OCN General Flashcards

A patient with non-Hodgkin lymphoma is receiving rituximab. Which pre-infusion assessment finding should cause the nurse to withhold the drug and notify the provider?

Answer: Temperature of 37.8°C (100°F) with suspected active infection

Rituximab can cause fatal infusion reactions and reactivation of infections; active infection warrants holding the drug and consulting the oncologist before proceeding.

Which clinical feature differentiates superior vena cava (SVC) syndrome from other oncologic emergencies?

Answer: Facial and upper extremity edema, venous distension of the neck and chest, and dyspnea

SVC syndrome presents with facial/arm edema, visible chest and neck vein distension, and dyspnea due to obstruction of venous return from the upper body to the right atrium.

A patient's caregiver asks about the purpose of a 'nadir' blood count check after chemotherapy. The nurse's best explanation is:

Answer: It identifies the point of lowest bone marrow function to monitor for infection and bleeding risk

The nadir is the lowest point of blood cell counts after chemotherapy (typically 7–14 days), representing the period of greatest vulnerability to infection and bleeding complications.

When caring for a patient with malignant pleural effusion, which intervention provides the most immediate relief of dyspnea?

Answer: Positioning in high Fowler's and assisting with thoracentesis

Thoracentesis to drain the effusion provides immediate relief of dyspnea by re-expanding the compressed lung; high Fowler's positioning aids breathing while preparing for the procedure.

A patient undergoing allogeneic stem cell transplant develops a skin rash, profuse diarrhea, and elevated bilirubin. The nurse recognizes these as signs of:

Answer: Graft-versus-host disease (GVHD)

The classic triad of skin rash, diarrhea, and liver dysfunction (elevated bilirubin) in an allogeneic transplant recipient indicates acute graft-versus-host disease caused by donor T-cells attacking host tissues.

Which nursing intervention best supports a patient's autonomy during the informed consent process for a clinical trial?

Answer: Ensuring the patient has adequate time to ask questions and understands they may withdraw at any time

True informed consent requires that patients fully understand risks, benefits, and alternatives and know they can withdraw without penalty; the nurse's role is to ensure comprehension and protect autonomy.

A patient with advanced cancer has a DNR order. They develop a bowel obstruction and severe pain. What is the nurse's priority action?

Answer: Focus on aggressive symptom management and comfort measures

A DNR order applies only to cardiopulmonary resuscitation; all other treatments, especially aggressive pain and symptom management, remain appropriate and are the priority in palliative care.