OCN Symptom Management 1 — Questions and Answers
Question 1: A patient reports a pain level of 8/10 on opioid therapy. Which principle guides reassessment timing after a dose change?
- Reassess within 1 hour for IV opioids and 2 hours for oral opioids (Correct answer)
- Reassess only at the next scheduled visit
- Reassess after 24 hours for all routes
- Reassess only if the patient calls the nurse
Correct answer: Reassess within 1 hour for IV opioids and 2 hours for oral opioids
Reassessment after opioid dose adjustments should occur within 1 hour for IV and within 2 hours for oral routes to evaluate effectiveness.
Question 2: Which antiemetic class is considered first-line for chemotherapy-induced nausea and vomiting (CINV)?
- 5-HT3 receptor antagonists (e.g., ondansetron) (Correct answer)
- Dopamine antagonists (e.g., metoclopramide)
- Corticosteroids alone
- Benzodiazepines alone
Correct answer: 5-HT3 receptor antagonists (e.g., ondansetron)
5-HT3 receptor antagonists are the cornerstone of CINV prophylaxis, especially for highly emetogenic chemotherapy regimens.
Question 3: Mucositis in oncology patients most commonly occurs in which setting?
- After head and neck radiation or high-dose chemotherapy (Correct answer)
- During maintenance hormone therapy
- After targeted therapy with erlotinib
- During anti-CD20 immunotherapy
Correct answer: After head and neck radiation or high-dose chemotherapy
Mucositis—inflammation of the oral and GI mucosa—is most severe after head and neck radiation and high-dose chemotherapy with stem cell transplant.
Question 4: What is the first-line treatment for opioid-induced constipation in oncology patients?
- Stimulant laxative (e.g., senna) with or without a stool softener (Correct answer)
- Increased dietary fiber alone
- Increased water intake alone
- Enemas as needed only
Correct answer: Stimulant laxative (e.g., senna) with or without a stool softener
A stimulant laxative such as senna should be started prophylactically with opioid therapy because opioids suppress bowel motility.
Question 5: Cancer-related fatigue (CRF) differs from normal fatigue in which key way?
- CRF is not relieved by rest or sleep (Correct answer)
- CRF resolves after one full night of sleep
- CRF is caused only by anemia
- CRF only occurs during chemotherapy
Correct answer: CRF is not relieved by rest or sleep
Cancer-related fatigue is uniquely persistent and is not relieved by rest, distinguishing it from normal activity-related fatigue.
Question 6: Which non-pharmacological intervention has the strongest evidence for reducing cancer-related fatigue?
- Moderate aerobic exercise (Correct answer)
- Complete bed rest
- High-dose vitamins
- Massage therapy alone
Correct answer: Moderate aerobic exercise
Multiple systematic reviews show that moderate aerobic exercise is the most evidence-based non-pharmacological intervention for cancer-related fatigue.
OCN Symptom Management 1
A patient reports a pain level of 8/10 on opioid therapy.
Which principle guides reassessment timing after a dose change?