Karch Chapter 14: Bonus Antineoplastic

A patient is diagnosed with a brain tumor. He is told the cancer cells proliferate. The patient asks the nurse what this means. What is the nurse's best response? a) "The proliferation of the cancer cells is the suppression of growth." b) "The proliferation of cancer cells is the metastasis of the tumor." c) "The proliferation of the cancer cells is the treatment with chemotherapy." d) "The proliferation is the growth of cancer cells and the rate of growth."

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

The nurse may be asked to administer which of the following medications to a patient to counteract the increase in uric acid and subsequent hyperuricemia resulting from the metabolic waste buildup from rapid tumor lysis? (Choose one) a) Allopurinol (Zyloprim) b) Mesna (Mesnex) c) Leucovorin (Wellcovorin) d) Amifostine (Ethyol)

Allopurinol (Zyloprim)

A patient is experiencing antineoplastic-induced nausea and vomiting. The health care provider prescribes ondansetron. The nurse understands that this agent acts in which way? a) Blocking serotonin receptors in the CTZ b) Directly blocking the chemoreceptor trigger zone (CTZ) c) Calming the activity of the gastrointestinal tract d) Blocking human substance P/neurokinin 1 receptors

Blocking serotonin receptors in the CTZ

The oncology nurse understands that he or she is administering chemotherapeutic agents that are most effective during a particular phase of the cell cycle. To what is this referred? a) Cell cycle-nonspecific b) Cell targeting c) Cell cycle-specific d) Growth fraction

Cell cycle-specific

A client is receiving bleomycin as part of his chemotherapy regimen. Which of the following would be most important for the nurse to monitor? a) Chest x-ray b) Platelet count c) Electrocardiogram d) Serum electrolytes

Chest x-ray

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 do which of the following? a) Drink a lot of water b) Increase the protein in her diet c) Limit fluid intake d) Take the medication at bedtime

Drink a lot of water

A patient is diagnosed with ovarian cancer. Why is this cancer considered to be an aggressive form? a) The woman has a supply of testosterone from the ovaries. b) The younger the patient, the more aggressive the form. c) It is fed by calcium in women who take estrogen. d) It is fed by the hormones produced by the ovaries.

It is fed by the hormones produced by the ovaries.

Which agent would the nurse expect to be administered orally? a) Fluorouracil b) Gemcitabine c) Methotrexate d) Cytarabine

Methotrexate

An elderly man has been admitted to a residential care facility and the nurse has conducted a medication reconciliation. The man has taken numerous drugs in the past, including a course of bicalutamide (Casodex) several years earlier. The nurse recognizes this drug as being an antiandrogen and is consequently justified in presuming that the man has a history of what disease? a) Lymphoma b) Prostate cancer c) Skin cancer d) Lung cancer

Prostate cancer

A nurse administers ondansetron to a client receiving chemotherapy for which reason? a) Reduce vomiting b) Prevent hypersensitivity c) Decrease secretions d) Relieve inflammation

Reduce vomiting

A patient with non-Hodgkin's lymphoma (NHL) will be starting a course of doxorubicin shortly. When planning this patient's care, what nursing diagnosis should the nurse prioritize? a) Risk for Ineffective Airway Clearance related to decreased neurological function b) Risk for Impaired Skin integrity related to cytotoxic effects of doxorubicin c) Risk for Infection related to suppressed bone marrow function d) Risk for Imbalanced Nutrition: More Than Body Requirements related to metabolic effects of doxorubicin

Risk for Infection related to suppressed bone marrow function

When describing the various effects of antineoplastic agents, the nurse explains that antineoplastic drugs primarily affect human cells that are rapidly multiplying, going through the cell cycle quickly. The nurse would identify the cells of which of the following as an example? a) Skin b) Ovaries c) Breast d) Testicles

Skin

What is the first action by the oncology nurse when observing extravasation with the patient receiving vincristine? a) Apply warm compresses. b) Consult the physician. c) Obtain a photograph of the site. d) Stop the infusion.

Stop the infusion.

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 it is not life-threatening. b) Forewarn about hair loss. c) Explain that hair preserves body heat. d) Suggest the use of a wig or cap.

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

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 are significantly more cost-effective than traditional chemotherapeutic drugs. b) Targeted therapies have the potential to damage cancerous cells while leaving normal body cells less affected. c) Targeted therapies achieve the therapeutic benefits of traditional chemotherapy with no risk of adverse effects. d) Targeted therapies have the potential to provide prophylactic protection against neoplasia in high-risk individuals.

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

What should the oncology nurse understand when administering a cell cycle-nonspecific chemotherapeutic agent about its effect? a) The drug will be effective through specific areas of the cell cycle. b) The drug will be effective through all phases of the cell cycle. c) The drug is not effective throughout all phases of the cell cycle. d) The drug has intermittent effectiveness throughout the cell cycle.

The drug will be effective through all phases of the cell cycle.

A patient is started on chemotherapy. The chemotherapy regimen includes three agents. What is the rationale for using three different antineoplastic agents? a) The use of three agents decreases the development of cell resistance. b) The use of three agents decreases the adverse effects. c) The use of three agents increases the length of treatment. d) The use of three agents increases the quantity of one of the agents.

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

An adverse effect of tamoxifen therapy involves menopausal symptoms. a) True b) False

True

Cancer is considered the second leading cause of death in the United States. a) False b) True

True

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) "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." d) "I think you have more to worry about than if you have hair. You can buy a wig."

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

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) hypertension. b) bradycardia. c) increased body temperature. d) dyspnea.

dyspnea.

Which of the following cytoprotective agents can be given along with antineoplastic drugs to help prevent or lessen certain adverse effects? Select all that apply: a) Dexrazoxane (Zinecard) b) Leucovorin (Wellcovorin) c) Mesna (Mesnex) d) Allopurinol (Zyloprim) e) Amifostine (Ethyol)

• Allopurinol (Zyloprim) • Amifostine (Ethyol) • Leucovorin (Wellcovorin) • Mesna (Mesnex) • Dexrazoxane (Zinecard)