OCN Systemic Therapies Practice Questions (15 Free)

Correct answer: C. Dose-dense schedules reduce tumor regrowth by shortening the interval between cycles

Dose density refers to administering chemotherapy at shorter intervals to minimize tumor regrowth between cycles. Dose intensity (drug amount per unit time) may be similar or adjusted. The key is the reduced interval, not necessarily higher intensity.

From practice test 8 of our OCN study guide (question 46). Original question, not an official exam item.

Correct answer: C. 28 days

Bevacizumab impairs wound healing by inhibiting VEGF. It should be held for at least 28 days before elective surgery to reduce bleeding and wound complications.

From practice test 8 of our OCN study guide (question 143). Original question, not an official exam item.

Correct answer: B. Age, weight, serum creatinine, and sex

Cockcroft-Gault requires age, weight, serum creatinine, and sex to estimate creatinine clearance. Height is used for BSA (Mosteller), not for Cockcroft-Gault; BUN and albumin are not part of the formula.

From practice test 3 of our OCN study guide (question 142). Original question, not an official exam item.

Correct answer: A. Cell-cycle specific for S phase, requiring prolonged exposure

5-fluorouracil is an antimetabolite that is S-phase specific, so continuous infusion ensures drug presence during DNA synthesis. Bolus dosing would miss cells not in S phase at the time.

From practice test 9 of our OCN study guide (question 42). Original question, not an official exam item.

Correct answer: C. EGFR

Erlotinib is an EGFR tyrosine kinase inhibitor used in non-small cell lung cancer. It blocks the epidermal growth factor receptor, not HER2, VEGF, or PD-1.

From practice test 2 of our OCN study guide (question 101). Original question, not an official exam item.

Correct answer: D. Fluid retention manifesting as periorbital edema or lower extremity swelling

Imatinib frequently causes fluid retention, often seen as periorbital edema or peripheral edema. This is manageable with diuretics if needed, and patients should be educated to report significant swelling.

From practice test 4 of our OCN study guide (question 24). Original question, not an official exam item.

Correct answer: D. Hold the ribociclib dose and notify the prescriber

CDK4/6 inhibitors like ribociclib require dose holds for grade ≥3 neutropenia and QTc prolongation >480 ms; the drug should be temporarily stopped and the prescriber notified. G-CSF may be used for neutropenia but does not address QTc prolongation; reducing infusion rate is irrelevant for oral drugs; antiarrhythmics are not first-line.

From practice test 3 of our OCN study guide (question 69). Original question, not an official exam item.

Correct answer: A. Hold ribociclib and obtain an electrocardiogram (EKG) to check QTc interval.

CDK4/6 inhibitors like ribociclib are associated with neutropenia and QTc prolongation. Grade 3 neutropenia typically requires holding the drug; an EKG is indicated because ribociclib can prolong the QT interval, especially if combined with other risk factors.

From practice test 5 of our OCN study guide (question 40). Original question, not an official exam item.

Correct answer: A. The drugs are given every 2 weeks with granulocyte colony-stimulating factor (G-CSF) support.

Dose-dense AC regimen administers doxorubicin and cyclophosphamide every 2 weeks rather than the conventional 3-week interval, and requires G-CSF support to prevent severe neutropenia. The shorter interval aims to reduce tumor regrowth between cycles.

From practice test 2 of our OCN study guide (question 115). Original question, not an official exam item.

Correct answer: A. Grapefruit and grapefruit juice.

Imatinib is metabolized by the CYP3A4 enzyme, and grapefruit juice inhibits CYP3A4, potentially increasing imatinib levels to toxic ranges. Patients should avoid grapefruit products. Other items listed do not have a confirmed significant interaction with imatinib.

From practice test 2 of our OCN study guide (question 34). Original question, not an official exam item.

Correct answer: D. 1500/µL

Standard chemotherapy protocols require ANC ≥ 1500/µL to ensure adequate neutrophil reserves and reduce infection risk.

From practice test 9 of our OCN study guide (question 9). Original question, not an official exam item.

Correct answer: C. Echocardiogram

Echocardiogram is the standard test to monitor left ventricular ejection fraction for trastuzumab-related cardiotoxicity. ECG detects arrhythmias but does not assess ejection fraction.

From practice test 2 of our OCN study guide (question 156). Original question, not an official exam item.

Correct answer: A. Increased imatinib levels due to CYP3A4 inhibition, risking toxicity

Imatinib is a substrate of CYP3A4. Fluconazole inhibits CYP3A4, leading to increased imatinib levels and potential toxicity. This combination requires close monitoring or dose adjustment.

From practice test 5 of our OCN study guide (question 152). Original question, not an official exam item.

Correct answer: C. M phase; prevent microtubule assembly

Vinca alkaloids bind to tubulin, preventing polymerization into microtubules, thus blocking mitosis in M phase.

From practice test 9 of our OCN study guide (question 29). Original question, not an official exam item.

Correct answer: B. Screening for hepatitis B virus (HBV) surface antigen and core antibody

Rituximab can cause reactivation of hepatitis B, which may lead to fulminant hepatitis. Screening for hepatitis B surface antigen and core antibody is mandatory before therapy; antiviral prophylaxis is given if positive.

From practice test 4 of our OCN study guide (question 97). Original question, not an official exam item.