ONCC Chemotherapy Administration and Safety 2

Question 1

A patient receiving cisplatin should receive which intervention BEFORE chemotherapy administration to reduce the risk of nephrotoxicity?

Accepted Answer

Administer IV hydration with normal saline and ensure adequate urine output

Answer

Restrict IV fluids to prevent fluid overload

Answer

Administer furosemide to increase urine concentration

Answer

Give oral hydration of 2 glasses of water only

Question 2

Which lab value is the MOST important to assess before administering methotrexate at high doses?

Accepted Answer

Renal function (BUN and creatinine)

Answer

Serum glucose

Answer

Serum potassium

Answer

Liver enzymes only

Question 3

Leucovorin (folinic acid) rescue is given after high-dose methotrexate to:

Accepted Answer

Rescue normal cells from methotrexate toxicity by bypassing dihydrofolate reductase inhibition

Answer

Increase the antitumor effect of methotrexate

Answer

Reduce methotrexate levels in the cerebrospinal fluid

Answer

Reverse renal failure caused by methotrexate

Question 4

A patient on vincristine reports difficulty walking and tingling in the hands and feet. The nurse should recognize this as:

Accepted Answer

Peripheral neuropathy, a dose-limiting toxicity of vincristine

Answer

Bone marrow suppression

Answer

A sign of extravasation at the infusion site

Answer

Hypercalcemia related to the malignancy

Question 5

Before administering bleomycin, the nurse should assess for which pre-existing condition that represents an absolute contraindication?

Accepted Answer

Severe pulmonary dysfunction

Answer

Hypertension

Answer

Mild renal insufficiency

Answer

History of peptic ulcer disease

Question 6

The nurse is preparing cyclophosphamide IV. Which measure is MOST important to prevent hemorrhagic cystitis?

Accepted Answer

Administer mesna and ensure vigorous IV hydration

Answer

Premedicate with allopurinol

Answer

Monitor serum creatinine hourly

Answer

Administer furosemide before the infusion

Question 7

When a patient is receiving 5-fluorouracil (5-FU) by continuous infusion and develops severe mucositis and hand-foot syndrome, which action should the nurse take FIRST?

Accepted Answer

Hold the infusion and notify the oncologist immediately

Answer

Increase the infusion rate to complete the dose faster

Answer

Apply ice to the affected areas and continue the infusion

Answer

Administer additional antiemetics