Chapter 32: Anticancer Drugs

A patient is being discharged after receiving IV chemotherapy. Which statement made by the patient indicates a need for additional teaching? A. "Chemotherapy is excreted in my bodily fluids" B. "I will not need to know how to check my temperature" C. "My spouse should wear gloves when emptying my urinal" D. "The chemotherapy will remain in my body for 2-3 days"

B

A patient is scheduled to receive high-dose cyclophosphamide, an alkalating agent, via an intravenous infusion as treatment for cancer. Which will be most important for the nurse to include when teaching the patient about cyclophosphamide? A. An indwelling urinary catheter will be placed. B. Drink at least 2 L of fluid per day C. Empty the bladder every 4 to 6 hours D. Limit fluid intake during chemotherapy

B

The patient, 61 years old, is to receive an antitumor antibiotic, doxorubucin, as part of his chemotherapy protocol. Which assessment is the most important before administering the medication? A. Cardiac status B. Liver function C. Lung sounds D. Neurologic status

A

The nurse is caring for a patient with colorectal cancer who is to receive fluorouracil, an antimetabolite. Which symptom will be most important for the nurse to report to the health care provider? A. Nausea B. Decreased appetite C. Bleeding gums D. Constipation

C

A patient is scheduled to receive a plant alkaloid, vincristine, as part of treatment for cancer. The medication record for the patient indicates that he is receiving phenytoin to control a seizure disorder. What should the nurse monitor for in this patient? A. Headaches B. Increased blood pressure C. Renal failure D. Seizures

D

The nurse is preparing IV vinblastin, bleomycin, and cisplatin, for administration to a patient on the nursing unit. Which precaution should the nurse take when hanging IV chemotherapy? A. Wear a clean cotton gown B. Wear shoe covers C. Wear a hair net D. Wear powder-free gloves

D

The nurse is teaching a 29-year old patient about an alkylating agent, cyclophosphamide, which will be given as part of her treatment protocol for cancer. Which priority information should be included in the teaching? A. Hair loss has never been reported with the use of cyclophosphamide B. Menstrual irregularities and sterility are not expected with this drug C. No special isolation procedures are needed when receiving this chemotherapy D. Pregnancy should be prevented during treatment with cyclophosphamide

D

A patient is receiving the antitumor antibiotic doxorubicin (Adriamycin) to treat lung cancer. The patient is experiencing shortness of breath and palpitations. The nurse is concerned that the patient has developed which condition? a. Anemia b. Cardiotoxicity c. Hypersensitivity d. Pulmonary infection

b

2. A patient is scheduled to receive chemotherapy drugs that will cause myelosuppression. Which action by the nurse will be most important? A. monitor for a change in temperature B. evaluate gastrointestinal function C. Assess for evidence of cardiac compromise D. Question the patient about changes in taste

A

A patient in the outpatient oncology clinic complains of fatigue after receiving chemotherapy. Which initial nursing intervention will be most appropriate? A. Assess for other factors contributing to her fatigue, such as trouble sleeping B. Encourage a high-protein, high-calorie diet, and design it with the patient. C. Refer the patient to a physical therapist to develop a strenuous exercise program D. encourage the patient to sleep as much as possible during the day to ease fatigue

A

A patient with breast cancer is scheduled to receive anastrozole, an aromatase inhibitor. Which information should be included in the patient teaching? A. Aromatase inhibitors block the peripheral conversion of androgens to estrogens B. Aromatase inhibitors are used to treat tumors that are not hormonally sensitive C. Aromatase inhibitors are used only in premenopausal women with breast cancer D. Aromatase inhibitors are used only in postmenopausal women with breast cancer

A

The 65-year old patient has metastatic cancer. He is scheduled to receive palliative chemotherapy. He states that he does not understand why he should receive palliative chemotherapy if it won't kill the cancer cells. What is the best response? A. "It is done to help improve your quality of life" B. "It is given to limit further growth of the cancer" C. "It is given to slow the growth of the cancer" D. "It will shrink the tumors throughout your body"

A

The nurse is administering an alkylating agent, doxorubicin, to a patient diagnosed with cancer. What should the nurse keep in mind with regard to tissue necrosis associated with this drug? A. Tissue necrosis may occur 3-4 weeks after administration B. Tissue necrosis occurs immediately after administration C. Tissue necrosis occurs 2-4 days after administration D. Tissue necrosis rarely occurs with this drug

A

The nurse is caring for a patient receiving combination chemotherapy. The patient asks why she has to take more than one agent. What is the nurse's best response? A. "It has better response rates than single-agent chemotherapy" B. "It has fewer side effects than when given alone" C. "It is always more effective than surgery or radiation" D. "Survival rates are always better"

A

The nurse is preparing to administer chemotherapy, which can cause severe nausea and vomiting, to a patient in the outpatient clinic. Which nursing action would be most appropriate? A. Give an antiemetic before administering the chemotherapy B. Withhold any antiemetic drugs until the patient complains of nausea C. Give an antiemetic only after the patient has vomited D. Offer the patient a glass of ginger ale to prevent nausea

A

The patient has a low platelet count secondary to chemotherapy. Which nursing actions would be the most appropriate? A. Apply pressure to injection site and assess for occult bleeding B. Help the patient conserve energy by scheduling care C. Monitor breath sounds and vital signs D. Provide small frequent meals and monitor loss of fluids from diarrhea

A

The patient is to receive an alkylating agent, cyclophosphamide, as part of her cancer treatment. Which nursing intervention should the nurse expect to complete? A. Assess for signs of hematuria, urinary frequency, or dysuria B. Decrease fluids to reduce the risk of calculus formation C. hydrate the patient with IV fluids only after administration of cyclophosphamide D. Medicate with an antiemetic only after the patient complains of nausea

A

A patient is scheduled to receive a plant alkaloid, vincristine, as part of her treatment for non-Hodgkin's lymphoma. She reports that she likes to "rely on nature" for complementary therapy. Which herbal/supplement(s) should be avoided by this patient? (Select all that apply) A. Bromelain B. Daily multivitamin C. Periwinkle D. Sheng-Mai-San E. Valerian

A, C, D

A patient is experiencing mucositis (stomatitis) after receiving chemotherapy. Which symptomatic treatments will be appropriate? (select all that apply) A. frequent mouth rinses B. Antiemetics C. Topical anesthetics D. Stress reduction E. Antibiotics

A, C, E

The nurse is caring for a patient who is receiving fluorouracil (5-FU) to treat pancreatic cancer. Which interventions are included in the nurse's plan of care for this patient? (Select all that apply.) a. Apply ice to the IV site if the patient reports pain. b. Administer antiemetics when the patient reports nausea. c. Counsel the patient to use waxed dental floss. d. Discourage visits with people who have respiratory infections. e. Offer ice chips frequently. f. Restrict to nothing by mouth during intravenous drug administration.

A,C,E

A patient is to receive a chemotherapy protocol that includes an alkylating agent, an antimetabolite, and an antitumor antibiotic. The patient asks the nurse why so much chemotherapy is needed. What is the nurse's best responses? A. a protocol that uses a combination of chemotherapeutic agents works in the S phase to kill cells. B. Combination chemotherapy increases the extent of tumor cell killing. C. Combination chemotherapy uses drugs that work the same way. D. An outcome of the use of combination chemotherapy is that it has no dose-limiting toxicities.

B

One week ago in the outpatient oncology clinic, a client received his first cycle of chemotherapy consisting of cyclophosphamide (Cytoxan), doxorubicin (Adriamycin), and fluorouracil (5-FU; Adrucil) (CAF). He returns to the clinic today for follow-up. Which nursing intervention would be most appropriate at this time? A. Culture the IV site and send a specimen to the laboratory for analysis B. Monitor blood counts and laboratory values C. Offer analgesics for pain and evaluate effectiveness D. Teach the patient about good skin cancer

B

The 70-year-old patient is to receive an alkalating agent, cyclophosphamide, for treatment of his lymphoma. His medical history is also positive for atrial fibrillation, arthritis, and cataracts. He takes digoxin 0.125 mg daily and naproxen 500 mg at bedtime. What should the nurse be aware of when giving these medications? A. cyclophosphamide increases digoxin levels B. cyclophosphamide decreases digoxin levels C. Digoxin increases cyclophosphamide levels D. These drugs cannot be given together

B

A patient in the outpatient oncology clinic has developed mucositis after receiving fluorouracil an antimetabolite. Which statement made by the patient indicates the need for additional teaching about mucositis? A. I will frequently rinse out my mouth with normal saline B. To relieve my mouth pain, i will use ice pops or ice chips C. I will use mouthwash with alcohol to clean my mouth D. Using a soft toothbrush will clean my teeth and freshen my breath

C

A patient in the outpatient oncology clinic has developed mucositis secondary to cancer therapy. Which statement made by the patient would indicate that she needs additional teaching about mucositis? A. "I will rinse my mouth out frequently with normal saline" B. "I will try using ice pops or ice chips to help relieve mouth pain" C. "I will use a mouthwash that has an alcohol base" D. "I will use a soft toothbrush"

C

A patient is admitted to the hospital 1 week after receiving teniposide in the outpatient oncology clinic. On physical assessment, the nurse notes the presence of petechiae, ecchymoses, and bleeding on the toothbrush when the patient brushes his teeth. Which nursing diagnosis would be most appropriate? A. Risk for fatigue B. Risk for infection C. Risk for bleeding D. Risk for falls

C

Which nursing outcome would be most appropriate as part of the planning for a patient scheduled to receive an alkylating agent, cyclophosphamide? A. Patient will be free from symptoms of stomatitis B. Patient will maintain cardiac output C. Patient will show no signs of hemorrhagic cystitis D. Patient will show no signs of syndrome of inappropriate antidiuretic hormone secretion (SIADH)

C

The patient is in the outpatient oncology clinic for treatment of her colon cancer. She is receiving an antimetabolite, fluorouracil (5-FU), as part of her treatment and has recently been started on metronidazole for treatment of trichomaniasis. What should concern the nurse about this order? A. 5-FU may decrease the effectiveness of metronidazole B. 5-FU cannot be given with metronidazole C. Metronidazole may increase the side effects of 5-FU D. Metronidazole may increase 5-FU toxicity

D

The nurse is caring for a patient who is receiving vincristine (Oncovin), a plant alkaloid chemotherapeutic agent, to treat non-Hodgkin's lymphoma. The nurse observes that the patient has difficulty walking. What action will the nurse take? a. Ask about numbness or tingling in the fingers and toes. b. Assess heart rate and blood pressure to evaluate for orthostatic hypotension. c. Assess the temperature to evaluate for infection. d. Request an order for a complete blood count and electrolytes.

a

A patient is receiving bleomycin (Blenoxane) as part of a chemotherapeutic regimen to treat leukemia. During intravenous administration of this drug, what will the nurse observe the patient closely for? a. Hypotension and visual disturbances b. Pain and blistering at the IV site c. Pink to red urine d. Shortness of breath and wheezing

d

A woman who has advanced breast cancer will begin receiving androgen therapy. The nurse will explain to the patient that androgen therapy is used to a. enhance her own estrogen production. b. give her a sense of well-being. c. minimize hot flashes. d. promote regression of her tumor.

d

An oncology home care nurse is preparing to administer a chemotherapeutic agent to a patient at the patient's home. What precautions will the nurse take while administering the IV chemotherapeutic agent? a. Clear a counter space for preparation of the solution. b. Don a surgical mask while administering the drug. c. Take surgical scrubs to wear during the infusion. d. Wear an impermeable, disposable gown when hanging the drug.

d

The nurse is caring for a patient who is receiving intravenous mechlorethamine (Mustargen). The patient reports pain at the IV site, and the nurse assesses swelling and pallor at the site. What action will the nurse take? a. Administer an analgesic medication. b. Apply a warm compress to the site. c. Slow the infusion and notify the provider. d. Stop the infusion immediately.

d

The nurse is teaching a patient who is receiving vincristine (Oncovin) about long-term management of the treatment regimen. Which information will the nurse provide in teaching the patient? a. "If you experience numbness of your hands, it will eventually resolve." b. "If your IV starts to hurt, you should pull the IV out immediately." c. "You should ask for antinausea medication at the first sign of nausea." d. "You should report difficulty buttoning your clothes to your provider."

d

The patient will be receiving chemotherapy that will lower her white blood cell count. Monitoring for which finding will be a nursing priority? A. Change in temperature B. Evidence of petechiae C. Increase in diarrhea D. Taste changes

A

A nurse is teaching a patient who will receive chemotherapy that will cause thrombocytopenia. Which instructions will the nurse include in the patient's teaching plan? (select all that apply) A. Use an electric razor when shaving B. Use a soft-bristled toothbrush C. Use aspirin for pain or headache D. Monitor oral temperature daily E. Ropart any bleeding (gums, petechiae, bruises, hematuria, melena) to the health care provider

A, B, E

A nurse is administering an antitumor antibiotic, doxorubucin, to a patient in the outpatient oncology clinic. Which information would be most important for the nurse to include in patient teaching? A. Blood counts will most likely remain normal B. Complete alopecia rarely occurs with this drug C. Report any shortness of breath, palpitations, or edema to the health care provider D. Tissue necrosis usually occurs 2 to 3 days after administration

C

A patient diagnosed with cancer is scheduled to receive the plant alkaloid, vincristine. Which nursing assessment will have the highest priority when providing care for this patient? A. Degree of alopecia B. Increased Digoxin levels C. Decreased phenytoin levels D. Peripheral neuropathy

C

A patient has reached the nadir of his blood counts secondary to chemotherapy. Which nursing diagnosis is the most appropriate? A. Risk for cardiac failure B. Risk for dehydration C. Risk for infection D. Risk for malnutrition

C

A patient is receiving chemotherapy and asks the nurse about side effects. What should the nurse know concerning the side effects of chemotherapy? A. Side effects are minimal because chemotherapy drugs are highly selective B. Side effects usually only occur during the first cycle of treatment C. Side effects are caused by toxicities to normal cells D. Side effects of chemotherapy are usually permanent

C

A patient is to receive an antimetabolite, fluorouracil (5-FU), as part of a treatment protocol for colon cancer. When teaching the patient about his drug, what should the nurse say concerning when the nadir usually occurs in the blood counts? A. 1-4 days after administration B. 5-9 days after administration C. 10-14 days after administration D. 15-19 days after administration

C

A patient presents with neutropenia secondary to cancer therapy. Which nursing diagnosis would be the most appropriate? A. Risk for cardiac failure B. Risk for dehydration C. Risk for infection D. Risk for malnutrition

C

A patient receiving an cyclophosphamide, epirubicin, and fluorouracil has experienced severe nausea, vomiting, and diarrhea over the past week. He has lost 5.5 pounds. Which nursing diagnosis would be most appropriate? A. knowledge deficit related to chemotherapeutic regimen B. Pain secondary to diarrhea C. Risk for altered nutrition D. Risk for infection secondary to low WBC counts

C

The nurse administering IV antimetabolite, fluorouracil (5-FU), to a patient in the outpatient oncology clinic. Which nursing intervention would be most appropriate? A. 5-FU is vesicant, so assess for tissue necrosis at the IV site B. Apply heat toe the IV site if extravasation occurs C. Assess for hyperpigmentation along the vein in which the drug is given D. Encourage mouth rinses once every 8 hours during chemotherapy

C

The nurse is administering an alkylating agent, doxorubicin, to a patient in the outpatient oncology clinic. What is priority information to include in the patient teaching? A. Blood counts will most likely remain normal B. Complete alopecia rarely occurs with this drug C. Report any shortness of breath, palpitations, or edema to your health care provider D. Tissue necrosis usually occurs 2-3 days after administration

C

The patient, 69 years old, is receiving cyclophosphamide, doxorubicin, and methotrexate for the treatment of prostate cancer. During morning rounds, the patient complains of feeling short of breath. Physical assessment reveals crackles in both lungs. What is the most likely cause of this clinical manifestation? A. Anxiety B. Cyclophosphamide C. Doxorubucin D. Methotrexate

C

The nurse is teaching a patient about an alkylating agent, doxorubicin, which she will receive as part of her treatment for breast cancer. Which statement made by the patient indicates that she needs additional teaching? A. "Doxorubicin is a severe vesicant" B. "My blood counts will be checked" C. "My cardiac status will be closely monitored" D. "This drug may turn my urine blue"

D

The patient has diarrhea secondary to chemotherapy. What important information should be included in patient teaching about chemotherapy-related diarrhea? A. Eat only very hot or very cold foods B. Increase intake of fresh fruits and vegetables C. Increase intake of high-fiber foods D. Limit caffeine intake

D

the nurse is teaching a community group about factors that influence the development of cancer in humans. Which information will the nurse include in this teaching? A. Aflatoxin is associated with cancer of the lungs B. Benzene is associated with cancer of the tongue C. Epstein-Barr virus is associated with cancer of the stomach D. Human Papillomavirus is associated with cancer of the cervix

D

A patient who is about to begin chemotherapy asks the nurse when the risk of infection is highest. The nurse will tell the patient that infection risk is greatest at which point? a. A week to 10 days after each chemotherapy dose b. During the week immediately after chemotherapy c. Immediately prior to each dose of chemotherapy d. When the patient's temperature is elevated by 1° F

a

A patient who has cancer is about to begin chemotherapy. The patient asks the nurse why two chemotherapeutic agents are being used instead of just one. Which response by the nurse is correct? a. "The drugs may be given in less toxic doses if two drugs are used." b. "Two agents used together can have synergistic effects." c. "Use of two drugs will increase tumorcidal activity in the G0 phase of the cell." d. "Using two agents will shorten the length of time chemotherapy is needed."

b

The nurse is caring for a patient who is receiving a third dose of high-dose cyclophosphamide (Cytoxan). The nurse notes hematuria. The nurse will notify the provider and will perform which action? a. Ask whether the patient takes allopurinol (Lopurin). b. Assess the patient's skin and fingernails for darkening. c. Question the patient about fluid intake. d. Reassure the patient that this is an expected side effect.

c

The nurse is teaching a patient who will take oral cyclophosphamide (Cytoxan). Which statement by the patient indicates understanding of the teaching? a. "I should follow a diet high in organ meats and beans while taking this drug." b. "I should brush my teeth and gums vigorously twice daily." c. "I should report any low-grade temperature elevation immediately." d. "I should take the drug at bedtime to minimize side effects."

c