Chemotherapy Competency Quiz 2

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| By Mtoupe
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Mtoupe
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Quizzes Created: 4 | Total Attempts: 2,858
Questions: 10 | Attempts: 152

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Chemotherapy Competency Quiz 2 - Quiz

Most of these questions came directly from a OCN practice quiz from the ONCC site. The beauty of it was I had to acturally take the quiz to get the answers. Great learning experience for me and I hope for you too. Open book, open discussion with your co-workers. Turn in your answers by noon on Friday to be eligible for drawing.


Questions and Answers
  • 1. 

    The pre-medication volume in the labeled syringe does not appear be contain the volume of drug expected.  What is the correct action.

    • A.

      Say nothing and use the drug. Its close enough.

    • B.

      Ask the dispensing nurse to re-verify and re-dispense as indicated. If it is a recurring problem notify your supervisor.

    • C.

      Get a vial of the drug from the mixing room and adjust the dose yourself.

    • D.

      Refuse to use the drug at all. Tell the dispensing nurse you dont trust her/him.

    Correct Answer
    B. Ask the dispensing nurse to re-verify and re-dispense as indicated. If it is a recurring problem notify your supervisor.
    Explanation
    The correct action in this situation is to ask the dispensing nurse to re-verify and re-dispense the medication as indicated. If this is a recurring problem, it is important to notify a supervisor. This is the appropriate course of action because it ensures that the correct medication dosage is administered and addresses any potential issues with the dispensing process. Refusing to use the drug or questioning the trustworthiness of the nurse are not productive solutions and may not address the underlying problem.

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  • 2. 

    A patient with small cell lung cancer has a four-pound weight gain, headache, and excessive thirst.  These symptoms indicate:

    • A.

      Tumor lysis syndrome

    • B.

      Hemolytic uremic syndrome

    • C.

      Neoplastic cardiac tamponade

    • D.

      Syndrome of inappropriate antidiuretic hormong

    Correct Answer
    D. Syndrome of inappropriate antidiuretic hormong
    Explanation
    Small cell lung cancer accounts for 80% of syndrome of inappropriate antidiuretic hormone syndrome (SIADH) cases. Signs and symptoms include thirst, weight gain, lethargy, headache, anorexia, muscle cramps, and weakness.

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  • 3. 

    A patient newly diagnosed with cancer tells the nurse, "The doctor ordered all of these tests for clinical staging.  What does that mean?" The nurse's best response is based on the knowledge that staging:

    • A.

      Predicts response treatment

    • B.

      Compares treatment results across populations.

    • C.

      Assesses the usual patterns of spread of specific cancers.

    • D.

      Evaluates the extent of local and potential metastatic disease.

    Correct Answer
    D. Evaluates the extent of local and potential metastatic disease.
    Explanation
    The primary purpose for staging is to provide optimal treatment selection and planning for each individual patient. Staging systems include clinical, surgical, pathology, and biochemical determinants to define the extent of disease and direct treatment of the individual. Staging does not directly predict response to treatment, assess patterns of spread, nor compare results across a population.
    Ref ONCC

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  • 4. 

    A patient receiving hospice care is refusing to take prescribed opiates and tells the nurse "pain is a part of life".  The initial ste

    • A.

      Explore the meaning of pain with the patient

    • B.

      Refer the patient to the chaplain

    • C.

      Schedule a visit with a CanSurmount volunteer

    • D.

      Request an evaluation from the pain service.

    Correct Answer
    A. Explore the meaning of pain with the patient
    Explanation
    It is useful to assess the meaning of the pain to the patient and family. Pain may be perceived as a punishment, and the nurse needs to help reframe this perception to provide comfort..

    Ref ONCC

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  • 5. 

    A patient receiving doxorubicin through a peripheral IV catheter reports burning at the site, but there is no notable swelling.  The nurse's first action is to:

    • A.

      Stop the administration of the drug

    • B.

      Flush with 10 ml of 0.9% normal saline

    • C.

      Reposition the patient's arm

    • D.

      Continue the administration while observing the site.

    Correct Answer
    A. Stop the administration of the drug
    Explanation
    Doxorubicin is a vesicant, meaning it can cause tissue damage. Pain and burning at the IV site is an immediate manifestation of extravasation. Administration of the drug should be stopped at the first sign of infiltration.

    Ref ONCC
    Ref: ONCC

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  • 6. 

    A patient is ordered opiates around the clock for pain control.  Prior to initiating opioid therapy, the nurse anticipates an order for:

    • A.

      Bulk laxatives.

    • B.

      Suppositories

    • C.

      Stimulant laxatives.

    • D.

      Oral mineral oil

    Correct Answer
    C. Stimulant laxatives.
    Explanation
    Opioids can delay gastric emptying, slow bowel motility, decrease peristalsis, and reduce secretions from the colonic mucosa. Constipation is the most common side effect of opioids and the only one for which individuals do not develop tolerance. Prevention, rather than treatment, op opioid side effects is important. Stimulant laxatives plus a stool softener is recommended when initiating opioid therapy.

    Ref ONCC

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  • 7. 

    Which of the following medications can cause increased sedation when administered with opiods?

    • A.

      Chlorpromazine

    • B.

      Ibuprofen

    • C.

      Naloxone

    • D.

      Prednisone

    Correct Answer
    A. Chlorpromazine
    Explanation
    Phenothiazines can potentiate the sedative effects of opiates. Nonsteroidal anti-inflammatory agents (NSAIDs) such as ibuprofen do not cause sedation. Naloxone antagonizes opioids, and prednisone can cause hyperexcitability and insomnia.

    Ref ONCC

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  • 8. 

    In addition to decreasing inflammation, corticosteroids:

    • A.

      Improve muscle tone

    • B.

      Stimulate weight loss

    • C.

      Stimulate the appetite.

    • D.

      Reduce anxiety.

    Correct Answer
    C. Stimulate the appetite.
    Explanation
    Corticosteroids, such as dexamethasone and prednisone can stimulate the appetite. Additionally, this class of medications can create a sense of well-being, and may cause weight gain.

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  • 9. 

    A 62 year old patient with CD33 positive acute myeloid leukemia in first relapse presents with a left ejection fraction of 40%.  The nurse anticipates any order for

    • A.

      Gemtuzumab ozogamicin.

    • B.

      All-trans retinaic acid.

    • C.

      Cytarabine

    • D.

      Rituximab

    Correct Answer
    A. Gemtuzumab ozogamicin.
    Explanation
    Gemtuzumab ozogamicin (Mylotarg) is used for the treatment of relapsed CD33-positive acute myeloid leukemia in patients greater that or equal to 60 years of age, who would not be considered candidates for cytotoxic chemotherapy.

    Ref ONCC

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  • 10. 

    A patient in remission complains of dysthymic behaviors for the past several weeks.  The nurse knows to assess for

    • A.

      Recurrence of disease

    • B.

      Cognitive learning

    • C.

      Bowel habits

    • D.

      Depression

    Correct Answer
    D. Depression
    Explanation
    Evidence suggests 25% of people with cancer have depression, and depressed people have poorer outcomes. Therefore, nurses need to assess for depression.

    Ref ONCC

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