OCN Symptom Management and Palliative Care 2 — Questions and Answers
Question 1: Mucositis is most likely to develop in patients receiving which treatment?
- Anti-hormonal therapy
- Checkpoint inhibitors
- High-dose methotrexate or radiation to the head and neck (Correct answer)
- Tyrosine kinase inhibitors
Correct answer: High-dose methotrexate or radiation to the head and neck
Mucositis is a common and painful complication of high-dose methotrexate and radiation to the head/neck region due to damage to rapidly dividing mucosal cells.
Question 2: A patient with advanced cancer reports dyspnea at rest. Which nursing intervention is most effective for immediate relief?
- Administer supplemental oxygen to all patients regardless of SpO2
- Position the patient upright and use a fan directed at the face (Correct answer)
- Encourage deep breathing exercises
- Restrict fluid intake
Correct answer: Position the patient upright and use a fan directed at the face
Upright positioning and a fan blowing air toward the face stimulate facial cold receptors and reduce the sensation of dyspnea.
Question 3: Which medication is first-line for treating opioid-induced nausea and vomiting?
- Ondansetron
- Prochlorperazine or metoclopramide (Correct answer)
- Lorazepam
- Dexamethasone
Correct answer: Prochlorperazine or metoclopramide
Opioid-induced nausea involves the chemoreceptor trigger zone; dopamine antagonists such as prochlorperazine or metoclopramide are first-line agents.
Question 4: Cachexia in cancer patients is best described as:
- Simple malnutrition from decreased oral intake
- A metabolic syndrome of weight loss, muscle wasting, and inflammation (Correct answer)
- A side effect of antiemetics
- Dehydration due to vomiting
Correct 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.
Question 5: Which assessment tool is validated specifically for measuring overall symptom burden in cancer patients?
- CAGE questionnaire
- Edmonton Symptom Assessment System (ESAS) (Correct answer)
- Mini-Mental State Examination
- Braden Scale
Correct answer: Edmonton Symptom Assessment System (ESAS)
The Edmonton Symptom Assessment System (ESAS) measures 9–10 common cancer symptoms using 0–10 scales and is validated for oncology populations.
Question 6: A patient with cancer develops sudden onset of confusion. Which potentially reversible cause should the nurse investigate first?
- Disease progression to the brain
- Hypercalcemia (Correct answer)
- Terminal restlessness
- Opioid tolerance
Correct answer: Hypercalcemia
Hypercalcemia of malignancy is a common and reversible cause of acute confusion in cancer patients and must be ruled out promptly.
OCN Symptom Management and Palliative Care 2
Mucositis is most likely to develop in patients receiving which treatment?