CRNI Antineoplastic and Biologic Therapies Questions and Answers

Question 1

A patient receiving a first-time infusion of rituximab develops facial flushing, chills, and rigors 30 minutes into the infusion. What is the CRNI's PRIORITY action?

Accepted Answer

Stop the infusion and notify the provider immediately.

Answer

Increase the infusion rate to complete the therapy faster.

Answer

Obtain a full set of vital signs and continue to monitor.

Answer

Administer acetaminophen and diphenhydramine as per protocol.

Question 2

According to OSHA and Oncology Nursing Society (ONS) guidelines, which of the following represents the minimum required personal protective equipment (PPE) for a nurse administering an intravenous push (IVP) of a hazardous antineoplastic drug?

Accepted Answer

Two pairs of chemotherapy-tested gloves, a disposable, coated gown, and a face shield.

Answer

One pair of gloves and a disposable gown.

Answer

A fluid-resistant gown and a surgical mask.

Answer

A fit-tested N95 respirator and safety goggles.

Question 3

A patient receiving a peripheral infusion of vincristine complains of burning at the IV site. The CRNI suspects extravasation. Which of the following interventions is critical for managing this specific type of extravasation?

Accepted Answer

Applying warm compresses and administering hyaluronidase.

Answer

Applying a cold compress to promote vasoconstriction.

Answer

Administering dexrazoxane as the indicated antidote.

Answer

Vigorously massaging the area to disperse the drug.

Question 4

A patient receiving the immune checkpoint inhibitor pembrolizumab reports a new onset of profuse, watery diarrhea two weeks after their third infusion. The CRNI should recognize this as a potential sign of which common immune-related adverse event (irAE)?

Accepted Answer

Immune-mediated colitis.

Answer

Cytokine release syndrome.

Answer

A Type 1 hypersensitivity reaction.

Answer

Drug-induced pancreatitis.

Question 5

A CRNI is preparing to administer doxorubicin. Which of the following baseline assessments is MOST critical to review before initiating therapy due to this agent's primary dose-limiting toxicity?

Accepted Answer

An echocardiogram or MUGA scan.

Answer

Pulmonary function tests.

Answer

A peripheral nerve conduction study.

Answer

Serum creatinine and BUN.

Question 6

A patient is scheduled to receive both paclitaxel and trastuzumab on the same day for HER2-positive breast cancer. To ensure patient safety and therapeutic efficacy, what is the standard administration sequence for these agents?

Accepted Answer

Administer paclitaxel first, followed by trastuzumab.

Answer

Administer both drugs concurrently using a Y-site connection.

Answer

Administer trastuzumab first, followed by paclitaxel.

Answer

The order of administration does not impact safety or efficacy.