COCN COCN Oncologic Emergencies 2

Question 1

The first-line pharmacologic treatment for malignant hypercalcemia, after IV hydration, is:

Accepted Answer

IV zoledronic acid or pamidronate

Answer

IV bisphosphonates (zoledronic acid or pamidronate) are the drugs of choice for sustained lowering of serum calcium in malignancy.

Question 2

Which medication is the cornerstone of initial treatment for malignant spinal cord compression?

Accepted Answer

High-dose corticosteroids (dexamethasone)

Answer

High-dose dexamethasone reduces perilesional edema, preserving neurologic function while definitive treatment is arranged.

Question 3

A patient develops syndrome of inappropriate antidiuretic hormone (SIADH) secondary to small cell lung cancer. The primary nursing concern is:

Accepted Answer

Hyponatremia and fluid restriction

Answer

SIADH causes dilutional hyponatremia; fluid restriction is the primary treatment to reduce water retention.

Question 4

Which assessment finding indicates worsening cardiac tamponade requiring emergency pericardiocentesis?

Accepted Answer

Increasing pulsus paradoxus (>10 mmHg) with hemodynamic instability

Answer

Progressive pulsus paradoxus with hemodynamic compromise indicates critical tamponade physiology requiring immediate drainage.

Question 5

Neutropenic fever in an oncology patient is defined as a single temperature above 38.3°C (101°F) with an ANC below:

Accepted Answer

500/mm³

Answer

Neutropenic fever requires ANC <500/mm³ (or <1000/mm³ expected to fall), combined with fever, as per IDSA guidelines.

COCN Test Practice Test