Antineoplastic Drugs

A client asks the nurse why the chemotherapy is often administered in cycles. Which response by the nurse would be most appropriate?

"We want to attack the cells that might be dormant or moving into a new phase."

The purpose of antineoplastic drugs is to affect cells that rapidly divide and reproduce; however, the adverse effects produced by antineoplastic drugs result from their systemic use, which exposes nonmalignant cells in the body that are rapidly dividing and reproducing. Which is not an example of a rapidly dividing and reproducing cell in the body?

nerve cell

Which drug would be classified as a mitotic inhibitor?

Vincristine

A 54-year-old male patient with small-cell lung cancer is receiving etoposide. The nurse will carefully monitor for:

hypotension.

A 57-year-old male patient who has been prescribed doxorubicin for small-cell lung cancer is advised by the nurse to avoid taking aspirin or drugs that contain aspirin because it may:

promote bleeding.

A patient is administered mesna (Mesnex) to prevent cystitis induced by ifosfamide. How will this medication combination prevent cystitis?

The medication combines with the metabolite of ifosfamide.

A patient with a diagnosis of chronic myeloid leukemia has met with the oncologist, who has recommended treatment with the kinase inhibitor imatinib. What route of administration will the client receive?

Oral administration of imatinib in a home setting

A client who is taking chemotherapeutic medications has developed stomatitis. What intervention should the nurse include in the client's plan of care? Encourage the client's family to bring in mouthwash Provide mouth care frequently Provide a minced or pureed diet Administer antifungal mouthwash as prescribed

Provide mouth care frequently

A client has been prescribed cabazitaxel 25 mg/m2 PO every three weeks for the treatment of prostate cancer. What is the nurse's priority response to this prescription?

Question the prescriber about the route

The nurse is caring for a client receiving a combination of antineoplastic medications. The client asks the nurse why so many different medications are being used instead of just one medication. The nurse should explain what characteristics of combination therapy? Select all that apply. Increases the quantity of each medication used Targets different phases of the cell cycle Decreases the development of cell resistance Decreases the adverse effects of each medication Prolongs the length of treatment

Targets different phases of the cell cycle Decreases the development of cell resistance

A 54-year-old received a diagnosis of breast cancer several weeks ago and her current treatment regimen includes tamoxifen, a cell cycle-nonspecific antineoplastic drug. What is a characteristic of a cell cycle-nonspecific drug?

The drug is effective regardless of whether a cancerous cell is proliferating.

A 51-year-old female patient has been receiving doxorubicin (Adriamycin) for metastatic breast cancer. Her medical record indicates she has cardiomyopathy and a cumulative dose of 300 mg/m2 of doxorubicin. Which measure would help limit the severity of the cardiomyopathy in this client?

The use of dexrazoxane in conjunction with doxorubicin

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?

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

An oncology nurse is performing patient teaching for a woman who is scheduled to begin treatment with a targeted therapy. The woman is unfamiliar with this class of drugs. How should the nurse best describe targeted therapies to this patient?

"These drugs are capable of controlling the signals that tell cancer cells to grow and divide."

A client with advanced prostatic cancer has opted for palliative care. At a care conference, the decision is made to pursue histrelin (Vantas) treatment. What should the nurse teach the client about this medication?

"This will involve giving you an implant of the drug"

A patient who will begin chemotherapy voices concern to the nurse about the accompanying nausea and vomitting. What is the best response by the nurse?

"We can relieve your nausea and vomiting with antiemetic drug therapy. You should ask for these medications whenever you need them."

The nurse is caring for a client newly diagnosed with a primary brain tumor. The client asks the nurse where the tumor came from. What is the nurse's best response? "Your tumor originated from a single cell that is genetically different from nearby cells." "Your tumor originated from changes in the structure of nerve tissue somewhere in your body." "Your tumor originated from somewhere outside the central nervous system from a cell just like other cells." "Your tumor most likely originated with a mutation in the pituitary gland that released pathologic hormones."

"Your tumor originated from a single cell that is genetically different from nearby cells."

A client diagnosed with a malignancy is receiving an antimetabolite as part of medication therapy. What should the nurse teach this client about the use of antimetabolite medication? Select all that apply. -Use safety measures due to possible dizziness, headache, and drowsiness -Report all other drugs and alternative therapies currently being taken -Avoid the consumption of high-tyramine foods -Cover the head at extremes of temperature -Plan for an appropriate exercise regimen

-Use safety measures due to possible dizziness, headache, and drowsiness - Report all other drugs and alternative therapies currently being taken -Cover the head at extremes of temperature

The nurse on an oncology unit is providing care for several clients with cancer, most of whom are receiving chemotherapy. What client should the nurse prioritize?

A client with hairy cell leukemia receiving pentostatin whose urine output is 35 mL over the past 12 hours

The nurse is caring for a client who current chemotherapy regimen includes mitomycin. The nurse should recognize that this client's most likely diagnosis is what? Neuroblastoma Non-Hodgkin's lymphoma Adenocarcinoma of the pancreas Metastatic lung cancer

Adenocarcinoma of the pancreas

Which cytoprotective agents can be given along with antineoplastic drugs to help prevent or lessen certain adverse effects? (Select all that apply.) Allopurinol (Zyloprim) Amifostine (Ethyol) Leucovorin (Wellcovorin) Mesna (Mesnex) Dexrazoxane (Zinecard)

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

A nurse should understand which adverse effects of antineoplastic drugs are related to the death of rapidly growing cells? (Select all that apply.) Alopecia Leukopenia Stomatitis Cardiotoxicity Thrombocytopenia

Alopecia Leukopenia Stomatitis Thrombocytopenia

Which of the following instructions would be most appropriate for a patient who is receiving temsirolimus?

Avoiding grapefruit juice

Which antineoplastic drugs are classified as antineoplastic antibiotics? (Select all that apply.) Bleomycin (Blenoxane) Carboplatin (Paraplatin) Dactinomycin (Cosmegen) Daunorubicin (DaunoXome) Busulfan (Busulfex)

Bleomycin (Blenoxane) Dactinomycin (Cosmegen) Daunorubicin (DaunoXome)

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?

Blocking serotonin receptors in the CTZ

A client is receiving idarubicin. What is the nurse's priority assessment?

Cardiac function

A child is prescribed an anthracycline drug. The nurse would teach the parents to observe for signs and symptoms of what adverse effect?

Cardiotoxicity

An oncology nurse is reviewing the pathophysiology of cancer and is discussing with a colleague the factors that contribute to the success or failure of a patient's chemotherapy. Which cancerous cell is most susceptible to the effects of chemotherapeutic drugs?

Cells that have a rapid mitotic rate

The nurse is caring for a client with cancer whose treatment regimen presents a risk of severe-to-fatal interstitial lung disease. What antineoplastic agent is the nurse administering that carries this risk? Valrubicin Triptorelin pamoate Histrelin acetate Ceretinib

Ceretinib

A nurse is preparing an antineoplastic agent for a school-aged client who has leukemia. What action related to the administration of this drug should the nurse perform first? -Perform thorough hand hygiene. -Check laboratory studies to determine most recent measures of bone marrow function. -Ensure a quiet environment, so the client can rest during administration of the drug. - Identify the client by checking the arm band and asking him or her to state his or her name.

Check laboratory studies to determine most recent measures of bone marrow function.

A client is receiving bleomycin as part of a chemotherapy regimen. Which would be most important for the nurse to monitor?

Chest x-ray

When describing alkylating agents, the nurse would explain that this medication is seen as the prototype:

Chlorambucil

Which antineoplastic drugs are classified as alkylating agents? (Select all that apply.) Bleomycin (Blenoxane) Chlorambucil (Leukeran) Vinblastine (Velban) Cyclophosphamide (Cytoxan) Ifosfamide (Ifex)

Chlorambucil (Leukeran) Cyclophosphamide (Cytoxan) Ifosfamide (Ifex)

A client has been prescribed treatment with antineoplastic drugs, which have a depressing effect on the bone marrow. What pre-administration assessment should the nurse perform for this client with respect to the depressing effect of the bone marrow?

Complete blood count

A patient who is receiving methotrexate is also receiving leucovorin. The nurse understands that this drug is being given for which reason?

Counteract effects of methotrexate

After teaching a group of students about antineoplastic antibiotics, the instructor determines that the teaching was successful when the students identify which drug as an example?

Doxorubicin

A client with breast cancer is receiving goserelin (Zoladex). What aspect of the client's most recent laboratory results would suggest an adverse effect of this particular drug?

Elevated serum calcium

A client with leukemia is being treated with a combination of antineoplastics, including methotrexate. The client's most recent laboratory results indicate the client is experiencing bone marrow suppression. What is the nurse's priority action?

Ensure that all staff and visitors adhere to infection control precautions.

A male client is receiving parenteral cytotoxic medications in the home. Adjunct therapy may include what substance?

Erythropoietin

A patient is to receive doxorubicin as treatment for leukemia. The nurse would instruct the patient that the typical cycle would be repeated at which frequency?

Every 3 weeks

When planning the care for a client receiving imatinib, the nurse would identify which nursing diagnosis as most likely?

Excess fluid volume related to fluid retention

Cancer cells can rapidly develop a resistance to alkylating agents. (True/False)

False

No cancer cells have been identified that can remain dormant for more than 2 years. (True/False)

False

After teaching a group of students about antineoplastic agents and their effect on cancer and healthy cells, the instructor determines that the teaching was successful when the students identify which drug as having the least effect on healthy cells?

Getitinib

A client's chemotherapeutic regimen includes procarbazine. What is the client's most likely diagnosis?

Hodgkin lymphoma

While receiving etoposide IV, extravasation occurs. Which agent would the nurse expect to be used?

Hyaluronidase

Which drug would have the least effect on healthy human cells?

Imatinib

What best reflects the action of antimetabolites?

Inhibits DNA production via replacing the natural substances needed for it

A nurse is administering an antineoplastic extravasation occurs. How can the nurse best prevent tissue damage caused by extravasation?

Inspect the site frequently for redness or swelling

A patient is diagnosed with ovarian cancer. Why is considered to be an aggressive form of cancer?

It is fed by the hormones produced by the ovaries.

Which would the nurse expect to administer to counteract the effects of methotrexate?

Leucovorin

A male patient has been on long-term bicalutamide (Casodex) therapy. In order to assess adverse effects of the drug therapy, the nurse will closely monitor:

Liver function

Which agent would the nurse expect to be administered orally?

Methotrexate

Which would the nurse identify as an antineoplastic antibiotic?

Mitomycin

The nurse is caring for a client receiving cyclophosphamide. What is the priority nursing action for this client? Monitor urinalysis results Administer an antiemetic when needed Provide small, frequent meals Provide vigilant oral care

Monitor urinalysis results

The client is taking ifosfamide as a component of cancer treatment, and the client's oncologist has just added mesna to the client's medication regimen. How should the nurse best assess for the therapeutic effect of mesna? Assessing the client for nausea and vomiting Monitoring the client's urine output for signs of hematuria Monitoring the client's bowel movements for frequency and character

Monitoring the client's urine output for signs of hematuria

A nurse is preparing to administer imatinib to a client. The nurse expects to administer this drug by which route?

Oral

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?

Prostate cancer

The nurse is caring for a client whose current antineoplastic regimen includes bicalutamide. The nurse should most likely foresee what additional aspect of this client's cancer treatment? Total mastectomy Prostatectomy Hemicolectomy Thyroidectomy

Prostatectomy

In describing the action of alkylating agents, what would the nurse include?

React chemically with portions of RNA, DNA, and other cellular proteins.

A client is prescribed doxorubicin drug therapy for carcinoma of the breast. On the second day of drug therapy, she calls in to report reddish urine. What should the nurse do?

Reassure the client that it is a harmless and expected response to the drug.

A nurse administers ondansetron to a client receiving chemotherapy for which reason?

Reduce vomiting

The nurse is providing care for an older adult client who has stomatitis secondary to the administration of methotrexate. The nurse should assess for indications of what nursing diagnoses? Select all that apply. Risk for infection Risk for bleeding Imbalanced nutrition Impaired skin integrity Autonomic dysreflexia

Risk for infection Risk for bleeding Imbalanced nutrition Impaired skin integrity

A nurse is providing client education to a 50-year-old woman who is taking methotrexate (MTX) for breast cancer. The nurse will instruct the client to avoid which drug?

Salicylates

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?

Sensory, motor, and perceptual functions

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?

Skin

A client with breast cancer will have radiation therapy and then begin chemotherapy. Drug therapy will consist of a combination of doxorubicin, cyclophosphamide, and paclitaxel. What should the nurse include in the client's teaching plan concerning the drug therapy? Select all that apply. -Stay in bed 2 days after each administration -Avoid the use of antiemetics unless absolutely necessary -Take special care when shaving or when brushing her teeth - Stay on a low-fat diet during the course of the drug therapy -Avoid large crowds and public places whenever possible

Take special care when shaving or when brushing her teeth Avoid large crowds and public places whenever possible

A postmenopausal woman with breast cancer will most likely be treated with which anti-estrogen drug?

Tamoxifen

An antineoplastic extravasates, and the antidote is administered. The nurse would apply warmth to the site if extravasation involved which drug?

Teniposide

The nurse is caring for a client who has leukemia. What aspect of this client's health status should the nurse prioritize when confirming the appropriateness and dosing of antimetabolites? The client currently has bone marrow suppression. The client has a long-standing diagnosis of type 2 diabetes mellitus. The client has had seizure activity in recent months. The client's blood pressure is usually in the range of 140/90 mm Hg.

The client currently has bone marrow suppression.

The client has just been started on an alkylating agent to treat testicular cancer. What assessment finding would suggest that the client is experiencing a common adverse effect of this medication? The client's most recent laboratory results indicate pancytopenia The client is oriented to person but not to place and time The client describes his mood as "bleak" and "dark" The client describes "bone pain" in his lumbar and thoracic spine

The client's most recent laboratory results indicate pancytopenia

What should the oncology nurse understand when administering a cell cycle-nonspecific chemotherapeutic agent about its effect?

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

A client with Hodgkin's disease has been prescribed vincristine. What nursing consideration should the nurse prioritize when administering this drug? - The nurse should avoid using a distal vein. - The nurse should encourage the client to eat six small meals a day. - The nurse should check for extravasation when the infusion is over. - The nurse should avoid any skin, eye, or mucous membrane contact with the drug.

The nurse should avoid any skin, eye, or mucous membrane contact with the drug.

An older adult woman has been diagnosed with acute lymphoblastic leukemia (ALL) and her care team has identified potential benefits of imatinib. Which characteristic of this patient's current health status may preclude the use of imatinib?

The patient has chronic heart failure resulting in significant peripheral edema.

When describing the process of cancer cell growth to a client, the nurse addresses angiogenesis. Which description would the nurse include?

The process of creating new blood vessels to supply oxygen and nutrients to the cells

A client with a diagnosis of bladder cancer is started on a chemotherapeutic regimen that includes three agents. What is the rationale for using multiple antineoplastic agents?

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

Anemia from chemotherapy treatment is the result of bone marrow suppression. (True/False)

True

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

True

A client with leukemia has been prescribed rasburicase to be administered before chemotherapy. What is the nurse's priority assessment after administration of this medication? Serum potassium levels Blood glucose levels Serum calcium levels Uric acid levels

Uric acid levels

A nurse is performing discharge teaching with a client who will soon return home. The client will continue taking imatinib for the foreseeable future, and the nurse is teaching the client about the safe administration of this drug. How should the nurse instruct the client to take imatinib?

With food and a large glass of water

Which agents would be considered cancer non-cell cycle specific agents?

alkylating agents

The nurse may be asked to administer which medications to a client to counteract the increase in uric acid and subsequent hyperuricemia resulting from the metabolic waste buildup from rapid tumor lysis? allopurinol amifostine mesna leucovorin

allopurinol

After teaching a group of nursing students about antimetabolite drugs, the instructor determines that the teaching was successful when the students identify which as an example?

capecitabine

A patient with acute lymphoblastic leukemia (ALL) is receiving imatinib on an inpatient basis. When planning the care of this patient, what assessment should be specified in the patient's plan of nursing care?

daily weights

Based on the nurse's understanding of antineoplastic drugs, the nurse would anticipate administering which in conjunction with doxorubicin (Doxil) as a cardioprotective agent?

dexrazoxane

A nurse is caring for a 46-year-old female patient who is taking paclitaxel for ovarian cancer. Two or three days after the infusion of the drug, the nurse must closely monitor for:

neurotoxicity.

A client has returned to the outpatient treatment center for a regular IV chemotherapy session. The nurse understands that one of the goals of chemotherapy is to:

prevent or treat adverse drug effects.

When preparing to administer ondansetron for a patient's nausea and vomiting, the nurse understands that this agent blocks:

serotonin.

A client with a diagnosis of cancer is experiencing pain and the early signs of organ dysfunction. The nurse should explain that these signs and symptoms result from: overgrowth of tumor cells. tumor cells invading healthy tissue. enzymes that generate blood vessels. the body's own misguided immune response.

tumor cells invading healthy tissue.

The nurse is preparing to administer a client's prescribed chemotherapy. The client has developed bone marrow suppression during treatment. What should the nurse include in the client's plan of care? Select all that apply. - Implement falls prevention measures -Administer anticoagulants as prescribed -Place the client on protective isolation -Monitor the client's laboratory values closely -Allow sufficient time for rest between scheduled activities

- Implement falls prevention measures -Place the client on protective isolation -Monitor the client's laboratory values closely -Allow sufficient time for rest between scheduled activities

A client is experiencing intense nausea while being treated with chemotherapeutics. What actions should the nurse perform? Select all that apply. -Administer antacids as prescribed, 30 minutes before meals -Ensure that the client has had a dietician consult -Administer antiemetics as prescribed -Provide the client with a low-residue diet -Provide the client with small, frequent meals

-Ensure that the client has had a dietician consult -Administer antiemetics as prescribed -Provide the client with small, frequent meals

The nurse is preparing a client who will begin chemotherapy in a few days. The nurse knows that which are the most common adverse effects encountered by most clients who receive chemotherapy? (Select all that apply.) Alopecia Neutrocytosis Thrombocytopenia Anemia Stomach ulcers

Alopecia Thrombocytopenia Anemia

Which antineoplastic drugs are classified as antimetabolites? (Select all that apply.) Mercaptopurine (Purinethol) Capecitabine (Xeloda) Fluorouracil (Adrucil) Etoposide (Toposar) Irinotecan (Camptosar)

Mercaptopurine (Purinethol) Capecitabine (Xeloda) Fluorouracil (Adrucil)

The nurse is caring for a client who is receiving a combination of antineoplastic agents. The client has been told that alopecia is likely to occur, and the client is tearful and distraught about this. What is the nurse's best response? -Validate the client's sense of impending loss and offer guidance for getting a wig -Encourage the client to view the hair loss as something that indicates cancer is being eradicated -Reassure the client that other people who are treated with cancer also experience this -Reassure the client that the hair loss will be temporary rather than permanent

Validate the client's sense of impending loss and offer guidance for getting a wig

The nurse is preparing to administer doxorubicin for a client who has a diagnosis of neuroblastoma. What action should the nurse perform? Assess the integrity of the client's deltoid sites Perform hand hygiene before administration to protect against cytotoxic effects Wear personal protective equipment Assess the integrity of the client's mucous membranes

Wear personal protective equipment