OCC Administration & Safety Protocols 2 — Questions and Answers
Question 1: When preparing chemotherapy agents in the pharmacy, which type of biological safety cabinet (BSC) is required?
- Class I BSC
- Class II Type A2 BSC
- Class II Type B2 BSC (Correct answer)
- Class III BSC
Correct answer: Class II Type B2 BSC
NIOSH and USP 800 require a Class II Type B2 BSC for hazardous drug compounding because it provides 100% exhaust to the outdoors with no air recirculation.
Question 2: A patient receives vincristine 2 mg IV. The nurse notes the order did not specify a route. Which action is most appropriate?
- Administer IV as vincristine is always given IV
- Hold the dose and clarify the route with the prescriber (Correct answer)
- Administer it intrathecally as an alternate safe route
- Give it orally since no route was specified
Correct answer: Hold the dose and clarify the route with the prescriber
Vincristine is fatal if given intrathecally, so any ambiguity in the route must be clarified before administration to prevent a catastrophic medication error.
Question 3: Which personal protective equipment (PPE) component is specifically required when administering aerosolized or nebulized hazardous drugs?
- Standard surgical mask
- N95 respirator or powered air-purifying respirator (PAPR) (Correct answer)
- Double nitrile gloves only
- Face shield alone
Correct answer: N95 respirator or powered air-purifying respirator (PAPR)
Aerosolized hazardous drugs require respiratory protection beyond a surgical mask; an N95 respirator or PAPR is required to prevent inhalation exposure.
Question 4: A nurse is administering paclitaxel when the patient reports flushing, urticaria, and shortness of breath. What is the FIRST action?
- Slow the infusion rate and monitor closely
- Stop the infusion immediately and call for help (Correct answer)
- Administer diphenhydramine and continue at a slower rate
- Draw blood cultures and notify pharmacy
Correct answer: Stop the infusion immediately and call for help
Signs of hypersensitivity reaction require immediate cessation of the infusion to prevent anaphylaxis progression before any other interventions.
Question 5: According to OSHA guidelines, chemotherapy spill kits must contain which item for absorbing liquid spills?
- Standard paper towels
- Plastic sheeting only
- Absorbent pads or towels designed for chemotherapy spills (Correct answer)
- Cotton gauze squares
Correct answer: Absorbent pads or towels designed for chemotherapy spills
Chemotherapy spill kits must contain chemotherapy-specific absorbent materials that capture and contain the hazardous agent without spreading contamination.
Question 6: What is the recommended minimum number of glove layers required when handling hazardous drugs per USP <800>?
- One pair of any gloves
- Two pairs of ASTM-tested chemotherapy gloves (Correct answer)
- One pair of latex gloves over one pair of nitrile
- Three pairs of standard nitrile gloves
Correct answer: Two pairs of ASTM-tested chemotherapy gloves
USP <800> requires double gloving with ASTM D6978-tested chemotherapy gloves to ensure adequate protection from hazardous drug permeation.
Question 7: When priming IV tubing for a chemotherapy infusion, which technique best minimizes occupational exposure?
- Prime with the chemotherapy agent directly into a gauze pad
- Prime tubing with plain IV fluid before attaching the drug bag (Correct answer)
- Prime over an open trash can to catch drips
- Leave the tubing unprimed and flush after starting the infusion
Correct answer: Prime tubing with plain IV fluid before attaching the drug bag
Priming IV tubing with a plain compatible IV solution before connecting the chemotherapy bag prevents drug exposure during the priming process.
OCC Administration & Safety Protocols 2
When preparing chemotherapy agents in the pharmacy, which type of biological safety cabinet (BSC) is required?