CHEMOTHERAPY & IMMUNOTHERAPY
CERTIFICATE EXAM Total Questions: 200 AND
ANSWERS ALREADY GRADED A+
Section 1: Safe Handling & Hazardous Drug Exposure (Questions 1–20)
1. According to USP <800>, which of the following activities requires the use of a
closed system transfer device (CSTD)?
A) Administering oral methotrexate tablets
B) Crushing capecitabine tablets for a feeding tube
C) Drawing up normal saline for flush
D) Applying topical fluorouracil cream with gloved hands
2. A nurse accidentally spills less than 5 mL of IV cyclophosphamide on a floor. The
first action is:
A) Wipe the spill with absorbent pads
B) Restrict access to the area
C) Notify the hazardous drug spill team
D) Use bleach to decontaminate
3. Which personal protective equipment (PPE) is the minimum required when
administering IV cisplatin via a CSTD?
A) One pair of chemotherapy gloves
B) Two pairs of chemotherapy gloves, gown, and eye protection
C) Standard medical gloves and a mask
D) Chemotherapy gloves and a respirator
4. A nurse who is pregnant should:
A) Avoid handling all hazardous drugs, including oral formulations
B) Handle only oral hazardous drugs with double gloves
,C) Administer IV chemotherapy if a CSTD is used
D) Continue handling all drugs, as risk is minimal
5. Which statement about hazardous drug waste disposal is correct?
A) Empty IV bags can go into regular trash
B) Trace waste (e.g., gloves) must go into yellow chemotherapy waste container
C) Body fluids from a patient within 48 hours of chemotherapy are not hazardous
D) Unused vials can be thrown into sharps container
6. A nurse experiences a needle stick from a needle used to draw blood from a
patient who received doxorubicin 4 hours ago. The immediate action is:
A) Squeeze the wound to express blood
B) Wash with soap and water, then report to occupational health
C) Apply bleach to the puncture site
D) Wait 24 hours to see if symptoms develop
7. Which of the following is a NIOSH Group 1 hazardous drug (requires maximum
containment)?
A) Rituximab
B) Cyclophosphamide
C) Trastuzumab
D) Bevacizumab
8. When preparing IV vincristine in a biological safety cabinet (BSC), the nurse
should:
A) Work with the sash fully open for visibility
B) Use aseptic non-touch technique only; no BSC needed
C) Place all supplies inside the BSC before starting
D) Keep the blower off to reduce noise
9. A patient receiving oral lenalidomide accidentally drops a capsule on the floor.
The correct action is:
A) Pick it up with a wet paper towel and discard in regular trash
B) Pick it up with gloved hands and dispose in hazardous waste container
,C) Leave it for environmental services
D) Crush it and flush down the sink
10. Which of the following patients requires a hazardous drug spill kit in their
home?
A) All patients on oral chemotherapy
B) Only patients on IV chemotherapy
C) Patients on oral targeted therapy with teratogenic risk
D) No patients require a home spill kit
11. The maximum time a chemotherapy drug can remain on a preparation surface
before cleaning is:
A) 1 hour
B) 2 hours
C) 4 hours
D) No time limit if not visible
12. Which of the following is a trace chemotherapy waste item?
A) A full, unused vial of carboplatin
B) An empty IV bag that contained paclitaxel
C) A patient’s bed linen 72 hours after chemotherapy
D) A syringe containing 10 mL of methotrexate
13. A nurse is reconstituting IV cyclophosphamide powder. The vial becomes
pressurized. The nurse should:
A) Quickly open the vial to release pressure
B) Use a venting needle with a hydrophobic filter
C) Discard the vial immediately
D) Add more diluent to decrease pressure
14. Which of the following is a requirement for a medical surveillance program per
OSHA?
A) Annual chest x-ray for all oncology nurses
B) Baseline and annual health history and physical exam for exposed workers
, C) Monthly complete blood count for all nurses
D) Genetic testing before handling hazardous drugs
15. A patient on home oral etoposide vomits 30 minutes after taking the dose.
The nurse should instruct:
A) Repeat the full dose now
B) Do not repeat the dose; wait until next scheduled dose
C) Take half the dose now
D) Crush the next dose to prevent vomiting
16. Which of the following is true regarding patient waste after IV chemotherapy?
A) Urine is not hazardous after 24 hours
B) Urine is hazardous for 48 hours after administration
C) Feces is never hazardous
D) Emesis is hazardous for 7 days
17. A closed system transfer device (CSTD) must be used for:
A) All IV hazardous drugs during administration
B) Only vesicants
C) Only drugs that cause alopecia
D) Oral hazardous drugs only if crushed
18. Which of the following is an example of primary engineering control for
hazardous drug preparation?
A) Chemotherapy gloves
B) Biological safety cabinet (BSC)
C) Eye wash station
D) Spill kit
19. A nurse is wearing a single pair of chemotherapy gloves. She notices a tear in
one glove during IV administration. The correct action is:
A) Finish the infusion quickly
B) Remove both gloves, wash hands, and apply new double gloves
C) Place a second glove over the torn glove
D) Apply tape over the tear
CERTIFICATE EXAM Total Questions: 200 AND
ANSWERS ALREADY GRADED A+
Section 1: Safe Handling & Hazardous Drug Exposure (Questions 1–20)
1. According to USP <800>, which of the following activities requires the use of a
closed system transfer device (CSTD)?
A) Administering oral methotrexate tablets
B) Crushing capecitabine tablets for a feeding tube
C) Drawing up normal saline for flush
D) Applying topical fluorouracil cream with gloved hands
2. A nurse accidentally spills less than 5 mL of IV cyclophosphamide on a floor. The
first action is:
A) Wipe the spill with absorbent pads
B) Restrict access to the area
C) Notify the hazardous drug spill team
D) Use bleach to decontaminate
3. Which personal protective equipment (PPE) is the minimum required when
administering IV cisplatin via a CSTD?
A) One pair of chemotherapy gloves
B) Two pairs of chemotherapy gloves, gown, and eye protection
C) Standard medical gloves and a mask
D) Chemotherapy gloves and a respirator
4. A nurse who is pregnant should:
A) Avoid handling all hazardous drugs, including oral formulations
B) Handle only oral hazardous drugs with double gloves
,C) Administer IV chemotherapy if a CSTD is used
D) Continue handling all drugs, as risk is minimal
5. Which statement about hazardous drug waste disposal is correct?
A) Empty IV bags can go into regular trash
B) Trace waste (e.g., gloves) must go into yellow chemotherapy waste container
C) Body fluids from a patient within 48 hours of chemotherapy are not hazardous
D) Unused vials can be thrown into sharps container
6. A nurse experiences a needle stick from a needle used to draw blood from a
patient who received doxorubicin 4 hours ago. The immediate action is:
A) Squeeze the wound to express blood
B) Wash with soap and water, then report to occupational health
C) Apply bleach to the puncture site
D) Wait 24 hours to see if symptoms develop
7. Which of the following is a NIOSH Group 1 hazardous drug (requires maximum
containment)?
A) Rituximab
B) Cyclophosphamide
C) Trastuzumab
D) Bevacizumab
8. When preparing IV vincristine in a biological safety cabinet (BSC), the nurse
should:
A) Work with the sash fully open for visibility
B) Use aseptic non-touch technique only; no BSC needed
C) Place all supplies inside the BSC before starting
D) Keep the blower off to reduce noise
9. A patient receiving oral lenalidomide accidentally drops a capsule on the floor.
The correct action is:
A) Pick it up with a wet paper towel and discard in regular trash
B) Pick it up with gloved hands and dispose in hazardous waste container
,C) Leave it for environmental services
D) Crush it and flush down the sink
10. Which of the following patients requires a hazardous drug spill kit in their
home?
A) All patients on oral chemotherapy
B) Only patients on IV chemotherapy
C) Patients on oral targeted therapy with teratogenic risk
D) No patients require a home spill kit
11. The maximum time a chemotherapy drug can remain on a preparation surface
before cleaning is:
A) 1 hour
B) 2 hours
C) 4 hours
D) No time limit if not visible
12. Which of the following is a trace chemotherapy waste item?
A) A full, unused vial of carboplatin
B) An empty IV bag that contained paclitaxel
C) A patient’s bed linen 72 hours after chemotherapy
D) A syringe containing 10 mL of methotrexate
13. A nurse is reconstituting IV cyclophosphamide powder. The vial becomes
pressurized. The nurse should:
A) Quickly open the vial to release pressure
B) Use a venting needle with a hydrophobic filter
C) Discard the vial immediately
D) Add more diluent to decrease pressure
14. Which of the following is a requirement for a medical surveillance program per
OSHA?
A) Annual chest x-ray for all oncology nurses
B) Baseline and annual health history and physical exam for exposed workers
, C) Monthly complete blood count for all nurses
D) Genetic testing before handling hazardous drugs
15. A patient on home oral etoposide vomits 30 minutes after taking the dose.
The nurse should instruct:
A) Repeat the full dose now
B) Do not repeat the dose; wait until next scheduled dose
C) Take half the dose now
D) Crush the next dose to prevent vomiting
16. Which of the following is true regarding patient waste after IV chemotherapy?
A) Urine is not hazardous after 24 hours
B) Urine is hazardous for 48 hours after administration
C) Feces is never hazardous
D) Emesis is hazardous for 7 days
17. A closed system transfer device (CSTD) must be used for:
A) All IV hazardous drugs during administration
B) Only vesicants
C) Only drugs that cause alopecia
D) Oral hazardous drugs only if crushed
18. Which of the following is an example of primary engineering control for
hazardous drug preparation?
A) Chemotherapy gloves
B) Biological safety cabinet (BSC)
C) Eye wash station
D) Spill kit
19. A nurse is wearing a single pair of chemotherapy gloves. She notices a tear in
one glove during IV administration. The correct action is:
A) Finish the infusion quickly
B) Remove both gloves, wash hands, and apply new double gloves
C) Place a second glove over the torn glove
D) Apply tape over the tear
