Pharmacology Prep U Chapter 14 Antineoplastic Agents

A client is being treated on the oncology unit and has developed worsening adverse effects over the past several days of chemotherapy. Administration of filgrastim may aid in achieving what desired outcome?

increase leukocytes

A female client will soon begin targeted therapy as a component of her treatment plan for chronic leukemia. The nurse is conducting health education about this new aspect of the client's drug regimen and the client has asked about the potential side effects of treatment. How should the nurse best respond?

"Both classes of drugs have adverse effects, but targeted therapies tend to have less of an effect on healthy body cells."

A client's chemotherapy regimen has been deemed successful, but the client is experiencing debilitating nausea and vomiting. These adverse effects should signal the nurse to the possibility of what nursing diagnosis?

Imbalanced nutrition: less than body requirements

A client received an injection of doxorubicin and is now observing a reddish urine. The client reports blood in the urine to the nurse. How should the nurse respond?

"The reddish urine is an expected response to the drug."

A patient having chemotherapy is losing her hair. She asks the nurse if her hair will come back as it originally was. What is the best response by the nurse?

"Your hair will grow back, but the new hair may be a different color or texture."

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 *Thrombocytopenia

The client is instructed to return to the clinic after calling and reporting various concerns. The nurse alerts the primary health care provider after noting which signs on the assessment? Select all that apply.

*Bleeding gums *Petechiae *Hematuria

A client is being treated for pancreatic cancer and has been prescribed streptozocin 500 mg/m2 IV for five consecutive days. The client's body surface area is 1.78 m2 and the client weighs 69.5 kg. The nurse should administer how many mg of this medication?

890

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

Avoiding grapefruit juice

A client on the oncology unit has begun chemotherapy with a regimen that includes bendamustine. The client has begun to experience alopecia. The nurse should prioritize assessments related to what potential nursing diagnosis?

Disturbed body image

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

The nurse understands that when administering cisplatin, the drug has a high potential for causing severe nausea and vomiting. What term is used to describe this group of antineoplastic drug?

Emetogenic

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.

False

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

Leucovorin

Which would the nurse identify as an antineoplastic antibiotic?

Mitomycin

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?

Salycilates

An adult client who has been diagnosed with a rectal tumor is scheduled to begin treatment with cisplatin. The nurse has conducted client teaching about the possibility of nausea and vomiting. In order to reduce the client's risk of severe nausea, the nurse should:

administer a combination of antiemetics prior to the administration of the drug.

A female patient is taking oral cyclophosphamide therapy for breast cancer. Because of possible adverse effects of the drug, the nurse will instruct the patient to:

drink a lot of water

What is the defining characteristic of a sarcoma?

originate from connective tissue

A recent nursing graduate is receiving special training to become certified in handling and administering chemotherapy drugs. This special training is necessary because of what nursing diagnosis among clients receiving chemotherapy?

risk for injury related to chemotherapy

A nurse is providing client education to a 35-year-old woman who has been prescribed cyclophosphamide therapy. When discussing possible hair loss, the nurse will advise the client to:

see a wig specialist.

Tamoxifen achieves a therapeutic effect by which means?

slowing the growth of cancer cells

The nurse should encourage the client to implement which intervention in order to minimize the risk of developing chemotherapy-triggered mucositis?

thoroughly rinse the mouth often, especially before and after meals

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

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

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

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

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 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 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?

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

A 79-year-old woman has recently moved to a long-term care facility, and the nurse at the facility is conducting a medication reconciliation. The nurse notes that the woman has recently been taking tamoxifen. The nurse is justified in concluding that the woman has a history of what malignancy?

breast cancer

A 25-year-old female client is prescribed methotrexate to treat rheumatoid arthritis (RA). The nurse should teach the client to:

use an effective contraceptive.

lung cancer. What effect will this regimen likely have on the client's hemostatic function?

The client's platelet count will decline.

A male client is diagnosed with prostate cancer. The treatment modality of choice includes both surgery and chemotherapy. What does the chemotherapeutic option include?

Hormonal therapies

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 conducting an ongoing assessment on a client who has received an antineoplastic agent. Which signs should the nurse prioritize and alert the health care provider concerning? Select all that apply.

* Cough * Sore throat * White blood cell count of less than 3500/mm3

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

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

Reduce vomiting

A client develops leukopenia after receiving chemotherapy. Which nursing diagnosis would be most appropriate?

Risk for infection

A client has been diagnosed with a brain tumor and is dealing with this diagnosis by seeking detailed information about cancer. The nurse would explain to the client that cancer is essentially a result of the disruption of the:

cell cycle

When assessing a client for adverse effects related to methotrexate (MTX) therapy, the nurse should prioritize what laboratory findings?

creatinine clearance

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

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 49-year-old client is diagnosed with ovarian cancer. What is a characteristic of malignant cells that differentiates them from normal body cells?

Cancerous cells grow in an uncontrollable fashion.

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

Chest x-ray

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

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 receiving carboplatin. The nurse would expect to administer this drug by which route?

Intravenous

During which phase of the cell cycle would a nurse expect a mitotic inhibitor to act?

M

A patient is to start with chemotherapy. The patient is worried about going bald in the course of the treatment. How can the nurse assist the patient in being comfortable with his or her body image?

Suggest the use of a wig or cap

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

Teniposide

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.

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 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/m2of doxorubicin. Which measure would help limit the severity of the cardiomyopathy in this client?

The use of dexrazoxane in conjunction with doxorubicin

What potential benefit is unique to biologic agent therapies?

They may affect cancer cells while leaving normal body cells unaffected.

Cancer is considered the second leading cause of death in the United States.

True

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

Fewer adverse effects are associated with monoclonal antibody therapy than those of cytotoxic drugs. However, some of the potential adverse effects of monoclonal antibodies can be life threatening, including which effect?

heart failure and bleeding problems