Antineoplastic and Biologic Therapies Flashcards
7 cards from real CRNI practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Antineoplastic and Biologic Therapies flashcards as text
Which statement best explains the mechanism of action of trastuzumab (Herceptin)?
Answer: It binds HER2 receptors, inhibiting cell proliferation signaling
Trastuzumab is a monoclonal antibody that targets HER2 (ErbB2) receptors, blocking downstream proliferative signaling in HER2-overexpressing tumors.
A patient develops tumor lysis syndrome 24 hours after starting chemotherapy. Which set of lab findings is characteristic?
Answer: Hyperuricemia, hyperkalemia, hyperphosphatemia, hypocalcemia
Tumor lysis syndrome classically presents with hyperuricemia, hyperkalemia, hyperphosphatemia, and hypocalcemia from rapid release of intracellular contents.
When teaching a patient about imatinib (Gleevec) oral therapy, which instruction is most important?
Answer: Avoid grapefruit juice as it increases drug levels
Grapefruit juice inhibits CYP3A4, the enzyme responsible for imatinib metabolism, leading to significantly increased drug plasma levels and toxicity risk.
A CRNI is assessing a patient for signs of pegfilgrastim (Neulasta) toxicity. Which complaint warrants immediate evaluation for splenic rupture?
Answer: Sudden severe left upper quadrant abdominal pain
Sudden severe left upper quadrant pain in a patient receiving colony-stimulating factors like pegfilgrastim must be evaluated urgently for splenic rupture, a rare but life-threatening complication.
Which action by the nurse demonstrates correct handling of oral antineoplastic agents per safe handling guidelines?
Answer: Wearing gloves when handling the oral medication and disposing in a hazardous waste container
Oral antineoplastics require PPE (minimum chemotherapy-rated gloves) during handling and must be discarded as hazardous pharmaceutical waste per NIOSH and ONS guidelines.
A patient on nivolumab (Opdivo) presents with worsening shortness of breath and new bilateral infiltrates on chest X-ray. The nurse suspects:
Answer: Immune-mediated pneumonitis from checkpoint inhibitor therapy
Immune checkpoint inhibitors like nivolumab can cause immune-mediated pneumonitis, which may present with dyspnea and bilateral infiltrates and requires immediate evaluation.
For a patient receiving oxaliplatin, which nursing intervention is most important to prevent exacerbation of the characteristic acute neurotoxicity?
Answer: Instructing the patient to avoid cold temperatures and cold beverages
Oxaliplatin causes acute cold-triggered peripheral sensory neuropathy; patients must avoid exposure to cold temperatures and cold liquids to prevent triggering or worsening this neuropathy.