OCN Symptom Management and Palliative Care 1 — Questions and Answers
Question 1: According to the WHO analgesic ladder, what class of medication is used at Step 3 for severe cancer pain?
- Non-opioid analgesics (e.g., acetaminophen)
- Weak opioids (e.g., codeine)
- Strong opioids (e.g., morphine) (Correct answer)
- Adjuvant analgesics only
Correct answer: Strong opioids (e.g., morphine)
Step 3 of the WHO analgesic ladder uses strong opioids such as morphine, oxycodone, or hydromorphone for severe pain.
Question 2: A cancer patient reports nausea that is worse with movement and relieved by staying still. Which antiemetic class best targets this type of nausea?
- 5-HT3 antagonists
- Antihistamines/anticholinergics (Correct answer)
- Dopamine antagonists
- Corticosteroids
Correct answer: Antihistamines/anticholinergics
Motion-related nausea is vestibular in origin and is best managed with antihistamines or anticholinergics such as meclizine or scopolamine.
Question 3: Which non-pharmacologic intervention is evidence-based for managing cancer-related fatigue?
- Prolonged bed rest
- Aerobic exercise (Correct answer)
- High-dose vitamin C supplementation
- Strict caloric restriction
Correct answer: Aerobic exercise
Moderate aerobic exercise is the most evidence-based intervention for cancer-related fatigue, improving energy and quality of life.
Question 4: What is the primary goal of palliative care in oncology?
- To provide curative treatment
- To improve quality of life by managing symptoms and psychosocial needs (Correct answer)
- To hasten death in terminal patients
- To replace all active cancer treatment
Correct answer: To improve quality of life by managing symptoms and psychosocial needs
Palliative care focuses on relieving suffering and improving quality of life for patients and families, and can be delivered alongside curative treatment.
Question 5: A patient on long-term opioid therapy reports no bowel movement in 4 days. The most appropriate first intervention is:
- Discontinue the opioid immediately
- Add a stimulant laxative such as senna (Correct answer)
- Recommend increased dietary fiber only
- Administer an enema without further assessment
Correct answer: Add a stimulant laxative such as senna
Opioid-induced constipation requires a stimulant laxative (e.g., senna) as first-line treatment; fiber alone is insufficient with opioids.
Question 6: Which scale is most commonly used in clinical practice to assess cancer pain intensity?
- Glasgow Coma Scale
- Numerical Rating Scale (NRS) 0–10 (Correct answer)
- Karnofsky Performance Status
- ECOG Performance Status
Correct answer: Numerical Rating Scale (NRS) 0–10
The 0–10 Numerical Rating Scale (NRS) is the most widely used clinical tool to assess pain intensity in cancer patients.
OCN Symptom Management and Palliative Care 1
According to the WHO analgesic ladder, what class of medication is used at Step 3 for severe cancer pain?