ONCC EXAM REVIEW QUESTIONS WITH
ACCURATE SOLUTIONS 2026
▶ Lesson 2: Alkylating Agents. Answer:
▶ Alkylating Agents. Answer: -function by causing a break in the DNA
helix strand, causing interference with DNA replication, which results in cell
death
▶ Alkylating Agent Subgroups. Answer: -Nitrogen mustards
(cyclophosphamide{Cytoxin}, ifosfamide{Ifex}, bendamustine{Treanda})
-Platinum-based (cisplatin{Planitol}, carboplatin{Paraplatin}): do not
possess an alkyl group
-nitrosoureas
▶ Nitrosoureas. Answer: -subgroup of alkylating agents
-able to cross the blood-brain barrier (effective in treating some brain
tumors, melanomas, lymphomas)
-Carmustine (BiCNU)
-Lomustine (CeeNu)
,-Streptozocin (Zanosar)
-pulmonary monitoring recommended
▶ Carboplatin (Paraplatin). Answer: -Alkylazing agent
-possibility for a hypersensitivity reaction which is rash, urticaria, erythema,
pruritis, rarely bronchospasm and hypotensision
-notify RN if itching, scratchy throat, difficulty breathing, rash
-Blood count, particularly platelets, monitored because thrombocytopenia is
a dose-limiting toxicity
-Oral dosage: 1-5mg/kg/day
▶ Cisplatin (Planitol). Answer: -Alkylating agent
-nephrotoxic (IV hydration 2-3 L per day)
-severe N/V
-ovarian and testicular
, ▶ Cyclophosphamide (Cytoxin). Answer: -Alkylating agent)
-hemorrhagic cystitis (dysuria, hematuria, hemorrhage)
-DC treatment if hemorrhagic cystitis
-adequate hydration
▶ Oxaliplatin. Answer: -Alkylating agent
-irritant and vesicant, extra caution with the IV site
-peripheral neuropathy is a dose-limiting side effect (exacerbated by cold
temperatures)
-avoid cold drinks and foods, wearing gloves and warm shoes
-avoid breathing cold air
▶ Intrathecal Chemotherapy. Answer: -injects chemo directly into the
subarachnoid space so it reaches the CNS
-Often used to treat leukemia and lymphoma that has spread to the CNS
since most IV chemo does not cross the blood-brain barrier
ACCURATE SOLUTIONS 2026
▶ Lesson 2: Alkylating Agents. Answer:
▶ Alkylating Agents. Answer: -function by causing a break in the DNA
helix strand, causing interference with DNA replication, which results in cell
death
▶ Alkylating Agent Subgroups. Answer: -Nitrogen mustards
(cyclophosphamide{Cytoxin}, ifosfamide{Ifex}, bendamustine{Treanda})
-Platinum-based (cisplatin{Planitol}, carboplatin{Paraplatin}): do not
possess an alkyl group
-nitrosoureas
▶ Nitrosoureas. Answer: -subgroup of alkylating agents
-able to cross the blood-brain barrier (effective in treating some brain
tumors, melanomas, lymphomas)
-Carmustine (BiCNU)
-Lomustine (CeeNu)
,-Streptozocin (Zanosar)
-pulmonary monitoring recommended
▶ Carboplatin (Paraplatin). Answer: -Alkylazing agent
-possibility for a hypersensitivity reaction which is rash, urticaria, erythema,
pruritis, rarely bronchospasm and hypotensision
-notify RN if itching, scratchy throat, difficulty breathing, rash
-Blood count, particularly platelets, monitored because thrombocytopenia is
a dose-limiting toxicity
-Oral dosage: 1-5mg/kg/day
▶ Cisplatin (Planitol). Answer: -Alkylating agent
-nephrotoxic (IV hydration 2-3 L per day)
-severe N/V
-ovarian and testicular
, ▶ Cyclophosphamide (Cytoxin). Answer: -Alkylating agent)
-hemorrhagic cystitis (dysuria, hematuria, hemorrhage)
-DC treatment if hemorrhagic cystitis
-adequate hydration
▶ Oxaliplatin. Answer: -Alkylating agent
-irritant and vesicant, extra caution with the IV site
-peripheral neuropathy is a dose-limiting side effect (exacerbated by cold
temperatures)
-avoid cold drinks and foods, wearing gloves and warm shoes
-avoid breathing cold air
▶ Intrathecal Chemotherapy. Answer: -injects chemo directly into the
subarachnoid space so it reaches the CNS
-Often used to treat leukemia and lymphoma that has spread to the CNS
since most IV chemo does not cross the blood-brain barrier
