CHP 55 PREP U
A
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
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? A) With food and a large glass of water B) On an empty stomach C) Thirty minutes before breakfast and in the early evening, at least 2 hours after dinner D) With a glass of grapefruit or cranberry juice
C
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.
D
A patient has been diagnosed with cancer. The physician prescribes antineoplastic drug therapy to the patient. How should the nurse explain the use of antineoplastic drugs? A) Leads to complete cure of cancer. B) Destroys only cancerous cells. C) Complete relief of symptoms of cancer. D) Delays spread of cancer to other sites.
D
A patient has received a large amount of chemotherapy to treat leukemia. The patient develops gastrointestinal upset, hypertension, and paresthesias. What syndrome is the patient developing? A) Fröhlich's syndrome B) Epidermal nevus syndrome C) Irritable bowel syndrome D) Lysis syndrome
C
A patient is administered bevacizumab (Avastin) to treat tumor growth in a breast tumor. What is the action of bevacizumab (Avastin)? A) It changes the RNA of the tumor cell. B) It binds to the 30S ribosome. C) It inhibits the formation of blood vessels. D) It blocks the cell wall synthesis.
A
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
A patient is scheduled to begin a course of rituximab for the treatment of multiple myeloma. The dose and rate of the initial infusion of the drug have been determined by the care team. The dose and rate will be increased in subsequent infusions of the drug based on what factor? a) The absence of adverse reactions B) The signs and symptoms of the patient's cancer C) The patient's nutritional status D) The patient's fluid and electrolyte balance
C
A patient is to receive rituximab 1,000 mg IV for rheumatoid arthritis. What medication should the nurse prepare to administer 30 minutes prior to the injection? A) Epinephrine 0.3 mL B) Diphenhydramine 50 mg C) Methylprednisilone 100 mg D) Rocephin 1 Gm
D
A patient newly diagnosed with CML has been prescribed treatment with imatinib. The patient asks the nurse how imatinib works. What would be the nurse's best response? A) "Imatinib alkylates cellular DNA." B) "Imatinib inhibits folic acid reductase, leading to inhibition of DNA synthesis and inhibition of cellular replication." C) "Imatinib binds to DNA and inhibits DNA synthesis in susceptible cells, causing cell death." D) "Imatinib inhibits the enzyme created by the Philadelphia chromosome abnormality in CML."
B
A patient taking antihypertensive medication is beginning rituximab therapy. What should the nurse instruct the patient to do prior to starting the rituximab? A) Be sure and take the antihypertensive medication the morning prior to rituximab therapy. B) Hold the antihypertensive medication for 12 hours before rituximab administration and 12-24 hours after. C) Hold the antihypertensive medications for 24-48 hours after the rituximab has been administered. D) Take the antihypertensive medication 30 minutes before rituximab therapy and hold 12 hours after.
A
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? A) daily weights B) assessment of deep tendon reflexes C) bilateral blood pressures D) pupillary response
B
A patient with advanced renal cell cancer is undergoing a course of treatment that includes sunitinib (Sutent). What diagnostic test should be performed prior to and during the administration of this drug? a) Pulse oximetry B) ECG C) Lung function testing D) Blood pressure monitoring
A
A patient with hypertension and mild chronic obstructive pulmonary disease is taking rituximab therapy. What can the nurse do to reduce the risk of adverse effects? A) Administer a nitrate. B) Administer digoxin. C) Administer epinephrine. D) Administer a corticosteroid.
A
After completing a head-to-toe assessment, an oncology nurse has just initiated the infusion of a patient's first dose of rituximab. When monitoring the patient for potential adverse effects, the nurse should closely observe the patient for which of the following signs and symptoms? A) Fever and chills B) Hypertension and tachycardia C) Epistaxis and skin flushing D) Confusion and loss of consciousness
B
Alemtuzumab (Campath) is used to treat malignant lymphoid cells. Which of the following factors are important for 3 months after the administration of alemtuzumab? A) Protect from injury B) Administer antimicrobial drugs C) Administer beta-adrenergic agonists D) Have an EKG monthly
B
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? A) "These drugs boost the functioning of your immune system so that it can overcome the cancerous cells in your body." B) "These drugs are capable of controlling the signals that tell cancer cells to grow and divide." C) "Targeted therapies are mutations in the reproduction of cancerous cells so that they no longer pose a threat to your health." D) "Targeted therapies help your immune system to produce antibodies against cancer cells, which it is not normally able to do."
A, B, C
Basiliximab (Simulect) is a monoclonal antibody that is an IL-2 receptor antagonist. A pharmacology professor asks the class to describe this drug's characteristics. Which of the following responses indicates the students understand the drug? Select all that apply. A) "It acts by binding to and blocking the CD25 antigen receptor site." B) "It helps with allograft rejection." C) "Patients will report gastrointestinal upset." D) "A patient taking this drug will have a WBC count above 6,000 cells/mL."
A, B
Because of the rapidly developing practice of using antibodies to target tumor cell receptor sites, the antibody prototype is the monoclonal antitumor antibody called rituximab (Rituxan). The pharmacotherapeutics of this drug means it treats which of the following conditions? Choose all that apply. A) CD20-positive B-cell malignancies B) Rheumatoid arthritis C) Celiac disease D) Crohn's disease
A, C
Cytotoxic antineoplastic medications can produce several adverse effects that can affect the treatment used. In caring for patients undergoing chemotherapy, for which of the following should monitoring occur? (Select all that apply.) A) Mucositis B) Hypouricemia C) Tetany D) Increased urine output
A
For which condition does the nurse understand the physician will order a combination therapy of rituximab and methotrexate? A) Rheumatoid arthritis B) Osteoarthritis C) Ulcerative colitis D) Pseudomembranous colitis
A, B, C
Infliximab (Remicade) is a monoclonal antibody, a chimeric human-murine IgG antibody. A pharmacology professor asks the class to describe this drug. Which of the following statements indicate a student knows all about infliximab? Select all that apply. A) "It acts by blocking tumor necrosis factor (TNF)." B) "It is licensed for treating moderate to severe Crohn's disease." C) "The patient may report having acne breakouts." D) "The most common adverse effect is gastric upset."
C
Prior to a patient being treated with eculizumab (Solirus), what medication should be administered to prevent a serious side effect of the eculizumab? A) The hepatitis B series B) A flu vaccine C) A meningococcal vaccination D) A pneumococcal pneumonia vaccination
A
Rituximab has been prescribed for a patient who has longstanding history of severe rheumatoid arthritis that has been minimally responsive to standard therapies. When assessing the patient prior to the start of the course of treatment, what assessment question is the nurse's priority? A) "Do you have any history of heart disease or irregular heart rhythms?" B) "Are all of your vaccinations currently up to date?" C) "Have you been in contact with anyone who has tuberculosis in the last several months?" D) "How would you describe your normal diet?"
A, C, D
Targeted therapies are less toxic than traditional chemotherapy, but for what adverse effects should the nurse assess? (Select all that apply.) A) Severe skin reactions B) Urinary incontinence C) Thrombosis D) Gastrointestinal toxicities E) Iritis
A, B, C
The Food and Drug Administration (FDA) has approved several targeted therapies for the treatment of cancer. Targeted therapy can best be described in which of the following ways? Choose all that apply. A) Interfere with specific extracellular and intracellular molecules and receptor sites B) Focus on proteins C) Still being studied in clinical trials D) Administered by the health care provider intravenously in a hospital or clinic setting
A, B
The antibody prototype is the monoclonal antitumor antibody called rituximab (Rituxan). The adverse effects of this drug are described by which of the following? Choose all that apply. A) fever, flushing, chills, and rigors B) respiratory distress, more common if tumor is larger C) increased appetite D) Hgb > 13 g/dL
A, B, C
The antibody prototype is the monoclonal antitumor antibody called rituximab (Rituxan). The pharmacodynamics of this drug can be described by which of the following? Choose all that apply. A) Binds specifically to the CD20 antigen B) Causes cell lysis C) Decreases IgG and IgM serum levels D) Administered via slow IV infusion for 4 to 8 weeks
C
The nurse is administering rituximab therapy when the patient has a seizure and then progresses into a comatose state. What does the nurse recognize has possibly occurred with this patient? A) The patient has a pre-existing electrolyte disorder. B) The patient had an undiagnosed seizure disorder. C) The patient has progressive multifocal leukoencephalopathy. D) The patient has developed meningococcal meningitis.
A
The nurse is administering rituximab to a patient who develops an infusion-related reaction. What should the first action by the nurse be? A)Stop the drug until the symptoms resolve. B) Administer only one half of the dose until the medication is complete. C) Administer a corticosteroid medication. Administer epinephrine 0.3 mL subcutaneously. D)
D
The nurse is administering rituximab to a patient who states "My heart feels like it is beating out of my chest." When the nurse connects the patient to the monitor, ventricular tachycardia is observed. What does the nurse understand is happening with this patient? A) The patient is having a myocardial infarction. B) The patient is having a dissecting aortic aneurysm. C) The patient is having a catecholamine response to fear. D) The patient is most likely having an infusion reaction syndrome.
D
The nurse is caring for a patient with a history of uncontrolled hypertension. For which chemotherapy agent should the nurse question an order? A) Panitumumab (Vectibix) B) Ofatumumab (Arzerra) C) Abciximab (ReoPro) D) Bevacizumab (Avastin)
D
The nurse is caring for a patient with breast cancer who will have 6 weeks of chemotherapy along with radiation therapy. Which adverse effect should the nurse monitor for in this patient? A) Monitor the patient for abdominal pain and hypoactive bowel sounds. B) Monitor the patient for headache, nausea, and vomiting. C) Monitor the patient for seizures. D) Monitor the patient for signs and symptoms of chronic heart failure.
C
The nurse is preparing to administer bevacizumab to a patient with metastatic cancer of the colon. What should the nurse do when preparing this medication? A) Mix the drug in a solution of dextrose and water. B) Pre-medicate the patient with a corticosteroid prior to administration. C) Cover the drug during administration because it is light sensitive. D) There is no special preparation for this medication. It may be administered without restrictions.
A
The nurse is preparing to administer intravenous (IV) infliximab (Remicade) for a patient with Crohn's disease. What care should the nurse take in the preparation of this drug? A) Mix the medication in a glass bottle with polyethylene tubing. B) Mix the medication in a bag of Lactated Ringer's solution with polyethylene tubing. C) Remicade does not require any special preparation. D) It may be mixed in D5W with regular tubing. Mix the medication in a plastic bag of normal saline with polyethylene tubing.
B
The nursing student asks the instructor why the newer targeted therapies are more effective than what is currently being used for cancer treatment. What is the best response by the instructor? A) "The targeted cancer therapies are less expensive than the current therapies, and more patients are seeking treatment." B) "The targeted cancer therapies have fewer adverse effects than current therapies." C) "The targeted cancer therapies are more toxic and more effective than current therapies." D) "The targeted cancer therapies will eliminate the need for other drugs to be used with them."
B
What discharge instructions should the nurse provide to the patient going home after rituximab therapy? A) Limit fluid intake to 1 L per 24 hour period and report increased urine output. B) Consume large amounts of water and report decreased urine output. C) Eat a bland diet for 24 hours after therapy. D) Take acetaminophen for the discomfort related to the transfusion.
D
Which medication does the nurse recognize as a single first-line agent for a 72-year-old patient with T-cell chronic lymphocytic anemia (CLL)? A) Abciximab (ReoPro) B) Ofatumumab (Arzerra) C) Panitumumab (Vectibix) D) Alemtuxumab (Campath 1-H)
D
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
A
Which treatment would be appropriate for a patient with breast cancer and an HER2-expressing tumor? A) Trastuzamab (Herceptin) B) Abciximab (ReoPro) C) Ofatumumab (Arzerra) D) Panitumumab (Vectibix)