Oncological emergencies, treatment modalities- immunotherapy, radiotherapy, surgical intervention, stem cell therapy, bone marrow transplantation, gene therapy
and other forms of therapy.
Time: 15:00
A patient with lymphoma receiving chemotherapy develops facial edema, shortness of breath, and distended neck veins. The nurse recognizes these as hallmark signs of which oncological emergency?
[a] Tumor Lysis Syndrome.
[b] Spinal Cord Compression.
[c] Superior Vena Cava (SVC) Syndrome.
[d] Hypercalcemia of Malignancy.
A patient is scheduled for brachytherapy for cervical cancer. What is the most important safety principle the nurse must adhere to when providing care?
[a] Wear a sterile gown and gloves.
[b] Adhere to the principles of time, distance, and shielding.
[c] Ensure the patient remains NPO.
[d] Administer prophylactic antibiotics.
Which statement accurately describes the primary mechanism of action for immunotherapy drugs known as immune checkpoint inhibitors (e.g., Pembrolizumab)?
[a] They directly poison and kill rapidly dividing cancer cells.
[b] They block hormones that fuel cancer growth.
[c] They "take the brakes off" the immune system, allowing it to attack cancer cells.
[d] They deliver a radioactive substance directly to the tumor.
What is the fundamental difference between an allogeneic and an autologous bone marrow transplant?
[a] An allogeneic transplant is used only for leukemia.
[b] An autologous transplant does not require a conditioning chemotherapy regimen.
[c] An allogeneic transplant uses stem cells from a donor, while an autologous transplant uses the patient's own stem cells.
[d] An autologous transplant has a higher risk of Graft-versus-Host Disease (GVHD).
A patient receiving chemotherapy for a large, bulky tumor is at high risk for Tumor Lysis Syndrome (TLS). The nurse should monitor for which characteristic laboratory findings?
A patient with metastatic bone cancer reports new, severe, localized back pain and leg weakness. The nurse should have a high index of suspicion for which oncological emergency?
[a] Pathological fracture.
[b] Malignant spinal cord compression.
[c] Sepsis.
[d] Tumor Lysis Syndrome.
A surgical intervention to remove a non-vital organ or tissue to reduce the chance of cancer developing, such as a prophylactic mastectomy in a BRCA gene carrier, is classified as:
[a] Palliative surgery.
[b] Curative surgery.
[c] Preventive surgery.
[d] Debulking surgery.
A patient who has received an allogeneic bone marrow transplant develops a diffuse rash, jaundice, and severe diarrhea. The nurse recognizes these as classic signs of which major complication?
[a] Veno-occlusive disease (VOD).
[b] Cytomegalovirus (CMV) infection.
[c] Graft-versus-Host Disease (GVHD).
[d] Graft failure.
A nurse is teaching a patient about skin care during external beam radiotherapy. Which instruction is most appropriate?
[a] "Scrub the area daily with an antibacterial soap to prevent infection."
[b] "Apply ice packs to the area to reduce redness and inflammation."
[c] "Gently cleanse the area with lukewarm water and pat dry, avoiding lotions unless prescribed."
[d] "Expose the treated area to sunlight for 15 minutes daily to promote healing."
Gene therapy for cancer treatment aims to:
[a] Increase the patient's red blood cell count.
[b] Block pain signals from reaching the brain.
[c] Introduce genetic material into a patient's cells to fight or correct disease.
[d] Harvest a patient's genes for diagnostic purposes only.
A patient with a low platelet count (thrombocytopenia) due to chemotherapy should be instructed by the nurse to:
[a] Perform deep breathing and coughing exercises regularly.
[b] Eat a diet high in iron and vitamin B12.
[c] Gargle with salt water several times a day.
[d] Use a soft-bristled toothbrush and an electric razor.
CAR T-cell therapy is a highly specialized form of immunotherapy that involves:
[a] Injecting a weakened virus to stimulate an immune response.
[b] Collecting a patient's T-cells and genetically engineering them to recognize and kill cancer cells.
[c] Administering monoclonal antibodies that block cancer cell growth.
[d] Transplanting T-cells from a healthy donor into the patient.
A patient is diagnosed with febrile neutropenia (absolute neutrophil count <500/mm³ and fever >38.3°C). What is the highest priority nursing action?
[a] Administer an antipyretic like paracetamol.
[b] Place the patient on a high-calorie diet.
[c] Obtain blood cultures and administer broad-spectrum antibiotics as ordered.
[d] Provide a warm blanket for comfort.
Palliative surgery for a patient with advanced cancer is performed with the primary goal of:
[a] Curing the cancer.
[b] Relieving symptoms and improving quality of life.
[c] Staging the cancer accurately.
[d] Preventing the cancer from developing.
Hypercalcemia of malignancy is a common oncological emergency. The initial and most important medical management is:
[a] Calcium supplementation.
[b] Administration of furosemide without fluid replacement.
[c] Strict bed rest.
[d] Aggressive intravenous hydration with normal saline.
Unlike traditional chemotherapy, targeted therapies like Trastuzumab (Herceptin) work by:
[a] Damaging the DNA of all rapidly dividing cells.
[b] Boosting the overall immune system non-specifically.
[c] Interfering with specific molecules (like the HER2 protein) involved in cancer cell growth.
[d] Preventing the formation of new blood vessels in all tissues.
The "conditioning" or "preparative" regimen given to a patient before a bone marrow transplant serves primarily to:
[a] Stimulate the production of new blood cells.
[b] Prevent immediate rejection of the graft.
[c] Eradicate the patient's existing bone marrow and any residual cancer cells.
[d] Test the patient's tolerance to high-dose chemotherapy.
A common and distressing side effect of immunotherapy is an autoimmune-like inflammatory response. If a patient on immunotherapy develops severe, watery diarrhea, the nurse should suspect:
[a] A typical Clostridium difficile infection.
[b] Immune-mediated colitis.
[c] A normal side effect that does not require intervention.
[d] Lactose intolerance.
A patient is undergoing a radical neck dissection for oral cancer. A priority postoperative nursing concern is:
[a] Monitoring for hypercalcemia.
[b] Maintaining a patent airway.
[c] Preventing constipation.
[d] Assessing for deep vein thrombosis.
Which type of therapy aims to prevent or relieve suffering and support the best possible quality of life for patients and their families, regardless of the stage of the disease?
[a] Curative therapy.
[b] Neoadjuvant therapy.
[c] Adjuvant therapy.
[d] Palliative therapy.
Disseminated Intravascular Coagulation (DIC) is a life-threatening oncological emergency characterized by:
[a] A massive increase in platelet production.
[b] Severe hypertension and bounding pulses.
[c] Widespread clotting and subsequent bleeding from depletion of clotting factors.
[d] A slow, progressive occlusion of major arteries.
Which treatment modality is considered a local therapy, meaning it primarily affects the cells in the treated area?
[a] Chemotherapy.
[b] Immunotherapy.
[c] Hormone therapy.
[d] Radiotherapy.
A major long-term risk for a patient who has received a stem cell transplant and is on immunosuppressive drugs is:
[a] Acute pancreatitis.
[b] Opportunistic infections.
[c] Development of diabetes mellitus.
[d] Chronic hypertension.
A nurse is administering a monoclonal antibody infusion (e.g., Rituximab). The nurse should be most vigilant for which potential immediate complication?
[a] Delayed nausea and vomiting.
[b] Hair loss.
[c] Infusion-related hypersensitivity reaction.
[d] Bone marrow suppression.
The primary goal of a debulking or cytoreductive surgery, often used in advanced ovarian cancer, is to:
[a] Remove as much of the tumor as possible to make subsequent chemotherapy more effective.
[b] Completely cure the cancer with surgery alone.
[c] Only obtain a tissue sample for diagnosis.
[d] Relieve a specific symptom like a bowel obstruction.
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