OCN OCN General 2 — Questions and Answers
Question 1: A patient receiving cisplatin-based chemotherapy develops tinnitus and decreased hearing. Which intervention is the priority?
- Administer antihistamines
- Notify the oncologist and hold the next dose (Correct answer)
- Reassure the patient this is temporary
- Increase IV fluid rate
Correct answer: Notify the oncologist and hold the next dose
Tinnitus and hearing loss are signs of cisplatin-induced ototoxicity, a serious irreversible adverse effect requiring immediate provider notification before continuing therapy.
Question 2: Which laboratory finding most strongly indicates tumor lysis syndrome (TLS) in a newly treated leukemia patient?
- Elevated serum sodium
- Elevated serum potassium, phosphate, and uric acid with decreased calcium (Correct answer)
- Decreased serum potassium and elevated calcium
- Elevated serum albumin and decreased BUN
Correct answer: Elevated serum potassium, phosphate, and uric acid with decreased calcium
TLS is characterized by hyperkalemia, hyperphosphatemia, hyperuricemia, and hypocalcemia due to rapid cell destruction releasing intracellular contents.
Question 3: A nurse is caring for a patient with cancer-related fatigue. Which recommendation is most evidence-based?
- Complete bed rest throughout treatment
- Encourage a structured, moderate aerobic exercise program (Correct answer)
- Avoid all physical activity until treatment ends
- Recommend high-dose vitamin C supplementation
Correct answer: Encourage a structured, moderate aerobic exercise program
Evidence consistently supports moderate aerobic exercise as the most effective intervention for cancer-related fatigue during and after treatment.
Question 4: A patient is prescribed ondansetron for chemotherapy-induced nausea. The nurse should monitor for which cardiac side effect?
- Bradycardia
- QT prolongation (Correct answer)
- Atrial fibrillation
- Hypertension
Correct answer: QT prolongation
Ondansetron (a 5-HT3 antagonist) can cause QT interval prolongation, increasing the risk of serious dysrhythmias such as torsades de pointes.
Question 5: When educating a patient about neutropenia precautions, which food should the nurse instruct the patient to avoid?
- Cooked chicken breast
- Pasteurized yogurt
- Raw sushi (Correct answer)
- Canned vegetables
Correct answer: Raw sushi
Raw or undercooked seafood poses a high risk of bacterial contamination and should be avoided by neutropenic patients who cannot mount an adequate immune response.
Question 6: A patient with breast cancer is prescribed tamoxifen. The nurse should instruct the patient to report which serious adverse effect immediately?
- Mild hot flashes
- Leg pain and swelling (Correct answer)
- Mild vaginal dryness
- Hair thinning
Correct answer: Leg pain and swelling
Tamoxifen increases the risk of thromboembolic events; leg pain and swelling may indicate deep vein thrombosis requiring urgent evaluation.
Question 7: Which staging system is most commonly used to stage solid tumors in oncology practice?
- Ann Arbor Classification
- FIGO staging
- TNM Classification (Correct answer)
- Rai staging
Correct answer: TNM Classification
The TNM (Tumor, Node, Metastasis) classification system is the universally accepted standard for staging most solid tumors and guides treatment planning.
OCN OCN General 2
A patient receiving cisplatin-based chemotherapy develops tinnitus and decreased hearing.
Which intervention is the priority?