WorksheetsUMMC Cytotoxic & Parenteral Nutrition Workshop 2022
Total questions: 28
Worksheet time: 11mins
Which statement is FALSE about cleanroom?
A clean space that eliminates bacterial contamination only
An isolated environment strictly controlled with respect to temperature, humidity and differential pressure
It must have good ventilation
The surfaces of a cleanroom must be smooth and easy to clean
What are the types of disinfectant used in a cleanroom?
i) Water for injection
ii) Alcohol based
iii) Quaternary ammonium
iv) Phenolic based
i, ii and iii
i, iii and iv
ii, iii and iv
i, ii and iv
What is the appropriate area for preparing cytotoxic drugs?
At the patient's bedside
Under Biosafety Cabinet (BSC) in the cleanroom facility
In a positive pressure cleanroom facility
At the meeting room with the personal protective equipment (PPE)
What is the terminology used to describe the chemotherapy used to destroy the leftover malignant cells after the tumour is being removed surgically?
Adjuvant
Neoadjuvant
Palliative
Induction
Which electrolytes are included in the Cisplatin hydration?
Magnesium sulfate and Calcium gluconate
Potassium chloride and Calcium gluconate
Potassium dihydrogen phosphate and Calcium gluconate
Magnesium sulfate and Potassium chloride
Patient TSJ is diagnosed with stage 4 lung cancer and is prescribed with a regimen containing IV Pemetrexed 500mg/m2. Patient's height is 170cm and weight 82kg. Assuming both renal and hepatic functions are normal, calculate the required Pemetrexed dose
890mg
985mg
925mg
750mg
What is the definition of near misses?
Any events when you missed a step in the standard operating procedures
Any errors detected at the patient area
Any errors that is overlooked during screening of protocols
Any errors detected in the pharmacy area before dispensing the medications
How do you prevent an error from happening?
i) Follow the standard operating procedures
ii) Always have an independent 2 point check
iii) When in doubt, discuss it with your supervisor
iv) Take a shorter work process to improve efficiency
i & iv
i, iii & iv
i, ii & iii
ii & iii
When a medication error occurs, what should be done first?
Keep quiet & continue work
Investigate the medication error thoroughly & objectively
Find the person who caused the error & give appropriate punishment
An error report will need to be filled through your supervisor after thorough investigation is done objectively
From the picture above, who is the owner of the initial?
First checker (checking label & worksheet)
Final checker (checking bag & product)
Drug reconstitution staff
Second check for packing
Which of the following needs the auxiliary label of “roll the syringe before use”?
Subcutaneous Methotrexate
Subcutaneous Bortezomib
Subcutaneous Azacitidine
Intramuscular Bleomycin
What are the chronological steps for cleaning before leaving sterile complex in the evening?
Water-> Decon-> Water-> Alcohol
Water-> Alcohol
Water-> Alcohol-> Water-> Decon
Water-> Alcohol-> Water-> Hydrogen peroxide
Which of the following DOES NOT need an auxillary label of 'DO NOT SHAKE'
Paclitaxel
Doxorubicin liposomal
Bevacizumab
Pemetrexed
For public patients, which medication requires payment?
i) Carboplatin
ii) Gemcitabine
iii) Irinotecan
iv) Oxaliplatin
i & ii
ii & iv
ii, iii & iv
ii only
Which drugs need a 0.2micron filter tubing?
i) paclitaxel
ii) Infliximab
iii) Aflibercept
iv) Ramucirumab
i, ii & iii
i only
i, iii & iv
All of the above
What do we need to check upon receiving a protocol?
i) Medication payment
ii) Medication dose
iii) Doctor's signature & stamp
iv) Chemotherapy date
ii, iii & iv
iii & iv
iii only
All of the above
Scenario:
Pharmacist Assistant “B” accidentally drops a pre-diluted vial of Ifosfamide on the floor in control room, therefore a spill has occurred. You are the pharmacist who is working on that day in control room.
Who is responsible to manage the spillage and what is the first thing that needs to be done?
Pharmacist Assistant.
Report to Management.
Pharmacist.
Limit spill with absorbent towels dampened with DECON 90
Pharmacist Assistant.
Limit spill with absorbent towel
Pharmacist.
Put a warning sign to isolate spillage area
You are Pharmacist who is working the on-call shift and received a call from 5PA, asking you on how to wear PPE. Which one of the following is the correct order of wearing PPE while handling cytotoxic spillage?
Mask
Gloves
Gown
Gloves (2nd)
Goggles
Booties
Gloves
Gown
Gloves (2nd)
Mask
Goggles
Booties
Mask
Gloves
Gown
Gloves (2nd)
Booties
Goggles
Gloves
Gown
Mask
Gloves (2nd)
Goggles
Booties
ALL statements below are WRONG about of cytotoxic spill kit, EXCEPT :
If the kit is used or the seal is broken, it must be returned to the pharmacy within 72 hours
post incidence.
Sterile and Non- Sterile gloves are the items included in the spill kit
Powder spillage requires the use of absorbent towel dampened with Decon 90 + Alcohol 20%.
All used and unused items need to be returned to the pharmacy within the same day of incidence.
Unused spill kits need to be re-serviced by 3 months times from preparation date
What are the advantages of portable infusion devices (baxter bottle)?
Promoting patient mobility
No need for hospitalization
To reduce toxicity in certain drugs
All of the above
The following regimens use baxter bottle for 5-Fluorouracil EXCEPT:
FOLFOX
FEC
FOLFIRI
The following infusion pumps are currently available in SC EXCEPT:
Baxter Multi-rate bottle (2,3 or 5mL/hr)
Baxter Fixed-rate bottle (2.5mL/hr)
Bbraun Easypump (2mL/hr)
TPN is a privision of nutrients administered intravenously to:
Achieve catabolism
Increase glucose intake
Allow patient to eat quicker
Achieve anabolism
What energy component makes up the majority of TPN solution?
Lipid
Vitamins
Dextrose
Amino acids
Which of the following electrolytes should NOT be added together?
sodium & phosphate
calcium & potassium
magnesium & sodium
calcium & phosphate
Which one of the following statements is TRUE about the dangers of cytotoxics?
Long term background exposure to multiple cytotoxic drugs is more of a concern than single event exposure to a single drug
Cytotoxic drugs are harmless in small quantities
We are protected from cytotoxic exposure as long as we just wear PPE
It is a scam perpetuated by PPE manufacturers and the medical-industrial complex
According to the Hierarchy of Controls, which of the following is the LEAST effective measure to reduce cytotoxic exposure?
Standard Operating Procedure (SOP)
Biosafety Cabinet
Personal Protective Equipment (PPE)
Designated area to store cytotoxic drugs, away from other drugs
Which of the following places are you likely to find traces of cytotoxic drugs?
i) Furniture and surfaces in areas immediately outside Sterile Complex
ii) Sterile Complex changing room
iii) Patient infusion area at Oncology Daycare
iv) Cytotoxic drug storage area in pharmacy store
i, iii, iv
ii, iii, iv
i, ii, iii
All of the above
