CRNI Antineoplastic and Biologic Therapies 5

Question 1

Which statement best explains the mechanism of action of trastuzumab (Herceptin)?

Accepted Answer

It binds HER2 receptors, inhibiting cell proliferation signaling

Answer

Trastuzumab is a monoclonal antibody that targets HER2 (ErbB2) receptors, blocking downstream proliferative signaling in HER2-overexpressing tumors.

Question 2

A patient develops tumor lysis syndrome 24 hours after starting chemotherapy. Which set of lab findings is characteristic?

Accepted Answer

Hyperuricemia, hyperkalemia, hyperphosphatemia, hypocalcemia

Answer

Tumor lysis syndrome classically presents with hyperuricemia, hyperkalemia, hyperphosphatemia, and hypocalcemia from rapid release of intracellular contents.

Question 3

When teaching a patient about imatinib (Gleevec) oral therapy, which instruction is most important?

Accepted Answer

Avoid grapefruit juice as it increases drug levels

Answer

Grapefruit juice inhibits CYP3A4, the enzyme responsible for imatinib metabolism, leading to significantly increased drug plasma levels and toxicity risk.

Question 4

A CRNI is assessing a patient for signs of pegfilgrastim (Neulasta) toxicity. Which complaint warrants immediate evaluation for splenic rupture?

Accepted Answer

Sudden severe left upper quadrant abdominal pain

Answer

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.

Question 5

Which action by the nurse demonstrates correct handling of oral antineoplastic agents per safe handling guidelines?

Accepted Answer

Wearing gloves when handling the oral medication and disposing in a hazardous waste container

Answer

Oral antineoplastics require PPE (minimum chemotherapy-rated gloves) during handling and must be discarded as hazardous pharmaceutical waste per NIOSH and ONS guidelines.

CRNI Exam Practice Test

CRNI Exam Practice Test

CRNI Antineoplastic and Biologic Therapies 5