ONS ONCC CHEMO RENEWAL EXAM | NEWEST ACTUAL EXAM |COMPREHENSIVE QUESTIONS AND VERIFIED ANSWERS | GRADED A+ 100% PASS | 2024 UPDATE !!!

ONS ONCC CHEMO RENEWAL EXAM
NEWEST ACTUAL EXAM COMPREHENSIVE
QUESTIONS AND VERIFIED ANSWERS
GRADED A+ | 100% PASS | 2024 UPDATE

Amgen (2007) defines RDI as "is a quantification of how closely an
x x x x x x x x x x x x



administered course of chemotherapy treatment adheres to a specific x x x x x x x x x



regimen." Three separate clinical trials evaluating outcomes in patients
x x x x x x x x x



with breast cancer related to RDI have demonstrated improved overall
x x x x x x x x x x



survival and 10-year disease free survival in patients who receive a RDI
x x x x x x x x x x x



> or =
x ? x - ✔✔✔ Correct Answer > 85%
x x x x x x




Which of the following do you feel will be done with the remaining
x x x x x x x x x x x x x



cycles of chemotherapy to hopefully prevent Mrs. Turner from having
x x x x x x x x x x



additional problems with neutropenia? - ✔✔✔ Correct Answer
x x x x x x x x



> Per the NCCN Guidelines
x x x x x



(http://www.nccn.org/professionals/physician_gls/pdf/myeloid_growt x



h.pdf), because of Mrs. Turner's age ≥ 65 as well as a previous
x x x x x x x x x x x x x



neutropenic episode, she would be a candidate to receive a GCSF. Her
x x x x x x x x x x x



xfebrile neutropenic episode requiring hospitalization puts her at high
x x x x x x x x x



risk for additional neutropenia.
x x x




Evidence shows that older patients with cancer can safely obtain the
x x x x x x x x x x x



same treatment benefits as younger patients when they receive
x x x x x x x x



standard chemotherapy regimens. Many physicians are x x x x x

,reluctant to give full-dose chemotherapy to older adults perhaps due
x x x x x x x x x x



to of fear of adverse events like febrile neutropenia. Suboptimal
x x x x x x x x x x



dosing from increasing the length of time between cycles or from
x x x x x x x x x x x



dose reduction is a serious issue because large, randomized clinical
x x x x x x x x x x



trials have demonstrated that the delivery of lower doses or shorter
x x x x x x x x x x x



courses of chemotherapy can reduce overall survival in older patients
x x x x x x x x x x



with breast cancer or lymphoma - ✔✔✔ Correct Answer >
x x x x x x x x x x



full dose x




It is important that the nurse recognizes certain drugs that, when
x x x x x x x x x x x



given together, may result in a higher risk of adverse events. For
x x x x x x x x x x x x



example, in neoadjuvant clinical trials using trastuzumab and
x x x x x x x x



pertuzumab, the incidence of decline in left ventricular ejection x x x x x x x x x



fraction (LVEF) was 1.9% in patients treated with trastuzumab and
x x x x x x x x x x



docetaxel, compared to x x



of those treated with trastuzumab, docetaxel, and
x x x x x x x



pertuzumab (Genentech, 2013). - ✔✔✔ Correct Answer > x x x x x x x x



8.4%


You know the reason that Mrs. Turner had another MUGA scan prior
x x x x x x x x x x x x



to receiving her 3rd cycle of neoadjuvant chemotherapy is because it
x x x x x x x x x x x



is recommended for which of the following agents? - ✔✔✔
x x x x x x x x x x



Correct Answer > Per the prescribing information for Perjeta
x x x x x x x x x



(http://www.gene.com/download/pdf/perjeta_prescribing.pdf) it x x



states to assess LVEF prior to initiation of PERJETA and at regular
x x x x x x x x x x x x



intervals (every six weeks in the neoadjuvant setting) during
x x x x x x x x x



treatment to ensure that LVEF is within the institution's normal limits.
x x x x x x x x x x



xMrs.
Turner's chemotherapy is given every 3 weeks so she should have her
x x x x x x x x x x x x



LVEF evaluated prior to cycle #3. If Mrs. Turner was receiving
x x x x x x x x x x x



trastuzumab without pertuzumab, the recommendation per the x x x x x x x



prescribing information for Herceptin x x x

, (http://www.gene.com/download/pdf/herceptin_prescribing.pdf) is to x x x



monitor baseline LVEF measurement immediately prior to initiation of
x x x x x x x x



xHerceptin and monitor LVEF every 3 months during and upon
x x x x x x x x x x



completion of Herceptin. x x




You realize that since Mrs. Turner is on a regimen that includes
x x x x x x x x x x x x



pertuzumab that she should have her LVEF monitored every 6 weeksx x x x x x x x x x x



since she is receiving neoadjuvant therapy. You review Mrs. Turner's
x x x x x x x x x x



most recent MUGA scan and see that her LVEF is 48%. - ✔✔✔
x x x x x x x x x x x x x



Correct Answer > Mrs. Turner's initial MUGA scan result was
x x x x x x x x x x



55% and is now decreased to 48% which is a > 10% decrease in her
x x x x x x x x x x x x x x x



LVEF. Per the prescribing information for Perjeta, if the LVEF is 45%,
x x x x x x x x x x x x



or is 45% to 49% with a 10% or greater absolute decrease below the
x x x x x x x x x x x x x x



pretreatment value, withhold PERJETA and trastuzumab and repeat x x x x x x x x



LVEF assessment within approximately 3 weeks
x x x x x x



(http://www.gene.com/download/pdf/perjeta_prescribing.pdf). You x x



should call the doctor to provide the results of the MUGA scan
x x x x x x x x x x x x



compared to her initial MUGA scan and anticipate that the
x x x x x x x x x x



trastuzumab and pertuzumab will be held for this cycle of x x x x x x x x x x



chemotherapy. Mrs. x



Turner should have a repeat MUGA scan prior to cycle #4 and based
x x x x x x x x x x x x x



on those results, discontinue PERJETA and trastuzumab if the LVEF has
x x x x x x x x x x



xnot improved or has declined further, unless the benefits for the
x x x x x x x x x x x



individual patient outweigh the risks. x x x x




Two of the agents in the patients currecnt regimen, trastuzumab and
x x x x x x x x x x x



pertuzumab, have the potential to cause a decline in - x x x x x x x x x



✔✔✔ Correct Answer > heart function
x x x x x