OCC OCC Chemotherapy-Induced Side Effects Management 1 — Questions and Answers
Question 1: A patient receiving cisplatin-based chemotherapy develops a serum creatinine of 2.1 mg/dL. Which intervention is the highest priority?
- Administer sodium bicarbonate IV
- Hold the next cisplatin dose and notify the oncologist (Correct answer)
- Increase the infusion rate to clear the drug faster
- Administer furosemide immediately
Correct answer: Hold the next cisplatin dose and notify the oncologist
Cisplatin is nephrotoxic, and a rising creatinine indicates renal impairment requiring dose hold and provider notification before proceeding.
Question 2: Which antiemetic class is MOST effective for preventing acute chemotherapy-induced nausea and vomiting (CINV) caused by highly emetogenic regimens?
- Dopamine antagonists (metoclopramide)
- Antihistamines (diphenhydramine)
- 5-HT3 receptor antagonists (ondansetron) (Correct answer)
- Corticosteroids alone
Correct answer: 5-HT3 receptor antagonists (ondansetron)
5-HT3 receptor antagonists are first-line agents for preventing acute CINV from highly emetogenic chemotherapy regimens.
Question 3: A patient on doxorubicin complains of mouth sores and is unable to eat. The nurse grades the mucositis as Grade 3. Which intervention is appropriate?
- Encourage hot liquids to stimulate saliva
- Initiate parenteral nutrition and notify the provider for dose modification (Correct answer)
- Apply petroleum jelly to the lips only
- Rinse with commercial mouthwash containing alcohol
Correct answer: Initiate parenteral nutrition and notify the provider for dose modification
Grade 3 mucositis (inability to eat) requires nutritional support and provider notification for possible chemotherapy dose modification.
Question 4: Which finding would MOST concern the oncology nurse when caring for a patient experiencing chemotherapy-induced peripheral neuropathy (CIPN)?
- Mild tingling in fingertips
- Inability to button a shirt or walk without assistance (Correct answer)
- Temporary numbness after infusion
- Sensitivity to cold during oxaliplatin infusion
Correct answer: Inability to button a shirt or walk without assistance
Loss of fine motor control and gait instability indicate severe functional impairment from CIPN, requiring urgent provider notification and possible dose modification.
Question 5: A patient receiving irinotecan develops profuse watery diarrhea 12 hours after infusion. What is the nurse's priority action?
- Administer loperamide per protocol and monitor hydration status (Correct answer)
- Encourage increased fluid intake and reassure the patient
- Prepare for immediate hospitalization
- Administer atropine for late-onset diarrhea
Correct answer: Administer loperamide per protocol and monitor hydration status
Late-onset diarrhea from irinotecan (>24 hours post-infusion) is managed with loperamide and vigilant hydration monitoring per protocol.
Question 6: Which lab value is the MOST critical to monitor for bone marrow suppression in a patient receiving myelosuppressive chemotherapy?
- Serum albumin
- Absolute neutrophil count (ANC) (Correct answer)
- Serum sodium
- Total bilirubin
Correct answer: Absolute neutrophil count (ANC)
The ANC is the primary indicator of neutropenia risk and infection susceptibility in patients receiving myelosuppressive chemotherapy.
OCC OCC Chemotherapy-Induced Side Effects Management 1
A patient receiving cisplatin-based chemotherapy develops a serum creatinine of 2.1 mg/dL.
Which intervention is the highest priority?