OCN OCN MCQ 3 — Questions and Answers
Question 1: Which assessment finding in a patient receiving bevacizumab (Vectibix) warrants immediate intervention?
- Mild fatigue and low-grade fever
- Sudden onset of severe headache and hypertension (Correct answer)
- Mild nausea after infusion
- Transient flushing during administration
Correct answer: Sudden onset of severe headache and hypertension
Bevacizumab can cause hypertensive crisis and increases risk of intracranial hemorrhage; sudden severe headache with hypertension is an emergency.
Question 2: A patient undergoing radiation to the pelvis reports painful bowel movements and bloody diarrhea at week 4 of treatment. The nurse recognizes this as:
- Radiation cystitis
- Acute radiation proctitis (Correct answer)
- Chemotherapy-induced colitis
- Pseudomembranous colitis
Correct answer: Acute radiation proctitis
Pelvic radiation commonly causes acute radiation proctitis, characterized by diarrhea, rectal pain, and bleeding during the treatment course.
Question 3: Which intervention is most appropriate for a patient experiencing grade 3 oral mucositis?
- Encourage use of commercial mouthwash with alcohol to reduce bacteria
- Provide parenteral nutrition and administer prescribed opioid analgesics (Correct answer)
- Recommend soft foods and saline rinses every 8 hours
- Apply topical antifungal rinse three times daily
Correct answer: Provide parenteral nutrition and administer prescribed opioid analgesics
Grade 3 mucositis involves inability to eat adequately and severe pain, requiring nutritional support and strong analgesics.
Question 4: A patient receiving cisplatin-based chemotherapy should be monitored most closely for which electrolyte imbalance?
- Hyperkalemia
- Hypernatremia
- Hypomagnesemia (Correct answer)
- Hypercalcemia
Correct answer: Hypomagnesemia
Cisplatin causes renal tubular damage leading to significant magnesium wasting and hypomagnesemia.
Question 5: When teaching a patient about the signs of tumor lysis syndrome, the nurse should instruct the patient to report:
- Increased urine output and decreased thirst
- Muscle cramps, irregular heartbeat, and decreased urine output (Correct answer)
- Increased appetite and improved energy levels
- Mild headache and low-grade temperature
Correct answer: Muscle cramps, irregular heartbeat, and decreased urine output
Tumor lysis syndrome causes hyperkalemia, hyperphosphatemia, and renal failure, manifesting as muscle cramps, cardiac dysrhythmias, and oliguria.
Question 6: A postmastectomy patient asks about lymphedema prevention. Which instruction should the nurse include?
- Avoid blood pressure measurements and venipunctures in the affected arm (Correct answer)
- Apply heat packs to the affected arm to improve lymphatic flow
- Perform vigorous exercise with the affected arm to stimulate drainage
- Wear a compression garment only during sleep
Correct answer: Avoid blood pressure measurements and venipunctures in the affected arm
Avoiding blood pressure cuffs and needle sticks in the affected arm prevents lymphatic obstruction and infection that can trigger or worsen lymphedema.
Question 7: Which ONS/ASCO guideline recommends the use of a validated tool such as the FACT-G or EORTC QLQ-C30 in oncology practice?
- Chemotherapy administration safety standards
- Standardized assessment of health-related quality of life (Correct answer)
- Infection prevention in neutropenic patients
- Evidence-based pain management algorithms
Correct answer: Standardized assessment of health-related quality of life
FACT-G and EORTC QLQ-C30 are validated instruments used to systematically measure health-related quality of life in cancer patients.
OCN OCN MCQ 3
Which assessment finding in a patient receiving bevacizumab (Vectibix) warrants immediate intervention?