AOCNP ADVANCED ONCOLOGY
CERTIFIED NURSE PRACTITIONER
FINAL EXAM REVIEW QUESTIONS &
VERIFIED ANSWERS (A+ GUARANTEE)
1. A patient with metastatic colorectal cancer is being considered for therapy with
Cetuximab. Which of the following molecular markers must be evaluated before starting this
treatment?
A. BRAF V600E mutation
B. KRAS and NRAS mutation status
C. DPYD gene expression
D. MSI-H/dMMR status
Answer: B
Conceptual Explanation: Cetuximab is an EGFR inhibitor. Clinical trials have
demonstrated that patients with KRAS or NRAS mutations in exons 2, 3, or 4 do not benefit
from anti-EGFR therapy; therefore, wild-type status is required for use.
2. A patient receiving high-dose Methotrexate therapy is experiencing delayed clearance.
What is the standard pharmacological intervention to prevent severe systemic toxicity?
A. Dexrazoxane
,B. Mesna
C. Glucarpidase
D. Amifostine
Answer: C
Conceptual Explanation: Glucarpidase is indicated for the treatment of toxic
methotrexate concentrations in patients with delayed methotrexate clearance due to
impaired renal function. Leucovorin is also used, but Glucarpidase rapidly reduces
extracellular levels.
3. Which of the following is the most appropriate management for a Grade 3 immune-related
pneumonitis secondary to Pembrolizumab?
A. Continue Pembrolizumab and start oral prednisone at 0.5 mg/kg/day
B. Administer prophylactic antibiotics and resume Pembrolizumab in 2 weeks
C. Hold Pembrolizumab and re-challenge once symptoms resolve to Grade 1
D. Permanently discontinue Pembrolizumab and initiate IV methylprednisolone 1-2
mg/kg/day
Answer: D
Conceptual Explanation: Grade 3 or 4 immune-related adverse events (irAEs) like
pneumonitis generally require permanent discontinuation of the checkpoint inhibitor and
high-dose corticosteroid therapy (1-2 mg/kg/day).
, 4. A patient with small cell lung cancer presents with a sodium level of 122 mEq/L, low serum
osmolality, and high urine osmolality. What is the first-line treatment for this condition?
A. Aggressive IV normal saline boluses
B. Administration of Desmopressin (dDAVP)
C. Fluid restriction (e.g., <800-1000 mL/day)
D. Rapid correction with 3% hypertonic saline
Answer: C
Conceptual Explanation: This patient has SIADH, common in SCLC. The mainstay of
treatment is fluid restriction. Rapid correction with hypertonic saline is reserved for severe
neurological symptoms due to the risk of central pontine myelinolysis.
5. According to the ASCO guidelines, which of the following patients should be screened for
Hepatitis B (HBV) before starting systemic anticancer therapy?
A. Only patients with a history of intravenous drug use
B. All patients receiving any systemic anticancer therapy
C. Only patients receiving anti-CD20 monoclonal antibodies or stem cell transplants
D. Patients with a history of jaundice or elevated liver enzymes
Answer: B
CERTIFIED NURSE PRACTITIONER
FINAL EXAM REVIEW QUESTIONS &
VERIFIED ANSWERS (A+ GUARANTEE)
1. A patient with metastatic colorectal cancer is being considered for therapy with
Cetuximab. Which of the following molecular markers must be evaluated before starting this
treatment?
A. BRAF V600E mutation
B. KRAS and NRAS mutation status
C. DPYD gene expression
D. MSI-H/dMMR status
Answer: B
Conceptual Explanation: Cetuximab is an EGFR inhibitor. Clinical trials have
demonstrated that patients with KRAS or NRAS mutations in exons 2, 3, or 4 do not benefit
from anti-EGFR therapy; therefore, wild-type status is required for use.
2. A patient receiving high-dose Methotrexate therapy is experiencing delayed clearance.
What is the standard pharmacological intervention to prevent severe systemic toxicity?
A. Dexrazoxane
,B. Mesna
C. Glucarpidase
D. Amifostine
Answer: C
Conceptual Explanation: Glucarpidase is indicated for the treatment of toxic
methotrexate concentrations in patients with delayed methotrexate clearance due to
impaired renal function. Leucovorin is also used, but Glucarpidase rapidly reduces
extracellular levels.
3. Which of the following is the most appropriate management for a Grade 3 immune-related
pneumonitis secondary to Pembrolizumab?
A. Continue Pembrolizumab and start oral prednisone at 0.5 mg/kg/day
B. Administer prophylactic antibiotics and resume Pembrolizumab in 2 weeks
C. Hold Pembrolizumab and re-challenge once symptoms resolve to Grade 1
D. Permanently discontinue Pembrolizumab and initiate IV methylprednisolone 1-2
mg/kg/day
Answer: D
Conceptual Explanation: Grade 3 or 4 immune-related adverse events (irAEs) like
pneumonitis generally require permanent discontinuation of the checkpoint inhibitor and
high-dose corticosteroid therapy (1-2 mg/kg/day).
, 4. A patient with small cell lung cancer presents with a sodium level of 122 mEq/L, low serum
osmolality, and high urine osmolality. What is the first-line treatment for this condition?
A. Aggressive IV normal saline boluses
B. Administration of Desmopressin (dDAVP)
C. Fluid restriction (e.g., <800-1000 mL/day)
D. Rapid correction with 3% hypertonic saline
Answer: C
Conceptual Explanation: This patient has SIADH, common in SCLC. The mainstay of
treatment is fluid restriction. Rapid correction with hypertonic saline is reserved for severe
neurological symptoms due to the risk of central pontine myelinolysis.
5. According to the ASCO guidelines, which of the following patients should be screened for
Hepatitis B (HBV) before starting systemic anticancer therapy?
A. Only patients with a history of intravenous drug use
B. All patients receiving any systemic anticancer therapy
C. Only patients receiving anti-CD20 monoclonal antibodies or stem cell transplants
D. Patients with a history of jaundice or elevated liver enzymes
Answer: B
