CHEMO CERTIFICATION TEST LATEST 2023 EXAM 100
QUESTIONS AND CORRECT ANSWERS (VERIFIED
ANSWERS) |AGRADE
How do alkylating agents function? - ANSWER: By causing a break in the DNA helix
strand, causing interference with DNA replication, which results in cell death
What is the most common subcategory of alkylating agents? - ANSWER: Nitrogen
mustards
Examples of nitrogen mustards (alkylating agents) - ANSWER: Cyclophosphamide
(Cytoxan), Ifosfamide (Ifex), Bendamustine (Treanda)
What type of chemo agents act similar to alkylating agents, but do not possess an
alkyl group molecule to attach to and destroy DNA? - ANSWER: Platinum-based
chemo
Examples of common platinum-based drugs - ANSWER: Cisplatin (Platinol) and
Carboplatin (Paraplatin)
What is another subcategory of alkylating agents? - ANSWER: Nitrosoureas
Function of nitrosoureas - ANSWER: Cross the blood-brain barrier, making them
effective in treating some brain tumors, melanomas, and lymphomas
Common nitrosoureas - ANSWER: Carmustine (BiCNU), Lomustine (CeeNu),
Streptozocin (Zanosar)
Two major warnings of carmustine (BiCNU) - ANSWER: Myelosuppression and
pulmonary toxicity
What type of cancers does carmustine (BiCNU) treat? - ANSWER: Brain tumors (ex.
glioblastoma), multiple myeloma, Hodgkin's and non-Hodgkin's lymphoma
Two major warnings of lomustine (CeeNu) or (Gleostine) - ANSWER: Delayed
myelosuppression and risk of overdosage
What types of cancers does lomustine (Gleostine) treat? - ANSWER: Brain tumors
and Hodgkin's lymphoma
What type of cancer does streptozocin (Zanosar) treat? - ANSWER: Metastatic islet
cell carcinoma of the pancreas
What major warning does streptozocin (Zanosar) have? - ANSWER: Renal toxicity
,What are the dose-limiting toxicities of alkylating agents? - ANSWER: Bone marrow
suppression, GI toxicities (N/V/D), renal toxicities, hepatotoxicity, pulmonary fibrosis,
hypersensitivities
Hypersensitivity may occur with late doses of what? - ANSWER: Carboplatin
What is possible in patients receiving alkylating agents, particularly when there is a
high tumor burden? - ANSWER: Tumor lysis syndrome
What pre-administration blood tests should be included in alkylating agents? -
ANSWER: BUN, creatinine, CBC with diff
Are alkylating agents emetogenic? - ANSWER: Yes, highly emetogenic
What is a bladder protectant typically administered with cyclophosphamide and
ifosfamide? - ANSWER: Mesna
What is the main nursing teaching to include with oxaliplatin? - ANSWER: Avoid
exposure to cold air and consuming cold fluids 3-4 days following treatment
What are the most nephrotoxic alkylating agents? - ANSWER: Streptozocin and
semustine, affecting more than 75% of patients, which may lead to treatment delays
What side effect can occur with alkylating agents/nitrosoureas that may worsen with
dehydration? - ANSWER: Pruritis and itching; encourage patients to drink at least 8-
10 glasses of fluid/day, minimize salt and alcohol intake
Alkylating agents and nitrosoureas have the potential to cause what? - ANSWER:
Secondary malignancies and fertility issues
Long-term myelosuppression can lead to what? - ANSWER: The development of a
secondary malignancy, 5-10 years after treatment
What is a short-term side efect of nitrosoureas (particularly carmustine and
lomustine)? - ANSWER: Kidney disease
Long-term side effects of carmustine and lomustine - ANSWER: Reduction of
pulmonary function: delayed pulmonary fibrosis--17 years after tx for patients who
received this in childhood/early adolescence
What test should be performed prior to treatment with carmustine or lomustine? -
ANSWER: Baseline pulmonary function tests, there are fatal cases of pulmonary
toxicity
How do antimetabolites function? - ANSWER: By blocking DNA and RNA growth by
interfering with enzymes that are necessary for normal cell metabolism
, What phase of the cell cycle do antimetabolites work? - ANSWER: The S phase, so
they are highly effective on tumors with fast growth rates
Most common antimetabolites: - ANSWER: Azacitidine (Vidaza), Capecitabine
(Xeloda), 5-Fluorourcacil (5-FU), Cytarabine (Ara-C), Decitabine (Dacogen),
Methotrexate
What cancers does fluorouracil treat? - ANSWER: Adenocarcinoma of colon and
rectum, adenocarcinoma of breast, gastric adenocarcinoma, pancreatic
adenocarcinoma
What are very common side effects of antimetabolites? - ANSWER: Mucositis,
diarrhea, myelosuppression, photosensitivity, hand-foot syndrome
Can antimetabolites be administered many routes? - ANSWER: Yes, very correct
route
Nursing teaching for methotrexate - ANSWER: Drug is yellow, large range of doses,
maintain hydration, monitor renal function, encourage oral hygiene, discourage
alcohol use, avoid folic acid, avoid sun exposure, avoid with pleural/pericardial
effusions and ascites
What is an example of an antimetabolite whose toxicities change with dose and rate
of infusion? - ANSWER: Cytarabine
Which antimetabolite has unique considerations for SC administration? - ANSWER:
Azacitidine
What does azacitidine treat? - ANSWER: Myelodysplastic syndrome (MDS)
What is MDS? - ANSWER: Abnormal bone marrow and blood cell morphology,
primarily occurring in older white males
What two antimetabolites can be administered intrathecally? - ANSWER: Cytarabine
and methotrexate
What are anthracyclines? - ANSWER: A classification of antitumor antibiotics that
interfere with enzymes that are necessary for DNA to replicate
Why are lifetime doses of anthracyclines limited? - ANSWER: Can cause permanent
cardiotoxicity
Examples of anthracyclines - ANSWER: Daunorubicin, doxorubicin, doxorubicin Hcl
liposomal, epirubicin, idarubicin
Examples of nonanthracycline antitumor antibiotics - ANSWER: Actinomycin D,
Mitomycin C, Bleomycin, mitoxantrone (although has anthracycline-type properties)
QUESTIONS AND CORRECT ANSWERS (VERIFIED
ANSWERS) |AGRADE
How do alkylating agents function? - ANSWER: By causing a break in the DNA helix
strand, causing interference with DNA replication, which results in cell death
What is the most common subcategory of alkylating agents? - ANSWER: Nitrogen
mustards
Examples of nitrogen mustards (alkylating agents) - ANSWER: Cyclophosphamide
(Cytoxan), Ifosfamide (Ifex), Bendamustine (Treanda)
What type of chemo agents act similar to alkylating agents, but do not possess an
alkyl group molecule to attach to and destroy DNA? - ANSWER: Platinum-based
chemo
Examples of common platinum-based drugs - ANSWER: Cisplatin (Platinol) and
Carboplatin (Paraplatin)
What is another subcategory of alkylating agents? - ANSWER: Nitrosoureas
Function of nitrosoureas - ANSWER: Cross the blood-brain barrier, making them
effective in treating some brain tumors, melanomas, and lymphomas
Common nitrosoureas - ANSWER: Carmustine (BiCNU), Lomustine (CeeNu),
Streptozocin (Zanosar)
Two major warnings of carmustine (BiCNU) - ANSWER: Myelosuppression and
pulmonary toxicity
What type of cancers does carmustine (BiCNU) treat? - ANSWER: Brain tumors (ex.
glioblastoma), multiple myeloma, Hodgkin's and non-Hodgkin's lymphoma
Two major warnings of lomustine (CeeNu) or (Gleostine) - ANSWER: Delayed
myelosuppression and risk of overdosage
What types of cancers does lomustine (Gleostine) treat? - ANSWER: Brain tumors
and Hodgkin's lymphoma
What type of cancer does streptozocin (Zanosar) treat? - ANSWER: Metastatic islet
cell carcinoma of the pancreas
What major warning does streptozocin (Zanosar) have? - ANSWER: Renal toxicity
,What are the dose-limiting toxicities of alkylating agents? - ANSWER: Bone marrow
suppression, GI toxicities (N/V/D), renal toxicities, hepatotoxicity, pulmonary fibrosis,
hypersensitivities
Hypersensitivity may occur with late doses of what? - ANSWER: Carboplatin
What is possible in patients receiving alkylating agents, particularly when there is a
high tumor burden? - ANSWER: Tumor lysis syndrome
What pre-administration blood tests should be included in alkylating agents? -
ANSWER: BUN, creatinine, CBC with diff
Are alkylating agents emetogenic? - ANSWER: Yes, highly emetogenic
What is a bladder protectant typically administered with cyclophosphamide and
ifosfamide? - ANSWER: Mesna
What is the main nursing teaching to include with oxaliplatin? - ANSWER: Avoid
exposure to cold air and consuming cold fluids 3-4 days following treatment
What are the most nephrotoxic alkylating agents? - ANSWER: Streptozocin and
semustine, affecting more than 75% of patients, which may lead to treatment delays
What side effect can occur with alkylating agents/nitrosoureas that may worsen with
dehydration? - ANSWER: Pruritis and itching; encourage patients to drink at least 8-
10 glasses of fluid/day, minimize salt and alcohol intake
Alkylating agents and nitrosoureas have the potential to cause what? - ANSWER:
Secondary malignancies and fertility issues
Long-term myelosuppression can lead to what? - ANSWER: The development of a
secondary malignancy, 5-10 years after treatment
What is a short-term side efect of nitrosoureas (particularly carmustine and
lomustine)? - ANSWER: Kidney disease
Long-term side effects of carmustine and lomustine - ANSWER: Reduction of
pulmonary function: delayed pulmonary fibrosis--17 years after tx for patients who
received this in childhood/early adolescence
What test should be performed prior to treatment with carmustine or lomustine? -
ANSWER: Baseline pulmonary function tests, there are fatal cases of pulmonary
toxicity
How do antimetabolites function? - ANSWER: By blocking DNA and RNA growth by
interfering with enzymes that are necessary for normal cell metabolism
, What phase of the cell cycle do antimetabolites work? - ANSWER: The S phase, so
they are highly effective on tumors with fast growth rates
Most common antimetabolites: - ANSWER: Azacitidine (Vidaza), Capecitabine
(Xeloda), 5-Fluorourcacil (5-FU), Cytarabine (Ara-C), Decitabine (Dacogen),
Methotrexate
What cancers does fluorouracil treat? - ANSWER: Adenocarcinoma of colon and
rectum, adenocarcinoma of breast, gastric adenocarcinoma, pancreatic
adenocarcinoma
What are very common side effects of antimetabolites? - ANSWER: Mucositis,
diarrhea, myelosuppression, photosensitivity, hand-foot syndrome
Can antimetabolites be administered many routes? - ANSWER: Yes, very correct
route
Nursing teaching for methotrexate - ANSWER: Drug is yellow, large range of doses,
maintain hydration, monitor renal function, encourage oral hygiene, discourage
alcohol use, avoid folic acid, avoid sun exposure, avoid with pleural/pericardial
effusions and ascites
What is an example of an antimetabolite whose toxicities change with dose and rate
of infusion? - ANSWER: Cytarabine
Which antimetabolite has unique considerations for SC administration? - ANSWER:
Azacitidine
What does azacitidine treat? - ANSWER: Myelodysplastic syndrome (MDS)
What is MDS? - ANSWER: Abnormal bone marrow and blood cell morphology,
primarily occurring in older white males
What two antimetabolites can be administered intrathecally? - ANSWER: Cytarabine
and methotrexate
What are anthracyclines? - ANSWER: A classification of antitumor antibiotics that
interfere with enzymes that are necessary for DNA to replicate
Why are lifetime doses of anthracyclines limited? - ANSWER: Can cause permanent
cardiotoxicity
Examples of anthracyclines - ANSWER: Daunorubicin, doxorubicin, doxorubicin Hcl
liposomal, epirubicin, idarubicin
Examples of nonanthracycline antitumor antibiotics - ANSWER: Actinomycin D,
Mitomycin C, Bleomycin, mitoxantrone (although has anthracycline-type properties)
