ONS ONCC CHEMO RENEWAL EXAM LATEST ACTUAL
EXAM 60 QUESTIONS AND CORRECT DETAILED
ANSWERS WITH RATIONALES|AGRADE
Main benefit of neoadjuvant chemotherapy (breast cancer patient) - ANSWER:
Neoadjuvant therapy does not increase survival when compared to adjuvant
therapy. It only changes the timing of treatment and can change surgical options if
the tumor is shrunk enough. If this occurs, the patient may only require a
lumpectomy plus radiation therapy instead of needing a mastectomy
Due to Mrs. Turner's age and comorbidities, her oncologist performs a
comprehensive geriatric assessment. You know that this assessment covers all but
which of the following: - ANSWER: A comprehensive geriatric assessment (CGA) is a
multidisciplinary evaluation to assess life expectancy and risk of morbidity and
mortality in the older patient. This assessment tool would evaluate and include the
following areas: functional status, socioeconomic issues, psychosocial distress,
comorbidities, cognitive function, nutritional status, polypharmacy, and a medication
review (NCCN Older Adult Oncology Guidelines, version 1.2015).
The NCCN Older Adult Oncology Guidelines (version 1.2015) provides information on
what is included in a comprehensive geriatric assessment. Currently, more than 60%
of cancers in the United States occur in people age ______and older and as the
oncology world ages, nearly half (46%) of cancer survivors are 70 years of age or
older - ANSWER: 65
What is your best explanation for why Mrs. Turner was given a port to receive her
chemotherapy? - ANSWER: Two of the agents (docetaxel and carboplatin) that Mrs.
Turner will receive are categorized as irritants. Docetaxel can cause a significant
reaction if it extravasates. It can lead to edema, erythema, occasional pain and
blister formation (ONS Chemo/Bio guidelines, 2014). That is the most likely reason
that Mrs. Turner was given a port for her treatments. Some patients will receive
their treatments through a peripheral IV without incident. Just because they are
intravenous agents does not mean that a port is required and needing a port has
nothing to do with her being older in age. Since none of these agents are vesicants,
they likely could have been given safely via peripheral route but having a port placed
is OK as well.
_____________can cause inflammation, pain, and burning but rarely cause tissue
necrosis comparable to a vesicant (unless a large amount or a very high
concentration of the irritant is extravasated). - ANSWER: Irrirtants
_____________can cause blistering and significant pain and tissue damage and
destruction, leading to tissue death. - ANSWER: Vesicants
A further classification of an antineoplastic agent's potential to cause damage is
whether its mechanism of action includes DNA binding. - ANSWER: Non-DNA-binding
, solutions remain in the local area of the extravasation, which improves the
possibility of drug deactivation.
DNA-binding agents attach to DNA nucleic acids, causing the antagonist to be
ingested cellularly, leading to progressive tissue destruction
DNA Binding Irritants - ANSWER: Bendamustinea
Dactinomycin
Daunorubicin
Doxorubicin
Epirubicin
Idarubicin
Mechlorethamine
Mitomycin
DNA Nonbinding vessicants - ANSWER: Amsacrine
Paclitaxel
Vinblastine
Vincristine
Vindesine
Vinorelbine
Extravasciation Alkylating / Mechlorethamine tx - ANSWER: Sodium thiosulfate
Inject 2 ml of sodium thiosulfate for each milligram of
mechlorethamine extravasated.
Inject subcutaneously into extravasation site using a 25
gauge or smaller needle (change needle with each injection).
Monitor extravasation site according to the institution's
policies and procedures.
Extravasciation Alkylating: Oxaliplatin - ANSWER: Apply warm compresses.
Dexamethasone
8 mg twice daily
for 14 days
Extravasation Tx: Anthracyclines --- Daunorubicin,
doxorubicin, epirubicin,
idarubicin - ANSWER: Totect
Apply ice pack (remove 15
minutes prior to Totect
treatment).
Infusion should be initiated within six hours of extravasation.
Infused over 1-2 hours for three days in an area other
than the extravasation site
The dose recommended is based on the patients' body
EXAM 60 QUESTIONS AND CORRECT DETAILED
ANSWERS WITH RATIONALES|AGRADE
Main benefit of neoadjuvant chemotherapy (breast cancer patient) - ANSWER:
Neoadjuvant therapy does not increase survival when compared to adjuvant
therapy. It only changes the timing of treatment and can change surgical options if
the tumor is shrunk enough. If this occurs, the patient may only require a
lumpectomy plus radiation therapy instead of needing a mastectomy
Due to Mrs. Turner's age and comorbidities, her oncologist performs a
comprehensive geriatric assessment. You know that this assessment covers all but
which of the following: - ANSWER: A comprehensive geriatric assessment (CGA) is a
multidisciplinary evaluation to assess life expectancy and risk of morbidity and
mortality in the older patient. This assessment tool would evaluate and include the
following areas: functional status, socioeconomic issues, psychosocial distress,
comorbidities, cognitive function, nutritional status, polypharmacy, and a medication
review (NCCN Older Adult Oncology Guidelines, version 1.2015).
The NCCN Older Adult Oncology Guidelines (version 1.2015) provides information on
what is included in a comprehensive geriatric assessment. Currently, more than 60%
of cancers in the United States occur in people age ______and older and as the
oncology world ages, nearly half (46%) of cancer survivors are 70 years of age or
older - ANSWER: 65
What is your best explanation for why Mrs. Turner was given a port to receive her
chemotherapy? - ANSWER: Two of the agents (docetaxel and carboplatin) that Mrs.
Turner will receive are categorized as irritants. Docetaxel can cause a significant
reaction if it extravasates. It can lead to edema, erythema, occasional pain and
blister formation (ONS Chemo/Bio guidelines, 2014). That is the most likely reason
that Mrs. Turner was given a port for her treatments. Some patients will receive
their treatments through a peripheral IV without incident. Just because they are
intravenous agents does not mean that a port is required and needing a port has
nothing to do with her being older in age. Since none of these agents are vesicants,
they likely could have been given safely via peripheral route but having a port placed
is OK as well.
_____________can cause inflammation, pain, and burning but rarely cause tissue
necrosis comparable to a vesicant (unless a large amount or a very high
concentration of the irritant is extravasated). - ANSWER: Irrirtants
_____________can cause blistering and significant pain and tissue damage and
destruction, leading to tissue death. - ANSWER: Vesicants
A further classification of an antineoplastic agent's potential to cause damage is
whether its mechanism of action includes DNA binding. - ANSWER: Non-DNA-binding
, solutions remain in the local area of the extravasation, which improves the
possibility of drug deactivation.
DNA-binding agents attach to DNA nucleic acids, causing the antagonist to be
ingested cellularly, leading to progressive tissue destruction
DNA Binding Irritants - ANSWER: Bendamustinea
Dactinomycin
Daunorubicin
Doxorubicin
Epirubicin
Idarubicin
Mechlorethamine
Mitomycin
DNA Nonbinding vessicants - ANSWER: Amsacrine
Paclitaxel
Vinblastine
Vincristine
Vindesine
Vinorelbine
Extravasciation Alkylating / Mechlorethamine tx - ANSWER: Sodium thiosulfate
Inject 2 ml of sodium thiosulfate for each milligram of
mechlorethamine extravasated.
Inject subcutaneously into extravasation site using a 25
gauge or smaller needle (change needle with each injection).
Monitor extravasation site according to the institution's
policies and procedures.
Extravasciation Alkylating: Oxaliplatin - ANSWER: Apply warm compresses.
Dexamethasone
8 mg twice daily
for 14 days
Extravasation Tx: Anthracyclines --- Daunorubicin,
doxorubicin, epirubicin,
idarubicin - ANSWER: Totect
Apply ice pack (remove 15
minutes prior to Totect
treatment).
Infusion should be initiated within six hours of extravasation.
Infused over 1-2 hours for three days in an area other
than the extravasation site
The dose recommended is based on the patients' body
