CPHON Exam 195 Questions with Verified Answers,100% CORRECT

CPHON Exam 195 Questions with Verified Answers Classification of Methotrexate - CORRECT ANSWER antimetabolite (s-phase) Classification of mercaptopurine and thioguinine - CORRECT ANSWER antimetabolite(s-phase) Classification of fludarabine/nelarabine - CORRECT ANSWER anti-metabolite Classification of cytarabine/gemcitabine - CORRECT ANSWER antimetabolite Classification and sub-class of ironotecan/topotecan - CORRECT ANSWER Topoisomerase inhibitors (campotothecins) Classification and subclass of etoposide/teniposide - CORRECT ANSWER Topoisomerase inhibitors (epipodophyllotoxins) Classification and subclass of VCR, vinblastine, vinorelbine - CORRECT ANSWER Tubulin inhibitors (plant derivates)/ vinca alkaloids Classification & subclass of Paclitaxel/docetaxel - CORRECT ANSWER tubulin inhibitors (plant derivative)/ taxanes What cell cycle is affected by bleomycin - CORRECT ANSWER G2 Drug class of bleomycin - CORRECT ANSWER Antibiotic Hydroxyurea is targetting what phase of the cell cycle - CORRECT ANSWER S phase Classification of Cyclophosphamide - CORRECT ANSWER alkylating agent Classification of Ifosphamide - CORRECT ANSWER alkylating agent Classification of Melphalan - CORRECT ANSWER alkylating agent classification of carmsutine - CORRECT ANSWER alkylating agent classification of busulfan - CORRECT ANSWER alkylating agent classification of thiotepa - CORRECT ANSWER alkylating agent classification of cisplatin/carboplatin - CORRECT ANSWER alkylating agent Class & subclass of dauno/doxo-rubicin - CORRECT ANSWER Topoisomerase inhibitor (anthracycline) What phase of the cell cycle is asparaginase - CORRECT ANSWER G and S phase What drug class is dactinomycin - CORRECT ANSWER Antibiotic What chemo drugs can cause radiation recall - CORRECT ANSWER Dactinomycin What types of chemos are most likely to cause a secondary malignancy like AML - CORRECT ANSWER Alkylating agents What is the most reliable test for diagnosing paroxysmal nocturnal hemoglobinuria - CORRECT ANSWER High resolution flow cytometry (replaced acid ham and sucrolse lysis test) When do hemophilia factors develop - CORRECT ANSWER During the first 50 exposures, often after the first 10 treatments What is the gold standard to diagnosing iron overload - CORRECT ANSWER Liver biopsy What are the signs and symptoms of PRES (posterior reversible encephalopathy syndrome) - CORRECT ANSWER Headaches, visual disturbances, seizures, altered consciousness What electrolyte should be monitored with cisplatin - CORRECT ANSWER Magnesium Neuro cognitive effects are late effects of what chemotherapy - CORRECT ANSWER Methotrexate and ARAC What is a side effect of DDAVP - CORRECT ANSWER Hyponatremia so should limit fluid intake for 24 hours How does desmopressin help treat bleeding disorders - CORRECT ANSWER Nonreplacement therapy that stimulates a rise in circulating vWf What sodium level indicates late SIADH (syndrome of inappropriate anti diuretic hormone)? - CORRECT ANSWER </ 120 When can immunizations be resumed in leukemia - CORRECT ANSWER 3-12 months after completion of treatment Chemo agents can be used to treat which blood disorder -sickle cell -hereditary spherocytosis -autoimmune hemolytic anemia -G6PD deficiency - CORRECT ANSWER Autoimmune hemolytic anemia refractory to other agents MERL acronym for clinical trials - CORRECT ANSWER 1. Max tolerated dose 2. Efficacy of new agent 3. Response overall and survival 4. Long term safety and efficacy Purpose of phase 1 clinical trial - CORRECT ANSWER Determine maximally tolerated dose Purpose of phase 2 clinical trial - CORRECT ANSWER Determine efficacy of new agent in treating cancer Purpose of phase 3 of clinical trial - CORRECT ANSWER Used to assess overall response, survival, and quality of life of newly diagnosed patient within the new treatment plan (2 arms**—-new vs established standard) Purpose of phase 4 of clinical trial - CORRECT ANSWER Further investigate long term safety and efficacy of testament that occurs after new treatment is approved for standard use What 2 organizations regulate clinical trials - CORRECT ANSWER FDA and institutional review board How long must clinical trial documents be kept - CORRECT ANSWER 7 years What information should be on an informed consent form - CORRECT ANSWER Study purpose and length, risks and benefits, alternatives Side effect of isotretinoin - CORRECT ANSWER Retinoid acid syndrome can occur 1-3 weeks after initiation of isotretinoin What's the first step to treat DIC in an APML patient - CORRECT ANSWER Fresh frozen plasma transfusion What are some genetic risk factors for renal tumors - CORRECT ANSWER Beckwith Wiedemann syndrome, aniridia, other overgrowth syndromes What is the hardest phase to kill cancer cells in - CORRECT ANSWER G0-resting phase How does retinoic acid treat APML - CORRECT ANSWER Brings about maturation of promuelocytic blasts and the rapid resolution of coagulopathy associated with treatment of APML. Improved remission rate and significant reduction in relapse rates What antigen does rituxan target - CORRECT ANSWER CD20 antigen on normal and malignant b lymphocytes in order to induce B cell lysis What medication can be used to prevent ototoxicity in cisplatin patients - CORRECT ANSWER Amifostine or thiosulfate What nerve pain symptoms can you see with VCR - CORRECT ANSWER loss of DTRs, jaw pain, constipation, ptosis, vocal cord paralysis What chemo agents have a cumulative lifetime dose - CORRECT ANSWER Anthracyclines relayed to cardiomyopathy (doxo, dauno, mitoxantrone) Bleomycin in relation to pulmonary side effects What test will you need frequently when on bleomycin - CORRECT ANSWER PFTs relayed to pulmonary fibrosis risk Late effect of steroids - CORRECT ANSWER Musculoskeletal effects, necrosis Mantle radiation can cause what type of Side effects/symptoms - CORRECT ANSWER Pneumonitis, dyspnea on exertion, non productive cough Radiation long term side effects - CORRECT ANSWER Growth retardation with TBI and spinal radiation When certain chemo agents are administered during radiation, what can occur - CORRECT ANSWER Radiation recall What types of chemo agents can cause radiation recall - CORRECT ANSWER Alkylators, taxanes, anthracyclines, antitumor antibiotics, anti metabolites, vinca alkaloids A decreased left ventricular function can potentiate if anthracyclines and what other treatment are combined - CORRECT ANSWER TBI What lab values do you monitor with amphotericin b - CORRECT ANSWER Bilirubin, ALT/AST (elevation) low K+ What's the reversal agent for midazolam (versed) - CORRECT ANSWER Flumazenil If the primary tumor has necrotic tissue around it, the initial intervention will be... - CORRECT ANSWER Surgical debridement If allergy to sulfamethoxazole trimethoprim, what do you use for PCP prophylaxis - CORRECT ANSWER Dapsone What do you use to treat c diff in an immunocpromised patient - CORRECT ANSWER Metronidazole (flagyl) What is the daily prophylactic medication against strep pneumoniae in sickle cell patients - CORRECT ANSWER Penicillin If a CVL with a red streak along the Catheter is present, what should you consider starting - CORRECT ANSWER Vancomycin relayed to infection potential What is the most effective drug for N/V or anorexia and why - CORRECT ANSWER Marinol because it binds to cannabinoid receptors which inhibits release of neurotransmitters they cause n/v What protects the thyroid during radiation treatment - CORRECT ANSWER SSKI—oral potassium iodide solution If a patient on antibiotics remains febrile for 3 days, what intervention should you consider next and why - CORRECT ANSWER CXR to look for lower lobe consolidation (fungal infection) What are the signs of DIC (labs) - CORRECT ANSWER Low platelets Prolonged PT/PTT high d dimer Low fibrinogen What chemo agent has a risk of thrombosis - CORRECT ANSWER Asparaginase Labs for tumor lysis syndrome - CORRECT ANSWER Increased Uric acid, phos, and potassium Decreased calcium What med can you give to treat tumor lysis (r/t calcium level) - CORRECT ANSWER Calcium gluconate Signs of typhlitis (infection of cecum) - CORRECT ANSWER Neutropenia, fever, RLQ pain, abdominal distention, high pitched or absent bowel sounds, N/V/D Symptoms/labs to look for with diabetes insipidus - CORRECT ANSWER Decreased ADH, increased diuresis, Polyuria, polydipsia, low SG Hypernatremia, hypokalemia Symptoms/labs for SIADH - CORRECT ANSWER Increased ADH, decreased urine output Thirsty; headache, muscle cramps Serum sodium below 130 What type of cancer is most likely to have SVC syndrome - CORRECT ANSWER NHL What are the symptoms of SVC - CORRECT ANSWER Facial edema, venous distention What type of chemo can cause seizures related to risk for SIADH - CORRECT ANSWER VCR With what chemo that infiltrate would you use HOT COMPRESS - CORRECT ANSWER VCR, VP16 (etop) With what chemos that infiltrate would you use COLD compress - CORRECT ANSWER Dauno, doxo, ida, dactinomycin Side effects of posterior fossa syndrome and when it occurs - CORRECT ANSWER Occurs: after posterior fossa surgery (24-48hr after) and can last 2-6 months SE: mutism, speech disturbance, dysphasia, decreased motor function, weakness, emotional lability, cranial nerve palsies Intermittent pain present for weeks to months before diagnosis. Pain worsens over time. Worse at night and with exercise. Dx? - CORRECT ANSWER Ewing's sarcoma Presents with leukocoria (cat eye reflex)—lack of normal red reflex or eye. Dx? - CORRECT ANSWER Retinoblastoma Hyperdiploidy is a good or bad prognostic factor for ALL? - CORRECT ANSWER Good Asymptomatic abdominal mass with hematuria or HTN or hemihypertrophy. Dx? - CORRECT ANSWER Wilms What is the most effective medication to treat CML - CORRECT ANSWER Imatinib mesylate (gleevac) If a hemophiliac falls and hits their head what do you do - CORRECT ANSWER Administer factor What is the most common childhood tumor - CORRECT ANSWER Brain tumor A patient presents with bruising, testicular swelling, and leg pain. Common Dx? - CORRECT ANSWER ALL Rhabdomyosarcoma—alveolar and undifferentiated cells....prognosis? - CORRECT ANSWER Poorest Rhabdomyosarcoma—botryoid and spindle cell....prognosis ? - CORRECT ANSWER Best Inheritance of hemophilia - CORRECT ANSWER Autosomal recessive (on the x) Inheritance of von Willebrand disease - CORRECT ANSWER Autosomal dominant Diagnostic test for autoimmune hemolytic anemia - CORRECT ANSWER Coombs test How does hydroxyurea help treat sickle cell - CORRECT ANSWER Increases fetal hemoglobin which inhibits polymerization of sickle hemoglobin Why are exchange transfusions used in treatment of sickle cell - CORRECT ANSWER Risk of stroke so exchange transfusions will reduce percent of hemoglobin s therefore reducing risk of stroke Treatment of choice for ITP - CORRECT ANSWER Steroids How do you treat hereditary spherocytosis - CORRECT ANSWER Splenectomy—allows RBCs to live longer so that during times of stress or infection, patient will not develop severe anemia Inheritance of thalassemia - CORRECT ANSWER Autosomal recessive caused by mutation in globin genes required for the synthesis of hemoglobin Describe venocclusive disease - CORRECT ANSWER Endothelial cell damage resulting in hepatocellular necrosis, fibrosis, and occlusion. Risk factors for getting VOD with BMT - CORRECT ANSWER Busulfan, radiation, pre existing liver disease, second transplant Why is ATGAM given to a BMT - CORRECT ANSWER To decrease risk of rejection by killing t lymphocytes Why is tacrolimus given to a BMT - CORRECT ANSWER Blocks activation of T cells Side effects of tacrolimus - CORRECT ANSWER Renal toxicity, HTN, mag wasting, hyperkalemia, seizures, gingival hypertrophy, hirsutism How do you calculate an ANC - CORRECT ANSWER [(% seg + % band ) x total WBC ] High eosinophil count can indicate what - CORRECT ANSWER An allergic response Autonomy - CORRECT ANSWER Duty to respect a patients right of self governance Beneficence - CORRECT ANSWER Duty to maximize benefits and enhance patients well being Monmaleficence - CORRECT ANSWER Duty to avoid causing harm and minimize harm to patient Justice - CORRECT ANSWER Duty to treat patients fairly and equitably How are red blood cells produced - CORRECT ANSWER Erythropoietin produced in kidneys in response to tissue hypoxia—> released into bloodstream—> bone marrow stimulated to make RBCs Normal PT - CORRECT ANSWER 12.6-15.9 Normal PTT range - CORRECT ANSWER 26-38 normal fibrinogen - CORRECT ANSWER 200-400 mg/dL Most common malignant tumor of the bone for kids - CORRECT ANSWER Osteosarcoma Diagnostic imaging of this cancer will show sunburst pattern - CORRECT ANSWER Osteosarcoma Which type of stem cell collection will result in fastest engraftment - CORRECT ANSWER Peripheral cell Which type of stem cell collection will result in least risk of gvhd - CORRECT ANSWER Cord blood What is the fastest growing tumor in humans - CORRECT ANSWER Burkitt lymphoma (NHL) Which type of bone tumor is radio resistant - CORRECT ANSWER Osteosarcoma Which type of bone Timor is a small round blue cell - CORRECT ANSWER Ewings Diagnostic test for which tumor will show moth eaten or onion skin appearance - CORRECT ANSWER Ewings Which subtype of rhabdo has the best prognosis - CORRECT ANSWER Botyroid/spindle cell Common site for rhabdo tumors in infants - CORRECT ANSWER Vagina/bladder Common site for rhabdo tumor in children under 8 - CORRECT ANSWER Head and neck tumors What type of brain tumor is a small round blue cell - CORRECT ANSWER Medulloblastoma What is the most common pediatric brain tumor - CORRECT ANSWER Astrocytoma What is the gold standard diagnostic test for brain tumors - CORRECT ANSWER MRI What are the triad symptoms of ICP - CORRECT ANSWER Morning headache, lethargy, n/v with relief of headache after throwing up Name this BM failure syndrome Sx: cafe au lait spots, missing thumbs, horseshoe kidney - CORRECT ANSWER Fanconi anemia Name this BM failure syndrome Sx: pancreatic insufficiency, FTT, webbed fingers and toes - CORRECT ANSWER Shwachman Diamond Syndrome What is the most common clinical presentation in von Willebrand - CORRECT ANSWER Mucocutaneous bleeding (nose bleed) What clinical trial phase would this be...to see if combination therapy is more effective than single agent chemo - CORRECT ANSWER Phase 3 What is an expected early complication of HPST -bronchiolitis -endocrine dysfunction -capillary leak syndrome -acute GVHD - CORRECT ANSWER capillary leak syndrome What type of disease would you give bevacizumab for? Give an example as well - CORRECT ANSWER Refractory solid tumors Ex. Astrocytoma What chemo can increase radio sensitivity of the liver -doxo -MTX -ARAC -topotecan - CORRECT ANSWER Doxorubicin What type of radiation is delivered via focused beam to a small well circumscribed area of the tumor - CORRECT ANSWER Stereotactic radio surgery What medication can be given to treat iron overload - CORRECT ANSWER Deferoxamine What are signs of precocious puberty - CORRECT ANSWER Advanced bone age & early breast development What complementary medicine can reduce severity of mucositis - CORRECT ANSWER Glutamine What type of pain is sharp, throbbing and worse with movement or weight bearing - CORRECT ANSWER Musculoskeletal What diagnosis would you assume for symptoms of painless adenoparhy, fatigue fever weight loss and night sweats - CORRECT ANSWER Hodgkin's lymphoma Anaplastic astrocytoma is what grade of tumor - CORRECT ANSWER 3 What's the appropriate diet order for a patient that you assume has pancreatitis - CORRECT ANSWER NPO and bowel rest What is the standard treatment for superior vena cava syndrome - CORRECT ANSWER Corticosteroids Most common bone tumor in children - CORRECT ANSWER osteosarcoma brain stem gliomas affect what cranial nerves - CORRECT ANSWER V-X prophylactic penicillin in SCD children should be given until what age - CORRECT ANSWER 3-5 years depending on what type of sickle cell or 1 year post splenectomy Post amputation pain is an example of what type of pain - CORRECT ANSWER neuropathic what is the fungal organism that causes PCP in immunocompromised kids - CORRECT ANSWER pneumocystis jiroveci moist desquamation can occur beginning at what radiation level - CORRECT ANSWER 50 Gy What are the 5 types of complicated grief - CORRECT ANSWER exaggerated masked delayed chronic disenfranchised cytogentic feature of burkitts lymphoma - CORRECT ANSWER translocation of B cell immunoglobulin genes What is the drug class of ondansetron - CORRECT ANSWER serotonin receptor antagonist How many stages of mucositis are there are what are they - CORRECT ANSWER 5 1. soreness & erythema 2. erythema and ulcers but still swallow 3. SEVERE: ulcers and extreme erythema 4. SEVERE: alimentation is not possible 5. healing why do you leuko-reduce blood products - CORRECT ANSWER to prevent transmission of CMV Survivors of what cancer have the most risk of the poorest quality of life - CORRECT ANSWER CNS tumors What physiological process of pain is described as changing or inhibiting pain impulses - CORRECT ANSWER modulation Cisplatin can cause what electrolyte abnormality - CORRECT ANSWER hypomagnesemia radiation doses higher than ____ Gy in the head and neck are associated with vasculopathies in the larger vessels of the brain - CORRECT ANSWER 30 Gy what meds can you give to prevent ototoxicity with chemo treatment - CORRECT ANSWER amifostine or thiosulfate What chemo agent is most likely to cause a secondary malignancy of AML - CORRECT ANSWER Etoposide (VP16) What medication can you give to a patient in TLS with an already high uric acid - CORRECT ANSWER rasburicase what type of cancer do you most commonly see SVCS occur - CORRECT ANSWER Non-Hodgkins lYmphoma Hyperdiploidy in ALL is what type of prognosis - CORRECT ANSWER good In what bleeding disorder is it autosomal recessive on the X chromosome so that only boys can get it? - CORRECT ANSWER Hemophilia A & B What type of testing would you do for a SCD patient with a potential silent infarct - CORRECT ANSWER neurocognitive testing transcranial doppler How does an exchange transfusion help sickle cell crisis - CORRECT ANSWER rapidly reduces percent of Hgb S A patient months post transplant is admitted with dyspnea, SOB, no fever. What is most likely the cause? - CORRECT ANSWER pulmonary obstruction r/t chronic GVHD What inherited conditions are associated with hepatoblastoma - CORRECT ANSWER Beckwith-Wiedemann, LiFraumeni, Chromosomal abnormalities What stage of Hodgkins involves lymph node regions on both sides of diaphragm - CORRECT ANSWER III A patient with the following potential syndromes is at an increased risk of what type of cancer: Wiskott Aldrich & ataxia telangiectasis - CORRECT ANSWER NHL What defines myeloid engraftment according to the Center for International Blood and BMT Research? - CORRECT ANSWER the first 3 consecutive days w an ANC > 500 What is the MOA of plant derivative chemos - CORRECT ANSWER causes cellular arrest during mitosis When is debulking surgery done? - CORRECT ANSWER when it is not possible to remove more than 90% of the tumor What GU side effect can mitoxantrone cause? - CORRECT ANSWER blue-green urine What is the antidote for VCR extravasation? - CORRECT ANSWER hyaluronidase What drug is a cardiac protectant given with HD anthracyclines - CORRECT ANSWER dexrazozane What are the risk factors for sepsis - CORRECT ANSWER prolonged neutropenia, mucositis, malnutrition, asplenia, invasive devices When you combine radiation and HD cyclophosphamide, what complications should you look out for? - CORRECT ANSWER myocarditis: acute or chronic -pericardial tamponade, hemorrhagic myocardial necrosis, PEA Testicular radiation > 600cGy can cause what? - CORRECT ANSWER azoospermia (zero sperm) What are the 3 components to the standards of nursing care - CORRECT ANSWER standards of professional practice standards of professional performance specialty practice guidelines What is fidelty in terms of healthcare ethics - CORRECT ANSWER keeping the patients best interests first when providing care What are the 5 As when it comes to EBP - CORRECT ANSWER ask, acquire, appraise, apply, assess Survivors of what cancer have the most risk of the poorest quality of life - CORRECT ANSWER CNS tumors What type of cytokine activates natural killer cells - CORRECT ANSWER interferons what type of cytokine acts as a messenger between cells in the immune system - CORRECT ANSWER Interleukins what diseases can the monoclonal antibody Rituximab be used to treat - CORRECT ANSWER lymphomas, ptld, refractory GVHD, ITP, autoimmune hemolytic anemia what medication can you give to treat cytokine release syndrome related to CAR-T - CORRECT ANSWER Tocilizumab What medication would you give to a hemophiliac to control bleeding (mucosal bleeding, tonsillectomy, dental extraction) - CORRECT ANSWER Aminocaproic acid (amicar) What does a cryo transfusion contain - CORRECT ANSWER FFP, factor 8, 13, vW factor, and fibrinogen What meds post BMT are most likely to cause PRES syndrome? - CORRECT ANSWER cyclosporine or tacrolimus what type of cancer is most likely to have a spinal cord compression - CORRECT ANSWER Sarcomas (ewings) What are the top 3 body systems seen with late side effects for cancer survivors - CORRECT ANSWER 1. Endocrine 2. Neuropsych 3. Musculoskeletal What is the byproduct produced by cyclophos/ifos that can cause hemorrhagic cystitis - CORRECT ANSWER acrolein