OCN General Flashcards

A patient receiving doxorubicin reports shortness of breath and a new nonproductive cough. Which complication should the nurse suspect first?

Answer: Cardiotoxicity with heart failure

Doxorubicin causes cumulative dose-dependent cardiotoxicity that can lead to dilated cardiomyopathy and heart failure, presenting with dyspnea and cough.

Which assessment finding in a patient with cancer indicates hypercalcemia of malignancy requiring urgent intervention?

Answer: Serum calcium of 13.5 mg/dL with confusion and polyuria

A serum calcium above 12 mg/dL with neurological symptoms (confusion) and polyuria represents severe hypercalcemia of malignancy requiring urgent IV hydration and bisphosphonate therapy.

The nurse is assessing oral mucositis in a chemotherapy patient using the NCI grading scale. Which finding corresponds to Grade 3 mucositis?

Answer: Severe symptoms preventing adequate oral intake

NCI Grade 3 mucositis is characterized by severe symptoms that prevent adequate oral intake, requiring enteral or parenteral nutritional support.

A cancer patient is receiving high-dose methotrexate. What is the primary antidote used to rescue normal cells?

Answer: Leucovorin (folinic acid)

Leucovorin (folinic acid) rescue bypasses the dihydrofolate reductase blockade caused by methotrexate, protecting normal cells from folate depletion toxicity.

Which type of cancer is most strongly associated with the Philadelphia chromosome (BCR-ABL translocation)?

Answer: Chronic myeloid leukemia (CML)

The Philadelphia chromosome (translocation between chromosomes 9 and 22) creating the BCR-ABL fusion gene is the hallmark of chronic myeloid leukemia.

When a patient with cancer develops spinal cord compression, which symptom requires the most urgent nursing assessment?

Answer: New onset urinary or bowel incontinence with back pain

New bowel or bladder dysfunction combined with back pain signals potential spinal cord compression, an oncologic emergency requiring immediate imaging and intervention to prevent permanent paralysis.

A patient receiving bevacizumab (a VEGF inhibitor) should be monitored most closely for which specific complication?

Answer: Hypertension and wound healing impairment

Bevacizumab inhibits vascular endothelial growth factor, leading to hypertension, impaired wound healing, and risk of arterial thromboembolism or GI perforation.