COCN COCN Oncologic Emergencies

Question 1

Superior vena cava (SVC) syndrome is most commonly caused by which malignancy in the United States?

Accepted Answer

Lung cancer and lymphoma

Answer

Lung cancer (especially small cell and squamous cell) and lymphoma account for the majority of SVC syndrome cases.

Question 2

A patient with SVC syndrome presents with facial swelling, plethora, and dyspnea. The priority nursing intervention is:

Accepted Answer

Elevate the head of the bed to 45 degrees and administer oxygen

Answer

Elevating the head reduces venous pressure in the upper body and supplemental oxygen addresses hypoxia in SVC syndrome.

Question 3

Spinal cord compression in a cancer patient most commonly presents with which early symptom?

Accepted Answer

Back pain that worsens with lying down or Valsalva maneuver

Answer

Back pain is the earliest and most common presenting symptom of malignant spinal cord compression, often preceding neurologic deficits.

Question 4

Which of the following cancers has the highest incidence of hypercalcemia of malignancy?

Accepted Answer

Squamous cell cancers and multiple myeloma

Answer

Squamous cell cancers (lung, head and neck) and multiple myeloma most frequently cause hypercalcemia through PTHrP or osteolytic mechanisms.

Question 5

A patient with lung cancer develops pulsus paradoxus, hypotension, and muffled heart sounds. The nurse recognizes this as:

Accepted Answer

Cardiac tamponade

Answer

Beck's triad (hypotension, muffled heart sounds, distended neck veins) plus pulsus paradoxus is classic for cardiac tamponade.

COCN Test Practice Test