Questions 1-60 of 60 | Page 1 of 1
Question 1
A patient receiving a seventh cycle of paclitaxel and carboplatin is assessed for:
a | anorexia. |
b | flank pain. |
c | weakness. |
d | shortness of breath. |
Question 2
To prevent hemorrhagic cystitis in a patient receiving ifosfamide, the nurse:
a | administers mesna at 60%–100% of the ifosfamide dose. |
b | administers amifostine at 60%–100% of the ifosfamide dose. |
c | has the patient drink 8 ounces of fluids every hour. |
d | checks the creatinine level prior to each dose. |
Question 3
A patient with CD20 positive, non-Hodgkin lymphoma is scheduled to begin rituximab. The nurse knows:
a | the risk of infusion reactions is decreased since the patient is chemotherapy-naive. |
b | infusion-related side effects are reduced with subsequent infusions. |
c | another therapy is ordered if the patient has an infusion reaction. |
d | most infusion-related reactions occur 24-48 hours after the infusion. |
Question 4
A patient scheduled for a fifth cycle of oxaliplatin reports difficulty buttoning his shirts. What is the nurse’s next action?
a | Instruct the patient to wear gloves. |
b | Administer the agent as ordered. |
c | Notify the physician |
d | Apply ice to the fingertips. |
Question 5
A patient scheduled to receive a fourth cycle of paclitaxel and cisplatin reports burning and numbness in his feet. The nurse’s priority is to assess for:
a | cerebellar neurotoxicity. |
b | chemical arachnoiditis. |
c | motor neuropathy. |
d | autonomic neuropathy. |
Question 6
A patient receiving cycle four of doxorubicin, bleomycin, vincristine, and dacarbazine reports dyspnea, tachypnea, and exercise intolerance. The patient is prepared for a:
a | computed tomography scan |
b | magnetic resonance imaging. |
c | chest tube insertion. |
d | positron-emission tomography. |
Question 7
Specialized white blood cells called lymphocytes mature from:
a | myeloid precursors. |
b | lymphoid precursors. |
c | agranulocytes. |
d | granulocytes. |
Question 8
High-dose cytarabine administration places a patient at risk for:
a | cerebellar toxicity. |
b | hand-foot syndrome. |
c | pulmonary fibrosis. |
d | anaphylaxis reaction. |
Question 9
Which of the following increases a patient’s risk for acute nausea and vomiting?
a | Age greater than 60 |
b | History of alcohol abuse |
c | History of tonsillectomy |
d | Female gender |
Question 10
Which of the following is a dose-limiting toxicity for vinorelbine?
a | Myelosuppression |
b | Neurotoxicity |
c | Hepatotoxicity |
d | Nausea |
Question 11
When spiking an IV bag containing a hazardous drug, the nurse should wear:
a | a surgical mask. |
b | an isolation gown. |
c | a respirator. |
d | a face shield. |
Question 12
The nurse administering cetuximab to a patient who is receiving concurrent radiation therapy is vigilant in monitoring for:
a | thyroid storm. |
b | enterocolitis. |
c | cardiopulmonary arrest. |
d | hemorrhage. |
Question 13
Which of the following stages of the cell life cycle gives cells some protection from exposure to cell cycle-specific chemotherapy agents?
a | Gap 1 |
b | Synthesis |
c | Gap 0 |
d | Premitotic |
Question 14
How do malignant transformed cells differ from normal cells?
a | They are different in structure from others of the same type. |
b | They are fully differentiated and encapsulated. |
c | They are unable to sustain an adequate blood supply. |
d | They are unable to move away from their usual location. |
Question 15
Which of the following best describes the effect of biologic therapy in the treatment of cancer? Biologic therapy:
a | inhibits hematopoietic cell growth. |
b | induces the apoptosis of cancer cells. |
c | enhances the host’s immune system. |
d | potentiates the effects of chemotherapy. |
Question 16
How are vesicants administered peripherally?
a | IV push |
b | Syringe pump |
c | Continuous infusion |
d | IV pump |
Question 17
A patient reports that there is leaking at the chemotherapy infusion site. After assessing and warning others, the nurse:
a | consults the pharmacist for instructions. |
b | contacts the physician for additional orders. |
c | retrieves the hazardous drug spill kit. |
d | relocates the patient to another room. |
Question 18
The risk of developing palmar-plantar erythrodysesthesia increases with combination therapy with:
a | capecitabine and radiation therapy. |
b | fluorouracil and leucovorin. |
c | docetaxel and capecitabine. |
d | fluorouracil and pegfilgrastim. |
Question 19
A patient receiving decitabine must have treatment delayed for which of the following?
a | ANC 1,200 neutrophils/mcL |
b | Aspartate aminotransferase 6 U/L |
c | Serum creatinine 2.5 mg/dL |
d | Direct bilirubin 0.3 mg/dL |
Question 20
Immune-related diarrhea for a patient being treated with pembrolizumab typically presents how many weeks after initiating therapy?
a | 6-18 weeks |
b | 4-5 weeks |
c | More than 19 weeks |
d | Less than 3 weeks |
Question 21
Using the Calvert formula, calculate the carboplatin dose for a 65-year-old male patient who weighs 80.2 kg. The patient’s serum creatinine is 0.8 mg/dL with a target AUC of 4.
a | 517.6 mg |
b | 519 mg |
c | 455.1 mg |
d | 397 mg |
Question 22
Which of the following is primarily involved in acute nausea and vomiting?
a | Inhibition of the vagus nerve |
b | Inhibition of the vestibular system |
c | Serotonin released from enterochromaffin cells |
d | Substance P binding to neurokinin-1 receptors |
Question 23
Which of the following agents is an irritant?
a | Epirubicin |
b | Daunorubicin |
c | Bleomycin |
d | Dactinomycin |
Question 24
A patient receiving nivolumab has a follow-up CT scan 12 weeks into therapy which shows a very slight increase in the size of his lung tumors. In the absence of any other significant changes in his condition, what is the expected treatment for the patient?
a | Continue the current therapy with nivolumab. |
b | Discontinue the drug. |
c | Change the treatment drug. |
d | Increase the dosage of nivolumab. |
Question 25
An example of an immune checkpoint inhibitor is:
a | carfilzomib |
b | pembrolizumab. |
c | rituximab. |
d | bortezomib. |
Question 26
When assessing a patient who received treatment with high-dose busulfan one year ago, the nurse is most concerned about which of the following signs and symptoms?
a | Cough, dyspnea, and low-grade fever |
b | Papulopustular rash and urticaria |
c | Weakness, numbness, and tingling |
d | Headache and decreased vision |
Question 27
Which of the following personal protection equipment is worn for handling hazardous drugs?
a | Two pairs of sterile powder-free gloves |
b | Disposable gown made of a high permeability fabric |
c | Standard surgical face mask with a face shield |
d | Two pairs of chemotherapy-tested gloves |
Question 28
The nurse notes a loss of blood return while administering IV vinblastine. After stopping the infusion and aspirating any remaining drug from the catheter, the nurse’s priority is to:
a | infuse dexrazoxane as soon as possible. |
b | inject sodium thiosulfate into the site. |
c | apply a warm pack for 15-20 minutes. |
d | apply ice for 6-12 hours. |
Question 29
The possible etiologies of venous irritation from chemotherapy administration include:
a | diluted drugs. |
b | an agent pH equal to 9.1. |
c | a small-bore peripheral IV. |
d | hypotonic solutions. |
Question 30
Which type of immune response includes skin and mucous membranes?
a | Adaptive |
b | Cell-mediated |
c | Humoral |
d | Innate |
Question 31
A patient who is two months pregnant and diagnosed with an aggressive type of breast cancer refuses treatment. The nurse requests a consult with the:
a | medication safety committee. |
b | ethics committee. |
c | tumor board. |
d | oncology department. |
Question 32
The final step in developing a biosimilar is to:
a | transfer the gene into a virus or an Escherichia coli vector |
b | remove the growth medium once the quantity is sufficient. |
c | purify and stabilize the protein and place in the drug format. |
d | identify and clone the protein at the core of the biologic. |
Question 33
A short-term outcome of patient education is:
a | decreasing healthcare costs. |
b | improving health-related quality of life. |
c | empowering active participation in health care. |
d | increasing customer satisfaction. |
Question 34
A hypersensitivity reaction to bleomycin is most likely to develop in a patient receiving treatment for which of the following diagnoses?
a | Testicular cancer |
b | Malignant melanoma |
c | Follicular lymphoma |
d | Cervical cancer |
Question 35
A patient reports worsening of an extravasation site. The nurse will find which initial document most helpful?
a | Osmolarity of the solution infused |
b | Photographs of the site with date and time |
c | Initial dose of the chemotherapyation |
d | Quality of blood return before the infusion |
Question 36
Which of the following small molecule inhibitors is indicated for the treatment of pancreatic cancer?
a | Erlotinib |
b | Carfilzomib |
c | Bortezomib |
d | Cabozantinib |
Question 37
Which of the following drugs has the highest predicted risk of a hypersensitivity reaction?
a | Fluorouracil |
b | Dactinomycin |
c | Dacarbazine |
d | Oxaliplatin |
Question 38
Which of the following drugs is a nonanthracycline antitumor antibiotic?
a | Bleomycin |
b | Idarubicin |
c | Epirubicin |
d | Doxorubicin |
Question 39
What is the mechanism of action of monoclonal antibodies?
a | Remove immune cells from the body, and retrain them to identify and kill specific antigens |
b | Target tumor-specific antigens on the surface of some cancer cells |
c | Accelerate and fully engage immune cells to create a robust immune response |
d | Introduce the immune system to fragments of weakened or dead bacteria |
Question 40
Hazardous drugs can be released into the environment when:
a | priming tubing with a neutral solution. |
b | compounding parenteral Schedule 1 agents. |
c | discarding syringes used to administer chemotherapy. |
d | administering premedications in the infusion suite. |
Question 41
Which of the following dose-limiting toxicities is attributed to cyclophosphamide?
a | Hemorrhagic cystitis |
b | Hepatotoxicity |
c | Peripheral neuropathy |
d | Nephrotoxicity |
Question 42
Using a medication cup to administer an oral tablet form of chemotherapy:
a | prevents aerosolization. |
b | assures an accurate dose is administered. |
c | avoids a hazardous drug spill. |
d | protects the surfaces from contamination. |
Question 43
A patient receiving a checkpoint inhibitor experiences a dose-limiting toxicity. What does the nurse anticipate the physician will order?
a | Decrease the next dose. |
b | Slow the rate of infusion. |
c | Administer the next dose. |
d | Hold the next dose. |
Question 44
Which is a nursing action for a patient with chronic lymphocytic leukemia who is scheduled to receive bendamustine?
a | Administer seizure prophylaxis. |
b | Encourage frequent voiding. |
c | Infuse the agent over 240 minutes. |
d | Evaluate serum calcium and potassium. |
Question 45
The goal of adjuvant therapy is to:
a | decrease the immune response prior to transplantation. |
b | shrink the primary tumor to improve the effectiveness of surgery. |
c | target minimal disease for a patient at high risk of recurrence. |
d | eliminate residual disease prior to receiving a stem cell transplant. |
Question 46
Which of the following drugs when given in its pegylated liposomal form reduces the risk of cardiotoxicity and allows for a significantly higher cumulative dose?
a | Daunorubicin |
b | Epirubicin |
c | Idarubicin |
d | Doxorubicin |
Question 47
The nurse is exposed to a hazardous drug through ingestion by:
a | pushing chemotherapy through an implanted port. |
b | splashing chemotherapy into the eyes. |
c | drinking in an area that chemotherapy is administered. |
d | breathing in aerosolized particles from a chemotherapy spill. |
Question 48
A patient with a VAD which has a good blood return reports pain and burning close to the access site shortly after idarubicin is started. The nurse expects to:
a | elevate the affected extremity until the pain subsides. |
b | administer hyaluronidase in multiple SQ injections. |
c | apply warm packs for 15 minutes four times daily. |
d | administer the dexrazoxane infusion through an alternate site. |
Question 49
During an initial infusion of trastuzumab, a patient begins to shake and reports chills, nausea, and a headache. The nurse should:
a | stop the infusion, manage the reaction, and then restart the infusion. |
b | permanently discontinue the infusion after managing the reaction. |
c | stop the infusion, administer epinephrine, and then restart the infusion. |
d | slow the infusion and administer diphenhydramine and methylprednisolone. |
Question 50
Which of the following is the final level of protection in the hierarchy of hazard controls?
a | Personal protective equipment |
b | Hazard elimination |
c | Administrative controls |
d | Engineering controls |
Question 51
Which of the following interventions is an example of utilizing evidence-based practice?
a | Using honey as an oral rinse for mucositis |
b | Applying emollients to manage skin toxicities |
c | Using reverse isolation routinely for patients with neutropenia |
d | Encouraging individual aerobic exercise activities for fatigue |
Question 52
Biotherapeutic agents work by:
a | destroying rapidly dividing cells. |
b | enhancing the immune response. |
c | killing slowly dividing cells. |
d | weakening cell transformation. |
Question 53
Which of the following toxicities is associated with rituximab?
a | Renal |
b | Ophthalmologic |
c | Pulmonary |
d | Gonadal |
Question 54
The nurse caring for a patient with colon cancer that has metastasized to the liver is concerned that stricture can be caused by:
a | cisplatin. |
b | carboplatin. |
c | fluorouracil |
d | floxuridine. |
Question 55
Calculate the ANC for a patient with the following laboratory values: WBC 1.7 x 109/L, neutrophils 14%, bands 20%, and hemoglobin 10 g/dL.
a | 3400 neutrophils/mcL |
b | 238 neutrophils/mcL |
c | 578 neutrophils/mcL |
d | 5780 neutrophils/mcL |
Question 56
The signs and symptoms of a peripheral extravasation include:
a | pain and swelling along the IV site |
b | ulceration and blistering along the IV site. |
c | blotches and streaking at the IV site. |
d | tightness and aching at the IV site. |
Question 57
A patient with relapsed non-Hodgkin lymphoma is receiving ibritumomab tiuxetan. The nurse understands that:
a | the patient will be placed on isolation and radiation precautions for three days after the drug is given. |
b | the drug is bound to a diphtheria toxin which targets the lymphoma cells and kills them. |
c | the patient’s platelet count should be greater than 100,000/mm3 before starting the therapy. |
d | the medication should be given in combination with an antiplatelet therapy. |
Question 58
A patient receiving chemotherapy is unable to retain liquids and has vomited nine times over the past day. What is the grade of these adverse events according to the NCI’s Common Terminology Criteria for Adverse Events?
a | 1 |
b | 2 |
c | 4 |
d | 3 |
Question 59
The physician calls to give the nurse verbal chemotherapy orders. Which of the following nursing actions is appropriate?
a | Request that the physician provide the order to the pharmacist. |
b | Have a second nurse listen to the physician’s order to verify the dosage. |
c | Notify the physician that telephone orders are unacceptable. |
d | Obtain the chemotherapy name and dosage and read the order back to the physician. |
Question 60
Infusion-related hypotension is associated with which of the following drugs?
a | Vinblastine |
b | Etoposide |
c | Vinorelbine |
d | Paclitaxel |