150Qs&A Basics of Chemotherapy: Mechanisms of
Action and Classification of Anticancer Drugs.
Rationale Included:(2025/2026)
1. Which chemotherapy drug class works by interfering with DNA
replication through alkyl group addition?
A. Antimetabolites
B. Antitumor antibiotics
C. Alkylating agents
D. Mitotic inhibitors
Rationale: Alkylating agents damage DNA by adding alkyl
groups, preventing DNA replication and cell division.
2. Cyclophosphamide is primarily classified as which type of
chemotherapy drug?
A. Antimetabolite
B. Alkylating agent
C. Plant alkaloid
D. Hormonal agent
Rationale: Cyclophosphamide is an alkylating agent that cross-
links DNA strands, inhibiting tumor cell growth.
3. Which drug is associated with hemorrhagic cystitis as a major
adverse effect?
A. Methotrexate
B. Cyclophosphamide
C. Vincristine
D. Bleomycin
Rationale: Cyclophosphamide metabolites can irritate the
bladder, leading to hemorrhagic cystitis.
,4. Which agent is routinely given with cyclophosphamide to prevent
hemorrhagic cystitis?
A. Leucovorin
B. Filgrastim
C. Mesna
D. Allopurinol
Rationale: Mesna binds toxic metabolites of cyclophosphamide
in the bladder, preventing cystitis.
5. Doxorubicin is classified under which group of chemotherapy
drugs?
A. Alkylating agents
B. Antitumor antibiotics
C. Antimetabolites
D. Hormonal agents
Rationale: Doxorubicin is an anthracycline antitumor antibiotic
that interferes with DNA replication.
6. Which serious adverse effect is dose-related with doxorubicin?
A. Pulmonary fibrosis
B. Neurotoxicity
C. Cardiotoxicity
D. Nephrotoxicity
Rationale: Doxorubicin can cause cumulative, dose-dependent
damage to cardiac muscle.
7. A patient receiving vincristine should be closely monitored for
which adverse effect?
A. Ototoxicity
B. Nephrotoxicity
C. Cardiac arrhythmias
D. Peripheral neuropathy
, Rationale: Vincristine commonly causes neurologic toxicity such
as numbness and tingling.
8. Which chemotherapy agent is a folic acid antagonist?
A. 5-fluorouracil
B. Cytarabine
C. Methotrexate
D. Bleomycin
Rationale: Methotrexate inhibits dihydrofolate reductase,
blocking folic acid metabolism in cancer cells.
9. Leucovorin is most often administered to reduce toxicity of which
medication?
A. Cisplatin
B. Vinblastine
C. Doxorubicin
D. Methotrexate
Rationale: Leucovorin “rescues” normal cells by providing
reduced folate after methotrexate therapy.
10. Cisplatin belongs to which class of chemotherapy drugs?
A. Antitumor antibiotics
B. Antimetabolites
C. Platinum compounds
D. Taxanes
Rationale: Cisplatin is a platinum-based chemotherapy agent
that cross-links DNA strands.
11. Which major toxicity is most associated with cisplatin?
A. Hepatotoxicity
B. Neurotoxicity
C. Nephrotoxicity
D. Hyperglycemia
, Rationale: Cisplatin can cause significant kidney damage,
requiring adequate hydration.
12. A key nursing intervention to prevent cisplatin-induced
nephrotoxicity is:
A. Restricting oral fluids
B. Encouraging high-potassium foods
C. Aggressive IV hydration
D. Administering sodium bicarbonate orally
Rationale: Adequate hydration helps flush cisplatin from the
kidneys and reduce renal damage.
13. Which chemotherapy drug is most associated with
pulmonary fibrosis?
A. Dactinomycin
B. Vincristine
C. Cyclophosphamide
D. Bleomycin
Rationale: Bleomycin toxicity commonly affects the lungs,
leading to fibrosis.
14. Paclitaxel is classified as which type of chemotherapy agent?
A. Alkylating agent
B. Antimetabolite
C. Mitotic inhibitor (taxane)
D. Hormonal agent
Rationale: Paclitaxel stabilizes microtubules, preventing cell
division.
15. Which adverse reaction is commonly associated with
paclitaxel infusion?
A. Severe constipation
B. Ototoxicity
Action and Classification of Anticancer Drugs.
Rationale Included:(2025/2026)
1. Which chemotherapy drug class works by interfering with DNA
replication through alkyl group addition?
A. Antimetabolites
B. Antitumor antibiotics
C. Alkylating agents
D. Mitotic inhibitors
Rationale: Alkylating agents damage DNA by adding alkyl
groups, preventing DNA replication and cell division.
2. Cyclophosphamide is primarily classified as which type of
chemotherapy drug?
A. Antimetabolite
B. Alkylating agent
C. Plant alkaloid
D. Hormonal agent
Rationale: Cyclophosphamide is an alkylating agent that cross-
links DNA strands, inhibiting tumor cell growth.
3. Which drug is associated with hemorrhagic cystitis as a major
adverse effect?
A. Methotrexate
B. Cyclophosphamide
C. Vincristine
D. Bleomycin
Rationale: Cyclophosphamide metabolites can irritate the
bladder, leading to hemorrhagic cystitis.
,4. Which agent is routinely given with cyclophosphamide to prevent
hemorrhagic cystitis?
A. Leucovorin
B. Filgrastim
C. Mesna
D. Allopurinol
Rationale: Mesna binds toxic metabolites of cyclophosphamide
in the bladder, preventing cystitis.
5. Doxorubicin is classified under which group of chemotherapy
drugs?
A. Alkylating agents
B. Antitumor antibiotics
C. Antimetabolites
D. Hormonal agents
Rationale: Doxorubicin is an anthracycline antitumor antibiotic
that interferes with DNA replication.
6. Which serious adverse effect is dose-related with doxorubicin?
A. Pulmonary fibrosis
B. Neurotoxicity
C. Cardiotoxicity
D. Nephrotoxicity
Rationale: Doxorubicin can cause cumulative, dose-dependent
damage to cardiac muscle.
7. A patient receiving vincristine should be closely monitored for
which adverse effect?
A. Ototoxicity
B. Nephrotoxicity
C. Cardiac arrhythmias
D. Peripheral neuropathy
, Rationale: Vincristine commonly causes neurologic toxicity such
as numbness and tingling.
8. Which chemotherapy agent is a folic acid antagonist?
A. 5-fluorouracil
B. Cytarabine
C. Methotrexate
D. Bleomycin
Rationale: Methotrexate inhibits dihydrofolate reductase,
blocking folic acid metabolism in cancer cells.
9. Leucovorin is most often administered to reduce toxicity of which
medication?
A. Cisplatin
B. Vinblastine
C. Doxorubicin
D. Methotrexate
Rationale: Leucovorin “rescues” normal cells by providing
reduced folate after methotrexate therapy.
10. Cisplatin belongs to which class of chemotherapy drugs?
A. Antitumor antibiotics
B. Antimetabolites
C. Platinum compounds
D. Taxanes
Rationale: Cisplatin is a platinum-based chemotherapy agent
that cross-links DNA strands.
11. Which major toxicity is most associated with cisplatin?
A. Hepatotoxicity
B. Neurotoxicity
C. Nephrotoxicity
D. Hyperglycemia
, Rationale: Cisplatin can cause significant kidney damage,
requiring adequate hydration.
12. A key nursing intervention to prevent cisplatin-induced
nephrotoxicity is:
A. Restricting oral fluids
B. Encouraging high-potassium foods
C. Aggressive IV hydration
D. Administering sodium bicarbonate orally
Rationale: Adequate hydration helps flush cisplatin from the
kidneys and reduce renal damage.
13. Which chemotherapy drug is most associated with
pulmonary fibrosis?
A. Dactinomycin
B. Vincristine
C. Cyclophosphamide
D. Bleomycin
Rationale: Bleomycin toxicity commonly affects the lungs,
leading to fibrosis.
14. Paclitaxel is classified as which type of chemotherapy agent?
A. Alkylating agent
B. Antimetabolite
C. Mitotic inhibitor (taxane)
D. Hormonal agent
Rationale: Paclitaxel stabilizes microtubules, preventing cell
division.
15. Which adverse reaction is commonly associated with
paclitaxel infusion?
A. Severe constipation
B. Ototoxicity
