Karnofsky Performance Scale
- NCI Common Terminology Criteria for Adverse Events (CTCAE) (Correct answer)
- Eastern Cooperative Oncology Group (ECOG) scale
- Numerical Rating Scale (NRS)
Correct answer: NCI Common Terminology Criteria for Adverse Events (CTCAE)
The NCI CTCAE is the standardized tool used in oncology to grade the severity (grades 1–5) of treatment-related adverse events.
AOCNP Cancer and Oncology Nursing 2
A patient receiving cisplatin-based chemotherapy develops tinnitus and high-frequency hearing loss.
Which intervention is the nurse's priority?