Chemotherapy Immunotherapy Certificate exam

Question 1

Which of the following statements best describes the process of dimerization?

 

 a

Intracellular signalling process to enable cell function

 b

Activation of a chemical process to prevent cell mitosis

 c

Attachment of a protein to signal intracellular division

 d

Extracellular binding process to activate a receptor

Question 2

Which of the following baseline testing is completed prior to administering cisplatin?

 

 a

Audiogram

 b

Electrocardiogram

 c

Chest x-ray

 d

Multigated acquisition scan

Question 3

Which of the following should a patient complete prior to starting an aromatase inhibitor?

 

 a

Bone density

 b

Carotid doppler

 c

Chest x-ray

 d

Renal ultrasound

Question 4

One cause of chemotherapy-induced nausea and vomiting is the:

 

 a

stimulation of neural structures.

 b

stabilization of serotonin levels.

 c

deactivation of enterochromaffin cells.

 d

inhibition of neurotransmitter receptors.

Question 5

Which medication has a side effect of cytokine-release syndrome?

 

 a

Aldesleukin

 b

Azathioprine

 c

Asparaginase

 d

Axitinib

Question 6

Which of the following is the emetogenicity level for a patient who is ordered irinotecan, oxaliplatin, leucovorin, and fluorouracil?

 

 a

Low

 b

Moderate

 c

High

 d

Minimal

Question 7

The benefits associated with the use of biosimilar agents may include:

 

 a

clinical trial enrollment.

 b

financial savings.

 c

substitution practices.

 d

off-label indications.

Question 8

Which of the following methods should the nurse use to overcome barriers to patient education?

 

 a

Provide effective symptom management.

 b

Allow misconceptions related to diagnosis.

 c

Limit time for questions.

 d

Utilize significant others as translators.

Question 9

Nursing considerations for the administration of ziv-aflibercept include:

 

 a

restarting the dose after proteinuria is less than 2g/24 hours.

 b

administering the agent over an hour using a 0.2 nylon filter.

 c

withholding the doses for hypotensive events.

 d

evaluating for dermatologic conditions prior to treatment.

Question 10

Which of the following is a hormone therapy agent used in the treatment of prostate cancer?

 

 a

Miconizole

 b

Ketoconazole

 c

Amifostine

 d

Sargramostim

Question 11

Maintaining a treatment plan's dose intensity is associated with:

 

 a

increased toxicity.

 b

improved patient survival.

 c

dose reductions.

 d

decreased tumor response.

Question 12

When administering an eighth dose of carboplatin the nurse:

 

 a

monitors for tumor lysis syndrome.

 b

monitors for a hypersensitivity reaction.

 c

schedules a chest x-ray.

 d

applies a cold compress to the IV site.

Question 13

Which of the following agents is indicated for metastatic adrendocortical cancer?

 

 a

Bicalutamide

 b

Mitotane

 c

Goserelin

 d

Abiraterone

Question 14

To prevent chemotherapy exposure, personal protective equipment should be removed in the following order:

 

 a

gown, both gloves, wash hands.

 b

outer gloves, inner gloves, wash hands, gown.

 c

gloves, gown, wash hands.

 d

outer gloves, gown, inner gloves, wash hands.

Question 15

Which of the following interventions is recommended for a patient receiving chemotherapy and experiencing mucositis?

 

 a

Oral rinsing with sodium bicarbonate

 b

Taking folinic acid

 c

Using allopurinol mouthwash

 d

Applying topical corticosteroids

Question 16

Which of the following adverse reactions should the nurse assess in a patient who is receiving paclitaxel dosed at 175 mg/m2 every three weeks?

 

 a

Peripheral neuropathy

 b

Hypertrichosis

 c

Hypertension

 d

Punctal stenosis

Question 17

Which drug has cumulative doses that are associated with secondary leukemias?

 

 a

Bortezomib

 b

Methotrexate

 c

Busulfan

 d

Paclitaxel

Question 18

What is the goal of a phase 2 clinical trial?

 

 a

Assess drug-food interactions.

 b

Demonstrate activity of the intervention.

 c

Provide human pharmacokinetics data.

 d

Determine maximum tolerated dose.

Question 19

Which of the following statements indicates that a patient receiving pembrolizumab needs additional teaching?

 

 a

"I will notify you if I begin experiencing severe itching even if there is not a rash."

 b

"I should immediately report any new cough or shortness of breath."

 c

"I can expect to have more loose stools and diarrhea at the beginning of treatment."

 d

"I can expect to feel more tired and fatigued during treatment."

Question 20

A patient is receiving chemotherapy at home. Which of the following instructions should the nurse provide for the care of clothing that becomes soiled with cytotoxic medication?

 

 a

Place linens in a plastic bag and dispose of in the trash.

 b

Wash with the regular household laundry using hot water.

 c

Spot clean the soiled area and then allow to air dry.

 d

Handle with gloves and wash separately from other laundry.

Question 21

Which of the following interventions may reduce vinorelbine-induced irritation?

 

 a

Flush vein with at least 75-125 mL after infusion.

 b

Infuse the drug over 30-60 minutes.

 c

Confirm the placement of a central line.

 d

Administer H1 and H2 blockers.

Question 22

Prior to administering high-dose methotrexate the nurse monitors:

 

 a

blood pressure.

 b

urine pH.

 c

fluid intake.

 d

oxygen saturation.

Question 23

Which of the following results is important to monitor for a patient being treated with pertuzumab?

 

 a

Creatinine clearance

 b

Bone scan

 c

Pulmonary function test

 d

Echocardiogram

Question 24

Which of the following medications is able to cross the blood-brain barrier to effectively treat some brain tumors?

 

 a

Vincristine

 b

Omacetaxine

 c

Lomustine

 d

Daunorubicin

Question 25

What best describes the effect of innate immunity? Innate immunity:

 

 a

limits the activity of immune effector cells.

 b

induces a generic immune response.

 c

generates an immunologic memory.

 d

produces specific immunoglobulins.

Question 26

The TP53 gene serves an important role in regulating:

 

 a

immunity.

 b

apoptosis.

 c

cyclins.

 d

oncogenes.

Question 27

Which of the following agents is classified as carcinogenic?

 

 a

Tamoxifen

 b

Interferon alfa 2a

 c

Alemtuzumab

 d

Dapsone

Question 28

An annual respiratory fit testing is required for:

 

 a

proper use.

 b

integumentary protection.

 c

distribution update.

 d

absorption parameter check.

Question 29

A patient scheduled to receive mitoxantrone is first evaluated with:

 

 a

an upper endoscopy.

 b

a pulmonary function test.

 c

a creatinine clearance.

 d

a multigated acquisition scan.

Question 30

A patient receiving idarubicin reports a burning sensation around the area of the central venous catheter. The most likely cause is:

 

 a

an irritation.

 b

hypersensitivity.

 c

a flare reaction.

 d

an extravasation.

Question 31

Patients who are prescribed everolimus need dose adjustments when taking:

 

 a

proton pump inhibitors.

 b

angiotensin-converting enzyme inhibitors.

 c

CYP3A4 inhibitors.

 d

protein kinase inhibitors.

Question 32

A patient who received four cycles of paclitaxel complains of burning, numbness, and tingling in the fingers and the toes. The most likely cause is:

 

 a

sensory neuropathy.

 b

palmar-plantar erythrodysesthesia.

 c

a hypersensitivity reaction.

 d

a low serum calcium.

Question 33

A patient being premedicated prior to receiving chemotherapy reports vaginal burning. Which medication can cause this?

 

 a

Granisetron

 b

Alprazolam

 c

Fosaprepitant

 d

Dexamethasone

Question 34

A patient has a glomerular filtration rate of 114 mL/min. Using the Calvert formula, what is the carboplatin dose if the target AUC is 6?

 

 a

709 mg

 b

798 mg

 c

684 mg

 d

834 mg

Question 35

Tyrosine kinase receptor activation is catalyzed by which of the following processes?

 

 a

Angiogenesis

 b

Apoptosis

 c

Phosphorylation

 d

Dimerization

Question 36

The priority nursing action after performing a comprehensive review of the prescribed chemotherapy is to:

 

 a

verify that the orders were signed by the provider.

 b

assess the patient's knowledge of medication side effects.

 c

review the medical record for evidence of informed consent.

 d

require an independent verification by a second practitioner.

Question 37

The amount of medication given over a period of time is defined as:

 

 a

calculated dose therapy.

 b

relative dose intensity.

 c

dose intensity.

 d

dose-dense therapy.

Question 38

A patient currently taking tamoxifen has been prescribed citalopram.  The nurse understands that citalopram can:

 

 a

reduce the risk of stroke.

 b

decrease the efficacy of tamoxifen.

 c

eliminate side effects of tamoxifen.

 d

decrease the symptoms of menopause.

Question 39

A patient is scheduled to start erlotinib. The nurse knows that the patient is in need of additional teaching when the patient states:

 

 a

"I can take the medication on an empty stomach."

 b

"I should call the office for diarrhea."

 c

"I will take the medication with breakfast."

 d

"I will call the office for a rash."

Question 40

Which of the following is included in the teaching for a patient scheduled to begin a regimen consisting of oxaliplatin and capecitabine?

 

 a

Take oral therapy two hours before eating and drinking.

 b

Chew on ice for the first three days of each cycle.

 c

Receive a nasal spray flu vaccine before beginning therapy.

 d

Use a calendar to track the days and times to take the medication.

Question 41

A priority nursing action is to dispose of drug-contaminated items into:

 

 a

infectious waste plastic bags.

 b

double-bagged paper bags.

 c

infectious waste containers.

 d

rigid chemotherapy waste containers.

Question 42

High dosing of which of the following agents can cause seizures?

 

 a

Ixabepilone

 b

Bendamustine

 c

Busulfan

 d

Eribulin

Question 43

The lifetime cumulative dose of daunorubicin in a patient without cardiovascular risk factors is:

 

 a

550 mg/m2.

 b

650 mg/m2.

 c

450 mg/m2.

 d

400 mg/m2.

Question 44

Contact inhibition is a property of:

 

 a

cytotoxic therapy.

 b

enzymes.

 c

malignant cells.

 d

normal cells.

Question 45

A monoclonal antibody that targets angiogenesis is ordered for a patient with lung cancer. The patient is most likely being treated with:

 

 a

pazopanib.

 b

bevacizumab.

 c

vandetanib.

 d

cetuximab.

Question 46

Which of the following is a patient-related risk factor for increased tissue damage in extravasation?

 

 a

Diabetes

 b

Catheter migration

 c

Vesicant concentration

 d

Type of vesicant

Question 47

Which laboratory value indicates an increased risk for an infusion reaction for a patient with lymphoma who is scheduled to receive rituximab?

 

 a

Hematocrit 35%

 b

Circulating lymphocytes 30,000/mm3

 c

Platelet count 100,000/mm3

 d

ANC 6,500/mm3

Question 48

 A patient is receiving bleomycin and reports dyspnea on exertion. The nurse anticipates an order for a:

 

 a

computed tomography scan.

 b

peak flow meter.

 c

ventilation scan.

 d

pulmonary function test.

Question 49

A patient receiving ipilimumab is receiving oral steroids for a maculopapular rash. After one week of steroids, the patient continues to have painful, diffuse erythematous macules and target lesions covering more than 30% of the body. What does the nurse tell the patient?

 

 a

"This is a condition unrelated to the cancer treatment."

 b

"This is a grade I pruritus requiring an oral antipruritic."

 c

"This is an emergent dermatologic toxicity requiring hospitalization."

 d

"This is an expected effect of therapy which needs no intervention."

Question 50

The appropriate gown to wear when administering chemotherapy is:

 

 a

a gown that is front-closing.

 b

a gown made with absorbent cotton.

 c

a disposable gown.

 d

a highly permeable gown.

Question 51

Which of the following agents has a high potential for immediate hypersensitivity reactions?

 

 a

Bleomycin

 b

Methotrexate

 c

Dacarbazine

 d

Paclitaxel

Question 52

An example of hormone therapy includes:

 

 a

Adrenolytics

 b

Small molecule agents

 c

Monoclonal antibodies

 d

Tyrosine kinase inhibitors

Question 53

A patient with colorectal cancer is scheduled to begin treatment with capecitabine. The nurse ensures that patient teaching is done for which side effect?

 

 a

Telangiectasia behind the ears

 b

Redness of palms and soles of feet

 c

Xerosis of the conjunctiva

 d

Paronychia of the nail fold

Question 54

A premedication of dexamethasone 8 mg PO BID beginning the day before treatment and continuing for the day of treatment and the day after treatment is ordered for:

 

 a

vinorelbine.

 b

teniposide.

 c

carboplatin.

 d

docetaxel.

Question 55

Which of the following situations related to oral chemotherapy treatment is most likely to result in serious adverse effects?

 

 a

A patient obtains a refill of the prescription and continues to take the medication during the "off week".

 b

A family member brings the medication bottle and dosing schedule to the followup appointment.

 c

The new cycle of treatment is delayed because the medication is unavailable from the pharmacy.

 d

A patient misses a follow-up appointment because he is unable to pay for transportation to the clinic.

Question 56

A patient has received a hematopoietic stem cell transplant. How soon does mucositis occur once the patient completes the conditioning regimen?

 

 a

Four to six days

 b

Seven to eight days

 c

Three to five days

 d

One to two days

Question 57

What is the mechanism of action for monoclonal antibodies?

 

 a

Remove immune cells from the body, and retrain them to identify and kill specific antigens

 b

Target tumor-specific antigens on the surface of some cancer cells

 c

Introduce the immune system to fragments of weakened or dead bacteria

 d

Accelerate and fully engage immune cells to create a robust immune response

Question 58

What is confirmed with the pharmacist before administration of intrathecal cytarabine?

 

 a

Diphenhydramine is available.

 b

Medication is reconstituted within 15 minutes.

 c

Preservative-free saline is used.

 d

Ondansetron is prepared.

Question 59

A patient is scheduled to receive melphalan 140 mg/m2. The patient's measurements are as follows: height 173 cm and weight 85 kg. What is the dose to be administered?

 

 a

280 mg

 b

283 mg

 c

257 mg

 d

295 mg

 

Question 60 When administering a vinca alkaloid, the nurse is prepared to manage:

 A dyspnea.

 B extravasation.

 C anaphylaxis.

 D chest pain.