Page | 1
ONS ONCC CHEMO RENEWAL
EXAM ACTUAL QUESTIONS 2026
WITH VERIFIED ANSWERS.
Which of the following is true related to paclitaxel treatment? -
correct answer-Paclitaxel is mixed in a mineral-oil like solvent
that can cause infusion related hypersensitivity reactions.
Premedication should be given to prevent this from occurring.
All patients should be pretreated with corticosteroids,
diphenhydramine, and H2 antagonists. Paclitaxel is an irritant
and potential vesicant. Therefore it is very important for patient
to receive education about symptoms to report (i.e. pain,
erythema, redness). To prevent severe myelosuppression,
paclitaxel should always be given prior to platinum-containing
medications. Paclitaxel should be administered via a 0.3 micron
in-line filter using a glass bottle or non-PVC bag and tubing.
Which of the following agents would you anticipate a
hypersensitivity reaction more often occurring after the patient
has already received several doses? - correct answer-Although
hypersensitivity and infusion reactions can occur at any time
and potentially with any chemotherapy agent, there are certain
agents that have a higher risk of causing a reaction. For some
agents, the reaction is more likely to occur after they have
received a few doses and have already been exposed to the
same agent. On the other hand, there are agents where the
hypersensitivity reactions can occur almost immediately on
, Page | 2
exposure. Reactions to platinum drugs (e.g., carboplatin,
cisplatin, oxaliplatin) usually occur after multiple treatments.
However, reactions caused by taxanes (e.g., paclitaxel,
docetaxel) usually occur within the first hour of the first or
second treatment. Reactions to monoclonal antibodies like
rituximab and cetuximab usually occur with the first treatment
as well. (Information from Zetka article)
Why use AUC instead of BSA for carboplatin dosing? - correct
answer-Carboplatin's elimination by the kidneys occurs in a
reliable manner that makes AUC the optimal method for dosing
the drug. Basically, AUC is a method of expressing the intended
exposure to the drug over time. Verification of carboplatin
doses can be daunting if institutional policies are not clear
regarding which formula to use under what conditions. In the
absence of clear institutional direction, documentation in the
orders and plan of care must state the process used to
determine the intended dose.
Mrs. Kearns is receiving her first dose of paclitaxel and about
20 minutes into the infusion, you notice that she begins to start
clearing her throat a lot. She also states that she is having
some lower back pain. You decide that you will take another set
of vital signs. While you are waiting for the monitor to reveal her
blood pressure, she begins to breathe heavier and appears
short of breath.
, Page | 3
What is the first/immediate thing you need to do for Mrs.
Kearns? - correct answer-a. Stop the paclitaxel infusion
Since you know that Mr. Rylan is getting R-CHOP, which of the
following pretreatment test results do you feel is a priority to
review prior to starting his chemotherapy? - correct answer-Mr.
Rylan is receiving doxorubicin as part of his chemotherapy
regimen. The patient's ejection fraction should be tested prior to
starting doxorubicin. Periodic monitoring is also suggested in
addition to testing ejection fraction one year post completion of
therapy. Per the prescribing information, one should assess left
ventricular cardiac function (e.g., MUGA or echocardiogram)
prior to initiation of doxorubicin, during treatment to detect
acute changes, and after treatment to detect delayed
cardiotoxicity
Mr. Rylan is receiving RCHOP. What is the lifetime cumulative
dose of doxorubicin that Mr. Rylan should not exceed? - correct
answer-Lifetime cumulative dose of doxorubicin is 550 mg/m2
except when patient has received prior chest irradiation or
when receiving concomitant cyclophosphamide where the
cumulative dose decreases to 450 mg/m2. Mr. Rylan is
receiving cyclophosphamide as part of RCHOP regimen so
therefore should not exceed 450 mg/m2.
ONS ONCC CHEMO RENEWAL
EXAM ACTUAL QUESTIONS 2026
WITH VERIFIED ANSWERS.
Which of the following is true related to paclitaxel treatment? -
correct answer-Paclitaxel is mixed in a mineral-oil like solvent
that can cause infusion related hypersensitivity reactions.
Premedication should be given to prevent this from occurring.
All patients should be pretreated with corticosteroids,
diphenhydramine, and H2 antagonists. Paclitaxel is an irritant
and potential vesicant. Therefore it is very important for patient
to receive education about symptoms to report (i.e. pain,
erythema, redness). To prevent severe myelosuppression,
paclitaxel should always be given prior to platinum-containing
medications. Paclitaxel should be administered via a 0.3 micron
in-line filter using a glass bottle or non-PVC bag and tubing.
Which of the following agents would you anticipate a
hypersensitivity reaction more often occurring after the patient
has already received several doses? - correct answer-Although
hypersensitivity and infusion reactions can occur at any time
and potentially with any chemotherapy agent, there are certain
agents that have a higher risk of causing a reaction. For some
agents, the reaction is more likely to occur after they have
received a few doses and have already been exposed to the
same agent. On the other hand, there are agents where the
hypersensitivity reactions can occur almost immediately on
, Page | 2
exposure. Reactions to platinum drugs (e.g., carboplatin,
cisplatin, oxaliplatin) usually occur after multiple treatments.
However, reactions caused by taxanes (e.g., paclitaxel,
docetaxel) usually occur within the first hour of the first or
second treatment. Reactions to monoclonal antibodies like
rituximab and cetuximab usually occur with the first treatment
as well. (Information from Zetka article)
Why use AUC instead of BSA for carboplatin dosing? - correct
answer-Carboplatin's elimination by the kidneys occurs in a
reliable manner that makes AUC the optimal method for dosing
the drug. Basically, AUC is a method of expressing the intended
exposure to the drug over time. Verification of carboplatin
doses can be daunting if institutional policies are not clear
regarding which formula to use under what conditions. In the
absence of clear institutional direction, documentation in the
orders and plan of care must state the process used to
determine the intended dose.
Mrs. Kearns is receiving her first dose of paclitaxel and about
20 minutes into the infusion, you notice that she begins to start
clearing her throat a lot. She also states that she is having
some lower back pain. You decide that you will take another set
of vital signs. While you are waiting for the monitor to reveal her
blood pressure, she begins to breathe heavier and appears
short of breath.
, Page | 3
What is the first/immediate thing you need to do for Mrs.
Kearns? - correct answer-a. Stop the paclitaxel infusion
Since you know that Mr. Rylan is getting R-CHOP, which of the
following pretreatment test results do you feel is a priority to
review prior to starting his chemotherapy? - correct answer-Mr.
Rylan is receiving doxorubicin as part of his chemotherapy
regimen. The patient's ejection fraction should be tested prior to
starting doxorubicin. Periodic monitoring is also suggested in
addition to testing ejection fraction one year post completion of
therapy. Per the prescribing information, one should assess left
ventricular cardiac function (e.g., MUGA or echocardiogram)
prior to initiation of doxorubicin, during treatment to detect
acute changes, and after treatment to detect delayed
cardiotoxicity
Mr. Rylan is receiving RCHOP. What is the lifetime cumulative
dose of doxorubicin that Mr. Rylan should not exceed? - correct
answer-Lifetime cumulative dose of doxorubicin is 550 mg/m2
except when patient has received prior chest irradiation or
when receiving concomitant cyclophosphamide where the
cumulative dose decreases to 450 mg/m2. Mr. Rylan is
receiving cyclophosphamide as part of RCHOP regimen so
therefore should not exceed 450 mg/m2.
