CH 14 Pathopharm

A client has been diagnosed with a brain tumor and is dealing with this diagnosis by seeking detailed information about cancer. The nurse would explain to the client that cancer is essentially a result of the disruption of what? A. Cell cycle B. Cell wall C. Lymphatic system D. Immune system

A. Cell cycle

A nurse educator is discussing the role of protooncogenes in the pathophysiology of cancer. What typically triggers protooncogenes to differentiate into oncogenes? A. exposure to a low-pH environment B. ischemia C. exposure to chemotherapeutic agents D. exposure to carcinogens

D. exposure to carcinogens

A 26-year-old man with testicular cancer is prescribed combination chemotherapy that involves using two drugs that are effective against testicular tumors. Combination drug therapy is superior to single-drug therapy because of: A. Lower risk for secondary cancers B. Higher tumor response rates C. Increased capillary permeability D. Decreased duration of remissions

B. Higher tumor response rates

The nurse may be asked to administer which medications to a client to counteract the increase in uric acid and subsequent hyperuricemia resulting from the metabolic waste buildup from rapid tumor lysis? A. amifostine B. allopurinol C. mesna D. leucovorin

B. allopurinol

A client with leukemia is being treated with a combination of antineoplastics, including methotrexate. The client's most recent laboratory results indicate the client is experiencing bone marrow suppression. What is the nurse's priority action? A. Space out the client's care to preserve energy and prevent fatigue. B. Provide small quantities of food several times per day, as tolerated. C. Ensure that all staff and visitors adhere to infection control precautions. D. Encourage the client to limit physical activity in order to reduce the risk of bleeding.

C. Ensure that all staff and visitors adhere to infection control precautions.

An adult client who has been diagnosed with a rectal tumor is scheduled to begin treatment with cisplatin. The nurse has conducted client teaching about the possibility of nausea and vomiting. In order to reduce the client's risk of severe nausea, the nurse should: A. ensure that the client is NPO from midnight prior to receiving the drug. B. encourage the client to request antiemetics if the nausea becomes unbearable. C. administer a combination of antiemetics prior to the administration of the drug. D. place the client on a low-residue diet.

C. administer a combination of antiemetics prior to the administration of the drug.

A client is diagnosed with a brain tumor. The client is told that the cancer cells proliferate. The client asks the nurse what this means. What is the nurse's best response? A. "The proliferation is the growth of cancer cells and the rate of growth." B. "The proliferation of cancer cells is the metastasis of the tumor." C. "The proliferation of the cancer cells is the suppression of growth." D. "The proliferation of the cancer cells is the treatment with chemotherapy."

A. "The proliferation is the growth of cancer cells and the rate of growth."

A client has chosen to be placed on hospice. Which is acceptable chemotherapy for a client on hospice? A. 682 B. Radiation combined with chemotherapy C. Adjuvant chemotherapy D. Neoadjuvant chemotherapy

A. 682

The nurse is assessing a client for adverse effects related to methotrexate therapy. What diagnostic finding should the nurse prioritize? A. creatinine clearance B. electrocardiogram (ECG) C. calcium and magnesium levels D. serum osmolality

A. creatinine clearance

A female patient is taking oral cyclophosphamide therapy for breast cancer. Because of possible adverse effects of the drug, the nurse will instruct the patient to: A female patient is taking oral cyclophosphamide therapy for breast cancer. Because of possible adverse effects of the drug, the nurse will instruct the patient to: A. drink a lot of water. B. limit fluid intake. C. increase the protein in her diet. D. take the medication at bedtime.

A. drink a lot of water.

A 63-year-old male patient has just begun treatment with IV paclitaxel. About 10 minutes into the infusion, the nurse becomes concerned about a possible anaphylactic reaction to the drug because the patient is experiencing: A. dyspnea. B. bradycardia. C. hypertension. D. increased body temperature.

A. dyspnea.

Which agent would the nurse expect to be administered orally? A. Gemcitabine B. Methotrexate C. Fluorouracil D. Cytarabine

B. Methotrexate

The nurse is providing medication education to a client with breast cancer who has been prescribed tamoxifen. How should the nurse explain the action of the drug? A. induces apoptosis of cancer cells B. slows the growth of cancer cells C. increases the viability of healthy cells that are adjacent to cancerous cells D. causes mutations of cancer cells

B. slows the growth of cancer cells

A 25-year-old female client is prescribed methotrexate to treat rheumatoid arthritis (RA). The nurse should teach the client to: A. take a pain reliever for sore throat. B. use an effective contraceptive. C. expect a mild rash and itching. D. drink milk with the medication.

B. use an effective contraceptive.

No cancer cells have been identified that can remain dormant for more than 2 years. T/F

false

A client is being treated for cancer and dronabinol has been added to the client's current medication regimen. What assessment finding would indicate a therapeutic effect of this medication? A. Absence of nausea B. Decreased pain C. Increased energy D. Stable white blood cell levels

A. Absence of nausea

A 49-year-old client is diagnosed with ovarian cancer. What is a characteristic of malignant cells that differentiates them from normal body cells? A. Cancerous cells grow in an uncontrollable fashion. B. Cancerous cells are not responsive to the presence of drugs. C. Cancerous cells do not require an energy source in order to proliferate. D. Cancerous cells have a theoretically infinite life span.

A. Cancerous cells grow in an uncontrollable fashion.

A child is prescribed an anthracycline drug. The nurse would teach the parents to observe for signs and symptoms of what adverse effect? A. Cardiotoxicity B. Gallbladder disease C. Esophageal varices D. Dehydration

A. Cardiotoxicity

The nurse may be asked to administer which medications to a client to counteract the increase in uric acid and subsequent hyperuricemia resulting from the metabolic waste buildup from rapid tumor lysis? A. allopurinol B. amifostine C. mesna D. leucovorin

A. allopurinol

Which would the nurse identify as an antineoplastic antibiotic? A. Teniposide B. Mitomycin C. Vinblastine D. Docetaxel

B. Mitomycin

A patient is to start with chemotherapy. The patient is worried about going bald in the course of the treatment. How can the nurse assist the patient in being comfortable with his or her body image? A. Explain that hair preserves body heat. B. Suggest the use of a wig or cap. C. Explain it is not life-threatening. D. Forewarn about hair loss.

B. Suggest the use of a wig or cap.

A postmenopausal woman with breast cancer will most likely be treated with which anti-estrogen drug? A. Cyclophosphamide B. Tamoxifen C. Cisplatin D. Bleomycin

B. Tamoxifen

A nurse educator who coordinates the staff education on an oncology unit is conducting an inservice on targeted therapies. What potential benefit of targeted therapies should the nurse highlight in this education session? A. Targeted therapies achieve the therapeutic benefits of traditional chemotherapy with no risk of adverse effects. B. Targeted therapies have the potential to damage cancerous cells while leaving normal body cells less affected. C. Targeted therapies are significantly more cost-effective than traditional chemotherapeutic drugs. D. Targeted therapies have the potential to provide prophylactic protection against neoplasia in high-risk individuals.

B. Targeted therapies have the potential to damage cancerous cells while leaving normal body cells less affected.

A client is undergoing a cytotoxic chemotherapy regimen for the treatment of stage III lung cancer. What effect will this regimen likely have on the client's hemostatic function? A. The client will require prophylactic heparin. B. The client's platelet count will decline. C. The client will be at increased risk of deep vein thrombosis (DVT). D. The client will likely experience thrombocytosis.

B. The client's platelet count will decline.

A patient having chemotherapy is losing her hair. She asks the nurse if her hair will come back as it originally was. What is the best response by the nurse? A. "Your hair will grow back, but it will be very thin and straight." B. "I think you have more to worry about than if you have hair. You can buy a wig." C. "Your hair will grow back, but the new hair may be a different color or texture." D. "Your hair may not grow back, but we can refer you to a wig specialist."

C. "Your hair will grow back, but the new hair may be a different color or texture."

A client's chemotherapeutic regimen includes procarbazine. What is the client's most likely diagnosis? A. Neuroblastoma B. Pancreatic cancer C. Astrocytoma D. Hodgkin lymphoma

D. Hodgkin lymphoma

How can a nurse best prevent tissue damage caused by an antineoplastic extravasation? A. Use an infusion pump B. Infuse into proximal veins whenever possible C. Administer through a hand vein, if possible D. Inspect the site frequently for redness or swelling

D. Inspect the site frequently for redness or swelling

A 54-year-old male patient with small-cell lung cancer is receiving etoposide. The nurse will carefully monitor for: A. hypertension. B. hypoglycemia. C. tachycardia. D. hypotension.

D. hypotension.

A male client is diagnosed with prostate cancer. The treatment modality of choice includes both surgery and chemotherapy. What does the chemotherapeutic option include? A. Antidiuretic hormone B. Diuretics C. Hormonal therapies D. Hemoglobin replacement therapy

C. Hormonal therapies

Many times a combination of antineoplastic medications are used to: A. decrease the side effects of each medication. B. increase the length of treatment. C. increase the quantity of each medication used. D. decrease the development of cell resistance.

D. decrease the development of cell resistance.

When describing the process of cancer cell growth to a client, the nurse addresses angiogenesis. Which description would the nurse include? A. The process of growing without the usual homeostatic restrictions that regulate cells B. The process of creating new blood vessels to supply oxygen and nutrients to the cells C. A process in which the cells lose their ability to differentiate and organize D. A process that involves the cells traveling to other areas of the body to develop new tumors

B. The process of creating new blood vessels to supply oxygen and nutrients to the cells

A client is receiving idarubicin. What is the nurse's priority assessment? A. Electrolyte levels B. Respiratory function C. Red cell indices D. Cardiac function

D. Cardiac function

A client has been prescribed cabazitaxel 25 mg/m2 PO every three weeks for the treatment of prostate cancer. What is the nurse's priority response to this prescription? A. Question the prescriber about the dose B. Confirm the client's baseline renal and hepatic function C. Perform a comprehensive assessment prior to administration D. Question the prescriber about the route

D. Question the prescriber about the route

A client on the oncology unit has begun chemotherapy with a regimen that includes bendamustine. The client has begun to experience alopecia. The nurse should prioritize assessments related to what potential nursing diagnosis? A. Hypothermia B. Disturbed body image C. Ineffective thermoregulation D. Impaired tissue integrity

B. Disturbed body image

A nurse in an outpatient treatment center is caring for a client who receives regular IV chemotherapy sessions. The nurse understands that one important goal of chemotherapy is what? A. Prevention or treatment of adverse drug effects B. promotion of uncontrolled cell growth C. Inhibition of normal cell production D. decrease in biologic targeted therapies

A. Prevention or treatment of adverse drug effects

A client received an injection of doxorubicin and is now observing a reddish urine. The client reports blood in the urine to the nurse. How should the nurse respond? A. "Let's get a urinalysis to confirm a urinary tract infection." B. "We need to notify the health care provider because this is a complication of the medication." C. "You may have hemorrhagic cystitis." D. "The reddish urine is an expected response to the drug."

D. "The reddish urine is an expected response to the drug."

Dosage of cytotoxic drugs for children is based on:

body surface area

A patient has just received the first dose of imatinib and the nurse on the oncology unit is amending the patient's care plan accordingly. What nursing diagnosis is most appropriate in light of this addition to the patient's drug regimen? A. Risk for Infection related to bone marrow suppression B. Risk for Acute Confusion related to adverse neurological effects of imatinib C. Risk for Impaired Skin Integrity related to exaggerated inflammatory response D. Risk for Deficient Fluid Volume related to changes in osmotic pressure

A. Risk for Infection related to bone marrow suppression

A female client will soon begin targeted therapy as a component of her treatment plan for chronic leukemia. The nurse is conducting health education about this new aspect of the client's drug regimen and the client has asked about the potential side effects of treatment. How should the nurse best respond? A. "Chemotherapy causes a lot of unpleasant side effects, and the advantage of targeted therapies is that these are all avoided." B. "Both classes of drugs have adverse effects, but targeted therapies tend to have less of an effect on healthy body cells." C. "Targeted therapies are often more effective than traditional chemotherapy, but the downside of this effectiveness is that adverse effects are more common and severe." D. "The adverse effects to targeted therapies are most often a result of the client's cancer, not the drugs themselves."

B. "Both classes of drugs have adverse effects, but targeted therapies tend to have less of an effect on healthy body cells."

The nurse is describing the necessity of recovery periods between treatment cycles to a client receiving chemotherapy. How should the nurse best explain the need? A. There is a need to restore a physiologic reserve of energy before further chemotherapy. B. Time is needed to replace many of the healthy body cells killed by chemotherapy. C. The restoration of fluid balance and nutrition is needed before continuing with chemotherapy. D. Time is required for the successful application of radiotherapy between cycles of chemotherapy.

B. Time is needed to replace many of the healthy body cells killed by chemotherapy.

A client with a diagnosis of bladder cancer is started on a chemotherapeutic regimen that includes three agents. What is the rationale for using multiple antineoplastic agents? A. The use of three agents increases the quantity of one of the agents. B. The use of three agents increases the length of treatment. C. The use of three agents decreases the development of cell resistance. D. The use of three agents decreases the adverse effects.

C. The use of three agents decreases the development of cell resistance.

What is the defining characteristic of a sarcoma? A. sequestered within bone or muscle tissue B. attributable to endogenous carcinogens C. congenital in nature D. originates from connective tissue

D. originates from connective tissue