ONS Chemo Certification Exam Questions With Correct Answers

ONS Chemo Certification Exam Questions With Correct Answers How do alkylating agents function? - CORRECT ANSWER By causing a break in the DNA helix strand, causing interference with DNA replication, which results in cell death What is the most common subcategory of alkylating agents? - CORRECT ANSWER Nitrogen mustards Examples of nitrogen mustards (alkylating agents) - CORRECT ANSWER Cyclophosphamide (Cytoxan), Ifosfamide (Ifex), Bendamustine (Treanda) What type of chemo agents act similar to alkylating agents, but do not possess an alkyl group molecule to attach to and destroy DNA? - CORRECT ANSWER Platinum-based chemo Examples of common platinum-based drugs - CORRECT ANSWER Cisplatin (Platinol) and Carboplatin (Paraplatin) What is another subcategory of alkylating agents? - CORRECT ANSWER Nitrosoureas Function of nitrosoureas - CORRECT ANSWER Cross the blood-brain barrier, making them effective in treating some brain tumors, melanomas, and lymphomas Common nitrosoureas - CORRECT ANSWER Carmustine (BiCNU), Lomustine (CeeNu), Streptozocin (Zanosar) Two major warnings of carmustine (BiCNU) - CORRECT ANSWER Myelosuppression and pulmonary toxicity What type of cancers does carmustine (BiCNU) treat? - CORRECT ANSWER Brain tumors (ex. glioblastoma), multiple myeloma, Hodgkin's and non-Hodgkin's lymphoma Two major warnings of lomustine (CeeNu) or (Gleostine) - CORRECT ANSWER Delayed myelosuppression and risk of overdosage What types of cancers does lomustine (Gleostine) treat? - CORRECT ANSWER Brain tumors and Hodgkin's lymphoma What type of cancer does streptozocin (Zanosar) treat? - CORRECT ANSWER Metastatic islet cell carcinoma of the pancreas What major warning does streptozocin (Zanosar) have? - CORRECT ANSWER Renal toxicity What are the dose-limiting toxicities of alkylating agents? - CORRECT ANSWER Bone marrow suppression, GI toxicities (N/V/D), renal toxicities, hepatotoxicity, pulmonary fibrosis, hypersensitivities Hypersensitivity may occur with late doses of what? - CORRECT ANSWER Carboplatin What is possible in patients receiving alkylating agents, particularly when there is a high tumor burden? - CORRECT ANSWER Tumor lysis syndrome What pre-administration blood tests should be included in alkylating agents? - CORRECT ANSWER BUN, creatinine, CBC with diff Are alkylating agents emetogenic? - CORRECT ANSWER Yes, highly emetogenic What is a bladder protectant typically administered with cyclophosphamide and ifosfamide? - CORRECT ANSWER Mesna What is the main nursing teaching to include with oxaliplatin? - CORRECT ANSWER Avoid exposure to cold air and consuming cold fluids 3-4 days following treatment What are the most nephrotoxic alkylating agents? - CORRECT ANSWER Streptozocin and semustine, affecting more than 75% of patients, which may lead to treatment delays What side effect can occur with alkylating agents/nitrosoureas that may worsen with dehydration? - CORRECT ANSWER Pruritis and itching; encourage patients to drink at least 8-10 glasses of fluid/day, minimize salt and alcohol intake Alkylating agents and nitrosoureas have the potential to cause what? - CORRECT ANSWER Secondary malignancies and fertility issues Long-term myelosuppression can lead to what? - CORRECT ANSWER The development of a secondary malignancy, 5-10 years after treatment What is a short-term side efect of nitrosoureas (particularly carmustine and lomustine)? - CORRECT ANSWER Kidney disease Long-term side effects of carmustine and lomustine - CORRECT ANSWER Reduction of pulmonary function: delayed pulmonary fibrosis--17 years after tx for patients who received this in childhood/early adolescence What test should be performed prior to treatment with carmustine or lomustine? - CORRECT ANSWER Baseline pulmonary function tests, there are fatal cases of pulmonary toxicity How do antimetabolites function? - CORRECT ANSWER By blocking DNA and RNA growth by interfering with enzymes that are necessary for normal cell metabolism What phase of the cell cycle do antimetabolites work? - CORRECT ANSWER The S phase, so they are highly effective on tumors with fast growth rates Most common antimetabolites: - CORRECT ANSWER Azacitidine (Vidaza), Capecitabine (Xeloda), 5-Fluorourcacil (5-FU), Cytarabine (Ara-C), Decitabine (Dacogen), Methotrexate What cancers does fluorouracil treat? - CORRECT ANSWER Adenocarcinoma of colon and rectum, adenocarcinoma of breast, gastric adenocarcinoma, pancreatic adenocarcinoma