OCC OCC Chemotherapy-Induced Side Effects Management 2 — Questions and Answers
Question 1: A patient's ANC is 450/mm³ on day 10 of their chemotherapy cycle. What is the nurse's priority intervention?
- Restrict all visitors and enforce neutropenic precautions (Correct answer)
- Administer prophylactic antibiotics without a provider order
- Continue normal care with standard handwashing only
- Delay the neutropenic precautions until ANC is below 100/mm³
Correct answer: Restrict all visitors and enforce neutropenic precautions
An ANC below 500/mm³ indicates severe neutropenia, requiring immediate implementation of neutropenic precautions to prevent life-threatening infection.
Question 2: Which chemotherapy agent is MOST associated with hand-foot syndrome (palmar-plantar erythrodysesthesia)?
- Vincristine
- Capecitabine (Correct answer)
- Cyclophosphamide
- Carboplatin
Correct answer: Capecitabine
Capecitabine is the agent most commonly associated with hand-foot syndrome, characterized by painful redness, swelling, and blistering of the palms and soles.
Question 3: A patient receiving bleomycin develops new-onset dry cough and dyspnea. What is the nurse's FIRST action?
- Administer a bronchodilator and monitor
- Stop the infusion and notify the provider immediately (Correct answer)
- Reassure the patient that this is a common side effect
- Reduce the infusion rate by half
Correct answer: Stop the infusion and notify the provider immediately
New pulmonary symptoms in a patient receiving bleomycin may indicate pulmonary toxicity, which is potentially fatal and requires immediate cessation and provider notification.
Question 4: Which instruction is MOST important for a patient experiencing chemotherapy-induced alopecia?
- Use a firm-bristle brush to stimulate scalp circulation
- Avoid sun exposure to the scalp and use SPF protection (Correct answer)
- Apply minoxidil twice daily to prevent hair loss
- Shampoo the scalp daily with medicated shampoo
Correct answer: Avoid sun exposure to the scalp and use SPF protection
The exposed scalp is vulnerable to UV damage during chemotherapy-induced alopecia, so sun protection is the most important self-care instruction.
Question 5: A patient on high-dose methotrexate reports decreased urine output and dark urine. Which intervention should the nurse anticipate?
- Restricting IV fluids to prevent overload
- Increasing urine alkalinization with sodium bicarbonate and aggressive hydration (Correct answer)
- Administering leucovorin rescue immediately without provider order
- Stopping oral medications only
Correct answer: Increasing urine alkalinization with sodium bicarbonate and aggressive hydration
Urine alkalinization and aggressive hydration prevent methotrexate precipitation in the renal tubules, reducing nephrotoxicity risk.
Question 6: A patient experiencing chemotherapy-induced fatigue rates their fatigue as 8/10. Which recommendation has the STRONGEST evidence for managing cancer-related fatigue?
- Complete bed rest until the end of treatment
- Moderate aerobic exercise tailored to tolerance (Correct answer)
- High-dose vitamin C supplementation
- Scheduled napping for 3 or more hours daily
Correct answer: Moderate aerobic exercise tailored to tolerance
Moderate aerobic exercise is the intervention with the strongest evidence for reducing cancer-related fatigue during and after chemotherapy.
OCC OCC Chemotherapy-Induced Side Effects Management 2
A patient's ANC is 450/mm³ on day 10 of their chemotherapy cycle.
What is the nurse's priority intervention?