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NCLEX RN Exam Bank: Chemotherapy Agents and
Side Effect Management Strategies
Table of Contents
Subtopic 1: Principles of Chemotherapy—Drug Classes and Mechanisms of Action (Q1–
Q20) ............................................................................................................................. 2
Subtopic 2: Acute and Chronic Side Effects of Chemotherapy (Q21–Q40) ....................... 11
Subtopic 3: Nursing Care and Monitoring Parameters During Chemotherapy (Q41–Q60) .. 20
Subtopic 4: Safe Handling, Storage, and Disposal of Chemotherapy Agents (Q61–Q80) ... 30
Subtopic 5: Chemotherapy-Induced Nausea, Vomiting (CINV), and Nutritional Support ... 39
Subtopic 6: Chemotherapy-Induced Cardiopulmonary and Hepatotoxic Complications
(Questions 101–120) ................................................................................................... 46
Subtopic 7: Managing Myelosuppression, Neutropenia, and Infection Risk...................... 53
Subtopic 8: Chemotherapy-Induced Peripheral Neuropathy and Neurotoxicity (Q141–Q160)
.................................................................................................................................. 60
Subtopic 9: Safe Handling, Storage, and Disposal of Chemotherapy Agents .................... 68
Subtopic 10: Psychosocial Considerations and Survivorship Care in Chemotherapy ........ 75
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Subtopic 1: Principles of Chemotherapy—Drug Classes
and Mechanisms of Action (Q1–Q20)
Question 1
A nurse is teaching a patient about alkylating agents used in chemotherapy. Which
statement best describes their mechanism of action?
A. Inhibit topoisomerase enzymes
B. Interfere with DNA replication by forming cross-links in DNA strands
C. Inhibit folic acid synthesis in cancer cells
D. Disrupt mitotic spindle formation
Correct Answer: B
Rationale: Alkylating agents like cyclophosphamide work by forming cross-links in DNA,
preventing replication and transcription, ultimately causing cell death.
Question 2
Which chemotherapy agent is classified as an antimetabolite?
A. Vincristine
B. Methotrexate
C. Doxorubicin
D. Cisplatin
Correct Answer: B
Rationale: Methotrexate is an antimetabolite that inhibits dihydrofolate reductase,
interfering with DNA synthesis.
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Question 3
Which chemotherapy agent is most associated with cardiotoxicity?
A. Vinblastine
B. Doxorubicin
C. Etoposide
D. Paclitaxel
Correct Answer: B
Rationale: Doxorubicin, an anthracycline, is well known for its dose-dependent risk of
cardiotoxicity, including irreversible heart failure.
Question 4
A nurse is administering paclitaxel. What is the drug’s primary action?
A. Alkylates DNA strands
B. Inhibits folate metabolism
C. Stabilizes microtubules and prevents their disassembly
D. Promotes angiogenesis in tumor cells
Correct Answer: C
Rationale: Paclitaxel promotes the stabilization of microtubules, preventing their
breakdown and thus disrupting mitosis.
Question 5
Which class of chemotherapy agents does vincristine belong to?
, 4
A. Antitumor antibiotics
B. Vinca alkaloids (Mitotic inhibitors)
C. Alkylating agents
D. Antimetabolites
Correct Answer: B
Rationale: Vincristine is a vinca alkaloid that inhibits mitosis by preventing microtubule
formation.
Question 6
Which agent is known to cause hemorrhagic cystitis as a side effect?
A. Doxorubicin
B. Cyclophosphamide
C. Methotrexate
D. Vinblastine
Correct Answer: B
Rationale: Cyclophosphamide produces acrolein, a toxic metabolite that irritates the
bladder lining, causing hemorrhagic cystitis.
Question 7
Fluorouracil (5-FU) works by:
A. Blocking mitotic spindle formation
B. Interfering with thymidylate synthase and DNA synthesis
NCLEX RN Exam Bank: Chemotherapy Agents and
Side Effect Management Strategies
Table of Contents
Subtopic 1: Principles of Chemotherapy—Drug Classes and Mechanisms of Action (Q1–
Q20) ............................................................................................................................. 2
Subtopic 2: Acute and Chronic Side Effects of Chemotherapy (Q21–Q40) ....................... 11
Subtopic 3: Nursing Care and Monitoring Parameters During Chemotherapy (Q41–Q60) .. 20
Subtopic 4: Safe Handling, Storage, and Disposal of Chemotherapy Agents (Q61–Q80) ... 30
Subtopic 5: Chemotherapy-Induced Nausea, Vomiting (CINV), and Nutritional Support ... 39
Subtopic 6: Chemotherapy-Induced Cardiopulmonary and Hepatotoxic Complications
(Questions 101–120) ................................................................................................... 46
Subtopic 7: Managing Myelosuppression, Neutropenia, and Infection Risk...................... 53
Subtopic 8: Chemotherapy-Induced Peripheral Neuropathy and Neurotoxicity (Q141–Q160)
.................................................................................................................................. 60
Subtopic 9: Safe Handling, Storage, and Disposal of Chemotherapy Agents .................... 68
Subtopic 10: Psychosocial Considerations and Survivorship Care in Chemotherapy ........ 75
, 2
Subtopic 1: Principles of Chemotherapy—Drug Classes
and Mechanisms of Action (Q1–Q20)
Question 1
A nurse is teaching a patient about alkylating agents used in chemotherapy. Which
statement best describes their mechanism of action?
A. Inhibit topoisomerase enzymes
B. Interfere with DNA replication by forming cross-links in DNA strands
C. Inhibit folic acid synthesis in cancer cells
D. Disrupt mitotic spindle formation
Correct Answer: B
Rationale: Alkylating agents like cyclophosphamide work by forming cross-links in DNA,
preventing replication and transcription, ultimately causing cell death.
Question 2
Which chemotherapy agent is classified as an antimetabolite?
A. Vincristine
B. Methotrexate
C. Doxorubicin
D. Cisplatin
Correct Answer: B
Rationale: Methotrexate is an antimetabolite that inhibits dihydrofolate reductase,
interfering with DNA synthesis.
, 3
Question 3
Which chemotherapy agent is most associated with cardiotoxicity?
A. Vinblastine
B. Doxorubicin
C. Etoposide
D. Paclitaxel
Correct Answer: B
Rationale: Doxorubicin, an anthracycline, is well known for its dose-dependent risk of
cardiotoxicity, including irreversible heart failure.
Question 4
A nurse is administering paclitaxel. What is the drug’s primary action?
A. Alkylates DNA strands
B. Inhibits folate metabolism
C. Stabilizes microtubules and prevents their disassembly
D. Promotes angiogenesis in tumor cells
Correct Answer: C
Rationale: Paclitaxel promotes the stabilization of microtubules, preventing their
breakdown and thus disrupting mitosis.
Question 5
Which class of chemotherapy agents does vincristine belong to?
, 4
A. Antitumor antibiotics
B. Vinca alkaloids (Mitotic inhibitors)
C. Alkylating agents
D. Antimetabolites
Correct Answer: B
Rationale: Vincristine is a vinca alkaloid that inhibits mitosis by preventing microtubule
formation.
Question 6
Which agent is known to cause hemorrhagic cystitis as a side effect?
A. Doxorubicin
B. Cyclophosphamide
C. Methotrexate
D. Vinblastine
Correct Answer: B
Rationale: Cyclophosphamide produces acrolein, a toxic metabolite that irritates the
bladder lining, causing hemorrhagic cystitis.
Question 7
Fluorouracil (5-FU) works by:
A. Blocking mitotic spindle formation
B. Interfering with thymidylate synthase and DNA synthesis
