CHEMOTHERAPY & IMMUNOTHERAPY
Administration Safety Exam
2025 Practice Edition
130 Multiple-Choice Questions with Answers and Rationales
Original oncology nursing practice assessment; not an official or reproduced certification
examination
Page 1 of 46
,Table of Contents
Section 1: Cancer Biology, Treatment Principles & Chemotherapy Fundamentals (Questions 1–15)
........................................ 3
Section 2: Chemotherapy Agents, Classification & Mechanisms of Action (Questions 16–30)
........................................ 8
Section 3: Immunotherapy & Biologic Therapy Fundamentals (Questions 31–45)
........................................ 13
Section 4: Safe Handling, Hazardous Drug Precautions & PPE (Questions 46–60)
........................................ 18
Section 5: Administration Routes, Vesicants & Extravasation Management (Questions 61–75)
........................................ 23
Section 6: Side Effects, Toxicities & Supportive Care (Questions 76–90) ........................................ 28
Section 7: Hypersensitivity Reactions, Anaphylaxis & Emergency Management (Questions 91–105)
........................................ 33
Section 8: Patient Education, Documentation & Ethical/Legal Considerations (Questions 106–130)
........................................ 38
Page 2 of 46
,Section 1: Cancer Biology, Treatment Principles & Chemotherapy
Fundamentals (Questions 1–15)
Q1: A tumor continues growing after normal feedback signals would stop cell division.
This most directly reflects:
A. Loss of normal growth regulation [CORRECT]
B. Increased differentiation only
C. Normal contact inhibition
D. Apoptosis of every malignant cell
Correct Answer: A
Rationale: Malignant cells acquire altered growth control and may evade normal cell-cycle
checkpoints; normal tissue regulation would restrain proliferation.
Q2: A patient asks why chemotherapy is given in cycles with rest periods. Which
explanation is best?
A. Cycles eliminate the need to monitor blood counts
B. Cycles allow treatment of susceptible tumor cells while permitting recovery of normal tissues
[CORRECT]
C. Rest periods make every cancer cell permanently resistant
D. Chemotherapy works only during sleep
Correct Answer: B
Rationale: Many regimens use cycles to balance antitumor effect with recovery from toxicity in
normal, especially rapidly dividing, tissues.
Q3: A chemotherapy drug is most active during DNA synthesis. Which cell-cycle phase is
its primary target?
A. M phase only
B. G2 phase only
C. S phase [CORRECT]
D. G0 phase
Correct Answer: C
Rationale: S-phase-specific agents interfere with DNA synthesis; G0 is resting, while other
drugs target different phases or are cell-cycle nonspecific.
Page 3 of 46
, Q4: A patient asks why a tumor biopsy is needed before choosing therapy. The best
response is that pathology can:
A. Determine the exact response to every future dose
B. Replace staging and imaging in all cases
C. Guarantee the cancer is localized
D. Confirm tumor type and provide features that guide treatment selection [CORRECT]
Correct Answer: D
Rationale: Histology and biomarkers help identify tumor biology and potential therapies;
biopsy alone does not establish every stage or predict certainty of response.
Q5: A cancer is described as stage IV. What does staging primarily communicate?
A. Anatomic extent and spread of disease [CORRECT]
B. Microscopic appearance alone
C. The drug dose to administer
D. Whether the patient will experience nausea
Correct Answer: A
Rationale: Stage describes extent/spread, while grade describes microscopic
aggressiveness; treatment selection also incorporates biomarkers and patient factors.
Q6: A tumor is well differentiated and resembles its tissue of origin. This finding most
often suggests:
A. Chemotherapy resistance is certain
B. Lower histologic grade than a poorly differentiated tumor [CORRECT]
C. Higher stage by definition
D. Metastatic spread in every case
Correct Answer: B
Rationale: Differentiation contributes to grade; it does not by itself determine stage or
guarantee treatment response.
Page 4 of 46
Administration Safety Exam
2025 Practice Edition
130 Multiple-Choice Questions with Answers and Rationales
Original oncology nursing practice assessment; not an official or reproduced certification
examination
Page 1 of 46
,Table of Contents
Section 1: Cancer Biology, Treatment Principles & Chemotherapy Fundamentals (Questions 1–15)
........................................ 3
Section 2: Chemotherapy Agents, Classification & Mechanisms of Action (Questions 16–30)
........................................ 8
Section 3: Immunotherapy & Biologic Therapy Fundamentals (Questions 31–45)
........................................ 13
Section 4: Safe Handling, Hazardous Drug Precautions & PPE (Questions 46–60)
........................................ 18
Section 5: Administration Routes, Vesicants & Extravasation Management (Questions 61–75)
........................................ 23
Section 6: Side Effects, Toxicities & Supportive Care (Questions 76–90) ........................................ 28
Section 7: Hypersensitivity Reactions, Anaphylaxis & Emergency Management (Questions 91–105)
........................................ 33
Section 8: Patient Education, Documentation & Ethical/Legal Considerations (Questions 106–130)
........................................ 38
Page 2 of 46
,Section 1: Cancer Biology, Treatment Principles & Chemotherapy
Fundamentals (Questions 1–15)
Q1: A tumor continues growing after normal feedback signals would stop cell division.
This most directly reflects:
A. Loss of normal growth regulation [CORRECT]
B. Increased differentiation only
C. Normal contact inhibition
D. Apoptosis of every malignant cell
Correct Answer: A
Rationale: Malignant cells acquire altered growth control and may evade normal cell-cycle
checkpoints; normal tissue regulation would restrain proliferation.
Q2: A patient asks why chemotherapy is given in cycles with rest periods. Which
explanation is best?
A. Cycles eliminate the need to monitor blood counts
B. Cycles allow treatment of susceptible tumor cells while permitting recovery of normal tissues
[CORRECT]
C. Rest periods make every cancer cell permanently resistant
D. Chemotherapy works only during sleep
Correct Answer: B
Rationale: Many regimens use cycles to balance antitumor effect with recovery from toxicity in
normal, especially rapidly dividing, tissues.
Q3: A chemotherapy drug is most active during DNA synthesis. Which cell-cycle phase is
its primary target?
A. M phase only
B. G2 phase only
C. S phase [CORRECT]
D. G0 phase
Correct Answer: C
Rationale: S-phase-specific agents interfere with DNA synthesis; G0 is resting, while other
drugs target different phases or are cell-cycle nonspecific.
Page 3 of 46
, Q4: A patient asks why a tumor biopsy is needed before choosing therapy. The best
response is that pathology can:
A. Determine the exact response to every future dose
B. Replace staging and imaging in all cases
C. Guarantee the cancer is localized
D. Confirm tumor type and provide features that guide treatment selection [CORRECT]
Correct Answer: D
Rationale: Histology and biomarkers help identify tumor biology and potential therapies;
biopsy alone does not establish every stage or predict certainty of response.
Q5: A cancer is described as stage IV. What does staging primarily communicate?
A. Anatomic extent and spread of disease [CORRECT]
B. Microscopic appearance alone
C. The drug dose to administer
D. Whether the patient will experience nausea
Correct Answer: A
Rationale: Stage describes extent/spread, while grade describes microscopic
aggressiveness; treatment selection also incorporates biomarkers and patient factors.
Q6: A tumor is well differentiated and resembles its tissue of origin. This finding most
often suggests:
A. Chemotherapy resistance is certain
B. Lower histologic grade than a poorly differentiated tumor [CORRECT]
C. Higher stage by definition
D. Metastatic spread in every case
Correct Answer: B
Rationale: Differentiation contributes to grade; it does not by itself determine stage or
guarantee treatment response.
Page 4 of 46
