OCN OCN MCQ 5 — Questions and Answers
Question 1: When educating a patient about tamoxifen therapy for hormone receptor-positive breast cancer, the nurse should emphasize reporting:
- Mild hot flashes and night sweats
- Leg pain, swelling, or shortness of breath (Correct answer)
- Mild vaginal dryness
- Occasional headache
Correct answer: Leg pain, swelling, or shortness of breath
Tamoxifen increases the risk of thromboembolic events; leg pain, swelling, and dyspnea are signs of DVT or pulmonary embolism requiring urgent evaluation.
Question 2: Which action demonstrates the oncology nurse's understanding of safe handling of oral chemotherapy agents at home?
- Instruct the patient that oral agents can be split or crushed to ease swallowing
- Teach the patient to wear gloves when handling tablets and store them away from children (Correct answer)
- Tell the patient that oral chemotherapy is safer than IV chemotherapy and requires no special precautions
- Advise the patient to store medications in a pillbox with other daily medications
Correct answer: Teach the patient to wear gloves when handling tablets and store them away from children
Oral chemotherapy agents are hazardous drugs requiring PPE during handling and safe storage away from others, especially children.
Question 3: A patient receiving high-dose corticosteroids as part of cancer treatment should be monitored for which complication?
- Hypoglycemia and weight loss
- Hyperglycemia, fluid retention, and immunosuppression (Correct answer)
- Hypotension and bradycardia
- Thrombocytopenia and anemia
Correct answer: Hyperglycemia, fluid retention, and immunosuppression
Corticosteroids cause hyperglycemia by increasing gluconeogenesis, promote sodium and fluid retention, and suppress immune function increasing infection risk.
Question 4: According to the NCCN distress thermometer guidelines, a distress score at which threshold warrants referral to psychosocial support services?
- 2 or above
- 4 or above (Correct answer)
- 6 or above
- 8 or above
Correct answer: 4 or above
NCCN guidelines recommend referral to appropriate resources when a patient scores 4 or higher on the Distress Thermometer.
Question 5: A patient with advanced cancer reports existential distress, stating 'I feel like my life has had no meaning.' Which nursing response best reflects a palliative care approach?
- 'Try not to think about it and focus on positive things.'
- 'Would you like me to arrange for a chaplain or counselor to speak with you?' (Correct answer)
- 'This is normal at this stage — everyone feels this way.'
- 'You should speak to your oncologist about antidepressants.'
Correct answer: 'Would you like me to arrange for a chaplain or counselor to speak with you?'
Palliative care addresses spiritual and existential distress; offering a chaplain or counselor validates the patient's experience and connects them with appropriate support.
Question 6: Which factor most significantly increases a patient's risk for developing anthracycline-induced cardiotoxicity?
- Low baseline hemoglobin level
- Cumulative lifetime dose exceeding recommended thresholds (Correct answer)
- Administration via continuous IV infusion rather than bolus
- Concurrent use of anti-nausea medications
Correct answer: Cumulative lifetime dose exceeding recommended thresholds
Anthracycline cardiotoxicity is dose-dependent; cumulative doses above thresholds (e.g., doxorubicin >450-550 mg/m²) significantly increase cardiomyopathy risk.
Question 7: An oncology nurse is preparing to administer a vesicant chemotherapy agent via peripheral IV. Which assessment finding requires the nurse to hold the infusion and reassess access?
- Patient reports mild anxiety about the infusion
- Blood return is sluggish and the site shows swelling with infusion (Correct answer)
- The patient's blood pressure is 130/82 mmHg
- The IV was placed 6 hours ago in the antecubital fossa
Correct answer: Blood return is sluggish and the site shows swelling with infusion
Sluggish blood return with swelling during vesicant infusion indicates possible extravasation, which must be stopped immediately to prevent tissue necrosis.
OCN OCN MCQ 5
When educating a patient about tamoxifen therapy for hormone receptor-positive breast cancer, the nurse should emphasize reporting: