Mixed Deck — All COCN Topics Flashcards

What cultural considerations should oncology nurses address in patient education?

Answer: Language preferences, health beliefs, decision-making practices, and spiritual needs

Culturally competent education considers the patient's language and literacy, cultural health beliefs and practices, family roles in decision-making, spiritual and religious considerations, and preferred communication styles.

What does the WOCN recommend regarding patient education?

Answer: Demonstrate care and allow patient practice

The WOCN (Wound, Ostomy and Continence Nurses Society) strongly advocates for a hands-on approach to patient education, recommending that nurses demonstrate ostomy care procedures and then allow patients to practice these skills themselves. This active learning approach builds confidence, reinforces learning, and promotes self-efficacy in managing their ostomy independently. It ensures practical competence.

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

Answer: High-dose corticosteroids (dexamethasone)

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

When preparing a neutropenic fever patient for empiric antibiotic therapy, what is the target time from fever detection to first antibiotic dose?

Answer: Within 1 hour

Current oncology guidelines recommend administering empiric broad-spectrum antibiotics within 60 minutes of fever identification in neutropenic patients.

Which reading material is most appropriate for evidence-based ostomy care guidelines?

Answer: WOCN clinical guidelines

The WOCN (Wound, Ostomy and Continence Nurses Society) clinical guidelines are specifically developed and regularly updated based on the latest evidence to provide comprehensive, authoritative recommendations for ostomy care. They are the most appropriate resource for healthcare professionals seeking evidence-based practices in this specialized field, ensuring high-quality patient care.

What radiation safety precautions must nurses follow when caring for patients with sealed radioactive implants?

Answer: Minimize time near the patient, maximize distance, and use shielding

The three principles of radiation protection — time (minimize exposure time), distance (maximize distance from the source), and shielding (use lead barriers when available) — apply when caring for patients with sealed radioactive implants.

According to best practices, what is the recommended frequency for assessing peristomal skin?

Answer: At every routine care session

Best practices dictate that peristomal skin should be assessed at every routine care session, particularly during each appliance change. This frequent assessment allows for early detection of any irritation, breakdown, or complications, enabling prompt intervention and prevention of more severe skin issues. Consistent monitoring is key to maintaining skin health.

In the management of DIC in an oncology patient, which blood product replaces clotting factors V and VIII most effectively?

Answer: Fresh frozen plasma (FFP)

FFP contains all clotting factors and is the primary product for replacing factor deficiencies in DIC.

A patient is recovering from a pancreaticoduodenectomy (Whipple procedure) for pancreatic cancer. Which postoperative complication is most common?

Answer: Delayed gastric emptying

Delayed gastric emptying is the most frequently occurring complication after pancreaticoduodenectomy, affecting 20–50% of patients due to disruption of gastric motility pathways.

Which type of leukemia is most commonly diagnosed in adults over 65 years old in the United States?

Answer: Chronic lymphocytic leukemia (CLL)

CLL is the most common adult leukemia in the US, predominantly affecting older adults.

What is the purpose of premedication before chemotherapy?

Answer: To prevent or reduce side effects such as nausea, allergic reactions, and hypersensitivity

Premedications (antiemetics, corticosteroids, antihistamines, antipyretics) are given before chemotherapy to prevent or minimize common side effects like nausea, vomiting, and hypersensitivity reactions.

Which assessment finding in a postoperative oncology patient requires the most immediate nursing intervention?

Answer: Urine output of 25 mL/hr for 2 consecutive hours

Urine output below 30 mL/hr for 2 consecutive hours indicates potential hypovolemia or renal compromise requiring immediate assessment and intervention.

Cachexia in advanced cancer is characterized by:

Answer: Systemic inflammation-driven metabolic changes causing muscle wasting not fully reversible with nutrition

Cancer cachexia involves complex cytokine-driven catabolism of muscle and fat that cannot be reversed by caloric supplementation alone.

Which laboratory value is most critical to monitor before administering myelosuppressive chemotherapy?

Answer: Absolute neutrophil count (ANC)

The ANC is the most critical value because myelosuppressive chemotherapy further decreases white blood cell production, and administering treatment with an already low ANC increases the risk of life-threatening neutropenic infections.

Which nursing assessment finding in a patient with acute leukemia would prompt the nurse to immediately notify the physician?

Answer: Sudden onset of severe headache and visual changes

Sudden headache and visual changes in a leukemia patient suggest CNS leukemia or intracranial bleeding, requiring urgent evaluation.

How should chemotherapy spills be managed in a healthcare facility?

Answer: Using a chemotherapy spill kit with absorbent materials and proper PPE per facility protocol

Chemotherapy spills require immediate response using a designated spill kit containing absorbent materials, PPE, waste disposal bags, and decontamination agents, following the facility's hazardous drug spill protocol.

What is compassion fatigue and how does it affect oncology nurses?

Answer: Physical and emotional exhaustion from caring for suffering patients, leading to reduced empathy and burnout

Compassion fatigue is a state of physical and emotional exhaustion that develops from repeated exposure to patients' suffering, potentially leading to decreased empathy, emotional numbness, burnout, and reduced quality of care.

What does recent literature recommend to reduce risk of peristomal moisture-associated dermatitis?

Answer: Proper fitting appliance and skin barrier

Recent literature consistently emphasizes that a properly fitting appliance and skin barrier are the most critical factors in preventing peristomal moisture-associated dermatitis. A well-fitted barrier prevents stoma output from contacting the skin, thereby protecting it from irritation and breakdown caused by moisture and enzymes. Ensuring a snug, secure fit is paramount.

What tool is used to measure the stoma for proper appliance fitting?

Answer: Measuring guide

A specialized measuring guide, often provided by ostomy product manufacturers, is used to accurately measure the stoma's diameter and shape. This precise measurement is crucial for cutting the skin barrier opening to the correct size, ensuring a snug fit that protects the peristomal skin from effluent and prevents leakage. Regular remeasurement is necessary as stoma size can change over time.

Which imaging modality is preferred for emergency evaluation of suspected malignant spinal cord compression?

Answer: MRI of the entire spine

MRI of the entire spine is the gold standard for identifying the level and extent of epidural cord compression.