Download Oncology Quick Reference: Cancer Treatments and Side Effects and more Exams Nursing in PDF only on Docsity!
Oncology certification Exam 230 Questions with Verified
Answers
Amifostine - CORRECT ANSWER Protects lungs from pneumonitis/radiation protective. Radioprotector. Prevenge - CORRECT ANSWER Vaccine that boosts immune response to cancer cells. For metastatic prostate ca. Alkylating agents - CORRECT ANSWER Damage DNA to prevent ca cells from reproducing. Not phase specific. Use to tx: leukemia, lymphoma, Hodgkins, MM, sarcoma, lung, breast &a ovary. I.e. Nitrogen mustard, cyclophos., nitrosoureas, Dacarbazine. Antimetabolites - CORRECT ANSWER Interfere with DNA and RNA growth by substituting the normal building blocks of RNA & DNA. Damage cells during the s phase. used to treat leukemia, breast, ovary, interstitial tract. cell cycle specific. 6 mercaptopurine (6-no) - CORRECT ANSWER Antimetabolite. Cladribine - CORRECT ANSWER Antimetabolite. Given for HC leukemia, CLL, NHL. S/E decreased WBC, infection, fever, N/V, TLS. Capecitabine - CORRECT ANSWER Antimetabolite Clafarabine - CORRECT ANSWER Antimetabolite Floxuribine - CORRECT ANSWER Antimetabolite Gemcitabine - CORRECT ANSWER Nitrogen mustard - CORRECT ANSWER Non-platin. Alkylating agent. Mechlorethamine, chlorabucil, cyclophosphamide, ifosphamide, & melphalon. Vesicant Nitrosourea - CORRECT ANSWER Streptococin, carmustine, limustine.
Non-platin. Alkylating agent. Alkyl sulfonate - CORRECT ANSWER Busulfan. Alkylating agent, non-platin. Thiazines - CORRECT ANSWER Dacarbazine (DTIC) & temozolomide. Alkylating agent, non-playing. ethylenimines - CORRECT ANSWER Thiotepa & altretamine (hexmethylmelamine) alkylating agent/ non-platin Carboplatin - CORRECT ANSWER Interferes with DNA replication, RNA transcription & nucleus acid function. Cell cycle non specific. alkylating agent. Given for ovarian, endometrial, lung, H&N. Irritant. N/V, bronchospasm, Hypotention, thrombocytopenia, TLS. Cisplatin - CORRECT ANSWER Alkylating agent. Interferes with DNA replication/rNA transcription & nuclei acid fx. Treatment for lung, H&N, c RBI all ca. s/e myelosuppression, N/V/D, ottotoxicity, anaphylaxis, facial edema, bronchospasms, tachycardia, Cumulative renal toxicity severe, TLS Oxalplatin - CORRECT ANSWER Alkylating agent. Irritant. Interferes with DNA replication/RNA transcription and nucleus acic fx. Avoid cold. S/e: N/V/D & neuropathy. Platins - CORRECT ANSWER Alkylating agents. interfere with DNA replication/RNA transcription & nucleic acid fx! Cell cycle non specific. Emergencies - CORRECT ANSWER Oncology Vesicants - CORRECT ANSWER Doxorubicin, nitrogen mustard, mitomycin DNA binding vesicants - CORRECT ANSWER Anthracyclines, doxorubicin, nitrogen mustard and mitomycin. Bind to nucleus acids of DNA in healthy cells causing cell death. This causes the cells to release extra cellular substances that get taken up early by cells. As it remains & circulates the cycle continues.
Irinotecan(Camptosar) - CORRECT ANSWER Irritant. Atropine to prevent severe diarrhea. s/e: abdominal cramping, N/V/D, dizziness, H/A, mucositis, alipecia. Ofatumumab(Arzerra) - CORRECT ANSWER Monoclonal antibody. Flu like symptoms, H/a, weakness, fever, N/V, cough, chills, hives, itching, chest pressure, SOB. Paclitaxel - CORRECT ANSWER Mild vesicant. Increased hypersensitivity Rd. If Rd don't re challenge. Vincristine - CORRECT ANSWER Vesicant. Fatal if given intrathecally. ANC - CORRECT ANSWER %polys+%bandsxWBC/ Bleomycin - CORRECT ANSWER Nonanthracyclne antitumor antibody. Irritant. Pulmonary fibrosis if lifetime dose > 400 units. S/e: hypersensitivity, skin/fingernail changes, mouth sores, at loss, alopecia, fatigue. Adjuvant therapy - CORRECT ANSWER Radiation used after therapy Neoadjuvent/induction - CORRECT ANSWER Before surgery either to improve cure rates or make surgery easier to perform. Brachiotherapy - CORRECT ANSWER Radiation delivered from sources placed inside the body. ALARA - CORRECT ANSWER The goal of radiation safety. As low as reasonable achievable. Xerostoma - CORRECT ANSWER Dry mouth resulting from radiation to salivary glands. Colony stimulating factors - CORRECT ANSWER Proteins that promote the production of RBCs, WBCs or PLTs. Used to tx myelosuppression (neutropenia, anemia, or thrombocytopenia)
WBC stimulants (granulocyte CSFs) - CORRECT ANSWER Fil grad Tim, pegfilgrastin. Trigger stem cells in bone marrow to produce more of a particular WBC. Stimulate hematopoietic development of granulocytes. Red blood cell stimulates for chemo induced anemia. - CORRECT ANSWER Erthropetin, epoetin-Alfa, darbepoetin. Stimulate stem cells to develops into RBCs, thereby increasing RBC production HGb/Hct levels! DIC - CORRECT ANSWER Activation of coagulation pathways, leading to thrombotic and hemorrhagic events. Conditions for which it occurs: sepsis, solid tumors, trauma, transfusion Rd, organ distraction, toxic rx's. Causes high production of fibrinogen can compromise blood supply to vital organs. 👆 fibrinogen. Infection is the most common underlying cause of rapid onset DIC. - CORRECT ANSWER APL is the most often associated with acute DIC. Bleeding that occurs simultaneously from at least 3 unrelated sites is a sign of DIC. - CORRECT ANSWER Chronic DIC - CORRECT ANSWER Minimal bleeding & diffuse thrombosis & is associated with solid metastic mucinous adenocarcinomas & tumors if the prostate, breast, stomach, lung & pancreas. Prostate most common. DIC laboratory findings - CORRECT ANSWER 👇PLT, 👇fibrinogen, 👇antithrombin, 👆FDP, D-diner & PT prolonged PR/PTT & INR. To of DIC - CORRECT ANSWER APL antineoplastics, Prostate- hormone therapy & infection-antibiotics. Chronic (anticoagulant, blood products) DIC - CORRECT ANSWER Chronic-minimal bleeding Acute DIC - CORRECT ANSWER Associated with infection Acute promyelocytic leukemia - CORRECT ANSWER Acute dissemenatedbintravascular coagulation.
TTP - CORRECT ANSWER Occurs in adults complications w/pregnancy; lupus; cancer, surgery & blood and bone marrow stem cell transplantation, hemorrhagic colitis secondary to infection from e-Coli. S/S of TTP - CORRECT ANSWER Purpura, petechia, pale skin/jaundice, fatigue, fever, tachycardia, tachyon was, oliguria, neuro changes. 👇rBC/PLTs, 👆bilirubin, Coombs neg, LDH 👆, ADAMSTS13 👇, proteinuria, hematuria 5 clinical laboratory findings key in D.C. Of TTP - CORRECT ANSWER Microangiopathic hemolytic anemic a, thrombocytopenia, renal dysfunction, fever, neurological changes. Tx of TTP - CORRECT ANSWER FFP replaces ADAMSTS13 & plasmapharesis removes antibodies S/S of TLS - CORRECT ANSWER Hyperkalemia Early sign of hyeprcalcemia - CORRECT ANSWER Confusion/restlessness Becks Triad - CORRECT ANSWER S/s of cardiac tamponad 👆CVP, hypotension, distant heart sounds. SIADH - CORRECT ANSWER Abnormal release of ADH in the presence of a normal similarity results in the reabsorption of too much water. Mild/chronic SIADH - CORRECT ANSWER Asymptomatic, muscle cramps, fatigue, anorexia/N/V thirst, h/a, sodium level 131-135 million/L Moderate SIADH - CORRECT ANSWER Wt gain, progressive neurological symptoms, lethargy, abdominal cramping. Oliguria, hypoactive reflexes. NA 126- 130 MMI/L. Severe SIADH - CORRECT ANSWER Cerebral edema, papiledema, ataxia, hypoactive reglflexes, seizures/psychosis, coma, death, Na < 120 mmi/L
SIADH labs - CORRECT ANSWER Na<130 mmi/L, K norm., bicarb norm., Phos. Norm or decreased BUN/Cr decreased, renal/thyroid fix norm. Tx of mild SIADH - CORRECT ANSWER Fluid restriction, to underlying malignancy, democycline Tx of moderate SIADH - CORRECT ANSWER Stabilize neurological symptoms, fluid restriction, cont to malignancy, hydration Tax of severe SIADH - CORRECT ANSWER ICU, hypertonic Saline, neurological monitoring, seizure precautions, loop diuretics, vasopressin-receptor antagonists. Ca - CORRECT ANSWER 8.4-10. Mg - CORRECT ANSWER 1.6-2. K - CORRECT ANSWER 3.5-5. Na - CORRECT ANSWER 137-145: Adjuvant chemo - CORRECT ANSWER Postoperatively, where surgery is the main tax, but chemo is given after surgery with the intent to cure or control disease. Multimodal therapy - CORRECT ANSWER In combination with other therapies such as radiation. Cell cycle GO phase - CORRECT ANSWER Resting stage. Cells have not started dividing. Cell cycle G1 - CORRECT ANSWER Cell starts making proteins & growing larger, so the new cells will be of normal cells. Cell cycle S phase - CORRECT ANSWER The chromosomes containing genetic code (DNA) are copied, so both the new cells formed will have matching strands of DNA.
Cardiotoxic - CORRECT ANSWER (cyclophosphamide, anthracyclines). May cause cardiomyopathy and symptoms of CHF, pericardial infusion & tamponade. Have been noted after high doses of Cyclophosphamide. Supra ventricular tachycardia - CORRECT ANSWER May occur after infusion of stem cells. Bacterial and fungal infections have caused endocarditis. Complimentary tx - CORRECT ANSWER A non mainstream therapy combined with conventional medicine. Alternative tx - CORRECT ANSWER A non mainstream therapy used instead of conventional. Conventional - CORRECT ANSWER Therapies that historically have had a widespread use in Western med. Neurotoxicity agents - CORRECT ANSWER Cisplatin, vincristine, taxanes Risk factors for osteoporosis - CORRECT ANSWER Ifosfamide, methotrexate, stem cell tax, premature menopause Cytokine - CORRECT ANSWER Hormone-like proteins with molecular wt. that are secreted by various cell types, which regulate the intensity & duration of immune response & mediate cell-to-cell communication. Brachytherapy - CORRECT ANSWER Radiation delivered from radiation sources placed inside or on the body radioactive isotopes are sealed in pellets or seeds & placed in pt's using needles, catheters or some type carrier. Can be temporary. PlISSIT - CORRECT ANSWER Permission, Limited information, specific suggestions, intensive therapy.
BETTER model - CORRECT ANSWER Bring up the topic, explain sexuality as a part of quality of life, tell the PT about appropriate resources, timing, educate about side effects, record in PT record. Men fertility preservation - CORRECT ANSWER Sperm banking, gonadal radiation shielding, intrauterine insemination, sperm injection, testicular sperm electroejaculation, donor sperm, meds Women fertility preservation - CORRECT ANSWER Embryo conservation, ovarian transportation, oocytevcryopreservation, gonadal radiation shielding, ovarian tissue cryopreservation, fertility procedures, donor ova/oocyte, donor embryo, surrogacy Developmental task-young/old - CORRECT ANSWER Establishing new life goals after retirement increased marital satisfaction. development of comorbid conditions. Interruption of life plans. Decreased sense of security for future. Emotional distress in spousal caregiver. Old-old developmental task - CORRECT ANSWER Experience physical, social, psychological, and economic changes. Demands on individuals ability to respond to changes in health. tend to minimize degree of threat from illness. NCCN distress thermometer - CORRECT ANSWER Quick & easily interpreted tool to determine the need for referral for additional evaluation and services. Adavnced directives - CORRECT ANSWER Legal documents that state a pt's wishes regarding medical decisions & may give specific details about how they would like to die. Living will - CORRECT ANSWER Controls specific future healthcare decisions when an individual is unable to make his or her own wishes known. They must have a terminal D.C. Or be in a persistent veggitative state. Describes specific txs: dialysis, DNA, DNA & preferences on organ donation. Hospice - CORRECT ANSWER Interdisciplinary care of pt's & families when a PT has an illness for which the prognosis is expected to be 6 months or less & when the focus of care is on comfort-oriented approaches.
Tumor grading G2 - CORRECT ANSWER Moderately differentiated/intermediate- grade Tumor grading G3 - CORRECT ANSWER Poorly differentiated/high-grade Tumor grading G4 - CORRECT ANSWER Undifferentiated/ high grade Beast ca - CORRECT ANSWER Uses Nottingham score derived by evaluating tubule formation, nuclear grade and notification rate Gleason score - CORRECT ANSWER Used to grade prostate ca. Based off of how the tumor tissue is organized, through 2 patterns TNM - CORRECT ANSWER The American Joint Committee on Ca uses TNM staging system T tumor size, N node involvement, M metastisi The first step in the development of ca is know as - CORRECT ANSWER Initiation Which type of gene promotes apoptosis - CORRECT ANSWER Tumor suppressor gene When a mutation occurs and tumor suppressor genes are inactivated, they - CORRECT ANSWER Become inactive and are unable to stop cell division 58 y/o retired who worked for fertilizer plant, but developed COPD. His dad and brother died of prostate ca and mom is a breast can survivor. He has recently been diagnosed with Ca. His ca is most likely to have developed from - CORRECT ANSWER An acquired mutation. Antigens - CORRECT ANSWER Foreign Substances in the immune system that trigger an immune response. Immune surveillance - CORRECT ANSWER Immune system can recognize and destroy cancer cells.
Innate immune - CORRECT ANSWER Occurs naturally and uses phagocytosis cells that release inflammatory mediators and natural killer cells. Aquired immunity - CORRECT ANSWER Involves antigen specific B and T lymphocytes in response to specific antigens or foreign proteins. Has memory that allows each response to the same antigen to be improved at each encounter. Further broken into Humoral and cell mediated. Humoral - CORRECT ANSWER Immune response is mediated by antibodies, which are secreted by plasma cells or transformed Blymphocytes, following exposure to an antigen. Once these antibodies bind to an antigen they are destroyed. Cell mediated - CORRECT ANSWER Immunity is mediated by T lymphocytes that can either induce cell death that express antigens or activate cells used in innate processes. Myeloid cells - CORRECT ANSWER Differentiate into monocytes, neutrophils, eosinophils, base, mast, and macrophages. Helpful respond to infection. Lymphoid cells - CORRECT ANSWER Differentiate into lymphocytes which include T & B cells or phagocytes T cells - CORRECT ANSWER Mature in the thymus gland. Responsible for killing infected cells & also communicating to other key components of the immune system. B cells - CORRECT ANSWER Secrete antibodies in response to recognizing foreign proteins or antigens. Natural killer cells - CORRECT ANSWER Attack any type of foreign body. These cells produce strong chemicals that bind to the foreign body without need to assess the antigen. The genetic information no discrimination act - CORRECT ANSWER Federal law passed to protect citizens with an inherited disorder from being treated unjustly because of their genetic make up.
Causes of anemia in cancer - CORRECT ANSWER Multiple origins such as frank bleeding, renal insufficiency, hemolysis, or chronic anemia. Cancer may directly exacerbate anemia by suppression of hematopoiesis or by cytokine production that kills red blood cells prematurely. Tumors may cause chronic blood loss, chemo causes myelosuppressive effects, and radiation can cause myelosuppression. S/s of anemia - CORRECT ANSWER Decreased activity tolerance, mild SOB, increased fatigue Moderate to severe anemia - CORRECT ANSWER Cardio effects(murmurs, tachycardia,dysthymias, postural hypotension), pulmonary effects (dyspnea, hypoxia, tachypnea, pulmonary edema) Genitourinary(h2o retention, menorrhagia or amenorrhea, impotence and proteinuria) central nervous system( h/a's dizziness, confusion, inability to concentrate, irritability, ataxia, weakness, retinal hemorrhage and loss of sensation) GI (indigestion, decreased motility, as cites, stomatitis, hepatosplenomegaly, blood loss) musculoskeletal (bone pain) integumentary (pale skin, poor skin turgor, hair loss, brittle nails, ecchymosis, poor wound healing, cyanosis , hyperthermia and edema Lab anemia - CORRECT ANSWER GR 1- (mild) hgb 10 GR 2 (mod) hgb 8- GR 3 severe hgb 6.5- GR 4 life threatening GR 5 death Mgmt of anemai - CORRECT ANSWER RBC transfusion Erythropoietic therapy Neutropenia - CORRECT ANSWER Decrease in # of circulating neutrophils Causes of neutropenia - CORRECT ANSWER Abnormal production Abnormal function Infection Side effect of drug
ANC - CORRECT ANSWER =%neutrophils (bands+segs) x WBC Granulocytes - CORRECT ANSWER Neutrophils most common 60%. 1st cells to respond to infection S/s of neutropenia - CORRECT ANSWER Fever (100.4) Fever with chills Vascular device access tenderness Cough Dysuria Mucositis Diarrhea Perirectal pain Changes in mental status Febrile neutropenia - CORRECT ANSWER Fever >100. Thrombocytopenia - CORRECT ANSWER Platelet count <150, 1/3 of platelets - CORRECT ANSWER Stored in the spleen Innate response - CORRECT ANSWER Generic immune response to antigens Adaptive response - CORRECT ANSWER Secondary line of defense (T-cell: cell mediated immunity) B cell: Humoral immunity) Lymphedema - CORRECT ANSWER Obstruction of the lymphatic system, causing a fluid collection of excess interstitial fluid, water bacteria, and cellular waste in the interstitial spaces Oral Mucositis (stomatitis) - CORRECT ANSWER Inflammation and ulceration of the oral mucosa Xerostomia - CORRECT ANSWER Subjective feeling of dryness in the mouth Cisplatin and delayed CINV - CORRECT ANSWER 80% experience
True about health care proxies - CORRECT ANSWER Proxies cannot be physicians, nurses or other health care providers unless the person is a close relative Which statement is true r/t spirituality in the cancer survivor? - CORRECT ANSWER Religiosity and spirituality in cancer patients and survivors is difficult to measure (due to how these terms are uniquely individualized) Which agency established an accreditation standard for requiring screening psychosocial concerns at least once during cancer care and documented guidelines for tx or referral for all cancer centers in the USA - CORRECT ANSWER The American College of surgeons commission on cancer (2011) What types of cancer develop from acquired mutations - CORRECT ANSWER Sporadic cancer The general oncology nurses role in genetic testing includes - CORRECT ANSWER Performing risk assessments that include personal, occupational, and family risk factors Primarily determines the nursesscope of practice from a legal perspective - CORRECT ANSWER Nursing practice Act in their state of residence/licensure According to the WHO Analgesic ladder which medication should be avoided due to CNS toxicity - CORRECT ANSWER Meperidine (Demerol)! Risk factors for cardiac tamponade - CORRECT ANSWER Malignancies to the chest (lung cancer and mets 80% of cases) , lymphatic dysfunction of the chest, HIV, hematologic malignancies, radiation therapy, chemo (high dose) , infections Hypercalcemia of malignancy - CORRECT ANSWER High risk! Solid tumor cancers ( breast and squamous cell lung) compromise more than 1/2 followed by MM. Others are T cell lymphoma, Hodgkin lymphoma and other types of non Hodgkin lymphoma. Rare in mets to the bone (prostate and small cell lung)
Type of oncologic pain syndrome resulting in tight, burning pain in the surgical site with dysesthesias and shock like pains - CORRECT ANSWER Post radical neck dissection Peripheral Neuropathy - CORRECT ANSWER Drugs which can cause: Cisplatin, vincristine, taxanes Paresthesia - CORRECT ANSWER Pins and needles Hyperesthesia - CORRECT ANSWER Abnormal increase in sensitivity to stimuli of the sense Hypoasthesia - CORRECT ANSWER An unusually reduced sensitivity to touch Dysesthesia - CORRECT ANSWER Painful neuro stim Chemo associated with PN - CORRECT ANSWER Cisplatin, (cumulative-dose related, majority will fully recover), Oxaliplatin (pharyngo-laryngo-dyesthesia aggravated by cold, dyesthesia of hands and feet, feeling of jaw tightening, feeling of loss of breath) Taxanes, (increases with cumulative doses) Vinca Alkaloids, Proteasome Inhibitors (velcade) Lhermitte's sign - CORRECT ANSWER "Lightening-like sensation" r/t PN DEXA scan - CORRECT ANSWER Specialized x-ray that can measure bone mineral density Osteolytic lesions - CORRECT ANSWER Common in MM, lung, thyroid, breast, and kidney Osteoblastic lesions - CORRECT ANSWER Common in prostate and breast Tx Neuropathic pain - CORRECT ANSWER Tricyclic Antidepressants, CA channel alpha-2-ligands (gabapentin) Topical therapy Nociceptive pain - CORRECT ANSWER Nonopiod analgesics Opioid analgesics
