OCN Symptom Management 2 — Questions and Answers
Question 1: Peripheral neuropathy induced by paclitaxel typically presents as which symptom pattern?
- Stocking-glove distribution numbness and tingling (Correct answer)
- Central chest pain and paresthesia
- Unilateral facial numbness
- Proximal muscle weakness only
Correct answer: Stocking-glove distribution numbness and tingling
Taxane-induced peripheral neuropathy typically causes a symmetric stocking-glove pattern of numbness, tingling, and burning in the extremities.
Question 2: A patient undergoing pelvic radiation for cervical cancer reports vaginal dryness and dyspareunia. The nurse should recommend:
- Vaginal moisturizers and dilator use as prescribed (Correct answer)
- Abstinence from all sexual activity permanently
- Hormone replacement therapy only
- Increased oral fluid intake
Correct answer: Vaginal moisturizers and dilator use as prescribed
Vaginal moisturizers and use of a vaginal dilator help maintain vaginal patency and moisture after pelvic radiation–induced mucosal changes.
Question 3: Hot flashes in breast cancer survivors receiving aromatase inhibitors are best managed initially with which non-pharmacological approach?
- Lifestyle modifications including layered clothing, cool room temperatures, and avoiding triggers (Correct answer)
- High-dose estrogen replacement
- Sedating antihistamines
- Increased caffeine intake
Correct 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.
Question 4: Tumor lysis syndrome (TLS) is most likely to occur in which cancer type after treatment initiation?
- Burkitt lymphoma and acute leukemia (Correct answer)
- Prostate cancer
- Colon cancer
- Melanoma
Correct answer: Burkitt lymphoma and acute leukemia
TLS is most common in rapidly proliferating tumors such as Burkitt lymphoma and acute leukemia because rapid cell death releases large amounts of intracellular contents.
Question 5: Which electrolyte abnormality is NOT associated with tumor lysis syndrome?
- Hypocalcemia (Correct answer)
- Hyperkalemia
- Hyperphosphatemia
- Hyperuricemia
Correct answer: Hypocalcemia
TLS causes hyperkalemia, hyperphosphatemia, hyperuricemia, and resultant hypocalcemia—not hypercalcemia; calcium falls because phosphate binds it.
Question 6: A patient with cancer reports a new severe headache rated 10/10 that began suddenly. The nurse's priority action is to:
- Notify the provider immediately — this may indicate CNS metastasis or hemorrhage (Correct answer)
- Administer PRN acetaminophen and reassess in 1 hour
- Document and reassess at the next scheduled assessment
- Apply a cool cloth and dim the lights
Correct answer: Notify the provider immediately — this may indicate CNS metastasis or hemorrhage
A sudden severe 'thunderclap' headache in a cancer patient is a red-flag symptom warranting immediate provider notification to rule out CNS emergency.
OCN Symptom Management 2
Peripheral neuropathy induced by paclitaxel typically presents as which symptom pattern?