ONS ONCC Chemo Renewal Exam Questions And Answers Verified 100% Correct

ONS ONCC Chemo Renewal Exam Questions And Answers Verified 100% Correct 85% - ANSWER Amgen (2007) defines RDI as "is a quantification of how closely an administered course of chemotherapy treatment adheres to a specific regimen." Three separate clinical trials evaluating outcomes in patients with breast cancer related to RDI have demonstrated improved overall survival and 10-year disease free survival in patients who receive a RDI or = ____?_____ Per the prescribing information for Perjeta ( prior to initiation of PERJETA and at regular intervals (every six weeks in the neoadjuvant setting) during treatment to ensure that LVEF is within the institution's normal limits. Mrs. Turner's chemotherapy is given every 3 weeks so she should have her LVEF evaluated prior to cycle #3. If Mrs. Turner was receiving trastuzumab without pertuzumab, the recommendation per the prescribing information for Herceptin ( LVEF measurement immediately prior to initiation of Herceptin and monitor LVEF every 3 months during and upon completion of Herceptin. - ANSWER You know the reason that Mrs. Turner had another MUGA scan prior to receiving her 3rd cycle of neoadjuvant chemotherapy is because it is recommended for which of the following agents? Mrs. Turner's initial MUGA scan result was 55% and is now decreased to 48% which is a 10% decrease in her LVEF. Per the prescribing information for Perjeta, if the LVEF is 45%, or is 45% to 49% with a 10% or greater absolute decrease below the pretreatment value, withhold PERJETA and trastuzumab and repeat LVEF assessment within approximately 3 weeks ( to provide the results of the MUGA scan compared to her initial MUGA scan and anticipate that the trastuzumab and pertuzumab will be held for this cycle of chemotherapy. Mrs. Turner should have a repeat MUGA scan prior to cycle #4 and based on those results, discontinue PERJETA and trastuzumab if the LVEF has not improved or has declined further, unless the benefits for the individual patient outweigh the risks. - ANSWER You realize that since Mrs. Turner is on a regimen that includes pertuzumab that she should have her LVEF monitored every 6 weeks since she is receiving neoadjuvant therapy. You review Mrs. Turner's most recent MUGA scan and see that her LVEF is 48%. heart function - ANSWER Two of the agents in the patients currecnt regimen, trastuzumab and pertuzumab, have the potential to cause a decline in _____________ 8.4% - ANSWER It is important that the nurse recognizes certain drugs that, when given together, may result in a higher risk of adverse events. For example, in neoadjuvant clinical trials using trastuzumab and pertuzumab, the incidence of decline in left ventricular ejection fraction (LVEF) was 1.9% in patients treated with trastuzumab and docetaxel, compared to ______ of those treated with trastuzumab, docetaxel, and pertuzumab (Genentech, 2013). Consider the potential toxicity related to each drug. Understand the monitoring guidelines for each drug. Have knowledge of clinically significant signs and symptoms. - ANSWER Key Points for Combination Therapy Improved patient outcomes. Increased nurse satisfaction. Potential cost savings. - ANSWER Evidence-based practice can have positive effects, such as: Smoking Increased age Alcohol intake History of Polyps - ANSWER Risk factors for colon cancer 50 - ANSWER The chance of developing colorectal cancer increases markedly after age _____. Roughly 9 out of 10 people diagnosed with colorectal cancer are at least ____ years old. Racial and ethnic backgrounds (African Americans and Jews of Eastern European descent (Ashkenazi Jews) have highest incidence) Diet high in red and processed meats Physical inactivity, obesity Type 2 diabetes Family history of colon cancer or inflammatory bowel disease Inherited familial syndromes (FAP, HNPCC) - ANSWER Other risk factors for the development of colorectal cancer include: FOLFOX6 Oxaliplatin 100mg/m2 and Leucovorin 400 mg/m2 IV over 2-hours, then 5-fluorouracil (5-FU) 400 mg/m2 IV bolus, followed by 5-FU 3,000 mg/m2 IV by continuous infusion over 46 hours - ANSWER Treatment regiment for Colorectal Cancer Cold sensory neuropathy - ANSWER Which of the following is a unique side effect that occurs with the agent oxaliplatin? Transient paresthesia Dysesthesia and hypoesthesia in the hands, feet, perioral area, or throat. Jaw spasm Abnormal tongue sensation Dysarthria Eye pain, and a feeling of chest pressure have also been observed - ANSWER Cold sensory neuropathy symptoms Duloxetine Gabapentin and Opioid Combination - ANSWER Effective treatments for peripheral neuropathy Per the ONS PEP resources for mucositis ( protocol would be what the nurse needs to ensure Mr. Patterson is doing at home for his early mucositis to prevent it from worsening. - ANSWER Thinking that this is early mucositis, which of the following should the nurse instruct Mr. Patterson to do to help his symptoms? Risk factors for mucositis that are not from the agents themselves include the following: dental disease and poor oral hygiene, ill-fitting dentures, advanced age and youth age, history of alcohol and tobacco use, poor nutrition, intake of irritating foods (spicy or acidic foods), and dehydration (Information from the chemo/bio guidelines page 214215). Mr. P. has both a poor diet and also uses tobacco (both chewing tobacco and cigarettes) and alcohol. The use of tobacco products is a big risk factor for development of mucositis. - ANSWER Which of the following of Mr. Patterson's lifestyle factors put him at the most risk for developing mucositis? Recommended for Practice: Cryotherapy Low Level Laser Therapy in Patients Undergoing Hematopoietic Cell Transplantation Low Level Laser Therapy in Patients With Head and Neck Cancer Oral Care Protocol Sodium Bicarbonate Likely to Be Effective: Benzydamine for Patients Receiving Combination Chemotherapy and Radiation Therapy Benzydamine for Radiation-Related Mucositis Lactobacillus Lozenges Palifermin for Patients Receiving Chemotherapy and Radiation for Head and Neck Cancer