ONS CHEMO CERTIFICATION RENEWAL EXAM
LATEST ACTUAL EXAM 350 QUESTIONS AND
CORRECT DETAILED ANSWERS WITH RATIONALES
A+ GRADE
How x do x alkylating x agents x function? x - x ANSWER-By x causing x a x break x in x the x DNA x helix x strand, x causing
x interference x with x DNA x replication, x which x results x in x cell x death
What x is x the x most x common x subcategory x of x alkylating x agents? x - x ANSWER-Nitrogen x mustards
Examples x of x nitrogen x mustards x (alkylating x agents) x - x ANSWER-Cyclophosphamide x (Cytoxan), x
Ifosfamide x (Ifex), x Bendamustine x (Treanda)
What x type x of x chemo x agents x act x similar x to x alkylating x agents, x but x do x not x possess x an x alkyl x group x
molecule x to x attach x to x and x destroy x DNA? x - x ANSWER-Platinum-based x chemo
Examples x of x common x platinum-based x drugs x - x ANSWER-Cisplatin x (Platinol) x and x Carboplatin x (Paraplatin)
What x is x another x subcategory x of x alkylating x agents? x - x ANSWER-Nitrosoureas
Function x of x nitrosoureas x - x ANSWER-Cross x the x blood-brain x barrier, x making x them x effective x in x treating
x some x brain x tumors, x melanomas, x and x lymphomas
Common x nitrosoureas x - x ANSWER-Carmustine x (BiCNU), x Lomustine x (CeeNu), x Streptozocin x (Zanosar)
Two x major x warnings x of x carmustine x (BiCNU) x - x ANSWER-Myelosuppression x and x pulmonary x toxicity
What x type x of x cancers x does x carmustine x (BiCNU) x treat? x - x ANSWER-Brain x tumors x (ex. x glioblastoma), x
multiple x myeloma, x Hodgkin's x and x non-Hodgkin's x lymphoma
Two x major x warnings x of x lomustine x (CeeNu) x or x (Gleostine) x - x ANSWER-Delayed x myelosuppression x and
x risk x of x overdosage
,What x types x of x cancers x does x lomustine x (Gleostine) x treat? x - x ANSWER-Brain x tumors x and x Hodgkin's x
lymphoma
What x type x of x cancer x does x streptozocin x (Zanosar) x treat? x - x ANSWER-Metastatic x islet x cell x carcinoma x
of x the x pancreas
What x major x warning x does x streptozocin x (Zanosar) x have? x - x ANSWER-Renal x toxicity
What x are x the x dose-limiting x toxicities x of x alkylating x agents? x - x ANSWER-Bone x marrow x suppression, x GI x
toxicities x (N/V/D), x renal x toxicities, x hepatotoxicity, x pulmonary x fibrosis, x hypersensitivities
Hypersensitivity x may x occur x with x late x doses x of x what? x - x ANSWER-Carboplatin
What x is x possible x in x patients x receiving x alkylating x agents, x particularly x when x there x is x a x high x tumor x
burden? x - x ANSWER-Tumor x lysis x syndrome
What x pre-administration x blood x tests x should x be x included x in x alkylating x agents? x - x ANSWER-BUN, x
creatinine, x CBC x with x diff
Are x alkylating x agents x emetogenic? x - x ANSWER-Yes, x highly x emetogenic
What x is x a x bladder x protectant x typically x administered x with x cyclophosphamide x and x ifosfamide? x - x
ANSWER- x Mesna
What x is x the x main x nursing x teaching x to x include x with x oxaliplatin? x - x ANSWER-Avoid x exposure x to x cold x
air x and x consuming x cold x fluids x 3-4 x days x following x treatment
What x are x the x most x nephrotoxic x alkylating x agents? x - x ANSWER-Streptozocin x and x semustine, x affecting x
more x than x 75% x of x patients, x which x may x lead x to x treatment x delays
, What x side x effect x can x occur x with x alkylating x agents/nitrosoureas x that x may x worsen x with x dehydration?
x - x ANSWER-Pruritis x and x itching; x encourage x patients x to x drink x at x least x 8-10 x glasses x of x fluid/day, x
minimize x salt x and x alcohol x intake
Alkylating x agents x and x nitrosoureas x have x the x potential x to x cause x what? x - x ANSWER-Secondary x
malignancies x and x fertility x issues
Long-term x myelosuppression x can x lead x to x what? x - x ANSWER-The x development x of x a x secondary x
malignancy, x 5-10 x years x after x treatment
What x is x a x short-term x side x efect x of x nitrosoureas x (particularly x carmustine x and x lomustine)? x - x
ANSWER- x Kidney x disease
Long-term x side x effects x of x carmustine x and x lomustine x - x ANSWER-Reduction x of x pulmonary x function: x
delayed x pulmonary x fibrosis--17 x years x after x tx x for x patients x who x received x this x in x childhood/early x
adolescence
What x test x should x be x performed x prior x to x treatment x with x carmustine x or x lomustine? x - x ANSWER-
Baseline x pulmonary x function x tests, x there x are x fatal x cases x of x pulmonary x toxicity
How x do x antimetabolites x function? x - x ANSWER-By x blocking x DNA x and x RNA x growth x by x interfering x with x
enzymes x that x are x necessary x for x normal x cell x metabolism
What x phase x of x the x cell x cycle x do x antimetabolites x work? x - x ANSWER-The x S x phase, x so x they x are x highly x
effective x on x tumors x with x fast x growth x rates
Most x common x antimetabolites: x - x ANSWER-Azacitidine x (Vidaza), x Capecitabine x (Xeloda), x 5-
Fluorourcacil x (5-FU), x Cytarabine x (Ara-C), x Decitabine x (Dacogen), x Methotrexate
What x cancers x does x fluorouracil x treat? x - x ANSWER-Adenocarcinoma x of x colon x and x rectum, x
adenocarcinoma x of x breast, x gastric x adenocarcinoma, x pancreatic x adenocarcinoma
LATEST ACTUAL EXAM 350 QUESTIONS AND
CORRECT DETAILED ANSWERS WITH RATIONALES
A+ GRADE
How x do x alkylating x agents x function? x - x ANSWER-By x causing x a x break x in x the x DNA x helix x strand, x causing
x interference x with x DNA x replication, x which x results x in x cell x death
What x is x the x most x common x subcategory x of x alkylating x agents? x - x ANSWER-Nitrogen x mustards
Examples x of x nitrogen x mustards x (alkylating x agents) x - x ANSWER-Cyclophosphamide x (Cytoxan), x
Ifosfamide x (Ifex), x Bendamustine x (Treanda)
What x type x of x chemo x agents x act x similar x to x alkylating x agents, x but x do x not x possess x an x alkyl x group x
molecule x to x attach x to x and x destroy x DNA? x - x ANSWER-Platinum-based x chemo
Examples x of x common x platinum-based x drugs x - x ANSWER-Cisplatin x (Platinol) x and x Carboplatin x (Paraplatin)
What x is x another x subcategory x of x alkylating x agents? x - x ANSWER-Nitrosoureas
Function x of x nitrosoureas x - x ANSWER-Cross x the x blood-brain x barrier, x making x them x effective x in x treating
x some x brain x tumors, x melanomas, x and x lymphomas
Common x nitrosoureas x - x ANSWER-Carmustine x (BiCNU), x Lomustine x (CeeNu), x Streptozocin x (Zanosar)
Two x major x warnings x of x carmustine x (BiCNU) x - x ANSWER-Myelosuppression x and x pulmonary x toxicity
What x type x of x cancers x does x carmustine x (BiCNU) x treat? x - x ANSWER-Brain x tumors x (ex. x glioblastoma), x
multiple x myeloma, x Hodgkin's x and x non-Hodgkin's x lymphoma
Two x major x warnings x of x lomustine x (CeeNu) x or x (Gleostine) x - x ANSWER-Delayed x myelosuppression x and
x risk x of x overdosage
,What x types x of x cancers x does x lomustine x (Gleostine) x treat? x - x ANSWER-Brain x tumors x and x Hodgkin's x
lymphoma
What x type x of x cancer x does x streptozocin x (Zanosar) x treat? x - x ANSWER-Metastatic x islet x cell x carcinoma x
of x the x pancreas
What x major x warning x does x streptozocin x (Zanosar) x have? x - x ANSWER-Renal x toxicity
What x are x the x dose-limiting x toxicities x of x alkylating x agents? x - x ANSWER-Bone x marrow x suppression, x GI x
toxicities x (N/V/D), x renal x toxicities, x hepatotoxicity, x pulmonary x fibrosis, x hypersensitivities
Hypersensitivity x may x occur x with x late x doses x of x what? x - x ANSWER-Carboplatin
What x is x possible x in x patients x receiving x alkylating x agents, x particularly x when x there x is x a x high x tumor x
burden? x - x ANSWER-Tumor x lysis x syndrome
What x pre-administration x blood x tests x should x be x included x in x alkylating x agents? x - x ANSWER-BUN, x
creatinine, x CBC x with x diff
Are x alkylating x agents x emetogenic? x - x ANSWER-Yes, x highly x emetogenic
What x is x a x bladder x protectant x typically x administered x with x cyclophosphamide x and x ifosfamide? x - x
ANSWER- x Mesna
What x is x the x main x nursing x teaching x to x include x with x oxaliplatin? x - x ANSWER-Avoid x exposure x to x cold x
air x and x consuming x cold x fluids x 3-4 x days x following x treatment
What x are x the x most x nephrotoxic x alkylating x agents? x - x ANSWER-Streptozocin x and x semustine, x affecting x
more x than x 75% x of x patients, x which x may x lead x to x treatment x delays
, What x side x effect x can x occur x with x alkylating x agents/nitrosoureas x that x may x worsen x with x dehydration?
x - x ANSWER-Pruritis x and x itching; x encourage x patients x to x drink x at x least x 8-10 x glasses x of x fluid/day, x
minimize x salt x and x alcohol x intake
Alkylating x agents x and x nitrosoureas x have x the x potential x to x cause x what? x - x ANSWER-Secondary x
malignancies x and x fertility x issues
Long-term x myelosuppression x can x lead x to x what? x - x ANSWER-The x development x of x a x secondary x
malignancy, x 5-10 x years x after x treatment
What x is x a x short-term x side x efect x of x nitrosoureas x (particularly x carmustine x and x lomustine)? x - x
ANSWER- x Kidney x disease
Long-term x side x effects x of x carmustine x and x lomustine x - x ANSWER-Reduction x of x pulmonary x function: x
delayed x pulmonary x fibrosis--17 x years x after x tx x for x patients x who x received x this x in x childhood/early x
adolescence
What x test x should x be x performed x prior x to x treatment x with x carmustine x or x lomustine? x - x ANSWER-
Baseline x pulmonary x function x tests, x there x are x fatal x cases x of x pulmonary x toxicity
How x do x antimetabolites x function? x - x ANSWER-By x blocking x DNA x and x RNA x growth x by x interfering x with x
enzymes x that x are x necessary x for x normal x cell x metabolism
What x phase x of x the x cell x cycle x do x antimetabolites x work? x - x ANSWER-The x S x phase, x so x they x are x highly x
effective x on x tumors x with x fast x growth x rates
Most x common x antimetabolites: x - x ANSWER-Azacitidine x (Vidaza), x Capecitabine x (Xeloda), x 5-
Fluorourcacil x (5-FU), x Cytarabine x (Ara-C), x Decitabine x (Dacogen), x Methotrexate
What x cancers x does x fluorouracil x treat? x - x ANSWER-Adenocarcinoma x of x colon x and x rectum, x
adenocarcinoma x of x breast, x gastric x adenocarcinoma, x pancreatic x adenocarcinoma
