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Ons oncc chemo renewal exam questions with correct answers

Ons oncc chemo renewal exam questions with correct answers

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ONS ONCC Chemo Renewal Exam

Questions with 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 - Answer- Main benefit of neoadjuvant

chemotherapy (breast cancer patient)

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). - Answer- 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:

65 - Answer- 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

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. - Answer- What is your best explanation for why

Mrs. Turner was given a port to receive her chemotherapy?

Irrirtants - Answer- _____________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).

Vesicants - Answer- _____________can cause blistering and significant pain and tissue

damage and destruction, leading to tissue death.

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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 - Answer- A further classification of

an antineoplastic agent's potential to cause damage is whether its mechanism of action

includes DNA binding.

Bendamustinea

Dactinomycin

Daunorubicin

Doxorubicin

Epirubicin

Idarubicin

Mechlorethamine

Mitomycin - Answer- DNA Binding Irritants

Amsacrine

Paclitaxel

Vinblastine

Vincristine

Vindesine

Vinorelbine - Answer- DNA Nonbinding vessicants

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. - Answer- Extravasciation Alkylating / Mechlorethamine tx

Apply warm compresses.

Dexamethasone

8 mg twice daily

for 14 days - Answer- Extravasciation Alkylating: Oxaliplatin

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

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The dose recommended is based on the patients' body

surface area.

• Day 1: 1,000 mg/m2

• Day 2: 1,000 mg/m2

• Day 3: 500 mg/m - Answer- Extravasation Tx: Anthracyclines --- Daunorubicin,

doxorubicin, epirubicin,

idarubicin

Hyaluronidase

Apply warm pack for

15-20 minutes four times

daily the next 24-48

hours and keep extremity

elevated.

Administer 1 ml of hyaluronidase subcutaneously in five

separate injections, each containing 0.2 ml of the solution

using a 25 gauge or smaller needle. - Answer- Extravasation Tx: Plant alkaloid

Vinblastine, vincristine,

vindesine,

vinorelbine

Apply ice pack for 15-20

minutes four times daily

the first 24 hours.

No known antidote - Answer- Extravascation Tx: Taxanes Docetaxel, paclitaxe

include aching and tightness along a peripheral vein above the administration site that

occurs as the drug infuses, as well as potential redness or darkening of the vein without

swelling and ulceration. Blood return is typically present; if not, an infiltration may have

occurred - Answer- Signs of symptoms of venous irritation:

warm compress - Answer- Most sources recommend the application of heat using

_______________ to help reduce local discomfort and the restart of the peripheral IV in

a larger vein (Polovich et al., 2014).

irinotecan - Answer- The manufacturer of ______________ recommends topical

flushing of the skin with sterile water and application of ice in the event of extravasation

of the drug (Pfizer Inc., 2012).

Burning, stinging pain around the administration site, although it is important to note that

some patients do not experience any pain with vesicant extravasation and may in fact

experience a feeling of coolness at the site (Polovich et al., 2014). - Answer-

Extravasation signs and symptoms can include

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ONS ONCC Chemo Renewal Exam Questions with 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 - Answer- Main benefit of neoadjuvant chemotherapy (breast cancer patient) 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). - Answer- 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: 65 - Answer- 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 Two of the agents (docetaxel and carboplatin) that Mrs. Turner will receive are categorized as ...
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