OCN Hematologic and Skin Toxicities Questions (15 Free)

Correct answer: D. ≤10 g/dL

Erythropoiesis-stimulating agents (ESAs) are indicated for chemotherapy-induced anemia when hemoglobin is ≤10 g/dL, with a target not to exceed 11 g/dL. A level ≤10 g/dL is the approved threshold for initiation.

From practice test 2 of our OCN study guide (question 7). Original question, not an official exam item.

Correct answer: C. Palifermin given before and after the conditioning regimen

Palifermin is a recombinant keratinocyte growth factor specifically indicated for patients with hematologic malignancies receiving myeloablative therapy that requires stem cell support. It reduces the duration and severity of mucositis.

From practice test 9 of our OCN study guide (question 27). Original question, not an official exam item.

Correct answer: B. Reduce the dose by 25%

If hemoglobin rises more than 1 g/dL in any two-week period, the ESA dose should be reduced. Holding is indicated only if hemoglobin exceeds 11 g/dL. Continuing or discontinuing are incorrect.

From practice test 4 of our OCN study guide (question 130). Original question, not an official exam item.

Correct answer: D. Hemoglobin ≤10 g/dL and goal to avoid transfusion

ESAs are approved for chemotherapy-induced anemia when hemoglobin is ≤10 g/dL, with the goal of avoiding transfusion, not to exceed 11 g/dL. A lower threshold or higher hemoglobin is not appropriate.

From practice test 4 of our OCN study guide (question 45). Original question, not an official exam item.

Correct answer: D. Use gentle cleansing with mild soap and water, and avoid adhesive tape on the area.

Radiation dermatitis management emphasizes gentle skincare and avoidance of irritants such as adhesive tapes, which can strip the epidermis and worsen skin breakdown. Hydrocortisone is not routinely recommended for prevention, scrubbing is too abrasive, and adhesives should be avoided.

From practice test 5 of our OCN study guide (question 145). Original question, not an official exam item.

Correct answer: B. Rinse with a saline or sodium bicarbonate solution every 4 hours and after meals

Saline or sodium bicarbonate rinses are gentle and recommended for mucositis. Alcohol-based mouthwash can irritate; hard-bristled toothbrushes can cause trauma; lidocaine gel is used for pain but not as routine care for Grade 1.

From practice test 2 of our OCN study guide (question 21). Original question, not an official exam item.

Correct answer: C. If hemoglobin >11 g/dL

ESAs should be held when hemoglobin exceeds 11 g/dL to avoid risks of thromboembolic events and potential tumor progression. Holding at 10 g/dL would be too early, and the trigger is not based solely on rate of rise.

From practice test 6 of our OCN study guide (question 142). Original question, not an official exam item.

Correct answer: C. The expected onset of chemotherapy-induced mucositis, coinciding with the neutrophil nadir.

Chemotherapy-induced mucositis typically appears 5-10 days after infusion, when mucosal cell turnover is disrupted and neutrophil counts are at their nadir. This timeline distinguishes mucositis from infection or other causes.

From practice test 3 of our OCN study guide (question 84). Original question, not an official exam item.

Correct answer: D. Gelclair or MuGard.

Gelclair and MuGard are mucosal protectants that form a barrier film over ulcerations, reducing pain and protecting from irritants. Magic mouthwash provides anesthesia, sucralfate coats but does not form a film, and nystatin treats fungal infection.

From practice test 4 of our OCN study guide (question 165). Original question, not an official exam item.

Correct answer: D. Drug accumulation in eccrine sweat glands of palms and soles

Hand-foot syndrome results from drug accumulation in the eccrine sweat glands of the palms and soles, leading to direct cytotoxicity. Hypersensitivity and autoimmune mechanisms are not implicated.

From practice test 5 of our OCN study guide (question 138). Original question, not an official exam item.

Correct answer: C. Single temperature 38.4°C (oral)

Febrile neutropenia is defined as a single oral temperature ≥38.3°C or a sustained temperature ≥38.0°C for 1 hour in a patient with ANC <500. A single temperature of 38.4°C meets the single temperature criterion.

From practice test 3 of our OCN study guide (question 95). Original question, not an official exam item.

Correct answer: B. Translocation of oral bacteria through ulcerated mucosa during neutropenia

The combination of mucosal breakdown (mucositis) and severe neutropenia allows oral streptococci to enter the bloodstream directly through ulcerated mucosa. Central line, aspiration, or urinary sources are less likely given the organism and timing.

From practice test 5 of our OCN study guide (question 71). Original question, not an official exam item.

Correct answer: D. Apply ice packs to the palms and soles during infusion.

Ice packs during liposomal doxorubicin infusion reduce drug accumulation in the skin. Hot showers worsen symptoms, moisturizers are recommended, and high-dose pyridoxine is not standard for this drug.

From practice test 3 of our OCN study guide (question 27). Original question, not an official exam item.

Correct answer: C. Interrupt capecitabine for 7-14 days, then restart at a reduced dose.

For Grade 2 hand-foot syndrome, standard management is a treatment interruption of 1-2 weeks to allow resolution, followed by dose reduction. Continuing at the same or increased dose would worsen toxicity.

From practice test 3 of our OCN study guide (question 101). Original question, not an official exam item.

Correct answer: B. Dyspnea on exertion that interferes with daily activities

Transfusion is indicated when anemia causes symptoms such as dyspnea affecting ADLs, tachycardia, or chest pain, even if hemoglobin is above the general threshold. Mild fatigue alone is not sufficient; the other options are not acute indications.

From practice test 4 of our OCN study guide (question 110). Original question, not an official exam item.