OCC OCC Oncology Emergencies & Complications

Question 1

A patient 48 hours post-chemotherapy develops fever of 101.5°F, chills, and an ANC of 300/mm³. What is the nurse's IMMEDIATE priority?

Accepted Answer

Obtain blood cultures and initiate broad-spectrum antibiotics within 60 minutes per protocol

Answer

Administer acetaminophen and reassess in 2 hours

Answer

Isolate the patient and await the provider's morning rounds

Answer

Increase oral fluid intake and monitor temperature every 4 hours

Question 2

Which clinical findings are characteristic of superior vena cava (SVC) syndrome in an oncology patient?

Accepted Answer

Facial plethora, upper extremity edema, and distended neck veins

Answer

Hypotension, bradycardia, and peripheral edema

Answer

Severe hypercalcemia, constipation, and confusion

Answer

Bilateral leg edema and dyspnea on exertion

Question 3

A patient undergoing aggressive chemotherapy for leukemia develops hyperkalemia, hyperphosphatemia, hypocalcemia, and elevated uric acid. What syndrome is occurring?

Accepted Answer

Tumor lysis syndrome

Answer

Hypercalcemia of malignancy

Answer

Disseminated intravascular coagulation

Answer

Syndrome of inappropriate antidiuretic hormone

Question 4

Which intervention is the MOST critical in preventing tumor lysis syndrome in high-risk patients?

Accepted Answer

Aggressive IV hydration and allopurinol or rasburicase administration before chemotherapy

Answer

Restricting dietary potassium

Answer

Administering calcium gluconate prophylactically

Answer

Placing the patient on continuous telemetry only

Question 5

A cancer patient on opioids and vincristine develops abdominal distension, absence of bowel sounds, and no bowel movement in 5 days. What complication is suspected?

Accepted Answer

Ileus/bowel obstruction from vincristine-induced neurotoxicity

Answer

Chemotherapy-induced diarrhea

Answer

Bowel perforation

Answer

Peritoneal carcinomatosis

Question 6

A patient receiving high-dose cyclophosphamide reports severe bladder pain, urinary frequency, and grossly bloody urine. What complication has occurred?

Accepted Answer

Hemorrhagic cystitis from acrolein metabolite accumulation

Answer

Urinary tract infection

Answer

Renal failure from drug nephrotoxicity

Answer

Bladder cancer as a late effect