OCN - Practice Tests
A patient has the following laboratory values: white blood cell count 2100 mm3;
neutrophils, segmented 23%; neutrophils, band 6%; hemoglobin 8.9 g/dl; and, platelets
100,000 mm 3. The nurse's initial patient teaching includes:
A. washing hands frequently.
B. using an electric razor.
C. avoiding trauma.
D. taking daily stool softeners. - answer A. washing hands frequently
There are many nonpharmacologic interventions for the prevention of infection.
Handwashing remains the single most important intervention to prevent infection.
A patient is receiving the first dose of paclitaxel. The nurse should be prepared to treat
the patient for:
A. shaking chills.
B. projectile vomiting.
C. hypersensitivity reaction.
D. urinary retention. - answer C. hypersensitivity reaction
A side effect associated with paclitaxel is hypersensitivity reaction. Hypersensitivity is an
exaggerated or inappropriate immune response that may be localized or systemic.
Pretreatment to prevent the reaction includes administering cimetidine,
diphenhydramine, and if not contraindicated, dexamethasone.
A patient who completed treatment for malignant melanoma one year ago complains of
still feeling tired. The nurse anticipates an order for:
A. darbepoetin.
B. methylphenidate.
C. lorazepam.
D. pegfilgrastim. - answer B. methylphenidate
Psychostimulants such as methylphenidate have been tested in certain populations
including patients with malignant melanoma as well as in patients with advanced
cancer. Patients reported improvement in symptoms of cancer-related fatigue with the
use of methylphenidate but it remains an area where more research is needed.
,A patient receiving 10 mg of sustained-release oxycodone every 12 hours requires 5 mg
of immediate-release oxycodone five to six times daily. The best adjustment in the pain
medication regimen is to request an order for:
A. 5 mg of immediate-release oxycodone every 3 hours.
B. 10 mg of immediate-release oxycodone every 6 hours.
C. 10 mg of sustained-release oxycodone every 8 hours.
D. 30 mg of sustained-release oxycodone every 12 hours. - answer D. 30 mg of
sustained-release oxycodone every 12 hours
The first sign that an increase in opioid dose is needed is a decrease in the duration of
analgesia for a given opioid dose. Patients may report the need for an increased
number of rescue doses. Sustained release doses plus immediate-release (rescue)
doses should be calculated. When slight improvement in analgesia is needed, a 25%
increase in opioid dose may be sufficient; for a moderate improvement, 50%; and for a
strong effect, 100% increase may be needed.
A patient with prostate cancer is taking oxycodone orally every four hours as needed for
pain. At a home visit, the nurse learns the patient is experiencing constant, dull back
pain and he has not moved his bowels for three days. These symptoms most likely
indicate:
A. ascites.
B. hypercalcemia.
C. impending spinal cord compression.
D. an adverse effect of the oxycodone. - answer C. impending spinal cord
compression
Spinal cord compression may result from tumor invasion into the vertebrae causing a
collapse on the spinal cord. Patients at high risk for cord compression include those with
prostate cancer. Dull back pain is an early symptom of spinal cord compression.
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 - answer 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. - answer 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. - answer 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. - answer 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. - answer D. call for an ambulance.
A patient has the following laboratory values: white blood cell count 2100 mm3;
neutrophils, segmented 23%; neutrophils, band 6%; hemoglobin 8.9 g/dl; and, platelets
100,000 mm 3. The nurse's initial patient teaching includes:
A. washing hands frequently.
B. using an electric razor.
C. avoiding trauma.
D. taking daily stool softeners. - answer A. washing hands frequently
There are many nonpharmacologic interventions for the prevention of infection.
Handwashing remains the single most important intervention to prevent infection.
A patient is receiving the first dose of paclitaxel. The nurse should be prepared to treat
the patient for:
A. shaking chills.
B. projectile vomiting.
C. hypersensitivity reaction.
D. urinary retention. - answer C. hypersensitivity reaction
A side effect associated with paclitaxel is hypersensitivity reaction. Hypersensitivity is an
exaggerated or inappropriate immune response that may be localized or systemic.
Pretreatment to prevent the reaction includes administering cimetidine,
diphenhydramine, and if not contraindicated, dexamethasone.
A patient who completed treatment for malignant melanoma one year ago complains of
still feeling tired. The nurse anticipates an order for:
A. darbepoetin.
B. methylphenidate.
C. lorazepam.
D. pegfilgrastim. - answer B. methylphenidate
Psychostimulants such as methylphenidate have been tested in certain populations
including patients with malignant melanoma as well as in patients with advanced
cancer. Patients reported improvement in symptoms of cancer-related fatigue with the
use of methylphenidate but it remains an area where more research is needed.
,A patient receiving 10 mg of sustained-release oxycodone every 12 hours requires 5 mg
of immediate-release oxycodone five to six times daily. The best adjustment in the pain
medication regimen is to request an order for:
A. 5 mg of immediate-release oxycodone every 3 hours.
B. 10 mg of immediate-release oxycodone every 6 hours.
C. 10 mg of sustained-release oxycodone every 8 hours.
D. 30 mg of sustained-release oxycodone every 12 hours. - answer D. 30 mg of
sustained-release oxycodone every 12 hours
The first sign that an increase in opioid dose is needed is a decrease in the duration of
analgesia for a given opioid dose. Patients may report the need for an increased
number of rescue doses. Sustained release doses plus immediate-release (rescue)
doses should be calculated. When slight improvement in analgesia is needed, a 25%
increase in opioid dose may be sufficient; for a moderate improvement, 50%; and for a
strong effect, 100% increase may be needed.
A patient with prostate cancer is taking oxycodone orally every four hours as needed for
pain. At a home visit, the nurse learns the patient is experiencing constant, dull back
pain and he has not moved his bowels for three days. These symptoms most likely
indicate:
A. ascites.
B. hypercalcemia.
C. impending spinal cord compression.
D. an adverse effect of the oxycodone. - answer C. impending spinal cord
compression
Spinal cord compression may result from tumor invasion into the vertebrae causing a
collapse on the spinal cord. Patients at high risk for cord compression include those with
prostate cancer. Dull back pain is an early symptom of spinal cord compression.
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 - answer 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. - answer 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. - answer 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. - answer 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. - answer D. call for an ambulance.
