COCN Surgical Oncology Nursing 1 — Questions and Answers
Question 1: A patient is scheduled for a modified radical mastectomy. Which preoperative teaching should the oncology nurse prioritize?
- Instructions for chemotherapy administration
- How to manage a central venous catheter at home
- Arm exercises and range of motion activities post-surgery (Correct answer)
- Dietary restrictions during radiation therapy
Correct answer: Arm exercises and range of motion activities post-surgery
After mastectomy with axillary lymph node dissection, arm exercises and range of motion activities are essential to prevent lymphedema and restore upper extremity function.
Question 2: Which assessment finding in a postoperative oncology patient requires the most immediate nursing intervention?
- Pain score of 4/10 at rest
- Serosanguineous drainage from the surgical wound
- Oral temperature of 37.2°C (99°F)
- Urine output of 25 mL/hr for 2 consecutive hours (Correct answer)
Correct 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.
Question 3: A patient returns from colon resection surgery with a Jackson-Pratt drain. The nurse notes the drainage has changed from serosanguineous to bright red. What is the priority action?
- Document the finding and reassess in one hour
- Clamp the drain and elevate the affected area
- Notify the surgeon immediately (Correct answer)
- Irrigate the drain with normal saline
Correct answer: Notify the surgeon immediately
A change in drain output to bright red indicates active hemorrhage, which requires immediate surgical notification for evaluation and potential intervention.
Question 4: Which intervention is most appropriate to prevent surgical site infection in a patient undergoing colorectal cancer surgery?
- Apply antibiotic ointment to the incision after closure
- Administer prophylactic antibiotics within 60 minutes before incision (Correct answer)
- Shave the surgical site the evening before surgery
- Administer prophylactic antibiotics 4 hours after the procedure
Correct answer: Administer prophylactic antibiotics within 60 minutes before incision
Evidence-based guidelines recommend administering prophylactic antibiotics within 60 minutes before the surgical incision to achieve adequate tissue concentrations at the time of incision.
Question 5: A patient is recovering from a pancreaticoduodenectomy (Whipple procedure) for pancreatic cancer. Which postoperative complication is most common?
- Pneumothorax
- Anastomotic leak
- Bile duct obstruction
- Delayed gastric emptying (Correct answer)
Correct 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.
Question 6: A nurse caring for a patient after right hemicolectomy observes that the stoma appears dark purple-brown on postoperative day 2. What is the most appropriate nursing action?
- Apply warm compresses to improve circulation
- Irrigate the stoma with normal saline
- Document as a normal postoperative finding
- Notify the surgeon immediately (Correct answer)
Correct answer: Notify the surgeon immediately
A dark purple or brown stoma indicates compromised vascular supply and potential stomal ischemia or necrosis, requiring immediate surgical notification.
Question 7: Which Enhanced Recovery After Surgery (ERAS) protocol element is most effective in reducing postoperative ileus in cancer surgery patients?
- Routine nasogastric tube insertion postoperatively
- Prolonged NPO status beginning 12 hours before surgery
- Bed rest for the first 48 hours to preserve energy
- Early ambulation within 24 hours of surgery (Correct answer)
Correct answer: Early ambulation within 24 hours of surgery
Early ambulation within 24 hours is a core ERAS component that stimulates gastrointestinal motility and significantly reduces the duration of postoperative ileus.
COCN Surgical Oncology Nursing 1
A patient is scheduled for a modified radical mastectomy.
Which preoperative teaching should the oncology nurse prioritize?