AOCNP Cancer Pharmacology and Chemotherapy 4

Question 1

A patient on capecitabine develops palmar-plantar erythrodysesthesia (hand-foot syndrome). Which management strategy is most appropriate?

Accepted Answer

Dose reduce capecitabine and initiate pyridoxine and urea-based cream

Answer

Grade 2-3 hand-foot syndrome requires capecitabine dose reduction, with supportive care including pyridoxine and emollient creams.

Question 2

Which of the following best describes the mechanism of action of bortezomib in multiple myeloma?

Accepted Answer

Inhibits the 26S proteasome, preventing degradation of pro-apoptotic factors

Answer

Bortezomib is a proteasome inhibitor that prevents degradation of regulatory proteins, promoting apoptosis in myeloma cells.

Question 3

A patient receiving high-dose methotrexate develops delayed clearance with rising creatinine. Which intervention is most critical?

Accepted Answer

Administer leucovorin rescue and aggressive IV hydration with urinary alkalinization

Answer

Leucovorin rescue combined with aggressive IV hydration and urinary alkalinization is essential to prevent life-threatening toxicity from delayed methotrexate clearance.

Question 4

Which toxicity is most specifically associated with bleomycin and requires monitoring with pulmonary function tests?

Accepted Answer

Pulmonary fibrosis and pneumonitis

Answer

Bleomycin causes pulmonary toxicity ranging from pneumonitis to fibrosis, which can be life-threatening and requires baseline and serial PFTs.

Question 5

An AOCNP is managing a patient on tamoxifen who is also prescribed paroxetine for depression. What is the primary concern?

Accepted Answer

Paroxetine inhibits CYP2D6, reducing conversion of tamoxifen to its active metabolite endoxifen

Answer

Paroxetine is a potent CYP2D6 inhibitor that significantly reduces conversion of tamoxifen to endoxifen, potentially reducing efficacy of hormonal therapy.

AOCNP - Advanced Oncology Certified Nurse Practitioner Practice Test

AOCNP - Advanced Oncology Certified Nurse Practitioner Practice Test

AOCNP Cancer Pharmacology and Chemotherapy 4