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ONS/ONCC Chemotherapy Immunotherapy Certificate Exam Latest 2024-2025 Questions And Answer, Exams of Nursing

Vanderbilt University (Vandy)Nursing

ONS/ONCC Chemotherapy Immunotherapy Certificate Exam Latest 2024-2025 Questions And Answers (Verified Answers) Lesson 1: Foundations to Set the Stage - ANSWER>> Focusing on Cellular Structure and Function - ANSWER>> The Normal Cell Cycle - ANSWER>>-The cell cycle refers to the ordered seres of processes of DNA replication and mitosis, or cell division -Cell nucleus regulates these processes by gathering and processing complexes molecular information Interphase and Mitotic Phase - ANSWER>>Cell division produces two identical cells through these two major phases During interphase: - ANSWER>>Cell grows and DNA is replicated through the following three steps:

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ONS/ONCC Chemotherapy Immunotherapy

Certificate Exam Latest 2024-2025 Questions

And Answers (Verified Answers)

Lesson 1: Foundations to Set the Stage - ANSWER>>

Focusing on Cellular Structure and Function - ANSWER>>

The Normal Cell Cycle - ANSWER>>-The cell cycle refers to the ordered seres of

processes of DNA replication and mitosis, or cell division

-Cell nucleus regulates these processes by gathering and processing complexes

molecular information

Interphase and Mitotic Phase - ANSWER>>Cell division produces two identical cells

through these two major phases

During interphase: - ANSWER>>Cell grows and DNA is replicated through the following

three steps:

1: First growth phase (G1 or first gap)

2: Synthesis phase (S phase)

3:Mitotic Phse (M phase)

First Growth Phase (G1 or first gap) - ANSWER>>-cells increase in size

-reproduce RNA

-"quality assurance" test that the cell will be ready to synthesis DNA

-Length of time is variable, can be from hours to days

Synthesis Phase (S phase) - ANSWER>>-DNA replicates

-Results in the formation of identical pairs of DNA (chromatids)

-which are attached a t the centromere

-lasts 2-10 hours

Mitotic Phase (M phase) - ANSWER>>-Replicated chromosomes are aligned,

separated, and move into 2 new, identical daughter cells

Partial preview of the text

Download ONS/ONCC Chemotherapy Immunotherapy Certificate Exam Latest 2024-2025 Questions And Answer and more Exams Nursing in PDF only on Docsity!

ONS/ONCC Chemotherapy Immunotherapy

Certificate Exam Latest 202 4 - 2025 Questions

And Answers (Verified Answers)

Lesson 1: Foundations to Set the Stage - ANSWER>> Focusing on Cellular Structure and Function - ANSWER>> The Normal Cell Cycle - ANSWER>>-The cell cycle refers to the ordered seres of processes of DNA replication and mitosis, or cell division

Cell nucleus regulates these processes by gathering and processing complexes molecular information Interphase and Mitotic Phase - ANSWER>>Cell division produces two identical cells through these two major phases During interphase: - ANSWER>>Cell grows and DNA is replicated through the following three steps: 1: First growth phase (G1 or first gap) 2: Synthesis phase (S phase) 3:Mitotic Phse (M phase) First Growth Phase (G1 or first gap) - ANSWER>>-cells increase in size
reproduce RNA
"quality assurance" test that the cell will be ready to synthesis DNA
Length of time is variable, can be from hours to days Synthesis Phase (S phase) - ANSWER>>-DNA replicates
Results in the formation of identical pairs of DNA (chromatids)
which are attached a t the centromere
lasts 2-10 hours Mitotic Phase (M phase) - ANSWER>>-Replicated chromosomes are aligned, separated, and move into 2 new, identical daughter cells

takes about 30-60 minutes Major points of cell regulation are entry and exit from - ANSWER>>-G1 checkpoint
S Phase
G2 checkpoint
M phase Restriction Point - ANSWER>>-The transition from the resting phase into an actively dividing phase (G0-G1) is a point where cellular transformation can occur
During this time, cells pass through a transition phase known as a restriction point
Extracellular growth factors trigger reentry into G1, and GF are required to send the cells past the restriction point, or the point of no return G0 Phase (resting phase) - ANSWER>>-After mitosis, cells may enter back into the G phase or go into a resting phase, known as G
Most cells in the human body reside in G
Exceptions to this are those that are (Resting in G0 phase) - ANSWER>>-Exceptions to this are those that are metabollically active, such as
granulocytes
and the epithelium of the GI tract Cell Cycling Time - ANSWER>>Amount of time from mitosis to mitosis Cell cycle video and image - ANSWER>>http://highered.mheducation.com/sites/0072495855/student_view0/chapter 2/animation__how_the_cell_cycle_works.html Check points in the Cell Cycle: Keeping it All Under Control - ANSWER>>-The cell cycle is carefully controlled through a series of checkpoints
Variation in duplication or distribution of chromosomes during cell division can alter the genetic information passed on to daughter cells, leading to cellular dysfunction and disease, such as cancer
These checkpoints monitor for DNA integrity and control progression through mitosis

Pluripotent Stem Cell - ANSWER>>-The cells of the immune system are created in the bome marrow from what is know as a ___

A stem cell that can differentiate into any cell type except for extraembryotic tissue, does not yet have a function Myeolid Precursor Cells - ANSWER>>Mature into:
RBCS
Plts
WBCs (Granulocytes) Lymphoid Precursor Cells - ANSWER>>Mature into:
Specialized WBCs called lymphocytes (Agranulocytes) Lines of Defense: The Immune System's Response to Attack - ANSWER>>Consists of 2 types of immunity: 1: Innate 2: Adaptive Innate Immunity - ANSWER>>-First line of defense against a pathogen
Does not retain memory of the entity
Involves the following: (skin, mucous membranes, and normal flora of the skin and gut) (Cellular components such as phagocytes, natural killer cells, granulocytes, and macrophages)

Phagocytes
Natural Killer Cells
Granulocytes
Macrophages - ANSWER>>1.Cells that engulf and destroy invader
Cells that sense receptors on self and non-self to determine if they should kill or not
Type of WBC that have granules (Neutrophils Eosinophils - parasites Basophils - release histamine to stimulate immune response)
Large phagocytic cells stimulated by infection Adaptive Immunity - ANSWER>>-Stimulated if innate immunity is insufficient

leads to immune system memory

Humoral immunity
Cell-mediated immunity
Regulatory T-cells Humoral Immunity - ANSWER>>-B-Cells
Memory B-Cells
Plasma act to produce immunoglobulins (Igs) or antibodies B-Cell - ANSWER>>-each one is programmed to make one specific antibody
Can recognize antigens whether they are freely circulating in the blood or attached to surface of a microbe
When dividing, can become plasma cells which will then begin secreting antibodies that are unique to that antigen Plasma Cells - ANSWER>>-some plasma cells will undergo apoptosis
Some will go to the BM where they will continue to secrete antibodies sometimes for years Cell-Mediated Immunity - ANSWER>>Depends upon cytotoxic T cells and helper T cells and their cyokinds
more effective against antigens within cells Regulatory T-cells AKA suppressor T-Cells - ANSWER>>regulate the immune response to prevent autoimmune reactions and limit inflammatory responses T-Cell - ANSWER>>-Can only recognize antigens when they are presented to them by "presenting cells"
Recognize phagocytized fragments of an antigen that are put on the surface of antigen- presenting cells Helper T-Cells (CD4+) - ANSWER>>-help other T-Cells by secreting chemicals
Help B Cells to respond
rapidly divide, in an effort to stay ahead of the antigen dividsion
some will turn into effector cells, which secrete different kinds of cytokines

Can stimulate the development of new blood vessels to supply the tumor (angiogenesis) Proto-oncogene - ANSWER>>-regulate normal cell growth and division
large family of genes that code for proteins and enzymes that turn on the cell cyle Oncogene - ANSWER>>when mistakes in copies of DNA can occur, if a mutation occurs next to a proto-oncogene, it can "turn on" and become a ______ Examples of oncogoenes - ANSWER>>1. EGFR or Erb-B1 (codes for an epidermal GF receptor in the receptor-tyrosine kinase family ad is associated with head and neck and colorectal cancers)
EGFR inhibitor therapies are known to cause cutaneous reactions

Erb-B2 or HER2/neu (codes for an EGFR protein in the tyrosine kinase family and is associated with some breast cancers) Tumor suppressor genes - ANSWER>>-act like brakes in a car, slowing down or stopping cell growth and division

in the presence of malignancies, they bind to DNA with intention of repairing or activating apoptosis
for it to be turned on it must be expressed or "opened" in the DNA helix so that it can be transcribed or copied p53 - ANSWER>>-"sucidie gene"
activates apoptosis when the cell is damaged beyond repair or too old to function
more than 50% of solid tumors, the gene is mutated and unable to perform its normal function Growth Signals - ANSWER>>-cancer cells are able to find their own growth signals making them self-sufficient Signal transduction - ANSWER>>-the communication or passage of a message telling the cell to do a biologic process, such as make a protein, divide, or make new blood vessels Signal transduction steps - ANSWER>>1. Messages usually sent from outside the cell where the messenger (ligand) first binds to the cell receptor which extended through the cell membrane

These receptors ae called receptor tyrosine kinases
To send the message through the membrane, the receptor often has to join with another recetor to become active and t autophophorylate
This is called dimerization and can be the following: Dimerization - ANSWER>>1. Homodimerization: binding with the same type of receptor, such as an epidermal GF receptor (EGFR) 1 receptor with another EGFR
Heterodimerization: binding with a different kind of receptor, such as EGFR1 binding with EGFR Protein tyrosine kinases phosphorylates - ANSWER>>-turned on by giving up a phosphate molecule

the message is now send via a "bucket bridage", or passing the message from one molecule to other signaling molecules until the message gets first into the cell nucleus
where it is transcribed Pathways - ANSWER>>many pathways and crossalks signaling btw and among the different pathways, and they all have the power to control cell behavior in one way or another mitogen-activating protein kinase (Raf-1/MAPK) pathway - ANSWER>>-shown to decrease the benefits of some cancer drugs
decrease disease-free survival time in some pts mammalian target of rapamycin (mTOR) survival pathway - ANSWER>>-play a role in resistance to some chemotherapy agents in certain pts by keeping cells that have been exposed to chemotherapy from undergoing apoptosis
role in angiogenesis phosphoinositide 3-kinases (PI3K) - ANSWER>>-transduction enzymes that activate Akt, leading to cell survival, increased cell proliferation, and growith Neoadjuvant Treatment - ANSWER>>-treatment given as a first step to shrink a tumor before the main treatment, usually surgery
examples: chemo, radiation therapy, hormone therapy Adjuvant therapy - ANSWER>>-additonal cancer treatment given after the primary treatment to lower the risk that the cancer can recur

nitrosoureas Nitrosoureas - ANSWER>>-subgroup of alkylating agents
able to cross the blood-brain barrier (effective in treating some brain tumors, melanomas, lymphomas)
Carmustine (BiCNU)
Lomustine (CeeNu)
Streptozocin (Zanosar)
pulmonary monitoring recommended Carboplatin (Paraplatin) - ANSWER>>-Alkylazing agent
possibility for a hypersensitivity reaction which is rash, urticaria, erythema, pruritis, rarely bronchospasm and hypotensision
notify RN if itching, scratchy throat, difficulty breathing, rash
Blood count, particularly platelets, monitored because thrombocytopenia is a dose- limiting toxicity
Oral dosage: 1-5mg/kg/day Cisplatin (Planitol) - ANSWER>>-Alkylating agent
nephrotoxic (IV hydration 2-3 L per day)
severe N/V
ovarian and testicular Cyclophosphamide (Cytoxin) - ANSWER>>-Alkylating agent)
hemorrhagic cystitis (dysuria, hematuria, hemorrhage)
DC treatment if hemorrhagic cystitis
adequate hydration Oxaliplatin - ANSWER>>-Alkylating agent
irritant and vesicant, extra caution with the IV site
peripheral neuropathy is a dose-limiting side effect (exacerbated by cold temperatures)

avoid cold drinks and foods, wearing gloves and warm shoes
avoid breathing cold air Intrathecal Chemotherapy - ANSWER>>-injects chemo directly into the subarachnoid space so it reaches the CNS
Often used to treat leukemia and lymphoma that has spread to the CNS since most IV chemo does not cross the blood-brain barrier
only MTX and cytarabine via this route
IT hydrocortisone is often given at the same time to reduce inflammation
MUST be preservative free to avoid CNS irritation Chemotherapy-Induced N/V (CINV) Risk factors - ANSWER>>-younger
have a hx of low or no alcohol consumption
are female
hx of morning sickness
prone to motion sickness
have had chemo previously Types of CINV - ANSWER>>-Acute: occurring within 24 hours
Delayed: from 24 hour - 5 days after
Breakthrough: Occurring despite treatment
Anticipatory: triggered by taste, odor, memories, visions, anxiety r/t chemo
Refractory: occurring despite subsequent cycles when treatment failed in earlier cycles Prevention/Treatment of hand foot syndrome - ANSWER>>-limit exposure of hands and feet to hot water
take cool showers
avoid exposure to sources of heat, such as using saunas or sitting in the sun
avoid activities that cause unnecessary force or friction on the hands or feet, such as running or aerobics
avoid contact with harsh chemicals used in detergents and household cleaning products

IgE-mediated - ANSWER>>-immediate (within 5 minute) HSR, present like classic allergic reactions T-Cell--Mediated - ANSWER>>-Delayed hypersensitivity reactions, can occur any time after the immediate hypersensitivity window, even days or weeks Type 1 HSR early S/SX - ANSWER>>-pruritus

restlessness, agitation, anxiety, feeling of impending doom
fever, flushing, chills
urticaria (hives)
maculopapular rash
edema of hands, face, and feet
N/V
dyspnea, wheezing, bronchospasm
hypotension, cyanosis
circulatory and respiratory collapse Type IV HSR - ANSWER>>-pneumonitis
mucositis
contact dermatitis
granulomas
Graph vs host disease Lesson 7: Cumulative Dose - ANSWER>> Cumulative dose - ANSWER>>total amount of one antineoplastic agent given to the pt, adding up each time that the pt has received it Cumulative lifetime dose - ANSWER>>-"cumulative dose should not exceed..."
total amount of specific antineoplastic agents that can be safely given over the course of a pt's lifetime Extravasation - ANSWER>>-leak of a drug capable of causing tissue damage from the vessel in which it is being administered into the surround tissue Irritant - ANSWER>>-causes inflammation, pain, and burning but rarely causes tissue necrosis Vesicants - ANSWER>>-causes blistering and significant pain and tissue damage and destruction, leading to tissue death Vesicants in PIVs - ANSWER>>-Do not use IV in hand, wrist, AC areas
Do NOT place the IV below a recent ventipuncture site used (<24 hours)

Use a flexible IV catheter When a vesicant extravasation occurs or is suspected, take the following steps: - ANSWER>>1. Immediately STOP administering the vesicant and IV fluids

Disconnect the IV tubing from the IV device. Do not remove the IV device or noncoring port needle
Attempt to aspirate residual vesicant from the IV device or port needling use a small (1-3 mL) syringe
Remove the peripheral IV device or port needle
Initiate appropriate management measures Managing Non-DNA Binding Vesicant Extravasation - ANSWER>>-Vinca Alkaloids (vincristine, vinblastine)

Do not bind to DNA in healthy cells when they extravasate into tissue. Indirect effect on healthy tissue
Treat with heat, elevation, and hyaluronidase local injection (spreads the vesicant through the tissue for faster metabolism of the vesicant agent)
Usually results in less tissue damage
Improves over a short period of time (days to weeks( Management of DNA-Binding Vesicant Extravasation - ANSWER>>--Anthracyclines (doxorubicin, epirubicin, daunorubicin, idarubicin)
Binds to DNA in healthy cells when they extravasate into tissue
When not immediately treated with dexrazoxane, the vesicant remains in the tissue and invades adjacent healthy tissue
Likely to result in more tissue damage
Left untreated, extravasations become larger and deeper, worsening over time (weeks to months) Lesson 11: Targeted Therapy - ANSWER>> How targeted therapy and chemo differ - ANSWER>>-targeted therapies act on specific molecular targets on or within the cells that are associated with cancer, whereas standard chemo act on all rapidly dividing cells

delivering toxic substances to the cell
stimulating the body's immune system BCR/ABL - ANSWER>>-fusion protein tyrosine kinase formed with a gene translocation occurs between gene 9 and 22

gene abnormality called the Philadelphia chromosome seen in CML and ALL VEGF - ANSWER>>this is the primary angiogenic factor produced by cells mTOR - ANSWER>>-target of rapamycin
a protein that tells cells when to grow, divide, and survive Two ways that angiogenesis inhibitors work - ANSWER>>1. some intergere with action of VEGF which stimulates n ew blood vessel formation

others target their molecules that stimulate new blood vessel growth Small Molecule Compound Targeted Therapies - ANSWER>>-end in - ib

targets located inside the cell because these gents are able to enter cells more easily
intracellular
most given orally Monoclonal Antibody Targeted Therapy - ANSWER>>- end in - mab
relatively large in size and therefore usually cannot enter cells
extracellular or transmembrane
man made version of antibodies that are designed to attack a very specific target on cancer cells
usually from mice Lesson 12: Immunotherapy - ANSWER>> Immunotherapy works by - ANSWER>>-stopping or slowing the growth of cancer cells
stopping cancer from spreading to other parts of the body

helping the immune system recognize cancer cells and increase its effectiveness at eliminating cancer cells Passive Immunotherapy - ANSWER>>-initate an antitumor effect but do not result in any immunologic memory
require repeated administration to be effective
includes monoclonal antibodies and cytokines Active Immunotherapy - ANSWER>>-capitalize on the immune system's ability to remember a foreign invade
mount an immune response against the tumor and hopefully remember the cancer cells long after treatment has stopped
includes cancer vaccines Specific Immunotherapy - ANSWER>>-capitalize on tumor markers to specifically target and kill cancer cells
examples are mAbs and cancer vaccines Nonspecific Immunotherapy - ANSWER>>-do no target cancer cells alone but rather stimulate a large immune response
given adjuvantly to other anticancer treatment drugs
examples are cytokines, interleukins, and checkpoint inhibitors Lesson 13: Safe Handling - ANSWER>> Hierarchy of Hazard Controls aimed at reducing worker exposure - ANSWER>>1. Elinination of the Hazard

Engineering Controls:
Administrative Controls
PPE:
Elimination of the Hazard: - ANSWER>>-highest level of protection from a hazardous exposure

substitute a less toxic substance for the hazardous material

wash hands True statements related to drug dose calculation and administration - ANSWER>>-the AUC calculation incorporates renal function as part of the equation

Pts who have had previous radiation therapy or chemo are considered special populations with regard to a potential need for dose modification
The AUC calculation is used for carboplatin dosing
Children may metabolize drugs differently than adults; dose modifications are possible What is a monoclonal antibody, and how is it different from chemo? - ANSWER>>- mAbs are agents that are derived from human or mouse antibodies or a combination of the two
mAbs search out proteins on the cells surface
mAbs recognize and bind to specific anatigens on the cells surface
natural killer cells and/or cytotoxic proteins of the immune system recognize and destroy the marked tumor cells
mAbs can also directly induce cell death as well
One of the biggest differences is that mAbs cause harm only to those cells that are marked or binded

Should I avoid my grandchildren and other family members when I am getting treatment? - ANSWER>>-it is perfectly safe for you to have contact with your loved ones while getting treatment

Hugging, kissing, and spending time together while eating are all safe activities
Safety with bodily fluids is necessary for the first 48 hours after receiving chemo Can I be intimate with my partner during treatment? - ANSWER>>-you should definiely check with your HCP first to be sure
traces of chemo may be present in vaginal fluid for up to 48 hours after treatment
use of a barrier is recommended for this reason for at least the first 48 hours

ONS/ONCC Chemotherapy Immunotherapy Certificate Exam Latest 2024-2025 Questions And Answer, Exams of Nursing

Related documents

Partial preview of the text

Download ONS/ONCC Chemotherapy Immunotherapy Certificate Exam Latest 2024-2025 Questions And Answer and more Exams Nursing in PDF only on Docsity!

ONS/ONCC Chemotherapy Immunotherapy

Certificate Exam Latest 202 4 - 2025 Questions

And Answers (Verified Answers)