OCN MCQ Flashcards

The initial course of action for a patient with a photoallergic reaction is:

Answer: Topical steroids

A photoallergic reaction is an immune-mediated skin reaction triggered by sun exposure after contact with a photosensitizing agent. The initial course of action involves reducing inflammation and suppressing the immune response in the affected skin. Topical steroids are the first-line treatment for localized photoallergic reactions due to their anti-inflammatory properties, which effectively alleviate symptoms like redness, itching, and rash.

The IOM's Six Aims of Quality Healthcare include all of the items below, with the exception of:

Answer: Safe and rapid

The Institute of Medicine (IOM), now the National Academy of Medicine, outlined six aims for quality healthcare: safe, effective, patient-centered, timely, efficient, and equitable. The option 'safe and rapid' is incorrect because 'rapid' is not one of the distinct aims. Instead, 'timely' is the correct aim, focusing on reducing harmful delays for both those who receive and those who give care.

Which of the following chemotherapy drugs is administered to treat the spread of prostate cancer?

Answer: Mitoxantrone (Novantrone)

Mitoxantrone (Novantrone) is an anthracenedione antineoplastic agent commonly used in the treatment of hormone-refractory metastatic prostate cancer. It works by interfering with DNA synthesis and repair, thereby inhibiting the growth of cancer cells. The other listed drugs are typically used for different types of cancer.

Due to severe and incurable pancreatic cancer, a patient was given hospice care and sent home with orders for morphine, lorazepam, and 2 L of oxygen. According to the nurse, which of the following situations poses the most risk to the patient's and the family's safety during the initial home visit?

Answer: The patient's wife is smoking in the living room

The presence of oxygen therapy in the home creates a significant fire hazard, as oxygen is highly combustible. Smoking in the same room as a patient receiving oxygen therapy dramatically increases the risk of a fire or explosion. This poses an immediate and severe threat to the patient's and family's safety, far outweighing other environmental factors.

The nurse is evaluating a patient with metastatic non-small cell lung cancer. During the assessment, the patient complains of periodic numbness and tingling in their hands and new back discomfort. The BEST thing the nurse can do is:

Answer: Communicate the finding to the appropriate provider

New neurological symptoms like numbness, tingling, and new back pain in a patient with metastatic cancer are concerning and require immediate medical evaluation. These symptoms could indicate serious complications such as spinal cord compression due to metastasis or peripheral neuropathy. Prompt communication with the provider ensures timely assessment and intervention, which is crucial for preventing further neurological damage or managing severe pain.

"I knew lymphedema could happen, but I never dreamed it would happen to me," a breast cancer survivor sobs. The nurse's first line of defense is to:

Answer: Allow the patient to express her feelings.

When a patient expresses strong emotions like sadness and disbelief, the nurse's initial priority is to provide emotional support and validate their feelings. Allowing the patient to express her feelings demonstrates empathy, builds trust, and helps the patient process the emotional impact of the diagnosis. While education and history taking are important, they should follow after addressing the immediate emotional distress.

A patient has been informed that adjuvant chemotherapy is required after cancer surgery. According to the nurse, adjuvant chemotherapy means:

Answer: Drugs given to target minimal disease or micro metastases

Adjuvant chemotherapy is administered after the primary treatment, such as surgery or radiation, to eliminate any remaining cancer cells that may not have been visible or completely removed. Its purpose is to target micrometastases or minimal residual disease. This reduces the risk of cancer recurrence and improves long-term survival rates.