Exam 5
A client is prescribed interferon beta-1a to be administered subcutaneously in the home setting. Which statement should the nurse include in the teaching about the medication?
"Administer the medication at bedtime."
A client diagnosed with metastatic kidney cancer and prescribed aldesleukin discusses obtaining the medication in an outpatient chemotherapy unit. As part of client education, the nurse would include what statement?
"Aldesleukin is highly toxic and given only to hospitalized clients."
A client with a diagnosis of chronic renal failure will soon begin a regimen of epoetin that will be administered by the client at home. Which statement indicates that the nurse's initial health education has been successful?
"I'm not all that comfortable with giving myself an injection, but I'm sure I'll be able to learn."
A nurse is providing teaching to a client who has been prescribed filgrastim for use in the home setting. Which statement should the nurse include?
"If you have pain, you can take acetaminophen."
A nurse is teaching a client about epoetin alfa. Which statement should the nurse include in the teaching?
"In 2 weeks, you will return for laboratory tests."
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?
"The proliferation is the growth of cancer cells and the rate of growth."
A client is being treated for renal carcinoma with aldesleukin. Which statement indicates that the client has understood the teaching?
"This drug will inhibit tumor growth."
Which client would likely be the most appropriate candidate for treatment with filgrastim?
A client whose acute myelogenous leukemia necessitated a bone marrow transplant
For which client would epoetin alfa NOT be indicated?
A client with a hemoglobin of 12, with shortness of breath.
Which nursing diagnosis would provide the most plausible indication for the use of epoetin alfa in a client with renal failure?
Activity intolerance related to decreased oxygen-carrying capacity
A hospital client's complex medical history includes a recent diagnosis of kidney cancer. Which medication is used to treat metastatic kidney cancer?
Aldesleukin
An adult client has recently begun cancer treatment with methotrexate (MTX). When reviewing this client's laboratory work, the nurse should consequently prioritize assessment of what?
BUN and creatinine
A 79-year-old woman has recently moved to a long-term care facility, and the nurse at the facility is conducting a medication reconciliation. The nurse notes that the woman has recently been taking tamoxifen. The nurse is justified in concluding that the woman has a history of what malignancy?
Breast cancer
A client with a diagnosis of renal failure is being treated for anemia with epoetin alfa. Frequent assessment of which laboratory values should be prioritized before and during treatment?
CBC
An oncology nurse is providing care for an adult client who is currently immunocompromised. The nurse is aware of the physiology involved in hematopoiesis and immune function, including the salient role of cytokines. What is the primary role of cytokines in maintaining homeostasis?
Cytokines perform a regulatory role in the development of diverse blood cells.
A client is administered a granulocyte colony-stimulating factor (G-CSF). What is the expected outcome of a G-CSF?
Decreased number of infections
A client with chronic renal failure is prescribed filgrastim. What is the effect of filgrastim?
Decreases neutropenia related to chemotherapy
A client has been diagnosed with chronic renal failure. Which agent will assist in raising the client's hemoglobin levels?
Epoetin alfa
A client has chronic renal failure. As the disease progresses, the client is experiencing increasing shortness of breath, due to anemia. The nurse would anticipate which medication order?
Epoetin alfa
A client has suffered from a gastrointestinal hemorrhage. Which agent will assist in raising the hemoglobin?
Epoetin alfa
An adult client has developed renal failure secondary to an overdose of a nephrotoxic drug. Which assessment finding would the nurse recognize as being most suggestive of impaired erythropoiesis?
Fatigue and increased heart rate
A 69-year-old client has been diagnosed with malignant melanoma. The care team has collaborated with the client and her family and agreed on a plan of care that includes administration of interferon alfa-2b. After administering interferon alfa-2b, the oncology nurse should anticipate that the client may develop which adverse effect?
Flulike symptoms
A client has been administered methotrexate, which is a purine antagonist used to treat a rapidly growing tumor. The client develops stomatitis. What is the priority nursing diagnosis for a client suffering from stomatitis?
Impaired skin integrity
A client is receiving epoetin alfa for anemia. Which adjunctive therapy is imperative with epoetin alfa?
Iron supplementation
A client is administered bevacizumab to treat tumor growth in a breast tumor. What is the action of a monoclonal antibody such as bevacizumab?
It prevents the activation of intracellular growth factors.
A client's current medical condition is suggestive of impaired erythropoiesis. Which laboratory study would be most clinically relevant in diagnosing this health problem?
RBC, hemoglobin, hematocrit
A client is undergoing a bone marrow transplant. Which medication is most effective in stimulating the production of granulocytes and macrophages?
Sargramostin
A client who is undergoing chemotherapy for the treatment of non-Hodgkin's lymphoma will soon begin treatment with epoetin alfa. The nurse should be aware that this drug may be administered by which route? Select all that apply.
Subcutaneous Intravenous
A 32-year-old female client is being treated with a cytotoxic antineoplastic agent. Which is the most important instruction related to the potential for teratogenicity?
The client should not become pregnant for several months.
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?
The client's platelet count will decline.
A client has chosen to receive palliative care after lung cancer metastasized to the bones and liver. Which is the most appropriate during palliative cancer care?
The use of chemotherapy to reduce pain
A client taking epoetin alfa requests changing the medication from the subcutaneous route to the PO route. How should the nurse respond?
This medication is destroyed in the stomach and can only be given by injection.
A client has received a large amount of chemotherapy to treat leukemia. The client develops gastrointestinal upset, hypertension, and paresthesias. What syndrome is the client developing?
Tumor lysis syndrome
An oncology nurse is preparing to administer cytotoxic chemotherapy medications. Which measure best protects the nurse from harm related to the chemotherapy?
Wearing protective equipment
Which process is cytokine-induced? Select all that apply.
cellular differentiation antibody production inflammation tissue repair
