EXAM||ACTUAL QUESTIONS & ANSWERS
1. Neoadjuvant therapy does not increase survival when compared to adjuvant
therapy. It only changes the timing of treatment and can change surgical op-
tions if the tumor is shrunk enough. If this occurs, the patient may only require
a lumpectomy plus radiation therapy instead of needing a mastectomy: Main
benefit of neoadjuvant chemotherapy (breast cancer patient)
2. A comprehensive geriatric assessment (CGA) is a multidisciplinary evalua-
tion to assess life expectancy and risk of morbidity and mortality in the older
patient. This assessment tool would evaluate and include the following areas:
functional status, socioeconomic issues, psychosocial distress, comorbidi-
ties, cognitive function, nutritional status, polypharmacy, and a medication
review (NCCN Older Adult Oncology Guidelines, version 1.2015).: Due to Mrs.
Turner's age and comorbidities, her oncologist performs a comprehensive geriatric
assessment. You know that this assessment covers all but which of the following:
3. 65: The NCCN Older Adult Oncology Guidelines (version 1.2015) provides in-
formation on what is included in a comprehensive geriatric assessment. Currently,
more than 60% of cancers in the United States occur in people age and older
and as the oncology world ages, nearly half (46%) of cancer survivors are 70 years
of age or older
4. Two of the agents (docetaxel and carboplatin) that Mrs. Turner will receive
are categorized as irritants. Docetaxel can cause a significant reaction if it
extravasates. It can lead to edema, erythema, occasional pain and blister
formation (ONS Chemo/Bio guidelines, 2014). That is the most likely reason
that Mrs. Turner was given a port for her treatments. Some patients will receive
their treatments through a peripheral IV without incident. Just because they
are intravenous agents does not mean that a port is required and needing a
port has nothing to do with her being older in age. Since none of these agents
are vesicants, they likely could have been given safely via peripheral route but
having a port placed is OK as well.: What is your best explanation for why Mrs.
Turner was given a port to receive her chemotherapy?
5. Irrirtants: can cause inflammation, pain, and burning but rarely
cause tissue necrosis comparable to a vesicant (unless a large amount or a very
, high concentration of the irritant is extravasated).
6. Vesicants: can cause blistering and significant pain and tissue
damage and destruction, leading to tissue death.
7. Non-DNA-binding solutions remain in the local area of the extravasation,
which improves the possibility of drug deactivation.
DNA-binding agents attach to DNA nucleic acids, causing the antagonist
to be ingested cellularly, leading to progressive tissue destruction: A further