ONCOLOGY CHEMO CERTIFICATION
EXAM ACTUAL QUESTIONS AND
CORRECT ANSWERS
Main benefit of neoadjuvant chemotherapy (breast cancer patient) - CORRECT
ANSWERS 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: - CORRECT
ANSWERS 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 - CORRECT ANSWERS 65
What is your best explanation for why Mrs. Turner was given a port to receive her
chemotherapy? - CORRECT ANSWERS 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). - CORRECT ANSWERS Irrirtants
_____________can cause blistering and significant pain and tissue damage and destruction,
leading to tissue death. - CORRECT ANSWERS Vesicants
A further classification of an antineoplastic agent's potential to cause damage is whether its
mechanism of action includes DNA binding. - CORRECT ANSWERS 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 - CORRECT ANSWERS Bendamustinea
Dactinomycin
Daunorubicin
Doxorubicin
Epirubicin
Idarubicin
Mechlorethamine
Mitomycin
DNA Nonbinding vessicants - CORRECT ANSWERS Amsacrine
Paclitaxel
Vinblastine
, Vincristine
Vindesine
Vinorelbine
Extravasciation Alkylating / Mechlorethamine tx - CORRECT ANSWERS 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 - CORRECT ANSWERS Apply warm
compresses.
Dexamethasone
8 mg twice daily
for 14 days
Extravasation Tx: Anthracyclines --- Daunorubicin,
doxorubicin, epirubicin,
idarubicin - CORRECT ANSWERS Totect
Apply ice pack (remove 15
minutes prior to Totect
EXAM ACTUAL QUESTIONS AND
CORRECT ANSWERS
Main benefit of neoadjuvant chemotherapy (breast cancer patient) - CORRECT
ANSWERS 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: - CORRECT
ANSWERS 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 - CORRECT ANSWERS 65
What is your best explanation for why Mrs. Turner was given a port to receive her
chemotherapy? - CORRECT ANSWERS 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). - CORRECT ANSWERS Irrirtants
_____________can cause blistering and significant pain and tissue damage and destruction,
leading to tissue death. - CORRECT ANSWERS Vesicants
A further classification of an antineoplastic agent's potential to cause damage is whether its
mechanism of action includes DNA binding. - CORRECT ANSWERS 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 - CORRECT ANSWERS Bendamustinea
Dactinomycin
Daunorubicin
Doxorubicin
Epirubicin
Idarubicin
Mechlorethamine
Mitomycin
DNA Nonbinding vessicants - CORRECT ANSWERS Amsacrine
Paclitaxel
Vinblastine
, Vincristine
Vindesine
Vinorelbine
Extravasciation Alkylating / Mechlorethamine tx - CORRECT ANSWERS 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 - CORRECT ANSWERS Apply warm
compresses.
Dexamethasone
8 mg twice daily
for 14 days
Extravasation Tx: Anthracyclines --- Daunorubicin,
doxorubicin, epirubicin,
idarubicin - CORRECT ANSWERS Totect
Apply ice pack (remove 15
minutes prior to Totect
