CRNI Antineoplastic and Biologic Therapies 4

Question 1

A patient receiving intrathecal methotrexate develops arachnoiditis. Which symptom cluster is most consistent with this complication?

Accepted Answer

Headache, nuchal rigidity, and back pain

Answer

Intrathecal methotrexate-induced arachnoiditis presents with meningeal irritation signs including headache, nuchal rigidity, and back pain.

Question 2

When preparing to administer rituximab, the CRNI knows to premedicate with which combination to reduce infusion-related reactions?

Accepted Answer

Acetaminophen and diphenhydramine

Answer

Standard premedication before rituximab includes acetaminophen and diphenhydramine to blunt cytokine-mediated infusion reactions.

Question 3

A patient on capecitabine (Xeloda) reports painful redness and swelling of the palms and soles. The nurse identifies this as:

Accepted Answer

Hand-foot syndrome (palmar-plantar erythrodysesthesia)

Answer

Hand-foot syndrome (palmar-plantar erythrodysesthesia) is a hallmark toxicity of capecitabine characterized by painful erythema and swelling of palms and soles.

Question 4

Which laboratory value is the most critical to assess before administering a dose of methotrexate?

Accepted Answer

Serum creatinine

Answer

Renal function (serum creatinine) must be assessed before methotrexate because the drug is renally eliminated and impaired clearance leads to severe toxicity.

Question 5

A nurse is caring for a patient who received high-dose cisplatin 48 hours ago. Which electrolyte imbalance requires the most vigilant monitoring?

Accepted Answer

Hypomagnesemia

Answer

Cisplatin causes renal tubular damage leading to significant magnesium wasting; hypomagnesemia is the most common and clinically significant electrolyte disturbance.

CRNI Exam Practice Test

CRNI Exam Practice Test

CRNI Antineoplastic and Biologic Therapies 4