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Chemotherapy Study Exam Section 1: Multiple Choice Questions (MCQs)
- What is the primary mechanism of action of chemotherapy? a) Enhancing immune response b) Disrupting cellular functions like replication and DNA repair c) Stimulating tumor growth d) Neutralizing toxins in the bloodstream Answer: b) Disrupting cellular functions like replication and DNA repair
- Which of the following chemotherapeutic agents is known to cause hemorrhagic cystitis? a) Methotrexate b) Vincristine c) Cyclophosphamide d) Doxorubicin Answer: c) Cyclophosphamide
- What is the primary treatment goal of neoadjuvant chemotherapy? a) Treating metastatic cancer b) Shrinking the tumor before surgery or radiation c) Managing chemotherapy- induced nausea d) Preventing neutropenia Answer: b) Shrinking the tumor before surgery or radiation
- Which of the following agents is known for its risk of cardiotoxicity? a) Cisplatin b) Doxorubicin c) Bleomycin d) Methotrexate Answer: b) Doxorubicin
- Which toxicity is characterized by peripheral neuropathy? a) Myelosuppression b) Hemorrhagic cystitis c) Nephrotoxicity d) Neurotoxicity Answer: d) Neurotoxicity Section 2: True/False Questions 6. Chemotherapy primarily affects slow-growing cells. Answer: False (It primarily affects rapidly dividing cells.)
- Myelosuppression includes thrombocytopenia, anemia, and leukopenia. Answer: True
- Oxaliplatin-induced neuropathy is worsened by exposure to heat. Answer: False (It is worsened by exposure to cold.)
- G-CSF and GM-CSF are used to stimulate white blood cell production in chemotherapy patients. Answer: True
- Brachytherapy is a form of systemic chemotherapy. Answer: False (Brachytherapy is a form of internal radiation therapy.) Section 3: Short Answer Questions 11. Explain the difference between cell cycle-specific and cell cycle-nonspecific chemotherapeutic agents. Answer: Cell cycle-specific agents target specific phases of the cell cycle, such as the S-phase or M-phase, while cell cycle-nonspecific agents can act on tumor cells regardless of their phase in the cell cycle.
- List three supportive treatments used to manage chemotherapy-induced myelosuppression. Answer: G-CSF or GM-CSF for neutropenia, erythropoietin (EPO) for anemia, and interleukin-11 (IL-11) for thrombocytopenia.
- What is tumor lysis syndrome, and how is it managed? Answer: Tumor lysis syndrome occurs when cancer cells break down rapidly, leading to hyperkalemia, hyperphosphatemia, and hypocalcemia, which can cause kidney damage. Management includes hydration, monitoring electrolytes, and administering allopurinol to prevent uric acid buildup.
- Name two chemotherapeutic agents known for causing nephrotoxicity and their management strategies. Answer: Cisplatin and methotrexate are nephrotoxic. Management includes hydration, monitoring renal function, and administering amifostine for renal protection.
- Why is sperm banking recommended before chemotherapy in male patients? Answer: Many chemotherapy agents can cause azoospermia, which may be temporary or permanent. Sperm banking allows for future fertility preservation.
Multiple Choice Questions (MCQs):
1. What is the primary cause of cancer development? a) Bacterial infections b) Genetic mutations in cellular DNA c) Fungal overgrowth d) Hormone replacement therapy Answer: b) Genetic mutations in cellular DNA 2. Which of the following cancers is most common in men? a) Breast cancer b) Ovarian cancer c) Prostate cancer d) Endometrial cancer Answer: c) Prostate cancer 3. The process of carcinogenesis occurs in three stages. Which is the correct sequence? a) Promotion, Initiation, Progression b) Initiation, Promotion, Progression c) Progression, Initiation, Promotion d) Initiation, Progression, Promotion Answer: b) Initiation, Promotion, Progression
Multiple Choice Questions (MCQs) – Advanced Level
1. Which of the following is NOT a function of the immune system in cancer surveillance? a) Recognition of tumor-associated antigens (TAAs) b) Activation of cytotoxic T cells to destroy tumor cells c) Promotion of tumor angiogenesis d) Induction of apoptosis in cancerous cells Answer: c) Promotion of tumor angiogenesis 2. Which environmental factor is MOST strongly associated with lung cancer? a) Chronic viral infections b) Secondhand smoke exposure c) Prolonged sun exposure d) Excessive alcohol consumption Answer: b) Secondhand smoke exposure 3. What role do oncogenes play in cancer development? a) Repair damaged DNA b) Suppress abnormal cell growth c) Prevent metastasis d) Promote uncontrolled cell division Answer: d) Promote uncontrolled cell division 4. Which type of cancer is strongly associated with Epstein-Barr Virus (EBV)? a) Cervical cancer b) Burkitt lymphoma c) Pancreatic cancer d) Lung cancer Answer: b) Burkitt lymphoma
Short Answer Questions
5. Explain how chronic inflammation contributes to carcinogenesis. Answer: Chronic inflammation leads to persistent cell damage, genetic mutations, and the
release of cytokines that promote cell proliferation and angiogenesis. This creates an environment that favors tumor development.
6. Differentiate between primary, secondary, and tertiary cancer prevention strategies. Answer: Primary Prevention: Prevents cancer from developing (e.g., HPV vaccination, smoking cessation). Secondary Prevention: Detects cancer early (e.g., mammograms, colonoscopies). Tertiary Prevention: Prevents recurrence and complications in cancer survivors (e.g., follow-up screenings).
Matching Questions
Match the following cancer risk factors with the type of cancer they are associated with: Risk Factor Type of Cancer A. Human Papillomavirus (HPV) 1. Liver Cancer B. Helicobacter pylori 2. Breast Cancer C. BRCA1 & BRCA2 Mutations 3. Cervical Cancer D. Hepatitis B Virus (HBV) 4. Stomach Cancer Answer: A → 3 (HPV → Cervical Cancer) B → 4 (H. pylori → Stomach Cancer) C → 2 (BRCA Mutations → Breast Cancer) D → 1 (HBV → Liver Cancer)
Case Study Questions
7. A 52-year-old female patient reports a lump in her breast. A biopsy confirms an invasive ductal carcinoma. The tumor is 3.5 cm in size, with regional lymph node involvement but no distant metastasis. a) What stage of breast cancer does this likely correspond to? b) What are the possible treatment options for this patient?
A 67-year-old male presents with urinary hesitancy, weak urine stream, and nocturia. His PSA (Prostate-Specific Antigen) level is elevated at 12 ng/mL. A digital rectal exam reveals a firm, irregular prostate nodule. A biopsy confirms adenocarcinoma of the prostate. Questions: a) What are the risk factors for prostate cancer? b) What is the significance of the PSA level in prostate cancer diagnosis? c) What are the treatment options for localized versus metastatic prostate cancer? d) How would you counsel the patient on potential side effects of prostate cancer treatments, such as surgery and radiation?
Case Study 3: Acute Myeloid Leukemia (AML)
A 45-year-old female presents with fatigue, frequent infections, and easy bruising over the past month. Blood work reveals severe anemia, thrombocytopenia, and elevated white blood cell count with blasts. A bone marrow biopsy confirms acute myeloid leukemia (AML). Questions: a) What are the hallmark signs and symptoms of AML? b) What laboratory findings are characteristic of AML? c) What are the treatment options for AML, and what are the potential complications? d) How would you explain the importance of infection prevention in patients undergoing chemotherapy for AML?
Case Study 4: Ovarian Cancer
A 60-year-old woman presents with bloating, early satiety, and pelvic discomfort for the past few months. A pelvic ultrasound shows a complex ovarian mass, and CA-125 levels are elevated. Further imaging reveals peritoneal involvement. Questions: a) What are the common risk factors for ovarian cancer? b) Why is ovarian cancer often diagnosed at an advanced stage? c) What treatment modalities are used for ovarian cancer? d) How would you educate the patient on the signs and symptoms of ovarian cancer for early detection?
Case Study 5: Lung Cancer with Brain Metastasis
A 58-year-old male with a 30-year history of smoking presents with a chronic cough, hemoptysis, and unexplained weight loss. Imaging reveals a mass in the right lung, and biopsy confirms small-cell lung cancer (SCLC). Further evaluation shows brain metastases. Questions: a) What is the typical progression and prognosis of small-cell lung cancer? b) What symptoms might indicate brain metastasis in lung cancer patients? c) What treatment options are available for SCLC with brain metastases? d) How would you address the patient’s concerns about palliative care and symptom management? Answer: Oncology nursing encompasses a wide range of specialties and age groups, addressing various aspects of cancer care from prevention to end-of-life management. Cancer, a complex group of disorders, arises from genetic mutations that lead to uncontrolled cell proliferation and can metastasize via lymphatic and vascular systems. Epidemiologically, cancer affects millions globally, with significant disparities influenced by socioeconomic factors and geographic variations. The immune system plays a critical role in identifying and eliminating cancer cells through immune surveillance mechanisms, although cancer cells can evade detection through various mechanisms, including immune checkpoint inhibitors. Understanding these foundational aspects equips oncology nurses to provide comprehensive care, including early detection through screening programs, patient education, and support across the cancer continuum. You said:
