AOCNP Radiation Oncology Nursing 4 — Questions and Answers
Question 1: A patient receiving pelvic radiation develops grade 3 radiation proctitis. Which intervention is most appropriate?
- Administer sucralfate enemas and low-residue diet (Correct answer)
- Increase dietary fiber intake immediately
- Discontinue radiation therapy permanently
- Initiate systemic corticosteroid therapy
Correct answer: Administer sucralfate enemas and low-residue diet
Sucralfate enemas coat and protect the rectal mucosa, and a low-residue diet reduces bowel irritation in grade 3 radiation proctitis.
Question 2: Which dosimetric parameter best predicts the risk of radiation-induced xerostomia when treating head and neck cancer?
- Mean parotid gland dose exceeding 26 Gy (Correct answer)
- Maximum spinal cord dose exceeding 45 Gy
- Mean mandible dose exceeding 50 Gy
- V20 of the larynx exceeding 30%
Correct answer: Mean parotid gland dose exceeding 26 Gy
A mean parotid gland dose above 26 Gy is strongly associated with permanent xerostomia in head and neck radiation therapy.
Question 3: A patient on concurrent chemoradiation with cisplatin reports tinnitus and decreased hearing. What is the priority nursing action?
- Notify the oncologist and hold cisplatin pending audiologic evaluation (Correct answer)
- Reassure the patient that these are expected side effects
- Increase IV hydration and continue treatment as scheduled
- Document findings and reassess at the next treatment visit
Correct answer: Notify the oncologist and hold cisplatin pending audiologic evaluation
Tinnitus and hearing loss are signs of cisplatin ototoxicity, requiring immediate oncologist notification and audiologic assessment before continuing treatment.
Question 4: During simulation for stereotactic body radiation therapy (SBRT) of a lung tumor, which immobilization technique is used to manage respiratory motion?
- 4D-CT with active breathing control or abdominal compression (Correct answer)
- Standard thermoplastic mask immobilization alone
- Prone positioning with wing board
- Free-breathing CT with no motion management
Correct answer: 4D-CT with active breathing control or abdominal compression
4D-CT captures tumor motion throughout the respiratory cycle, and devices like abdominal compression or active breathing control limit that motion for SBRT planning.
Question 5: A patient receiving whole brain radiation therapy (WBRT) asks about long-term cognitive effects. Which statement by the nurse is most accurate?
- Cognitive decline is a recognized late effect, and memantine may reduce its severity (Correct answer)
- WBRT does not cause cognitive changes because the dose is kept low
- Cognitive effects are temporary and fully resolve within 6 months
- Only patients over age 70 experience long-term cognitive changes from WBRT
Correct answer: Cognitive decline is a recognized late effect, and memantine may reduce its severity
Radiation-induced neurocognitive decline is a known late effect of WBRT, and clinical trials support memantine use to help preserve cognitive function.
Question 6: Which skin care recommendation is evidence-based for managing acute radiation dermatitis during breast irradiation?
- Use gentle, fragrance-free moisturizers and avoid tight clothing over the field (Correct answer)
- Apply hydrocortisone cream daily beginning on the first day of treatment
- Wash the treatment area with antibacterial soap to prevent infection
- Avoid any topical products in the radiation field throughout treatment
Correct answer: Use gentle, fragrance-free moisturizers and avoid tight clothing over the field
Fragrance-free moisturizers reduce discomfort and support skin integrity, while tight clothing increases friction and worsens dermatitis.
Question 7: A patient completing chemoradiation for anal cancer asks when to expect treatment response assessment. What is the correct nurse response?
- Response is typically assessed 8–12 weeks after treatment completion due to continued tumor regression (Correct answer)
- A PET-CT is performed immediately after the last radiation fraction
- Surgical resection is scheduled within 2 weeks if no visible response is seen
- Response cannot be assessed; surveillance colonoscopy is the only follow-up needed
Correct answer: Response is typically assessed 8–12 weeks after treatment completion due to continued tumor regression
Anal cancer continues to regress for up to 12 weeks post-treatment, so response assessment is deferred to allow full tumor response before determining further management.
AOCNP Radiation Oncology Nursing 4
A patient receiving pelvic radiation develops grade 3 radiation proctitis.
Which intervention is most appropriate?