Mixed Deck — All OCN Topics Flashcards

The 'teachback' method in patient education is best described as:

Answer: Asking the patient to explain the information back in their own words to confirm understanding

Teach-back is an evidence-based health literacy technique where the nurse asks the patient to restate information to verify comprehension before discharge.

Which of the following best prevents tumor lysis syndrome in high-risk patients starting chemotherapy?

Answer: Allopurinol or rasburicase plus aggressive IV hydration

Allopurinol (or rasburicase for very high-risk cases) combined with aggressive IV hydration is the standard prophylaxis for TLS in high-risk patients.

Cachexia in cancer patients is best described as:

Answer: A metabolic syndrome of weight loss, muscle wasting, and inflammation

Cancer cachexia is a complex metabolic syndrome driven by inflammation and tumor factors, causing involuntary weight loss and muscle wasting that cannot be fully reversed by nutrition alone.

Which early sign of increased intracranial pressure (ICP) from brain metastases should the oncology nurse recognize?

Answer: Morning headache that improves upon sitting upright

Headache that is worst in the morning and improves when upright is a classic early sign of elevated ICP from brain metastases due to positional changes in cerebrospinal fluid pressure.

The MASCC risk index is used in oncology to:

Answer: Identify low-risk febrile neutropenia patients eligible for oral antibiotics

The MASCC (Multinational Association for Supportive Care in Cancer) score stratifies febrile neutropenia into low vs. high risk, guiding outpatient vs. inpatient management.

Hot flashes in breast cancer survivors receiving aromatase inhibitors are best managed initially with which non-pharmacological approach?

Answer: Lifestyle modifications including layered clothing, cool room temperatures, and avoiding triggers

Non-pharmacological strategies such as trigger avoidance, cool environments, and layered clothing are recommended first because estrogen is contraindicated in breast cancer.

Why are immobilization devices (e.g., thermoplastic masks, body molds) used during radiation therapy?

Answer: To ensure reproducible patient positioning for each treatment fraction

Immobilization devices hold the patient in the exact same position for every treatment fraction, ensuring the radiation beam targets the tumor consistently throughout the course of therapy.

TNM staging for solid tumors classifies cancers based on which three factors?

Answer: Tumor size/extent, lymph Node involvement, and Metastasis

TNM staging uses primary tumor extent (T), regional lymph node involvement (N), and distant metastasis (M) to classify cancer stage and guide treatment.

Which chemotherapy agent is associated with hemorrhagic cystitis as a major side effect?

Answer: Cyclophosphamide

Cyclophosphamide's metabolite acrolein irritates the bladder lining, causing hemorrhagic cystitis; mesna and hydration are used for prevention.

A newly diagnosed cancer patient tells the nurse, 'I just can't believe this is happening to me.' The nurse's best therapeutic response is:

Answer: 'I understand this must be very difficult and shocking for you right now.'

Acknowledging the patient's emotional state with empathic reflection validates their experience and builds therapeutic trust.

What cumulative dose of doxorubicin is associated with the greatest risk of cardiomyopathy?

Answer: 450–550 mg/m²

Cardiotoxicity from doxorubicin significantly increases when the cumulative dose exceeds 450–550 mg/m².

Which element is essential in a comprehensive cancer survivorship care plan?

Answer: Summary of treatment received and schedule of recommended follow-up

A survivorship care plan must include a treatment summary and follow-up schedule so the patient and primary care provider can manage long-term and late effects.

What is the most appropriate dietary recommendation for a patient experiencing radiation-induced diarrhea from pelvic irradiation?

Answer: Low-residue, low-fat diet avoiding raw fruits, vegetables, and dairy

A low-residue, low-fat diet reduces bowel stimulation and stool frequency, easing radiation-induced diarrhea by decreasing the bulk that passes through the irritated bowel.

Which assessment finding is most characteristic of superior vena cava (SVC) syndrome in a cancer patient?

Answer: Facial and neck swelling with venous distension and dyspnea

SVC syndrome causes obstruction of venous drainage from the head and neck, resulting in facial/neck edema, venous distension, and respiratory distress.

Epithelial-to-mesenchymal transition (EMT) in cancer enables which key behavior?

Answer: Cancer cells to lose cell junctions and gain migratory and invasive properties

EMT is a developmental process hijacked by cancer cells to lose epithelial characteristics and gain mesenchymal traits, enabling migration and metastasis.

A patient receiving whole-brain radiation therapy reports significant fatigue. Which nursing intervention is most appropriate?

Answer: Teach energy conservation strategies and encourage light activity balanced with rest

Energy conservation techniques and a balance of activity and rest are the evidence-based first-line approach for managing radiation-induced fatigue without unnecessary deconditioning.

Which of the following best describes 'breakthrough pain' in cancer patients?

Answer: Transient flares of pain that exceed baseline despite stable around-the-clock analgesia

Breakthrough pain is a transient exacerbation of pain that occurs against a background of otherwise controlled baseline pain.

Which statement best reflects the nurse's role in informed consent for cancer treatment?

Answer: The nurse witnesses the signature, reinforces information, and ensures the patient's questions are answered

Informed consent is obtained by the physician; the nurse's role is to witness, reinforce information, and act as an advocate ensuring the patient's questions are addressed.

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.

A patient who completed chest radiation 6 weeks ago presents with fever, dry cough, and dyspnea. Which radiation complication is most likely?

Answer: Radiation pneumonitis

Radiation pneumonitis typically occurs 1–3 months after chest irradiation and presents with fever, dry cough, and dyspnea due to inflammatory lung damage.