OCN QUESTIONS AND ANSWERS SET A+
✔✔Which terms are associated with malignant tumors originating in the epithelial
tissue?
A. Osteo and chondra
B. Lympho and myelo
C. Adeno and squamous
D. Lipo and rhabdo - ✔✔C. Adeno and squamous
Tumors are classified by the tissue of origin. The malignancies that arise from the
epithelium are squamous cell, adenocarcinoma, basal cell, and choriocarcinoma.
✔✔The severe pain associated with post-herpetic neuropathy is most effectively treated
by:
A. propoxyphene.
B. hydromorphone.
C. amitriptyline.
D. extra-strength acetaminophen. - ✔✔C. amitriptyline.
Pain associated with herpes zoster is severe and can be debilitating. The pain is
described as continuous, deep and burning. Opioids are used to treat acute herpes
zoster. Tricyclic antidepressants are used to treat post-herpetic neuralgia.
✔✔An oncology nurse teaching a cancer biology class explains that a proto-oncogene's
role is to:
A. stimulate angiogenesis.
B. cause apoptosis.
C. inhibit tumor growth.
D. promote cell division. - ✔✔D. promote cell division
,Proto-oncogenes promote the specialization and division of normal cells. A change in a
proto-oncogenes genetic sequence can result in uncontrolled cell growth, ultimately
causing the formation of a cancerous tumor. Proto-oncogenes can be transformed into
oncogenes in three ways: point mutation (alteration of a single nucleotide base pair),
translocation (in which a segment of the chromosome breaks off and attaches to
another chromosome), or amplification (increase in the number of copies of the proto-
oncogene).
✔✔Which of the following statements by a patient most likely indicates the need for
further education about preventing infection?
A. I need to be very diligent about washing my hands after working in the garden.
B. I do not want to get an influenza shot until all my chemotherapy is finished.
C. I keep my wound dressing supplies in a closed storage container.
D. I will not permit my grandchildren to visit me if they are sick. - ✔✔B. I do not want to
get an influenza shot until all my chemotherapy is finished
Because a percentage of patients will achieve protection from the influenza vaccination
and the risks for adverse effects are low, all patients with cancer and their household
contacts should receive annual vaccination. NCCN recommends vaccination at least
two weeks prior to cytotoxic or immunosuppressive. If this is not possible, patients can
be vaccinated during treatment and revaccinated at least three months after therapy.
✔✔A 69-year-old patient who received chemotherapy seven days ago calls the nurse to
report a temperature of 101°F (38.3°C) and lightheadedness. The nurse determines the
patient is dyspneic and diaphoretic. The nurse's initial response is to instruct the patient
to:
A. take acetaminophen.
B. recheck his temperature in two hours.
C. report to the emergency department.
D. call for an ambulance. - ✔✔D. call for an ambulance.
The time at which chemotherapy exerts its maximum effect on the bone marrow and the
white blood count reaches its lowest point is the nadir. This usually occurs within 7 to 10
days after administration. Patients are most susceptible to infections at this time due to
neutropenia. In a neutropenic patient, infection may rapidly progress to sepsis, a
systemic inflammatory response to microorganisms in the blood. Early signs of sepsis
include fever, chills, and tachypnea. Patients over the age of 65 are at greater risk.
Untreated sepsis can result in septic shock and death. Immediate reporting of
symptoms and medical management is necessary.
✔✔A patient expresses anger about his diagnosis of cancer and the need to receive his
first chemotherapy treatment. The nurse's best response is to:
A. initiate a referral to a social worker.
, B. call the physician and ask for the treatment to be delayed.
C. explain to the patient that the doctor ordered treatment to start today.
D. suggest ways for the patient to participate in the treatment plan. - ✔✔D. suggest
ways for the patient to participate in the treatment plan.
Loss of personal control is perceived as lacking the ability to control events that affect
life style and goals. Both disease and treatment are considered risk factors for a loss of
personal control. Personal control can be maintained through verbalization of feelings
and participation in care.
✔✔A patient with lymphoma reports persistent nausea, muscle cramps, weakness, and
paresthesia of the fingers two days after receiving the first cycle of chemotherapy. The
patient most likely is experiencing:
A. hypercalcemia.
B. tumor lysis syndrome.
C. disseminated intravasular coagulation.
D. syndrome of inappropriate antidiuretic hormone secretion. - ✔✔B. tumor lysis
syndrome
Tumor lysis syndrome involves a metabolic imbalance that occurs with the rapid release
of intracellular potassium, phosphorus, and nucleic acid into the blood as a result of
tumor cell kill. Early signs and symptoms of tumor lysis syndrome include the following:
muscle cramps, weakness, nausea and vomiting, diarrhea, lethargy, and paresthesia.
✔✔During the initial evaluation of a patient, the treatment plan is outlined and includes
amputation of the right leg. The patient begins to scream and cry, stating, "But I have
small children. I need to be able to run, walk, and play with them." The nurse's best
response is:
A. It sounds like you fear your treatment plan, tell me what you know about it.
B. Many patients feel better after they are fitted with a prosthesis.
C. If you do not receive the amputation, your chance of dying is great.
D. The psychiatric nurse will help you cope with the amputation. - ✔✔A. It sounds like
you fear your treatment plan, tell me what you know about it.
Anger as part of the mourning process often is felt most profoundly in those who
experience disfiguring surgery, loss of body parts, and loss of control of the body.
Nurses can address the underlying feelings with reflective statements. A reflective
statement will help patients to gain control and focus on the real issues.
✔✔Which of the following is a complication that can occur after a percutaneous lung
biopsy is performed?
A. Pleural effusion
B. Atelectasis
✔✔Which terms are associated with malignant tumors originating in the epithelial
tissue?
A. Osteo and chondra
B. Lympho and myelo
C. Adeno and squamous
D. Lipo and rhabdo - ✔✔C. Adeno and squamous
Tumors are classified by the tissue of origin. The malignancies that arise from the
epithelium are squamous cell, adenocarcinoma, basal cell, and choriocarcinoma.
✔✔The severe pain associated with post-herpetic neuropathy is most effectively treated
by:
A. propoxyphene.
B. hydromorphone.
C. amitriptyline.
D. extra-strength acetaminophen. - ✔✔C. amitriptyline.
Pain associated with herpes zoster is severe and can be debilitating. The pain is
described as continuous, deep and burning. Opioids are used to treat acute herpes
zoster. Tricyclic antidepressants are used to treat post-herpetic neuralgia.
✔✔An oncology nurse teaching a cancer biology class explains that a proto-oncogene's
role is to:
A. stimulate angiogenesis.
B. cause apoptosis.
C. inhibit tumor growth.
D. promote cell division. - ✔✔D. promote cell division
,Proto-oncogenes promote the specialization and division of normal cells. A change in a
proto-oncogenes genetic sequence can result in uncontrolled cell growth, ultimately
causing the formation of a cancerous tumor. Proto-oncogenes can be transformed into
oncogenes in three ways: point mutation (alteration of a single nucleotide base pair),
translocation (in which a segment of the chromosome breaks off and attaches to
another chromosome), or amplification (increase in the number of copies of the proto-
oncogene).
✔✔Which of the following statements by a patient most likely indicates the need for
further education about preventing infection?
A. I need to be very diligent about washing my hands after working in the garden.
B. I do not want to get an influenza shot until all my chemotherapy is finished.
C. I keep my wound dressing supplies in a closed storage container.
D. I will not permit my grandchildren to visit me if they are sick. - ✔✔B. I do not want to
get an influenza shot until all my chemotherapy is finished
Because a percentage of patients will achieve protection from the influenza vaccination
and the risks for adverse effects are low, all patients with cancer and their household
contacts should receive annual vaccination. NCCN recommends vaccination at least
two weeks prior to cytotoxic or immunosuppressive. If this is not possible, patients can
be vaccinated during treatment and revaccinated at least three months after therapy.
✔✔A 69-year-old patient who received chemotherapy seven days ago calls the nurse to
report a temperature of 101°F (38.3°C) and lightheadedness. The nurse determines the
patient is dyspneic and diaphoretic. The nurse's initial response is to instruct the patient
to:
A. take acetaminophen.
B. recheck his temperature in two hours.
C. report to the emergency department.
D. call for an ambulance. - ✔✔D. call for an ambulance.
The time at which chemotherapy exerts its maximum effect on the bone marrow and the
white blood count reaches its lowest point is the nadir. This usually occurs within 7 to 10
days after administration. Patients are most susceptible to infections at this time due to
neutropenia. In a neutropenic patient, infection may rapidly progress to sepsis, a
systemic inflammatory response to microorganisms in the blood. Early signs of sepsis
include fever, chills, and tachypnea. Patients over the age of 65 are at greater risk.
Untreated sepsis can result in septic shock and death. Immediate reporting of
symptoms and medical management is necessary.
✔✔A patient expresses anger about his diagnosis of cancer and the need to receive his
first chemotherapy treatment. The nurse's best response is to:
A. initiate a referral to a social worker.
, B. call the physician and ask for the treatment to be delayed.
C. explain to the patient that the doctor ordered treatment to start today.
D. suggest ways for the patient to participate in the treatment plan. - ✔✔D. suggest
ways for the patient to participate in the treatment plan.
Loss of personal control is perceived as lacking the ability to control events that affect
life style and goals. Both disease and treatment are considered risk factors for a loss of
personal control. Personal control can be maintained through verbalization of feelings
and participation in care.
✔✔A patient with lymphoma reports persistent nausea, muscle cramps, weakness, and
paresthesia of the fingers two days after receiving the first cycle of chemotherapy. The
patient most likely is experiencing:
A. hypercalcemia.
B. tumor lysis syndrome.
C. disseminated intravasular coagulation.
D. syndrome of inappropriate antidiuretic hormone secretion. - ✔✔B. tumor lysis
syndrome
Tumor lysis syndrome involves a metabolic imbalance that occurs with the rapid release
of intracellular potassium, phosphorus, and nucleic acid into the blood as a result of
tumor cell kill. Early signs and symptoms of tumor lysis syndrome include the following:
muscle cramps, weakness, nausea and vomiting, diarrhea, lethargy, and paresthesia.
✔✔During the initial evaluation of a patient, the treatment plan is outlined and includes
amputation of the right leg. The patient begins to scream and cry, stating, "But I have
small children. I need to be able to run, walk, and play with them." The nurse's best
response is:
A. It sounds like you fear your treatment plan, tell me what you know about it.
B. Many patients feel better after they are fitted with a prosthesis.
C. If you do not receive the amputation, your chance of dying is great.
D. The psychiatric nurse will help you cope with the amputation. - ✔✔A. It sounds like
you fear your treatment plan, tell me what you know about it.
Anger as part of the mourning process often is felt most profoundly in those who
experience disfiguring surgery, loss of body parts, and loss of control of the body.
Nurses can address the underlying feelings with reflective statements. A reflective
statement will help patients to gain control and focus on the real issues.
✔✔Which of the following is a complication that can occur after a percutaneous lung
biopsy is performed?
A. Pleural effusion
B. Atelectasis
