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

Aggressive IV hydration with normal saline before and after cisplatin is standard practice to dilute the drug in the kidneys and protect against nephrotoxicity.

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

High-dose methotrexate is renally excreted; impaired kidney function causes drug accumulation leading to severe mucositis, myelosuppression, and organ toxicity.

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

Leucovorin provides a reduced folate that bypasses the methotrexate-blocked enzyme dihydrofolate reductase, protecting normal cells from folate depletion toxicity.

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

Vincristine causes peripheral neuropathy as its primary dose-limiting toxicity due to its mechanism of inhibiting microtubule formation in nerve cells.

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

Bleomycin causes pulmonary fibrosis and is contraindicated in patients with severe pre-existing pulmonary dysfunction because it can cause fatal respiratory compromise.

ONCC - Oncology Nursing Certification Corporation Practice Test

ONCC - Oncology Nursing Certification Corporation Practice Test

ONCC Chemotherapy Administration and Safety 2