ONS CHEMOTHERAPY & BIOLOGY
THERAPY ACTUAL EXAM TEST BANK 2026
COMPLETE QUESTIONS AND VERIFIED
ANSWERS
●● Common alkylating agents. Answer: Alkylating agents function by
causing a break in the DNA helix strand, causing interference with DNA
replication, which results in cell death.
Alkylating agents are subcategorized into several groups. The most
common alkylating agents, known as nitrogen mustards, typically
include the following:
Cyclophosphamide (Cytoxan®)
Ifosfamide (Ifex®)
Bendamustine (Treanda®)
Platinum-based chemotherapy agents act similarly to alkylating agents,
but they do not possess an alkyl group molecule to attach to and destroy
DNA. Despite this, they are often termed alkylating agents, or
alkylating-like agents. Common platinum-based drugs include the
following:
Cisplatin (Platinol®)
Carboplatin (Paraplatin®)
,However, depending on the type of patients that you see, other
alkylating agents may be more common in your workplace. A third
subcategory of alkylating agents is known as the nitrosoureas.
●● Alkylating Agents:
Dose limiting? Side effects?. Answer: These agents have many dose-
limiting toxiciites that need to be monitored closely, including the
following:
Bone marrow suppression, which can put a patient at risk for infection
Gastrointestinal (GI) toxicities, particularly nausea, vomiting, and
diarrhea
Renal toxicities
Hepatotoxicity
Pulmonary fibrosis
Hypersensitivities
●● Key points to remember about the alkylating agents and
nitrosoureas:. Answer: - Hypersensitivity may occur with late doses of
carboplatin.
- Tumor lysis syndrome is possible in patients receiving alkylating
agents, particularly when there is a high tumor burden.
- Preadministration blood tests should include blood urea nitrogen,
creatinine, and a complete blood count with differential.
, - These agents are typically highly emetogenic.
- When administering cyclophosphamide or ifosfamide, mesna is
typically used as a bladder protectant.
- When administering oxaliplatin, instruct patients to avoid exposure to
cold air and consuming cold fluids for 3-4 days following treatment.
- Streptozocin and semustine are the most nephrotoxic drugs, affecting
more than 75% of patients, which may lead to treatment delays.
- Pruritus and itching can occur with patients receiving alkylating agents
and nitorsoureas. This may worsen with dehydration, so patients are
encouraged to drink at least 8-10 glasses of fluid per day, in addition to
minimizing salt and alcohol intake.
- Alkylating agents and nitrosoureas have the potential to cause
secondary malignancies and fertility issues.
●● Common side effect to remember about Cyclophosphamide
(Alkylating Agent). Answer: This drug is known to cause hemorrhagic
cystitis (inflammation of the bladder), which might reveal itself as
dysuria, hematuria, and hemorrhage. One important measure to prevent
this is adequate hydration prior to, during, and after treatment. While at
home, be sure to drink 2-3 L per day, and be sure to empty your bladder
frequently. Often, mesna is given with IV fluids to prevent hemorrhagic
cystitis.
●● Common side effect to remember about Carboplatin (Alkylating
Agent). Answer: There is a possibility for a hypersensitivity reaction,
which might reveal itself as rash, urticaria, erythema, pruritus, or, rarely,
bronchospasm and hypotension. Patients should notify their nurse
THERAPY ACTUAL EXAM TEST BANK 2026
COMPLETE QUESTIONS AND VERIFIED
ANSWERS
●● Common alkylating agents. Answer: Alkylating agents function by
causing a break in the DNA helix strand, causing interference with DNA
replication, which results in cell death.
Alkylating agents are subcategorized into several groups. The most
common alkylating agents, known as nitrogen mustards, typically
include the following:
Cyclophosphamide (Cytoxan®)
Ifosfamide (Ifex®)
Bendamustine (Treanda®)
Platinum-based chemotherapy agents act similarly to alkylating agents,
but they do not possess an alkyl group molecule to attach to and destroy
DNA. Despite this, they are often termed alkylating agents, or
alkylating-like agents. Common platinum-based drugs include the
following:
Cisplatin (Platinol®)
Carboplatin (Paraplatin®)
,However, depending on the type of patients that you see, other
alkylating agents may be more common in your workplace. A third
subcategory of alkylating agents is known as the nitrosoureas.
●● Alkylating Agents:
Dose limiting? Side effects?. Answer: These agents have many dose-
limiting toxiciites that need to be monitored closely, including the
following:
Bone marrow suppression, which can put a patient at risk for infection
Gastrointestinal (GI) toxicities, particularly nausea, vomiting, and
diarrhea
Renal toxicities
Hepatotoxicity
Pulmonary fibrosis
Hypersensitivities
●● Key points to remember about the alkylating agents and
nitrosoureas:. Answer: - Hypersensitivity may occur with late doses of
carboplatin.
- Tumor lysis syndrome is possible in patients receiving alkylating
agents, particularly when there is a high tumor burden.
- Preadministration blood tests should include blood urea nitrogen,
creatinine, and a complete blood count with differential.
, - These agents are typically highly emetogenic.
- When administering cyclophosphamide or ifosfamide, mesna is
typically used as a bladder protectant.
- When administering oxaliplatin, instruct patients to avoid exposure to
cold air and consuming cold fluids for 3-4 days following treatment.
- Streptozocin and semustine are the most nephrotoxic drugs, affecting
more than 75% of patients, which may lead to treatment delays.
- Pruritus and itching can occur with patients receiving alkylating agents
and nitorsoureas. This may worsen with dehydration, so patients are
encouraged to drink at least 8-10 glasses of fluid per day, in addition to
minimizing salt and alcohol intake.
- Alkylating agents and nitrosoureas have the potential to cause
secondary malignancies and fertility issues.
●● Common side effect to remember about Cyclophosphamide
(Alkylating Agent). Answer: This drug is known to cause hemorrhagic
cystitis (inflammation of the bladder), which might reveal itself as
dysuria, hematuria, and hemorrhage. One important measure to prevent
this is adequate hydration prior to, during, and after treatment. While at
home, be sure to drink 2-3 L per day, and be sure to empty your bladder
frequently. Often, mesna is given with IV fluids to prevent hemorrhagic
cystitis.
●● Common side effect to remember about Carboplatin (Alkylating
Agent). Answer: There is a possibility for a hypersensitivity reaction,
which might reveal itself as rash, urticaria, erythema, pruritus, or, rarely,
bronchospasm and hypotension. Patients should notify their nurse
