ONCOLOGY CERTIFICATION NURSING
EXAM 2025/2026 QUESTIONS AND
ANSWERS 100% PASS
Infiltration - ANS passage or escape of IV administered drugs into the tissue
extravasation - ANS leakage of drugs capable of causing tissue damage into the
subcutaneous or subdermal tissue or other unintended sites.
irritation - ANS a localized inflammatory reaction at the infusion or injection site
flare reaction - ANS a local allergic reaction along a vein caused by irritating drugs.
infusion reactions - ANS reactions mediated by the immune system (hypersensitivity,
anaphylaxis, cytokine release syndrome)
DNA-binding vesicants - ANS vesicant binds to nucleic acids in the DNA of healthy cells in the
tissue, causing cell death. the dead cells then release complexes, which are taken up by
adjacent healthy cells. this process causes a continuing cycle of tissue damage as the vesicant is
retained in the tissue for a long period of time.
NON-DNA binding vesicants - ANS the vesicant has an indirects effect on healthy cells. it does
not bind to cellular DNA. it is metabolized in the tissue and is more easily neutralized.
1 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED
,cabazitaxel (jevtana) - ANS a taxane where infiltration has not caused skin or tissue
impairment
Docetaxel (taxotere) - ANS extravasation may cause hyperpigmentation, erythema and
tenderness.
paclitaxel (taxol) - ANS injection site reactions, including reactions secondary to
extravasation, usually mild and consist of erythema, tenderness, skin hyperpigmentation or
swelling at injection site. seen more often with 24 hour infusions than with 3 hour infusions.
severe reactions such as phlebitis, cellulitis, induration, skin exfoliation, necrosis and fibrosis
have been reported. onset has been delayed by a week to 10 days.
recall reactions - ANS recurrence of skin reactions at the site of previous extravasation
following paclitaxel injection at a different site.
docetaxel and paclitaxel - ANS classified as exfoliants or drugs that may cause inflammation
and peeling of skin without causing underlying tissue death.
factors affecting tissue damage severity following a vesicant extravasation - ANS 1. DNA
binding vesicants cause greater tissue damage than non-dna binding vesicants
2. the higher the concentration and greater amount of a vesicant the more damaged caused.
3. location of the extravasation such as those with little subcutaneous tissue and overlying
veins, arteries and nerves are likely to have more damage.
4. older age, comorbidity and impaired immunocompetence cause more damage.
risk factors for peripheral extravasation - ANS 1. small, fragile veins
2. previous multiple venipunctures
3. sensory deficits
4. application of topical skin numbing agents prior to venipuncture
5. limited vein selection d/t lymph node dissection
6. impaired cognition, altered mental status or somnolence
7. probing during IV catheter insertion
2 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED
, 8. administration site in areas prone to movement
9. use of rigid IV devices.
10. prior treatment with irritating or sclerosing drugs
11. administration of a vesicant peripherally when the manufacturer stipulates it should be
administered via a central line.
possible etiologies of peripheral extravasations - ANS 1.vein wall puncture, piercing or
trauma.
2. dislodgement of the catheter from a vein
3. administration of a vesicant in a vein below a recent venipuncture site.
4.administration of a vesicant in a vein below or recent or non-healed vesicant extravasation
site.
5. inadvertent intramuscular or subcutaneous vesicant administration.
Risk factors for extravasation from central VADs - ANS 1. difficulty encountered during device
insertion
2. inadvertent slicing, piercing or nicking of catheter prior to insertion
3. device misplacement with catheter tip outside of the venous system.
4. insufficient length of non coring needle (implanted port)
5. presence of a fibrin sheath or thrombus at the catheter tip.
6.catheter migration
7. long dwell time of catheters inserted using a subclavian approach, in which the catheter is
placed between the clavicle and first rib
possible etiologies of extravasations from central VADs - ANS 1. inadvertent misplacement of
catheter tip outside of the venous system during insertion procedure.
2. vein perforation during insertion
3. post insertion vein erosion, catheter leakage, rupture or fracture.
4. separation of the catheter from a portal body.
5. incomplete insertion of a non coring needle into an implanted port
3 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED
EXAM 2025/2026 QUESTIONS AND
ANSWERS 100% PASS
Infiltration - ANS passage or escape of IV administered drugs into the tissue
extravasation - ANS leakage of drugs capable of causing tissue damage into the
subcutaneous or subdermal tissue or other unintended sites.
irritation - ANS a localized inflammatory reaction at the infusion or injection site
flare reaction - ANS a local allergic reaction along a vein caused by irritating drugs.
infusion reactions - ANS reactions mediated by the immune system (hypersensitivity,
anaphylaxis, cytokine release syndrome)
DNA-binding vesicants - ANS vesicant binds to nucleic acids in the DNA of healthy cells in the
tissue, causing cell death. the dead cells then release complexes, which are taken up by
adjacent healthy cells. this process causes a continuing cycle of tissue damage as the vesicant is
retained in the tissue for a long period of time.
NON-DNA binding vesicants - ANS the vesicant has an indirects effect on healthy cells. it does
not bind to cellular DNA. it is metabolized in the tissue and is more easily neutralized.
1 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED
,cabazitaxel (jevtana) - ANS a taxane where infiltration has not caused skin or tissue
impairment
Docetaxel (taxotere) - ANS extravasation may cause hyperpigmentation, erythema and
tenderness.
paclitaxel (taxol) - ANS injection site reactions, including reactions secondary to
extravasation, usually mild and consist of erythema, tenderness, skin hyperpigmentation or
swelling at injection site. seen more often with 24 hour infusions than with 3 hour infusions.
severe reactions such as phlebitis, cellulitis, induration, skin exfoliation, necrosis and fibrosis
have been reported. onset has been delayed by a week to 10 days.
recall reactions - ANS recurrence of skin reactions at the site of previous extravasation
following paclitaxel injection at a different site.
docetaxel and paclitaxel - ANS classified as exfoliants or drugs that may cause inflammation
and peeling of skin without causing underlying tissue death.
factors affecting tissue damage severity following a vesicant extravasation - ANS 1. DNA
binding vesicants cause greater tissue damage than non-dna binding vesicants
2. the higher the concentration and greater amount of a vesicant the more damaged caused.
3. location of the extravasation such as those with little subcutaneous tissue and overlying
veins, arteries and nerves are likely to have more damage.
4. older age, comorbidity and impaired immunocompetence cause more damage.
risk factors for peripheral extravasation - ANS 1. small, fragile veins
2. previous multiple venipunctures
3. sensory deficits
4. application of topical skin numbing agents prior to venipuncture
5. limited vein selection d/t lymph node dissection
6. impaired cognition, altered mental status or somnolence
7. probing during IV catheter insertion
2 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED
, 8. administration site in areas prone to movement
9. use of rigid IV devices.
10. prior treatment with irritating or sclerosing drugs
11. administration of a vesicant peripherally when the manufacturer stipulates it should be
administered via a central line.
possible etiologies of peripheral extravasations - ANS 1.vein wall puncture, piercing or
trauma.
2. dislodgement of the catheter from a vein
3. administration of a vesicant in a vein below a recent venipuncture site.
4.administration of a vesicant in a vein below or recent or non-healed vesicant extravasation
site.
5. inadvertent intramuscular or subcutaneous vesicant administration.
Risk factors for extravasation from central VADs - ANS 1. difficulty encountered during device
insertion
2. inadvertent slicing, piercing or nicking of catheter prior to insertion
3. device misplacement with catheter tip outside of the venous system.
4. insufficient length of non coring needle (implanted port)
5. presence of a fibrin sheath or thrombus at the catheter tip.
6.catheter migration
7. long dwell time of catheters inserted using a subclavian approach, in which the catheter is
placed between the clavicle and first rib
possible etiologies of extravasations from central VADs - ANS 1. inadvertent misplacement of
catheter tip outside of the venous system during insertion procedure.
2. vein perforation during insertion
3. post insertion vein erosion, catheter leakage, rupture or fracture.
4. separation of the catheter from a portal body.
5. incomplete insertion of a non coring needle into an implanted port
3 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED
