CPHON Chemotherapy Administration and Safety 1 — Questions and Answers
Question 1: Which personal protective equipment (PPE) is MOST important when administering intravenous vesicant chemotherapy to a pediatric patient?
- Surgical mask only
- Double gloves and a gown (Correct answer)
- Face shield only
- Standard gloves only
Correct answer: Double gloves and a gown
Double gloves and a gown are required when handling vesicant chemotherapy agents to protect the nurse from skin exposure.
Question 2: A child receiving vincristine develops jaw pain and peripheral tingling. The nurse recognizes these as signs of:
- Hypersensitivity reaction
- Peripheral neuropathy (Correct answer)
- Tumor lysis syndrome
- Extravasation
Correct answer: Peripheral neuropathy
Vincristine is a known neurotoxin; jaw pain and peripheral tingling are hallmark signs of vinca alkaloid-induced peripheral neuropathy.
Question 3: When preparing to administer intrathecal chemotherapy to a child, which action is MOST critical?
- Use a 20-gauge needle
- Verify the drug with a second licensed nurse (Correct answer)
- Warm the solution to body temperature
- Administer via rapid IV push
Correct answer: Verify the drug with a second licensed nurse
Intrathecal chemotherapy must be verified by two licensed nurses because errors can be immediately life-threatening.
Question 4: A nurse notices swelling and burning at a child's IV site during doxorubicin infusion. The FIRST action should be:
- Slow the infusion rate
- Stop the infusion immediately and disconnect the IV (Correct answer)
- Apply a warm compress
- Flush the line with normal saline
Correct answer: Stop the infusion immediately and disconnect the IV
Stopping the infusion immediately and disconnecting the IV prevents further tissue exposure to the vesicant agent.
Question 5: Which chemotherapy agent requires prehydration and mesna to prevent hemorrhagic cystitis?
- Methotrexate
- Ifosfamide (Correct answer)
- Cytarabine
- L-asparaginase
Correct answer: Ifosfamide
Ifosfamide is metabolized to acrolein, which is toxic to the bladder; mesna binds acrolein and prehydration dilutes it.
Question 6: A child on high-dose methotrexate has a serum methotrexate level of 10 micromol/L at 24 hours. The nurse should anticipate administering:
- Dexrazoxane
- Leucovorin rescue (Correct answer)
- Rasburicase
- Filgrastim
Correct answer: Leucovorin rescue
Leucovorin (folinic acid) is the rescue agent for methotrexate toxicity, bypassing the enzyme methotrexate inhibits.
CPHON Chemotherapy Administration and Safety 1
Which personal protective equipment (PPE) is MOST important when administering intravenous vesicant chemotherapy to a pediatric patient?