2026 ONS ONCC CHEMOTHERAPY CORRECT EXAMS
SCRIPT QUESTIONS AND ANSWERS SURE A+
✔✔Per the NCCN Guidelines
(http://www.nccn.org/professionals/physician_gls/pdf/myeloid_growth.pdf), because of
Mrs. Turner's age ≥ 65 as well as a previous neutropenic episode, she would be a
candidate to receive a GCSF. Her febrile neutropenic episode requiring hospitalization
puts her at high risk for additional neutropenia. - ✔✔Which of the following do you feel
will be done with the remaining cycles of chemotherapy to hopefully prevent Mrs. Turner
from having additional problems with neutropenia?
✔✔full dose - ✔✔Evidence shows that older patients with cancer can safely obtain the
same treatment benefits as younger patients when they receive ________ standard
chemotherapy regimens. Many physicians are reluctant to give full-dose chemotherapy
to older adults perhaps due to of fear of adverse events like febrile neutropenia.
Suboptimal dosing from increasing the length of time between cycles or from dose
reduction is a serious issue because large, randomized clinical trials have demonstrated
that the delivery of lower doses or shorter courses of chemotherapy can reduce overall
survival in older patients with breast cancer or lymphoma
✔✔85% - ✔✔Amgen (2007) defines RDI as "is a quantification of how closely an
administered course of chemotherapy treatment adheres to a specific regimen." Three
separate clinical trials evaluating outcomes in patients with breast cancer related to RDI
, have demonstrated improved overall survival and 10-year disease free survival in
patients who receive a RDI > or = ____?_____
✔✔Per the prescribing information for Perjeta
(http://www.gene.com/download/pdf/perjeta_prescribing.pdf) it states to assess LVEF
prior to initiation of PERJETA and at regular intervals (every six weeks in the
neoadjuvant setting) during treatment to ensure that LVEF is within the institution's
normal limits. Mrs. Turner's chemotherapy is given every 3 weeks so she should have
her LVEF evaluated prior to cycle #3. If Mrs. Turner was receiving trastuzumab without
pertuzumab, the recommendation per the prescribing information for Herceptin
(http://www.gene.com/download/pdf/herceptin_prescribing.pdf) is to monitor baseline
LVEF measurement immediately prior to initiation of Herceptin and monitor LVEF every
3 months during and upon completion of Herceptin. - ✔✔You know the reason that Mrs.
Turner had another MUGA scan prior to receiving her 3rd cycle of neoadjuvant
chemotherapy is because it is recommended for which of the following agents?
✔✔Mrs. Turner's initial MUGA scan result was 55% and is now decreased to 48% which
is a > 10% decrease in her LVEF. Per the prescribing information for Perjeta, if the
LVEF is 45%, or is 45% to 49% with a 10% or greater absolute decrease below the
pretreatment value, withhold PERJETA and trastuzumab and repeat LVEF assessment
within approximately 3 weeks
(http://www.gene.com/download/pdf/perjeta_prescribing.pdf). You should call the doctor
to provide the results of the MUGA scan compared to her initial MUGA scan and
anticipate that the trastuzumab and pertuzumab will be held for this cycle of
chemotherapy. Mrs. Turner should have a repeat MUGA scan prior to cycle #4 and
based on those results, discontinue PERJETA and trastuzumab if the LVEF has not
improved or has declined further, unless the benefits for the individual patient outweigh
the risks. - ✔✔You realize that since Mrs. Turner is on a regimen that includes
pertuzumab that she should have her LVEF monitored every 6 weeks since she is
receiving neoadjuvant therapy. You review Mrs. Turner's most recent MUGA scan and
see that her LVEF is 48%.
✔✔heart function - ✔✔Two of the agents in the patients currecnt regimen, trastuzumab
and pertuzumab, have the potential to cause a decline in _____________
✔✔8.4% - ✔✔It is important that the nurse recognizes certain drugs that, when given
together, may result in a higher risk of adverse events. For example, in neoadjuvant
clinical trials using trastuzumab and pertuzumab, the incidence of decline in left
ventricular ejection fraction (LVEF) was 1.9% in patients treated with trastuzumab and
docetaxel, compared to ______ of those treated with trastuzumab, docetaxel, and
pertuzumab (Genentech, 2013).
✔✔Consider the potential toxicity related to each drug.
Understand the monitoring guidelines for each drug.
SCRIPT QUESTIONS AND ANSWERS SURE A+
✔✔Per the NCCN Guidelines
(http://www.nccn.org/professionals/physician_gls/pdf/myeloid_growth.pdf), because of
Mrs. Turner's age ≥ 65 as well as a previous neutropenic episode, she would be a
candidate to receive a GCSF. Her febrile neutropenic episode requiring hospitalization
puts her at high risk for additional neutropenia. - ✔✔Which of the following do you feel
will be done with the remaining cycles of chemotherapy to hopefully prevent Mrs. Turner
from having additional problems with neutropenia?
✔✔full dose - ✔✔Evidence shows that older patients with cancer can safely obtain the
same treatment benefits as younger patients when they receive ________ standard
chemotherapy regimens. Many physicians are reluctant to give full-dose chemotherapy
to older adults perhaps due to of fear of adverse events like febrile neutropenia.
Suboptimal dosing from increasing the length of time between cycles or from dose
reduction is a serious issue because large, randomized clinical trials have demonstrated
that the delivery of lower doses or shorter courses of chemotherapy can reduce overall
survival in older patients with breast cancer or lymphoma
✔✔85% - ✔✔Amgen (2007) defines RDI as "is a quantification of how closely an
administered course of chemotherapy treatment adheres to a specific regimen." Three
separate clinical trials evaluating outcomes in patients with breast cancer related to RDI
, have demonstrated improved overall survival and 10-year disease free survival in
patients who receive a RDI > or = ____?_____
✔✔Per the prescribing information for Perjeta
(http://www.gene.com/download/pdf/perjeta_prescribing.pdf) it states to assess LVEF
prior to initiation of PERJETA and at regular intervals (every six weeks in the
neoadjuvant setting) during treatment to ensure that LVEF is within the institution's
normal limits. Mrs. Turner's chemotherapy is given every 3 weeks so she should have
her LVEF evaluated prior to cycle #3. If Mrs. Turner was receiving trastuzumab without
pertuzumab, the recommendation per the prescribing information for Herceptin
(http://www.gene.com/download/pdf/herceptin_prescribing.pdf) is to monitor baseline
LVEF measurement immediately prior to initiation of Herceptin and monitor LVEF every
3 months during and upon completion of Herceptin. - ✔✔You know the reason that Mrs.
Turner had another MUGA scan prior to receiving her 3rd cycle of neoadjuvant
chemotherapy is because it is recommended for which of the following agents?
✔✔Mrs. Turner's initial MUGA scan result was 55% and is now decreased to 48% which
is a > 10% decrease in her LVEF. Per the prescribing information for Perjeta, if the
LVEF is 45%, or is 45% to 49% with a 10% or greater absolute decrease below the
pretreatment value, withhold PERJETA and trastuzumab and repeat LVEF assessment
within approximately 3 weeks
(http://www.gene.com/download/pdf/perjeta_prescribing.pdf). You should call the doctor
to provide the results of the MUGA scan compared to her initial MUGA scan and
anticipate that the trastuzumab and pertuzumab will be held for this cycle of
chemotherapy. Mrs. Turner should have a repeat MUGA scan prior to cycle #4 and
based on those results, discontinue PERJETA and trastuzumab if the LVEF has not
improved or has declined further, unless the benefits for the individual patient outweigh
the risks. - ✔✔You realize that since Mrs. Turner is on a regimen that includes
pertuzumab that she should have her LVEF monitored every 6 weeks since she is
receiving neoadjuvant therapy. You review Mrs. Turner's most recent MUGA scan and
see that her LVEF is 48%.
✔✔heart function - ✔✔Two of the agents in the patients currecnt regimen, trastuzumab
and pertuzumab, have the potential to cause a decline in _____________
✔✔8.4% - ✔✔It is important that the nurse recognizes certain drugs that, when given
together, may result in a higher risk of adverse events. For example, in neoadjuvant
clinical trials using trastuzumab and pertuzumab, the incidence of decline in left
ventricular ejection fraction (LVEF) was 1.9% in patients treated with trastuzumab and
docetaxel, compared to ______ of those treated with trastuzumab, docetaxel, and
pertuzumab (Genentech, 2013).
✔✔Consider the potential toxicity related to each drug.
Understand the monitoring guidelines for each drug.
