OCN OCN Trivia 5 — Questions and Answers
Question 1: A patient with cancer reports pain rated 8/10 and is currently on oral morphine. The nurse anticipates which change to the analgesic regimen?
- Switch to a non-opioid NSAID only
- Add a benzodiazepine to reduce anxiety
- Increase the opioid dose or change to a stronger opioid formulation (Correct answer)
- Recommend non-pharmacologic methods exclusively
Correct answer: Increase the opioid dose or change to a stronger opioid formulation
According to the WHO analgesic ladder, uncontrolled moderate-to-severe pain requires dose escalation or rotation to a stronger opioid.
Question 2: Which intervention is most effective in preventing chemotherapy-induced nausea and vomiting (CINV) prior to a highly emetogenic regimen?
- Administering antiemetics only after nausea begins
- Pre-medicating with a 5-HT3 antagonist, a NK1 antagonist, and dexamethasone (Correct answer)
- Restricting all oral intake for 12 hours before chemotherapy
- Prescribing a benzodiazepine as the sole antiemetic agent
Correct answer: Pre-medicating with a 5-HT3 antagonist, a NK1 antagonist, and dexamethasone
CINV guidelines recommend a triple-drug prophylactic regimen (5-HT3 antagonist + NK1 antagonist + dexamethasone) before highly emetogenic chemotherapy.
Question 3: The nurse is caring for a patient with hypercalcemia of malignancy. Which symptom would the nurse expect to assess?
- Muscle cramps and positive Trousseau sign
- Bradycardia and prolonged QT interval
- Confusion, polyuria, constipation, and fatigue (Correct answer)
- Stridor and laryngospasm
Correct answer: Confusion, polyuria, constipation, and fatigue
Hypercalcemia of malignancy classically presents with confusion, polyuria, constipation, anorexia, and profound fatigue.
Question 4: Which of the following is a common long-term side effect of cisplatin-based chemotherapy?
- Cardiomyopathy
- Nephrotoxicity and ototoxicity (Correct answer)
- Pulmonary fibrosis
- Hepatic veno-occlusive disease
Correct answer: Nephrotoxicity and ototoxicity
Cisplatin is well known for causing cumulative nephrotoxicity and ototoxicity (hearing loss/tinnitus) as major long-term toxicities.
Question 5: When educating a patient about neutropenia precautions, which dietary instruction is most important?
- Increase raw fruit and vegetable intake to boost vitamins
- Avoid undercooked meats, raw eggs, and unpasteurized products (Correct answer)
- Limit fluid intake to reduce kidney workload
- Switch to a vegan diet to reduce inflammation
Correct answer: Avoid undercooked meats, raw eggs, and unpasteurized products
Patients with neutropenia must avoid foods at high risk for bacterial contamination, including raw/undercooked meats, raw eggs, and unpasteurized dairy.
Question 6: A patient receiving doxorubicin (an anthracycline) asks why the nurse is monitoring cumulative lifetime dose. The nurse explains this is done to prevent:
- Peripheral neuropathy
- Renal failure
- Cardiomyopathy (Correct answer)
- Hepatotoxicity
Correct answer: Cardiomyopathy
Anthracyclines like doxorubicin cause dose-dependent cardiotoxicity; cumulative dose is tracked to reduce the risk of irreversible cardiomyopathy.
Question 7: Which statement about cancer-related fatigue (CRF) best reflects current evidence-based practice?
- Patients should rest completely and avoid all physical activity
- Exercise is contraindicated until treatment is completed
- Moderate aerobic exercise during treatment is the most effective intervention for CRF (Correct answer)
- CRF resolves immediately after chemotherapy ends
Correct answer: Moderate aerobic exercise during treatment is the most effective intervention for CRF
Evidence consistently shows that moderate aerobic exercise is the most effective evidence-based intervention for reducing cancer-related fatigue during and after treatment.
OCN OCN Trivia 5
A patient with cancer reports pain rated 8/10 and is currently on oral morphine.
The nurse anticipates which change to the analgesic regimen?