505 test 5

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

A. Inspect the site frequently for redness or swelling

A patient being treated for HIV with saquinavir informs the nurse they he has been "suffering from depression" and taking St. John's wort to help. What is important for the nurse to discuss with this patient? A. Refraining from use of St. John's wort, which can cause decreased effectiveness of saquinavir B. Taking St. John's wort only as directed by the manufacturer to decrease the toxic effects C. Informing the health care provider if any bleeding or bruising is observed when taking the St. John's wort D. Reporting to the health care provider if any yellowing of the eyes or skin develops

A. Refraining from use of St. John's wort, which can cause decreased effectiveness of saquinavir

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

A. Tamoxifen

A nurse is caring for a patient being treated with antineoplastic drugs. The patient reports recently experiencing bloody urine. What complication might this patient be experiencing? A. Thrombocytopenia B. Megaloblastic anemia C. Hodgkin's disease D. Crystalluria

A. Thrombocytopenia

An adverse effect of tamoxifen therapy involves menopausal symptoms. A. True B. False

A. True

Which diagnostic test measures HIV RNA in the plasma? A. Viral load B. Enzyme immunoassay C. ELISA D. Western Blot assay

A. Viral load

The nurse should exercise caution when administering antimetabolites to a patient with: A. bone marrow suppression. B. diabetes mellitus. C. hypertension. D. seizure activity.

A. bone marrow suppression.

The oncology nurse understands that chemotherapeutic agents are most effective during a particular phase of the cell cycle. This means the agents are: A. cell cycle-specific. B. cell cycle-nonspecific. C. growth fraction. D. cell targeting.

A. cell cycle-specific.

The nurse reviews the plan of care for a patient receiving antineoplastic therapy. The nurse notes a nursing diagnosis of risk for infection. Which adverse effect would the nurse expect the patient to exhibit? A. pancytopenia B. gastrointestinal toxicity C. dehydration D. alopecia

A. pancytopenia

A client asks the nurse what cancer cell growth is called. What would the nurse tell the client? A. proliferation B. anaplasia C. pleomorphism D. neoplasm

A. proliferation

A patient began combination antiretroviral therapy 7 months ago and is being followed closely by a care team that includes members of several disciplines. When attempting to determine the efficacy of the patient's current drug regimen, the nurse should prioritize which of the following laboratory data? A. Viral load B. CD4 cell count C. Total leukocyte level D. Neutrophil level

B. CD4 cell count

A patient diagnosed with acute primary HIV infection is in the clinic. What treatment should be initiated for this patient? A. Monotherapy protease inhibitor therapy B. Combination antiretroviral therapy C. Zidovudine therapy once daily D. Didanosine therapy once daily

B. Combination antiretroviral therapy

The lower the client's viral load, the: A. shorter the time to AIDS diagnosis. B. longer the survival time. C. shorter the survival time. D. longer the time immunity.

B. longer the survival time.

A medical-surgical registered nurse (RN) is requested to go to the oncology unit, which is short staffed. When the RN arrives to the unit, the oncology nurse states, "We are so short today that you are going to have to administer chemotherapy to some of the clinic patients." According to the Oncology Nurses Society (ONS), of what should the oncology nurse be aware? A. Because there is a critical shortage of oncology nurses in the unit, it is within the scope of practice for the RN to administer the chemotherapy. B. The oncology nurse should be aware that he or she must watch the RN administer the chemotherapy. C. Chemotherapy should be administered by RNs who have successfully completed a course in chemotherapy administration. D. The oncology nurse should be aware that he or she may delegate chemotherapy to another nurse as long as the oncology nurse is in the department.

C. Chemotherapy should be administered by RNs who have successfully completed a course in chemotherapy administration.

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. Decreased duration of remissions B. Lower risk for secondary cancers C. Higher tumor response rates D. Increased capillary permeability

C. Higher tumor response rates

Which of the following patients has the greatest potential to benefit from treatment with rituximab? A. A woman who has been diagnosed with ductal carcinoma in situ B. A man with AIDS who is currently being treated for Kaposi's sarcoma C. A lifelong smoker who has been diagnosed with non-small cell lung cancer D. A woman who has chronic lymphocytic leukemia

D. A woman who has chronic lymphocytic leukemia

A patient with breast cancer being treated with tamoxifin is also taking the oral anticoagulant coumadin for chronic atrial fibrillation. What is important to monitor in this patient? A. Blood urea nitrogen and creatinine levels B. Liver enzymes C. White blood count D. Prothrombin time

D. Prothrombin time

A 45-year-old woman with acute leukemia is going to begin chemotherapy with vincristine. The nurse is aware that vincristine must always be administered A. at a rapid infusion rate. B. at a slow infusion rate. C. through an IV line primed with vincristine. D. through a central line.

D. through a central line.

A patient is diagnosed with a brain tumor. The patient is told that the cancer cells proliferate. The patient 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 been started on vincristine as part of treatment for cancer. What factor will the nurse need to assess with regard to interactions with this medication? A. Alcohol intake B. Sensory, motor, and perceptual functions C. Exposure to sunlight D. Cigarette smoking

B. Sensory, motor, and perceptual functions

During which phase of the cell cycle would a nurse expect a mitotic inhibitor to act? A. M B. G0 C. G1 D. S

A. M

A client who is HIV positive is taking zidovudine. Which adverse effects should the nurse closely monitor for in this client? A. Anemia and granulocytopenia B. Numbness in the extremities C. Alterations in the renal function D. Pancreatitis

A. Anemia and granulocytopenia

The physician should be notified for a possible reduction in the ordered dose for a patient with a new prescription of tamoxifen (Nolvadex) for which of the following symptoms? A. Atrial fibrillation who takes warfarin (Coumadin) B. History of surgery for cataracts C. Diabetes mellitus taking metformin (Glucophage) D. History of renal disease

A. Atrial fibrillation who takes warfarin (Coumadin)

The nurse should notify the physician immediately if which of the following occurs during observation of a client receiving an antineoplastic drug as they may be signs of thrombocytopenia? Select all that apply: A. Bleeding gums B. Petechiae C. Tarry stools D. Hematuria E. Coffee-ground emesis

A. Bleeding gums B. Petechiae C. Tarry stools D. Hematuria E. Coffee-ground emesis

A 29-year-old man is distraught at being recently diagnosed with HIV. He has just had his first appointment with his care provider since being diagnosed and the drug treatment regimen is being planned and explained by his primary care provider. Which of the following principles will guide the planning and implementation of the patient's drug treatment regimen? A. HIV replication is best suppressed by the simultaneous use of multiple anti-HIV drugs. B. Suppression of the viral load and maximization of CD4+ levels are best achieved by the exclusive use of nucleoside reverse transcriptase inhibitors (NRTIs). C. The patient and the care provider need to decide whether to use protease inhibitors (PIs) or whether to use NRTIs in treatment. D. The patient's medical history prior to HIV diagnosis will be the primary determinant of the drug regimen that is chosen.

A. HIV replication is best suppressed by the simultaneous use of multiple anti-HIV drugs.

The drug imatinib (Gleevec) is used to treat chronic myeloid leukemia and is much more successful than others. To have optimal effects of this drug for chronic myeloid leukemia, what chromosomal variation does the patient have to have? A. Philadelphia chromosome B. Boston chromosome C. Pittsburgh chromosome D. Washington chromosome

A. Philadelphia chromosome

An HIV-positive patient has a positive baseline tuberculin skin test. What is the next step for this patient? A. Begin the patient on Isoniazid and Rifampin. B. Schedule a chest x-ray. Repeat the skin test. C. There is no next step. D. The tuberculin test result is negative because the patient is immunocompromised.

B. Schedule a chest x-ray. Repeat the skin test.

A 42-year-old female with breast cancer has had a radical mastectomy. She will have radiation therapy and then begin chemotherapy. Drug therapy will consist of a combination of doxorubicin, cyclophosphamide, and paclitaxel. What will the nurse include in the teaching plan concerning the drug therapy? A. Stay on a low-fat diet during the course of the drug therapy. B. Take special care when shaving or brushing her teeth. C. Continue to go to church or to the mall just as she did before the diagnosis of cancer. D. Stay in bed 2 days after each administration.

B. Take special care when shaving or brushing her teeth.

The nursing instructor is discussing HIV/AIDS with the junior nursing class. The instructor tells the students that it is important to understand how HIV-1 integrates itself into a person's immune system and how immunity plays a role in the course of HIV disease. What else is this knowledge essential for? A. Knowing therapy options for different patients B. Understanding medication therapy C. Understanding vaccine distribution D. Knowing expected results of different therapies

B. Understanding medication therapy

A 24-year-old female patient with hepatitis is being treated with interferon alfa-2a therapy. The nurse will schedule the patient to have a complete blood count (CBC) every month during therapy to: A. assess the effectiveness of the therapy. B. monitor for signs of bone marrow suppression. C. monitor for signs of iron-deficiency anemia. D. assess for signs of toxicity.

B. monitor for signs of bone marrow suppression.

A patient has been scheduled to begin treatment with rituximab for non-Hodgkin's lymphoma. The nurse who will administer this drug should understand that it targets A. the function of the complement system. B. specific antigens on the surface of malignant B cells. C. the DNA of mature plasma cells. D. the molecular structure of the cells making up the semipermeable membrane of cancerous cells.

B. specific antigens on the surface of malignant B cells.

A client asks the nurse why he has to have several courses of a chemotherapy drug instead of just one dose. The nurse states that it is based on the cell kill theory. Which of the following statements describes the cell kill theory? A. The cell kill theory is based on the premise that one dose of a chemotherapy drug will kill all the cancer cells if enough of the medication is given to a client. B. The cell kill theory describes the ways that different chemotherapy medications work to kill both healthy and cancerous cells within the human body. C. The cell kill theory describes the process of giving multiple doses of chemotherapy with each dose, killing approximately 90% of the cancer cells. After several rounds of chemotherapy, nearly all of the cancer cells are killed and the body's immune system will kill the few cancer cells that are left. D. The cell kill theory describes the phenomenon that occurs during the life cycle of a cancer cell as it is treated with a chemotherapy medication.

C. The cell kill theory describes the process of giving multiple doses of chemotherapy with each dose, killing approximately 90% of the cancer cells. After several rounds of chemotherapy, nearly all of the cancer cells are killed and the body's immune system will kill the few cancer cells that are left.

A patient has been administered a cytotoxic antineoplastic agent. The patient is a 32-year-old female. Which of the following is the most important instruction related to teratogenicity? A. The medication will be completely eliminated 24 hours after the administration. B. The patient should protect herself from infections and take Bactrim. C. The patient should not become pregnant for several months. D. The patient will not get pregnant due to the elimination of ova.

C. The patient should not become pregnant for several months.

The nurse is caring for a patient who has HIV and is taking saquinavir therapy. What should the nurse include in the dietary education for this patient? A. The patient should limit carbohydrates when taking this medication. B. The patient should limit proteins while taking this medication. C. The patient should not take this medication with grapefruit or pomegranate juice. D. The patient is not restricted to a specific diet while taking this medication.

C. The patient should not take this medication with grapefruit or pomegranate juice.

A patient's physician is considering the addition of efavirenz to the patient's drug regimen for the treatment of recently diagnosed HIV. Which aspects of the patient's medical history should prompt the nurse to question the use of this drug? A. The patient has a diagnosis of type 2 diabetes and did not consistently monitor blood glucose levels prior to diagnosis with HIV. B. The patient experienced an adverse reaction to an influenza immunization several years ago. C. The patient's body mass index at the time of diagnosis was 27 (overweight). D. The patient has hepatitis C and a history of heavy alcohol use.

D. The patient has hepatitis C and a history of heavy alcohol use.

While studying for a pharmacology test, a student asks peers about interferons. What statement about interferons is true? A. They stimulate B lymphocyte activity. B. They interfere with multiplication of stem cells. C. They stimulate growth and differentiation of lymphoid cells into lymphocytes. D. They interfere with the ability of viruses in infected cells to replicate.

D. They interfere with the ability of viruses in infected cells to replicate.

A patient on 5-FU calls the clinic and reports that he has between five and seven loose bowel movements daily. The nurse will instruct the patient to A. treat the diarrhea with OTC medications. B. avoid protein-rich foods. C. avoid grapefruit and grapefruit juice. D. notify the clinic if the stools are black or if there is evidence of blood.

D. notify the clinic if the stools are black or if there is evidence of blood.

A nurse has completed a medication reconciliation of a patient who has been admitted following a motor vehicle accident. Among the many drugs that the patient has received in the previous year is rituximab. The nurse would be justified in suspecting the patient may have received treatment for which of the following diseases? A. Non-Hodgkin's lymphoma B. Malignant melanoma C. Nonsmall cell lung cancer D. Renal cell carcinoma

A. Non-Hodgkin's lymphoma

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 which cells as an example? A. Skin B. Breast C. Testicles D. Ovaries

A. Skin

What would the nurse identify as the primary purpose of performing a CD4 count for a patient infected with HIV? A. The CD4 count is an indication of the patient's current immunological status. B. The CD4 count indicates the risk for disease progression and is the most important indicator of treatment response. C. The CD4 count is considered a direct way of measuring drug resistance. D. The CD4 count evaluates the genetic makeup of a patient's virus and detects the presence of drug-resistant mutations in relevant genes.

A. The CD4 count is an indication of the patient's current immunological status.

The antibody prototype is the monoclonal antitumor antibody called rituximab (Rituxan). The drug interactions of this drug are described by which of the following? Select all that apply. A. vaccines B. no known drug interactions C. antibiotics D. antihistamines

A. vaccines

A male patient is taking indinavir (Crixivan) for HIV. To decrease the risk of kidney stones, the nurse's teaching plan will include which of the following? A. Increase physical activity B. Drink 1 to 2 L of water a day C. Avoid taking acetaminophen D. Decrease fatty foods in his diet

B. Drink 1 to 2 L of water a day

A patient is beginning a course of chemotherapy for the treatment of chronic lymphocytic leukemia. To what is the start of this therapy referred? A. Consolidation therapy B. Induction therapy C. Maintenance therapy D. Palliative therapy

B. Induction therapy

Prior to administering a dose of 5-FU to a patient with pancreatic cancer, the nurse is conducting the necessary drug research. The nurse is aware that 5-FU is a cell cycle-specific chemotherapeutic agent. Which statement best describes cell cycle-specific drugs? A. They follow a specific sequence of cytotoxic events in order to achieve cell death. B. They affect cancerous cells during a particular phase of cellular reproduction. C. They achieve a synergistic effect when administered in combination with cell cycle-nonspecific drugs. D. They affect cancerous cells and normal body cells in a similar manner.

B. They affect cancerous cells during a particular phase of cellular reproduction.

A 26-year-old man is receiving interferon alfa-2a for AIDS-related Kaposi sarcoma. His physician has also prescribed theophylline for his asthma. The nurse is aware that combining interferon alfa-2a and theophylline can result in which of the following? A. Hypertension B. Toxicity C. Anorexia D. Hypothyroidism

B. Toxicity

What medication should the nurse prepare to administer to prevent Pneumocystis jirovechi for a patient taking alemtuzumab who has lymphopenia? A. Rocephin 1 GM IV prior to injection B. Trimethoprim-sulfamethoxazole DS C. Famciclovir D. Acyclovir

B. Trimethoprim-sulfamethoxazole DS

A male patient has been prescribed thalidomide for the treatment of multiple myeloma. What intervention is most likely to reduce the patient's risk of experiencing adverse effects of this treatment? A. Arrange for a pressure-reducing mattress B. Avoid placing the patient's extremities in a dependent position C. Perform vigilant skin care D. Apply antiembolism stockings

D. Apply antiembolism stockings

A nurse experienced a needle stick injury while administering a subcutaneous heparin injection to an HIV-positive patient. Which of the following aspects of postexposure prophylaxis (PEP) should be implemented in the nurse's treatment? A. The nurse's current health status and medical history will determine whether PEP is appropriate. B. The nurse should begin PEP within 7 days of the injury in order to reduce the chance of seroconversion. C. The nurse should be tested weekly for HIV for the next 12 months. D. PEP should be initiated within 1 or 2 hours of the time the nurse was exposed.

D. PEP should be initiated within 1 or 2 hours of the time the nurse was exposed.

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 provide prophylactic protection against neoplasia in high-risk individuals. C. Targeted therapies are significantly more cost-effective than traditional chemotherapeutic drugs. D. Targeted therapies have the potential to damage cancerous cells while leaving normal body cells less affected.

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