NUR 2031 Exam 3 Questions

A client receiving chemotherapy asks the nurse why an antibiotic was prescribed. Which tissue affected by chemotherapy should the nurse consider when formulating a response? 1. Liver 2. Blood 3. Bone marrow 4. Lymph nodes

3. Bone marrow

A client receiving combination chemotherapy for treatment of metastatic carcinoma asks the nurse in the clinic why more than one type of drug is necessary. Which concept is most important to teach the client in relation to why drug cocktails are more effective than a single drug in cancer therapy? 1. Drug resistance 2. Tumor doubling time 3. Cellular growth cycle 4. Retained radioactive particles

3. Cellular growth cycle

A client with small-cell lung cancer is receiving chemotherapy. A complete blood count is prescribed before each round of chemotherapy. Which component of the complete blood count is of greatest concern to the nurse? 1. Platelets 2. Hematocrit 3. Red blood cells (RBCs) 4. White blood cells (WBCs)

4. White blood cells (WBCs)

Which chemotherapy drug can cause hemorrhagic cycstitis (HC)? A. Flurouracil B. Cyclophosphamide C. Doxorubicin D. Vincristine

B. Cyclophosphamide, nursing intervention = hydrate and monitor I&O

A client with HIV infection has been receiving antiretroviral therapy for 2 months. At the initiation of treatment, the patient had a viral load (VL) of 60 copies/mL and a CD4 count of 450 cells/mm3. Today's lab results reveal a VL of 20 copies/mL and a CD4 cell count of 800 cells/mm3. How will the nurse interpret the patient's results? A. A drug restistant strain is present B. The client is progressing well. C. Treatment goals have been met. D. Treatment failure has occurred.

B. The client is progressing well.

Which chemotherapy causes bone marrow suppression? A. Flurouracil B. Cyclophosphamide C. Doxorubicin D. Vincristine

A. Fluorouracil, assess baseline lab values

A client is receiving doxorubicin as part of a chemotherapy protocol. The nurse should assess the client for which major life-threatening side effect of doxorubicin? 1. Anemia 2. Cardiotoxicity 3. Pulmonary fibrosis 4. Ulcerative stomatitis

2. Cardiotoxicity

A client receiving chemotherapy for cancer develops sores in the mouth and asks the nurse why this happened. What is the nurse's best response? 1. "The sores occur because of the direct irritating effects of the drug." 2. "These tissues are poorly nourished because you have a decreased appetite." 3. "The frequently dividing cells of the gastrointestinal tract are damaged by the drug." 4. "This side effect occurs because it targets the cells of the gastrointestinal system."

3. "The frequently dividing cells of the gastrointestinal tract are damaged by the drug."

A 6-year-old child who just completed a cycle of chemotherapy is to be discharged home. What is the priority teaching point at discharge? 1. Purchasing a wig 2. Ensuring adequate rest 3. Offering sufficient fluids 4. Performing thorough hand washing

4. Performing thorough hand washing

A patient is receiving cyclophosphamide therapy. Which statement by the patient indicates more teaching is necessary? A. "I will take the medication before bed." B. "I will eat a diet low in organ meats, beans, and peas." C. "I may experience hair loss." D. "I will not visit anyone who has a respiratory infection."

A."I will take the medication before bed." to prevent accumulation of drug in bladder during the night.

A nurse is caring for a client who is human immunodeficiency virus (HIV) positive. Which complication associated with this diagnosis is most important for the nurse to teach prevention strategies? 1. Infection 2. Depression 3. Social isolation 4. Kaposi sarcoma

1. Infection

A nurse administers lactulose to a client with cirrhosis of the liver. Which laboratory test change leads the nurse to determine that the lactulose is effective? 1. Decreased amylase 2. Decreased ammonia 3. Increased potassium 4. Increased hemoglobin

2. Decreased ammonia

A client with Hodgkin disease is placed on an ABVD combination chemotherapy regimen. Because doxorubicin is part of this therapy, what education will the nurse provide about this drug? 1. Cease taking any medication that contains vitamin D. 2. Keep the doxorubicin in a dark place protected from light. 3. Expect urine to turn red for a few days after taking this drug. 4. Take the doxorubicin on an empty stomach with large amounts of fluids.

3. Expect urine to turn red for a few days after taking this drug.

A client with cirrhosis of the liver develops ascites, and the health care provider prescribes spironolactone. What should the nurse monitor the client for? 1. Bruising 2. Tachycardia 3. Hyperkalemia 4. Hypoglycemia

3. Hyperkalemia

A client who has been diagnosed with acute lymphocytic leukemia will be receiving doxorubicin infusions as part of a chemotherapy regimen. The nurse monitors the client for signs and symptoms of doxorubicin toxicity. What clinical finding indicates that toxicity has occurred? 1. Alopecia 2. Dyspnea 3. Metallic taste to food 4. Cardiac rhythm abnormalities

4. Cardiac rhythm abnormalities (Cardiotoxic)

An adolescent who is undergoing chemotherapy for the treatment of bone cancer has stomatitis as a result of chemotherapy. What should the nurse include when teaching the child about self-care? Select all that apply. 1. Clean the teeth with a swab. 2. Drink fluids through a straw. 3. Brush the teeth three times a day. 4. Rinse frequently with a mouthwash. 5. Avoid foods served at extremes of temperature.

1. Clean the teeth with a swab. 2. Drink fluids through a straw. 5. Avoid foods served at extremes of temperature.

An older adult client who is receiving chemotherapy for cancer has severe nausea and vomiting and becomes dehydrated. The client is admitted to the hospital for rehydration therapy. Which nursing actions have specific gerontologic implications the nurse must consider? Select all that apply. 1. Assessment of skin turgor 2. Documentation of vital signs 3. Assessment of intake and output 4. Administration of antiemetic drugs 5. Replacement of fluid and electrolytes

1. Assessment of skin turgor 4. Administration of antiemetic drugs 5. Replacement of fluid and electrolytes

The nurse assesses a patient who is receiving doxorubicin intravenously. The nurse determines extravasation has occurred. The first action by the nurse is to A. attempt to aspirate residual doxorubicin from the patient's vein. B. remove the intravenous catheter. C. pack the intravenous site with ice. D. stop the intravenous infusion of doxorubicin.

D. Stop the intravenous infusion of doxorubicin.

A patient is receiving the alkylating drug cyclophosphamide. It is most important for the nurse to provide

IV hydration & assessment of fluid status (to prevent hemorrhagic cystitis)

Which chemotherapy medication causes reddish colored urine? A. Flurouracil B. Cyclophosphamide C. Doxorubicin D. Vinca alkaloids

C. Doxorubicin (red devil)

A client is admitted to the hospital with slight jaundice and reports of pain on the left side and back. A diagnosis of acute pancreatitis is made. Which common response to acute pancreatitis should the nurse monitor in the client? 1. Crackles 2. Hypovolemia 3. Gastric reflux 4. Jugular vein distention

2. Hypovolemia

A client is receiving combination chemotherapy for treatment of metastatic carcinoma. For which systemic side effect should the nurse monitor the client? 1. Ascites 2. Nystagmus 3. Leukopenia 4. Polycythemia

3. Leukopenia

A 1-year-old infant is receiving zidovudine for management of human immunodeficiency (HIV) infection. The nurse determines that the infant is exhibiting signs of life-threatening zidovudine toxicity. What clinical finding supports this conclusion? 1. Weight loss 2. Extreme lethargy 3. Bruises over the body 4. Increased urine output

3. Bruises over the body

What determines if a client will develop AIDS from an HIV infection? 1. Level of IgM in the blood 2. The number of CD4+ T-cells available 3. Presence of antigen-antibody complexes 4. Speed with which the virus invades the RNA

2. The number of CD4+ T-cells available

A nurse is providing discharge instructions to a client diagnosed with cirrhosis and varices. Which information should the nurse include in the teaching session? Select all that apply. 1. Adhering to a low-carbohydrate diet 2. Avoiding aspirin and aspirin-containing products 3. Limiting alcohol consumption to two drinks weekly 4. Avoiding acetaminophen and products containing acetaminophen 5. Avoiding coughing, sneezing, and straining to have a bowel movement

2. Avoiding aspirin and aspirin-containing products 4. Avoiding acetaminophen and products containing acetaminophen 5. Avoiding coughing, sneezing, and straining to have a bowel movement

A 5-year-old child who is HIV positive is taken to the health department for immunizations before the start of school. The CD4 count shows severe immunosuppression. What immunizations can the child be given safely at this time? Select all that apply. 1. Varicella 2. Hepatitis A 3. Polio vaccine (IPV) 4. Measles, mumps, rubella (MMR) 5. Diphtheria, tetanus, pertussis (DTaP)

2. Hepatitis A 3. Polio vaccine (IPV) 5. Diphtheria, tetanus, pertussis (DTaP) No live vaccines

After surgery for cancer, a client is to receive chemotherapy. When teaching the client about the side effects of chemotherapy, what advice should the nurse share about alopecia characteristics? 1. Usually rare 2. Not permanent 3. Frequently prolonged 4. Sometimes preventable

2. Not permanent

A client who underwent chemotherapy has leukopenia. Which instruction from the nurse will be beneficial for the client? 1. "You should avoid exposure to the sun." 2. "You should eat high-fiber foods and increase fluid intake." 3. "You should avoid large crowds and people with infections." 4. "You should consume iron supplements and erythropoietin."

3. "You should avoid large crowds and people with infections."

A nurse identifies that a client receiving chemotherapy has lost weight. What are appropriate nursing interventions for this client? Select all that apply. 1. Providing low-carbohydrate meals 2. Explaining the effect of chemotherapy 3. Encouraging the intake of preferred foods 4. Promoting the intake of small, frequent meals 5. Administering prescribed antiemetics before meals

3. Encouraging the intake of preferred foods 4. Promoting the intake of small, frequent meals 5. Administering prescribed antiemetics before meals

A client with cancer develops pancytopenia during the course of chemotherapy. The client asks the nurse why this has occurred. What explanation will the nurse provide? 1. Steroid hormones have a depressant effect on the spleen and bone marrow. 2. Lymph node activity is depressed by radiation therapy used before chemotherapy. 3. Noncancerous cells also are susceptible to the effects of chemotherapeutic drugs. 4. Dehydration caused by nausea, vomiting, and diarrhea results in hemoconcentration.

3. Noncancerous cells also are susceptible to the effects of chemotherapeutic drugs.

A child with Wilms tumor is undergoing chemotherapy in a protocol that includes vincristine and doxorubicin hydrochloride. Which common side effect unique to doxorubicin will the nurse expect to observe in the child? 1. Hair loss 2. Vomiting 3. Red urine 4. Stomatitis

3. Red urine

Which intervention would reduce the risk of perinatal transmission via vaginal birth in an adolescent who is diagnosed with HIV infection? 1. Using forceps during delivery 2. Using a fetal scalp electrode during delivery 3. Using antiretroviral during the intrapartum period 4. Administering zidovudine an hour before labor

3. Using antiretroviral during the intrapartum period

A nurse is caring for a child who is receiving vincristine as part of a chemotherapy protocol. What body systems are most important for the nurse to assess after drug administration? Select all that apply. 1. Respiratory 2. Neurological 3. Reproductive 4. Hematologic 5. Gastrointestinal

2. Neurological 4. Hematologic 5. Gastrointestinal (in notes, it says to assess for respiratory distress)

A client who is obese and has a history of alcohol abuse is admitted to the hospital with the diagnosis of acute pancreatitis. Which is the initial priority expected client outcome in response to therapy at this time? 1. Report decreased pain 2. Insert nasogastric (NG) tube quickly 3. Join Alcoholics Anonymous 4. Lose four pounds (1.8 kilograms) a week

1. Report decrease pain

The nurse is caring for a client undergoing chemotherapy for cancer treatment. The client's laboratory results indicate bone marrow suppression. What will the nurse encourage the client to do? 1. Use an electric razor when shaving 2. Drink citrus juices frequently for nourishment 3. Increase activity level by ambulating frequently 4. Sleep with the head of the bed slightly elevated

1. Use an electric razor when shaving (bleeding precautions)

A client with cirrhosis of the liver and ascites has been taking chlorothiazide, a thiazide diuretic. Why did the provider add spironolactone to the client's medication regimen? 1. To stimulate sodium excretion 2. To help prevent potassium loss 3. To increase urine specific gravity 4. To reduce arterial blood pressure

2. To help prevent potassium loss

The serum ammonia level of a client with hepatic cirrhosis and ascites is elevated. What nursing intervention is the priority? 1. Weigh the client daily. 2. Restrict the client's oral fluid intake. 3. Measure the client's urine specific gravity. 4. Observe the client for increasing confusion.

4. Observe the client for increasing confusion.

A nurse is caring for a client receiving chemotherapy. The nurse is concerned about tumor lysis syndrome (TLS). Which of the following lab data will she find with TLS? A. Hyperuricemia B. Hypophosphatemia C. Hypokalemia D. Hypercalcemia

A. Hyperuricemia

A patient is experiencing heavy mental bleeding, stomatitis, hand & foot syndrome, and a fever. What chemotherapy drug is this patient taking?

Fluorouracil

A patient being treated for cancer is receiving medication for palliation. The nurse understands that palliative therapy is used to

Relieve symptoms. If cancer can no longer be controlled, chemotherapy may be used to relieve disease-related symptoms or improve quality of life. This is called palliative treatment