OCN MCQ Flashcards

A patient receiving immunotherapy with pembrolizumab develops a new onset dry cough and dyspnea at rest. The nurse should suspect:

Answer: Immune-mediated pneumonitis

PD-1 inhibitors like pembrolizumab can cause immune-related pneumonitis, requiring prompt evaluation and possible immunosuppressive therapy.

Which cancer screening recommendation aligns with current American Cancer Society guidelines for average-risk adults?

Answer: Colorectal cancer screening beginning at age 45

The ACS updated guidelines recommend colorectal cancer screening beginning at age 45 for average-risk individuals.

A patient's pain is described as burning and shooting down the leg following spinal metastasis. This type of pain is classified as:

Answer: Neuropathic pain

Burning, shooting, or electric shock-like pain radiating along a nerve distribution is characteristic of neuropathic pain.

A patient with cancer-related hypercalcemia of malignancy is most likely to present with which set of symptoms?

Answer: Fatigue, constipation, polyuria, and confusion

Hypercalcemia classically presents with fatigue, constipation, polyuria/polydipsia, and altered mental status (bones, stones, groans, moans).

During a blood product transfusion, a patient reports chills, back pain, and dark urine 15 minutes into the infusion. The nurse's priority action is to:

Answer: Stop the transfusion immediately and maintain IV access with normal saline

These symptoms indicate an acute hemolytic transfusion reaction; the transfusion must be stopped immediately while IV access is maintained.

Which chemotherapy agent class is most commonly associated with secondary leukemia as a long-term complication?

Answer: Alkylating agents and topoisomerase II inhibitors

Alkylating agents and topoisomerase II inhibitors are most strongly linked to treatment-related myelodysplastic syndrome and AML.

A patient on long-term opioid therapy for cancer pain reports worsening constipation unresponsive to laxatives. Which agent is specifically FDA-approved for opioid-induced constipation in cancer patients?

Answer: Naloxegol or methylnaltrexone

Peripherally acting mu-opioid receptor antagonists (PAMORAs) like naloxegol and methylnaltrexone are specifically approved for opioid-induced constipation without reversing central analgesia.