Fundamentals Of Chemotherapy Immunotherapy
Administration Exam | QUESTIONS AND
CORRECT ANSWERS| 2025
Hematologic cancer (blood cancer) - SOLUTION --cancer that begins in bone marrow or immune
system cells.
-Ex: leukemia, lymphoma, multiple myeloma
Leukemia - SOLUTION -cancer starts in blood-forming tissues like bone marrow
-causes lots of abnormal blood cells to be produced and enter bloodstream
Lymphoma - SOLUTION --cancer that begins in immune system (WBC=lymphocytes)
-hodgkin and non-hodgkins
-B lymphocytes (B cells) - make antibodies (bacteria and viruses, most common lymphoma
-T lymphocytes (T cells) - boost/slow immune, destroy germs and abnormal cells
Hodgkin lymphoma - SOLUTION -Reed-Sternberg cell (cancer cells in classic)
-typically starts in B cells
Non-Hodgkin's Lymphoma - SOLUTION --large, diverse group of cancers in immune system cells
-indolent (slow growing) or aggressive (fast)
Myeloma - SOLUTION -Cancer in plasma cells (WBC that produce antibodies)
Chemotherapy - SOLUTION -All antineoplastic agents used to treat cancer, given through oral and
parenteral routes or other routes as specified in the standard, not including hormonal therapies.
Who can order chemotherapy? - SOLUTION -Written and signed by licensed independent
practitioners (MD/DO, PA, Oncology NP)
Can you use verbal orders for chemotherapy? - SOLUTION -NO! Only when holding/stopping admin.
Who can mix Chemotherapy? - SOLUTION -Pharmacist, Pharmacy tech, MD/DO, qualified RN
Who can administer chemotherapy? - SOLUTION -Registered Nurses with specialized education, prep
and training. See specific state laws and statutes
How often is chemo competency reassessed> - SOLUTION -Annual continuing ed and competency
assessment is recommended
What is the dose verification process? - SOLUTION --confirm plan with patient
-two practitioners verify: drug name, dose, volume, rate, route, expiration date, appearance
-document verification in chart
, What PPE is required for IV Chemotherapy? - SOLUTION --Gloves: two pairs, HD tested
-Gown: disposable, back closed, long sleeved
-Respirator: NIOSH approved
-Eye & Face: face shield/mask
Neoadjuvant therapy (tumor burden) - SOLUTION -Chemo BEFORE primary treatment (common in
breast and colon)
Adjuvant therapy - SOLUTION -Chemo AFTER primary treatment (common in solid tumor)
Bone Marrow - SOLUTION -soft, sponge-like tissue in center of most bones, produce WBC, RBC, and
platelets.
Myelosuppression - SOLUTION -bone marrow activity is decreased, causing less RBC, WBC and
Platelets.
Myeloablation - SOLUTION -severe myelosuppression
Induction phase - SOLUTION -initial phase, typically in hospital, intended myelosuppression
Consolidation phase (intensification/postremission therapy) - SOLUTION -after successful induction,
kills cancer cells left in body (ex radiation, stem cell transplant)
Synergy - SOLUTION -when one chemo drug helps another work better at the same time
Complete response - SOLUTION -no identifiable cancer present for at least one month or longer
Partial response - SOLUTION -Measurable tumor reduced by 50% for at least one month with no new
tumors
Stable disease - SOLUTION -Tumor size reduced by less than 50% or less than 25% increase in growth
Progressive disease - SOLUTION -tumor growth more than 25% or new cancer
What are the phases of the cell cycle? - SOLUTION --G1 phase
-S phase
-G2 phase
-M phase
What happens in G1 phase? - SOLUTION -The cell increases in size and prepares to replicate its DNA.
What do chemo drugs do to target S phase? - SOLUTION -Prevent cell from making DNA and/or RNA
(replicating)
(ex: antifolates (methotrexate), antipyrimidines (5-fu), antipurines (hydroxyurea))
What do chemo drugs do to target G2 phase? - SOLUTION -Cells prepare to divide, chemo drugs stop
development of elements needed for cell division
(ex: topoisomerase I and II inhibitors, bleomycin)
What do chemo drugs do to target M phase? - SOLUTION -Cells divide, drugs prevent cell division,
including metaphase arrest or microtubular disorganization
Administration Exam | QUESTIONS AND
CORRECT ANSWERS| 2025
Hematologic cancer (blood cancer) - SOLUTION --cancer that begins in bone marrow or immune
system cells.
-Ex: leukemia, lymphoma, multiple myeloma
Leukemia - SOLUTION -cancer starts in blood-forming tissues like bone marrow
-causes lots of abnormal blood cells to be produced and enter bloodstream
Lymphoma - SOLUTION --cancer that begins in immune system (WBC=lymphocytes)
-hodgkin and non-hodgkins
-B lymphocytes (B cells) - make antibodies (bacteria and viruses, most common lymphoma
-T lymphocytes (T cells) - boost/slow immune, destroy germs and abnormal cells
Hodgkin lymphoma - SOLUTION -Reed-Sternberg cell (cancer cells in classic)
-typically starts in B cells
Non-Hodgkin's Lymphoma - SOLUTION --large, diverse group of cancers in immune system cells
-indolent (slow growing) or aggressive (fast)
Myeloma - SOLUTION -Cancer in plasma cells (WBC that produce antibodies)
Chemotherapy - SOLUTION -All antineoplastic agents used to treat cancer, given through oral and
parenteral routes or other routes as specified in the standard, not including hormonal therapies.
Who can order chemotherapy? - SOLUTION -Written and signed by licensed independent
practitioners (MD/DO, PA, Oncology NP)
Can you use verbal orders for chemotherapy? - SOLUTION -NO! Only when holding/stopping admin.
Who can mix Chemotherapy? - SOLUTION -Pharmacist, Pharmacy tech, MD/DO, qualified RN
Who can administer chemotherapy? - SOLUTION -Registered Nurses with specialized education, prep
and training. See specific state laws and statutes
How often is chemo competency reassessed> - SOLUTION -Annual continuing ed and competency
assessment is recommended
What is the dose verification process? - SOLUTION --confirm plan with patient
-two practitioners verify: drug name, dose, volume, rate, route, expiration date, appearance
-document verification in chart
, What PPE is required for IV Chemotherapy? - SOLUTION --Gloves: two pairs, HD tested
-Gown: disposable, back closed, long sleeved
-Respirator: NIOSH approved
-Eye & Face: face shield/mask
Neoadjuvant therapy (tumor burden) - SOLUTION -Chemo BEFORE primary treatment (common in
breast and colon)
Adjuvant therapy - SOLUTION -Chemo AFTER primary treatment (common in solid tumor)
Bone Marrow - SOLUTION -soft, sponge-like tissue in center of most bones, produce WBC, RBC, and
platelets.
Myelosuppression - SOLUTION -bone marrow activity is decreased, causing less RBC, WBC and
Platelets.
Myeloablation - SOLUTION -severe myelosuppression
Induction phase - SOLUTION -initial phase, typically in hospital, intended myelosuppression
Consolidation phase (intensification/postremission therapy) - SOLUTION -after successful induction,
kills cancer cells left in body (ex radiation, stem cell transplant)
Synergy - SOLUTION -when one chemo drug helps another work better at the same time
Complete response - SOLUTION -no identifiable cancer present for at least one month or longer
Partial response - SOLUTION -Measurable tumor reduced by 50% for at least one month with no new
tumors
Stable disease - SOLUTION -Tumor size reduced by less than 50% or less than 25% increase in growth
Progressive disease - SOLUTION -tumor growth more than 25% or new cancer
What are the phases of the cell cycle? - SOLUTION --G1 phase
-S phase
-G2 phase
-M phase
What happens in G1 phase? - SOLUTION -The cell increases in size and prepares to replicate its DNA.
What do chemo drugs do to target S phase? - SOLUTION -Prevent cell from making DNA and/or RNA
(replicating)
(ex: antifolates (methotrexate), antipyrimidines (5-fu), antipurines (hydroxyurea))
What do chemo drugs do to target G2 phase? - SOLUTION -Cells prepare to divide, chemo drugs stop
development of elements needed for cell division
(ex: topoisomerase I and II inhibitors, bleomycin)
What do chemo drugs do to target M phase? - SOLUTION -Cells divide, drugs prevent cell division,
including metaphase arrest or microtubular disorganization
