Chemotherapeutic Therapy Chapter 46, Antineoplastic Drugs - Sherpath Questions
Which statement made by the patient indicates a need for further teaching regarding doxorubicin, an antitumor antibiotic? A) "I do not have to worry about infection because the drug is an antibiotic." B) "I will notify my doctor if the injection site becomes red." C) "I will need to avoid large crowds." D) "If I start having trouble breathing, I will notify my doctor."
A) "I do not have to worry about infection because the drug is an antibiotic." - The patient will need more information regarding doxorubicin. Even though the antitumor chemotherapeutic class is considered an antibiotic, it does not treat infection. All chemotherapeutic drugs, including antitumor antibiotics, will suppress the immune system, which increases the risk for infection.
Match the chemotherapeutic drug to its class. Antimetabolites - Plant alkaloids - Antitumor antibiotics - Alkylating drugs - Cyclophosphamide Vincristine Doxorubicin Fluorouracil
Antimetabolites - Fluorouracil Plant alkaloids - Vincristine Antitumor antibiotics - Doxorubicin Alkylating drugs - Cyclophosphamide
A patient with multiple myeloma received cyclophosphamide at 0900. Which time would the nurse expect the drug to peak? A) 0930 B) 1100 C) 1300 D) 1500
B) 1100 - Cyclophosphamide peaks in 1 to 3 hours. The drug was given at 0900; therefore 1 to 3 hours later is 1100.
A nurse is disposing of urine from a patient who is receiving chemotherapeutic drugs. Which action would the nurse take to decrease the risk for occupational exposure? A) Dispose the urine in an enclosed container. B) Apply a face shield. C) Have the patient dispose of the urine. D) Dispose of the urine in a biohazard container.
B) Apply a face shield - Masks with a face shield should be worn by the nurse when there is a danger of splashing of body fluids, such as urine, to minimize the risk for occupational exposure.
A patient diagnosed with metastatic pancreatic cancer is prescribed fluorouracil as part of a combination regimen with oxaliplatin, leucovorin, and irinotecan. Which treatment cycle would the nurse expect fluorouracil to be repeated? A) Once a week B) Every 2 weeks C) Once a month D) Every 2 months
B) Every 2 weeks - Chemotherapeutic drugs are administered in cycles followed by a rest period. Fluorouracil as part of a combination therapy is administered every 2 weeks.
Oral cyclophosphamide 700 mg is prescribed to a patient weighing 125 pounds. Which action would the nurse take first? A) Decrease the dose. B) Hold the drug. C) Notify the health care provider. D) Notify the pharmacist.
B) Hold the drug. - The nurse should first hold the drug, then notify the health care provider. Cyclophosphamide 700 mg is more than the usual dose of 1 to 5 mg/kg. One hundred and twenty-five pounds is equal to 57 kg. Therefore the maximum dose based on the usual dosing regimen is 285 mg, not 700 mg.
A patient receiving chemotherapeutic drugs complains of mouth lesions and inability to eat or swallow. The nurse notes the patient has opioid analgesic, topical anesthetic, antiemetic, and sedative prescribed. Which drug would the nurse most likely provide? A) Opioid analgesic B) Topical anesthetic C) Antiemetic D) Sedative
B) Topical anesthetic - The nurse will most likely provide a topical anesthetic for the lesions to decrease the pain. Mouth lesions (stomatitis) are common side effects of chemotherapeutic drugs. Topical anesthetic numbs the mouth without unwanted side effects.
A patient with Hodgkin's lymphoma is taking phenobarbital, a CYP2D6 inducer, along with cyclophosphamide. The nurse is concerned knowing that CYP2D6 inducers have which effect on chemotherapeutic drugs? A) Increase drug concentration B) Increase drug absorption C) Decrease drug concentration D) Increase drug elimination
C) Decrease drug concentration - Drugs that are hepatic inducers can decrease the drug concentration of chemotherapeutic drugs that are metabolized by the liver.
In which phase of the cell cycle do most antimetabolites affect cells? A) Mitosis B) G2 phase C) S phase D) G1 phase
C) G1 phase
Which type of chemotherapy refers to chemotherapeutic drugs packaged in a fat globule? A) Conventional B) Topical C) Liposomal D) Prodrug
C) Liposomal - Liposomal chemotherapy refers to chemotherapeutic drugs packaged in a fat globule, or liposome.
A patient is prescribed vincristine for Hodgkin's lymphoma. On further questioning, the nurse discovers the patient has plant allergies, specifically to periwinkle. Which action would the nurse take? A) Administer the drug. B) Administer an antihistamine. C) Notify the health care provider. D) Conduct an allergy test before administering vincristine.
C) Notify the health care provider. - Hypersensitivity to any component of a drug is an absolute contraindication, and the nurse should notify the health care provider. Vincristine contains vinca alkaloids, which are made from periwinkle plants.
A patient receiving vincristine asks why it must be given intravenously. Which response would the nurse provide to the patient? A) "Intravenous drug administration has fewer side effects." B) "Intravenous administration allows the drug effects to peak in 1 day." C) "Oral administration has a faster onset." D) "Oral administration has a low absorption rate."
D) "Oral administration has a low absorption rate." - Vincristine is 100% absorbed with IV administration. The absorption would be low or erratic when taken by mouth.
The nurse preparing to administer chemotherapeutic drugs notes the patient has had a significant drop in neutrophils. The nurse would anticipate administering which product into the patient's plan of care? A) Red blood cells (RBCs) B) Platelets C) Natural killer cells (NKCs) D) Colony-stimulating factors (CSFs)
D) Colony-stimulating factors (CSFs) CSFs can be administered to minimize neutropenia, a state of low neutrophils. CSF stimulates the bone marrow to produce neutrophils.
Which part of the cell does fluorouracil affect during the S phase of the cell cycle? A) Estrogen receptors B) RNA C) Mitochondria D) DNA
D) DNA - Fluorouracil affects the cell's DNA during the S phase of the cell cycle.
Which statement is accurate regarding tamoxifen? A) It blocks or alters DNA replication, decreasing the estrogen response. B) It is primarily indicated for cervical cancer. C) It mostly affects the S phase of the cell cycle. D) It acts as both an agonist and antagonist at estrogen receptor sites.
D) It acts as both an agonist and antagonist at estrogen receptor sites - Tamoxifen is a prodrug and is the drug of choice to treat breast cancer by blocking some estrogen receptors and activating other estrogen receptors.
Which location would the nurse prepare chemotherapeutic drugs before administration? A) Patient's room B) Medication room C) Nurse's station D) Separate work area
D) Separate work area - Chemotherapeutic drugs should be prepared in a separate work area to prevent occupational exposure.
A nurse provides teaching to a male patient receiving chemotherapeutic drugs. Which statements made by the patient indicate an understanding of potential side effects of chemotherapeutic drugs? (Select all that apply) A) "I will use a soft toothbrush to brush my teeth." B) "I may need to take stool softeners to avoid constipation." C) "When I have an appetite, I will make sure to eat large amounts of high-protein food." D) "I should use an alcohol-based mouthwash to kill germs." E) "I will bank some of my sperm so I still have the option of having children in the future."
A) "I will use a soft toothbrush to brush my teeth." - Chemotherapeutic drugs can cause stomatitis, which are painful lesions in the mouth. The patient should use a soft toothbrush due to stomatitis. B) "I may need to take stool softeners to avoid constipation." -Chemotherapeutic drugs can cause constipation. The patient can take stool softeners to avoid constipation. E) "I will bank some of my sperm so I still have the option of having children in the future." - Chemotherapeutic drugs can cause infertility. Male patients can bank their sperm before starting chemotherapy.
CASE STUDY J.W. is a 35-year-old man who was recently diagnosed with multiple myeloma. He will start treatment with cyclophosphamide and prednisone. J.W. has never been ill before and is quite nervous about starting treatment. He is newly married and wishes to have children. He also seems to be having difficulty coping with his diagnosis. His significant other is available for teaching purposes, because J.W. is not able to fully grasp the details of his treatment regimen. His significant other is very supportive and involved and attends all clinic appointments with him. Understanding J.W.'s anxiety about his cyclophosphamide treatment and wishing to facilitate as smooth a procedure as possible, the nurse plans to administer anti-emetic drug therapy. During which time frame will the anti-emetic therapy be most beneficial to J.W.? A) Just before administration of the cyclophosphamide to J.W. B) Every three hours as requested by J.W. C) Two hours before administration of the cyclophosphamide to J.W. D) Upon initial complaints of nausea by J.W.
A) Just before administration of the cyclophosphamide to J.W. - Antiemetics should be given just before administering cyclophosphamide to decrease the severity of nausea and vomiting.
Through which primary route is cyclophosphamide excreted? A) Kidneys B) Liver C) Intestines D) Sudoriferous glands
A) Kidneys - Cyclophosphamide is excreted in urine by the kidneys.
Which statements describe the benefits of treating cancer cells with a combination of different classes of chemotherapeutic drugs? (Select all that apply) A) Therapeutic effect in all phases of cancer cells is increased. B) Adverse effects are decreased. C) Development of drug resistance is decreased. D) Destruction of cancer cells is increased. E) Length of treatment is decreased.
A) Therapeutic effect in all phases of cancer cells is increased -Combination therapy with different classes of chemotherapeutic drugs increases the likelihood of affecting cancer cells in all phases of the cell cycle. C) Development of drug resistance is decreased - Combination therapy with different classes of chemotherapeutic drugs decreases the development of drug resistance. D) Destruction of cancer cells is increased - Combination therapy with different classes of chemotherapeutic drugs increases the destruction (cytotoxicity) of cancer cells.
A patient presents with Philadelphia chromosome-negative acute lymphoblastic leukemia that has failed multiple chemotherapeutic drug therapy. Which chemotherapeutic agent would the nurse expect to administer? A) Vincristine liposomal B) Doxorubicin liposomal C) Doxorubicin conventional D) Vincristine conventional
A) Vincristine liposomal - Vincristine liposomal is indicated for Philadelphia chromosome-negative acute lymphoblastic leukemia that failed multiple chemotherapeutic drug therapy.
