OCN OCN General 4

Question 1

A patient asks the nurse what BRCA1 gene mutation means for their cancer risk. Which response is most accurate?

Accepted Answer

It significantly increases lifetime risk of breast and ovarian cancers

Answer

BRCA1 mutations significantly elevate lifetime risk for both breast cancer (55–72%) and ovarian cancer (44%), guiding decisions about enhanced surveillance and risk-reduction strategies.

Question 2

Which intervention is most appropriate when a patient develops chemotherapy extravasation of a vesicant agent?

Accepted Answer

Stop the infusion immediately, aspirate residual drug, and apply cold compresses for most vesicants

Answer

For vesicant extravasation, the infusion must be stopped immediately, residual drug aspirated, the IV removed, and cold compresses applied (except for vinca alkaloids which require warmth).

Question 3

Which statement best describes the mechanism of action of checkpoint inhibitors such as pembrolizumab?

Accepted Answer

They block inhibitory signals that cancer cells use to evade T-cell immune surveillance

Answer

Pembrolizumab (anti-PD-1) blocks the PD-1/PD-L1 pathway that tumors exploit to suppress T-cell activity, restoring the immune system's ability to recognize and destroy cancer cells.

Question 4

A nurse notes that a patient's absolute neutrophil count (ANC) is 450 cells/mm³. Which classification and action is correct?

Accepted Answer

Severe neutropenia (< 500); initiate neutropenic precautions and notify provider

Answer

An ANC below 500 cells/mm³ is severe neutropenia, placing the patient at very high infection risk and requiring immediate neutropenic precautions, provider notification, and possible filgrastim therapy.

Question 5

A patient with cancer reports a pain level of 7/10 currently on acetaminophen alone. According to the WHO analgesic ladder, what is the next appropriate step?

Accepted Answer

Add a weak opioid such as tramadol or codeine (Step 2)

Answer

The WHO three-step analgesic ladder recommends adding a weak opioid (Step 2) when a non-opioid alone provides inadequate pain control before escalating to strong opioids.

OCN Exam Practice Test

OCN Exam Practice Test

OCN OCN General 4