AOCNP Cancer and Oncology Nursing 3 — Questions and Answers
Question 1: A patient with breast cancer is receiving doxorubicin. Which baseline assessment is most critical before initiating therapy?
- Serum creatinine and eGFR
- Echocardiogram or MUGA scan for cardiac function (Correct answer)
- Pulmonary function tests
- Liver biopsy
Correct answer: Echocardiogram or MUGA scan for cardiac function
Doxorubicin is cardiotoxic; baseline left ventricular ejection fraction must be established before starting therapy to monitor for cardiomyopathy.
Question 2: A patient with cancer reports pain rated 7/10 and is currently on scheduled oral morphine. The nurse notes the last dose was given 2 hours ago. What is the most appropriate action?
- Wait until the next scheduled dose
- Administer the prescribed breakthrough (PRN) opioid dose (Correct answer)
- Apply a fentanyl patch
- Request a non-opioid analgesic only
Correct answer: Administer the prescribed breakthrough (PRN) opioid dose
Breakthrough dosing is indicated for uncontrolled pain between scheduled doses and is a standard component of cancer pain management.
Question 3: Which dietary recommendation is appropriate for a patient with chemotherapy-induced mucositis?
- Encourage spicy foods to stimulate taste
- Offer soft, bland, moist foods at room temperature (Correct answer)
- Recommend carbonated beverages to maintain hydration
- Suggest citrus juices for vitamin C
Correct answer: Offer soft, bland, moist foods at room temperature
Soft, bland, moist foods at room temperature minimize mucosal irritation and are best tolerated during mucositis.
Question 4: A patient receiving paclitaxel develops hypersensitivity within minutes of starting the infusion. What is the FIRST nursing intervention?
- Slow the infusion rate and administer diphenhydramine
- Stop the infusion, maintain IV access, and call for emergency assistance (Correct answer)
- Administer epinephrine intramuscularly without delay
- Flush the line and switch to a different chemotherapy agent
Correct answer: Stop the infusion, maintain IV access, and call for emergency assistance
Stopping the infusion immediately and maintaining IV access while calling for help is the first step in managing chemotherapy hypersensitivity reactions.
Question 5: A patient with multiple myeloma is at greatest risk for which skeletal complication?
- Osteosarcoma of the long bones
- Pathological fractures due to osteolytic lesions (Correct answer)
- Osteoblastic lesions causing bone sclerosis
- Avascular necrosis of the femoral head
Correct answer: Pathological fractures due to osteolytic lesions
Multiple myeloma causes osteolytic (bone-destroying) lesions that significantly weaken bone structure, increasing the risk of pathological fractures.
Question 6: Which finding indicates an oncologic emergency requiring the nurse to contact the provider immediately?
- Hemoglobin 10.2 g/dL in a patient on chemotherapy
- Absolute neutrophil count (ANC) of 480/mm³ with fever of 38.4°C (Correct answer)
- Platelet count of 95,000/mm³ in a stable outpatient
- Serum potassium of 3.3 mEq/L in an asymptomatic patient
Correct answer: Absolute neutrophil count (ANC) of 480/mm³ with fever of 38.4°C
Febrile neutropenia (ANC <500 with fever ≥38.3°C) is a life-threatening oncologic emergency requiring immediate evaluation and empiric antibiotics.
Question 7: Which psychosocial intervention is most evidence-based for reducing cancer-related anxiety in newly diagnosed patients?
- Providing printed educational pamphlets only
- Referral to a clinical social worker or psycho-oncologist and support groups (Correct answer)
- Advising the patient to avoid discussing their diagnosis
- Prescribing benzodiazepines as first-line treatment
Correct answer: Referral to a clinical social worker or psycho-oncologist and support groups
Psychosocial support through trained professionals and peer support groups is the most evidence-based approach to managing cancer-related anxiety.
AOCNP Cancer and Oncology Nursing 3
A patient with breast cancer is receiving doxorubicin.
Which baseline assessment is most critical before initiating therapy?