OCN Chemotherapy Administration 2 — Questions and Answers
Question 1: Which chemotherapy drug requires leucovorin rescue to prevent life-threatening toxicity?
- High-dose methotrexate (Correct answer)
- Doxorubicin
- Paclitaxel
- Gemcitabine
Correct answer: High-dose methotrexate
Leucovorin (folinic acid) rescue is used after high-dose methotrexate to protect normal cells from folate depletion toxicity.
Question 2: Doxorubicin has a cumulative lifetime dose limit primarily because of which toxicity?
- Cardiomyopathy (Correct answer)
- Nephrotoxicity
- Neurotoxicity
- Hepatotoxicity
Correct answer: Cardiomyopathy
Doxorubicin accumulates in cardiac tissue and can cause irreversible cardiomyopathy; the total lifetime dose is capped at 450–550 mg/m².
Question 3: What is the purpose of using a CVAD (central venous access device) for chemotherapy?
- To safely administer vesicants and reduce peripheral vein damage (Correct answer)
- To allow the patient to go home sooner
- To reduce drug costs
- To improve oral bioavailability
Correct answer: To safely administer vesicants and reduce peripheral vein damage
CVADs provide reliable venous access for vesicant infusions, protecting peripheral veins and reducing extravasation risk.
Question 4: Before administering paclitaxel, the nurse should premedicate with which agents to prevent hypersensitivity reactions?
- Corticosteroids, diphenhydramine, and an H2 blocker (Correct answer)
- Acetaminophen and ibuprofen
- Ondansetron and lorazepam
- Metoclopramide and dexamethasone
Correct answer: Corticosteroids, diphenhydramine, and an H2 blocker
Paclitaxel's Cremophor EL solvent causes hypersensitivity reactions; premedication with a steroid, antihistamine, and H2 blocker is required.
Question 5: Which chemotherapy class works by intercalating into DNA strands and inhibiting topoisomerase II?
- Anthracyclines (Correct answer)
- Alkylating agents
- Antimetabolites
- Vinca alkaloids
Correct answer: Anthracyclines
Anthracyclines such as doxorubicin intercalate into DNA and inhibit topoisomerase II, preventing DNA replication.
Question 6: Oral chemotherapy education should stress which of the following to patients?
- Never handle tablets with bare hands and use safe disposal methods (Correct answer)
- Crush tablets to improve absorption
- Share doses with caregivers if they have the same cancer
- Store in the bathroom medicine cabinet for convenience
Correct answer: Never handle tablets with bare hands and use safe disposal methods
Oral chemotherapy is still a hazardous drug requiring gloves for handling and proper disposal to protect the patient and household members.
OCN Chemotherapy Administration 2
Which chemotherapy drug requires leucovorin rescue to prevent life-threatening toxicity?