CPHON Chemotherapy Administration and Safety 2 — Questions and Answers
Question 1: Which chemotherapy class works by cross-linking DNA strands to prevent cell replication?
- Antimetabolites
- Alkylating agents (Correct answer)
- Topoisomerase inhibitors
- Vinca alkaloids
Correct answer: Alkylating agents
Alkylating agents attach alkyl groups to DNA, causing cross-links that prevent strand separation and halt replication.
Question 2: When administering L-asparaginase, the nurse's PRIORITY assessment is monitoring for:
- Alopecia
- Anaphylaxis (Correct answer)
- Mucositis
- Constipation
Correct answer: Anaphylaxis
L-asparaginase is a protein derived from bacteria and carries a significant risk of hypersensitivity or anaphylactic reactions.
Question 3: A pediatric patient is receiving continuous infusion of 5-fluorouracil. Which assessment finding warrants immediate notification of the provider?
- Mild nausea
- Chest pain and cardiac arrhythmia (Correct answer)
- Temporary hair thinning
- Low-grade fever of 37.8°C
Correct answer: Chest pain and cardiac arrhythmia
5-fluorouracil can cause coronary vasospasm and cardiotoxicity, making chest pain and arrhythmias a medical emergency.
Question 4: What is the recommended maximum cumulative lifetime dose of doxorubicin in pediatric patients to minimize cardiotoxicity?
- 100 mg/m²
- 200 mg/m²
- 450–550 mg/m² (Correct answer)
- 1,000 mg/m²
Correct answer: 450–550 mg/m²
The cumulative lifetime dose of doxorubicin is generally capped at 450–550 mg/m² to reduce the risk of cardiomyopathy.
Question 5: A child is prescribed bleomycin as part of a lymphoma protocol. Which baseline test is MOST important before starting therapy?
- Echocardiogram
- Pulmonary function tests (Correct answer)
- Renal ultrasound
- Bone marrow biopsy
Correct answer: Pulmonary function tests
Bleomycin causes pulmonary fibrosis; baseline pulmonary function tests help detect early lung toxicity during treatment.
Question 6: Which chemotherapy agent is classified as a topoisomerase II inhibitor and requires cardiac monitoring?
- Vincristine
- Etoposide (Correct answer)
- Cytarabine
- Busulfan
Correct answer: Etoposide
Etoposide inhibits topoisomerase II, which can cause secondary leukemia and requires monitoring for hypotension during infusion.
CPHON Chemotherapy Administration and Safety 2
Which chemotherapy class works by cross-linking DNA strands to prevent cell replication?