Test 2

A nursing student asks a nurse why chemotherapeutic agents are given intermittently instead of continuously. The nurse will tell the student that the intermittent dosing: A. Allows normal cells to recover and repopulate. B. Catches malignant cells in latent phase. C. Suppresses drug resistance in tumor cells. D. Increases cancer cell kill and speeds up treatment.

A. Allows normal cells to recover and repopulate.

A nurse is obtaining a drug history from an older adult patient who is taking multiple medications prescribed by different providers. Which two medications taken together create a reason for concern? A. Acetaminophen (Tylenol) and oxycodone. B. Amitriptyline (Elavil) and diphenhydramine (Benadryl). C. Fexofenadine (Allegra) and an over the counter laxative. D. Zolpidem (Ambien) and sertraline (Zoloft).

B. Amitriptyline (Elavil) and diphenhydramine (Benadryl).

An infant has allergies and often develops a pruritic rash when exposed to allergens. The infant's parents ask the nurse about using a topical antihistamine. What should the nurse tell them? A. The child will also need oral medication to achieve effective results. B. Applying an antihistamine to the skin can cause toxicity in this age group. C. Topical medications have fewer side effects than those given by other routes. D. Antihistamines given by this route are not absorbed well in children.

B. Applying an antihistamine to the skin can cause toxicity in this age group.

What contributes to drug resistance to chemotherapeutic agents? (select all) A. Increased drug uptake by tumor cells. B. Cellular production of P-glycoprotein. C. Reduced target molecule sensitivity. D. Drug-induced cellular maturation. E. Creation of selection pressure by drugs.

B. Cellular production of P-glycoprotein. C. Reduced target molecule sensitivity. E. Creation of selection pressure by drugs.

The parents of a child with asthma ask the nurse why their child cannot use oral corticosteroids more often, because they are so effective. The nurse will offer which information that is true for children? A. Frequent use of this drug may lead to a decreased response. B. Chronic steroid use can inhibit growth. C. A hypersensitive reaction to this drug may occur. D. Systemic steroids are more toxic in children.

B. Chronic steroid use can inhibit growth.

A nurse is caring for a patient who is being treated with interferon alfa-2b for malignant melanoma, (a noncytotoxic agent). For which of the following adverse effects should the nurse monitor? (select all) A. Tinnitus B. Depression C. Peripheral neuropathy D. Bone loss E. Muscle aches

B. Depression C. Peripheral neuropathy E. Muscle aches

Which are guidelines for selecting chemotherapeutic agents to use in combination therapy? (select all) A. Each drug should have different dosing schedules. B. Each drug should be effective. C. Drugs used should have different mechanisms. D. Each drug should be delivered by different routes. E. Toxicities should be minimally overlapping.

B. Each drug should be effective. C. Drugs used should have different mechanisms. E. Toxicities should be minimally overlapping.

A patient who has leukemia is receiving chemotherapy and develops severe anemia. The provider has ordered hospitalization and blood transfusions. The patient asks the nurse about using erythropoietin instead. What will the nurse tell this patient? A. Erythropoietin is used to prolong life in patients with myeloid malignancies. B. Erythropoietin can make your leukemia worse. C. Ask your provider about ordering erythropoietin instead of a transfusion. D. You will probably receive erythropoietin along with the transfusion.

B. Erythropoietin can make your leukemia worse.

A 43 year old patient with a strong family history of breast cancer considers taking tamoxifen (nolvadex) for cancer prevention. Which assessment finding is a possible contraindication? A. Prior hysterectomy B. History of DVT C. History 0of osteoporosis D. Hyperlipidemia

B. History of DVT

Which types of drugs taken by a pregnant patient are more likely to have effects on a fetus? A. Protein-bound drugs B. Lipid-soluble drugs C. Drugs that are highly polar D. ionized drugs

B. Lipid-soluble drugs

An elderly adult woman is admitted to the hospital after several days of vomiting, diarrhea, and poor intake of foods and fluids. in preparing to care for this patient, the nurse will look for what lab values to help guide medication administration? (select all) A. Gastric pH B. Plasma drug levels C. Serum creatinine D. Serum albumin E. Creatinine clearance

B. Plasma drug levels D. Serum albumin E. Creatinine clearance

Hormone therapy is most frequently prescribed for patients who have which type of cancer? (select all) A. Liver B. Prostate C. Lung D. Bone E. Breast

B. Prostate E. Breast

A nurse is caring for an older adult patient during the intermediate postoperative period after a total hip replacement. The surgeon has ordered meperidine (Demerol) for severe pain. What will the nurse do? A. Ask for a PRN order for diphenhydramine (Benadryl) for the expected side effect of itching. B. Request an order for morphine instead of meperidine (Demerol). C. Suggest to the surgeon that the patient receive diazepam (Valium) to reduce anxiety and the need for narcotics. Administer the medication as prescribed and initiate a fall risk protocal.

B. Request an order for morphine instead of meperidine (Demerol).

A pregnant patient asks the nurse about the safe use of medications during the third trimester. What will the nurse tell her about drugs taken at this stage? A. They require lower doses if they are metabolized by the liver. B. They may need to be given higher doses if they undergo renal clearance. C. They are more likely to cause anatomical defects if they are teratogenic. D. They are less likely to cross the placenta and affect the fetus.

B. They may need to be given higher doses if they undergo renal clearance.

A premenopausal woman has ER-positive breast cancer, and her prescriber has ordered tamoxifen (nolvadex). She asks the nurse is anastrozole (Arimidex) would work better for her. What will the nurse tell her? A. Anastrozole is more likely to promote endometrial carcinoma. B. Until she is postmenopausal Anastrozole will not be effective. C. Cancer recurrence is higher with Anastrozole. D. Anastrozole is more likely to cause hot flushes than tamoxifen.

B. Until she is postmenopausal Anastrozole will not be effective.

The nurse on an oncology unit prepares to administer the fourth cycle of docetaxel (Taxotere) to a patient with breast cancer. Which clinical finding would cause the nurse to withhold the dose and call the prescriber? A. Alanine transaminase (ALT) 1.2 times the upper limit. B. Creatinine clearance of 130 mL/min./1.73 m2. C. Neutrophil count below 500/mm3. D. Alkaline phosphate 2 times the upper limit.

C. Neutrophil count below 500/mm3.

A nursing student asks the nurse what differentiates anti-estrogen drugs from aromatase inhibitors in the treatment of breast cancer. What is the correct response by the nurse? A. Anti-estrogen dugs decrease the risk for thrombotic events. B. Aromatase inhibitors block the production of estrogen by the ovaries. C. Aromatase inhibitors can be used for tumor cells that lack estrogen receptors. D. Anti-estrogen drugs increase the risk for endometrial cancer.

D. Anti-estrogen drugs increase the risk for endometrial cancer.

A patient in her second trimester of pregnancy tells the nurse she is worried that a medication she took before knowing she was pregnant might have harmed the fetus. What will the nurse do? A. Counsel the patient to consider termination of the pregnancy. B. Suggest to the patient that she go to a high-risk pregnancy center. C. Contact the patient's provider to request an ultrasound. D. Ask the patient what she took and when she learned she was pregnant.

D. Ask the patient what she took and when she learned she was pregnant.

A patient will begin taking tamoxifen (nolvadex) to treat breast cancer. The nurse performs a medication history and learns that the patient is taking sertraline (Zoloft) for depression. The nurse will tell the patient to contact her provider to ask about: A. Switching from sertraline to fluoxetine (Prozac). B. Increasing her dose of sertraline. C. Decreasing her dose of tamoxifen. D. Changing from sertraline to escitalopram (Lexapro)

D. Changing from sertraline to escitalopram (Lexapro)

A nurse is caring for a patient and her newborn immediately after delivery. The patient's medication history includes prenatal vitamins, one or two glasses of wine before knowing she was pregnant, occasional use of an albuterol inhaler last trimester, and IV morphine during labor. What will the nurse expect to do? A. Administer opioids to the infant to prevent withdrawal syndrome. B. Prepare the patient for motor delays in the infant caused by the alcohol use. C. Note a high-pitched cry and irritability in the infant and observe for seizures. D. Monitor the infant's respirations and prepare to administer naloxone if needed.

D. Monitor the infant's respirations and prepare to administer naloxone if needed.

An infant is receiving a medication that has a narrow therapeutic range. The nurse reviews the medication information and learns that the drug is excreted by the kidneys. When giving the medication, the nurse will assess the infant for: A. unusual CNS effects. B. Decreased effectiveness of the drug. C. Shorter period of the drug's effects. D. Signs of drug toxicity.

D. Signs of drug toxicity.

A woman who is breast-feeding her infant must take a prescription medication for 2 weeks. Medication is safe, but the patient wants to make sure her baby receives as little of the drug as possible. What will the nurse tell the patient to do? A. Give the baby formula as long as the mother is taking the medication. B. Pump breast milk and feed the baby by bottle. C. Take the medication 1 hour before breast-feeding. D. Take the medication immediately after breast-feeding.

D. Take the medication immediately after breast-feeding.

A nurse is preparing to give medications to 4 older patients who are taking multiple medications. which patient is most likely to have an adverse drug reaction related to increased drug effects? A. Obese patient. B. Patient with decreased serum creatine. C. Patient with chronic diarrhea. D. The patient with a chronically low appetite.

D. The patient with a chronically low appetite

A patient will begin receiving vincristine (Oncovin) to treat Hodkin's lymphoma. Which side effects will the nurse tell the patient to report immediately? A. Hair loss B. Diarrhea, nausea, and vomiting C. Headaches D. Tingling of the extremities

D. Tingling of the extremities

Optimal use of chemotherapy drugs in combination is based on which premise? (select all) A. Each drug should have a different mechanism of action. B. Each drug is effective by itself. C. One should be administered orally and the other administered intrathecally to decrease toxicity. D. Toxicities should focus on the body tissue. E. The drugs should have the same mechanism of action.

A. Each drug should have a different mechanism of action. B. Each drug is effective by itself.

When administering medications to infants, it is important to remember which of the following? (select all) A. Infants have immature livers, which slows drug metabolism. B. oral medications are contraindicated in infants because a nurse cannot administer medication to an uncooperative patient. C. Immaturity of renal function causes infants to excrete drugs less efficiently. D. Non-breastfeeding infants are less likely to develop toxicity when given double lipid-soluble drugs. E. Infants are more sensitive to medications that act on the CNS.

A. Infants have immature livers, which slows drug metabolism. C. Immaturity of renal function causes infants to excrete drugs less efficiently. E. Infants are more sensitive to medications that act on the CNS.

Which actions should the nurse perform to ensure that the medication dose for a pediatric patient is correct? (select all) A. Notify the provider if the drug doses prescribed varies from the recommended reference range. B. Change the route of administration to IV. C. Use the patient's weight in pounds. D. Compare the drug dosage prescribed with the calculated safe range. E. Use a current drug reference to determine usual dosage per 24 hours.

A. Notify the provider if the drug doses prescribed varies from the recommended reference range. D. Compare the drug dosage prescribed with the calculated safe range. E. Use a current drug reference to determine usual dosage per 24 hours.

A nursing student asks a nurse how cancer cells become resistant to methotrexate (rheumatrex). The nurse is correct to respond by saying that cancer cells aquire resistance to methotrexate by: A. Reduced uptake of methotrexate into cells. B. Reduced production of transporter that pumps methotrexate out of cells. C. Reduced synthesis of dihydrofolate reductase. D. Increased ability to convert the drug to a polyglutamated form.

A. Reduced uptake of methotrexate into cells.

A patient has just been diagnosed with cancer and will begin chemotherapy. The patient asks the nurse about the possibility of nausea and vomiting. The nurse will tell the patient that: A. The provider will order drugs to help prevent nausea and vomiting before each dose. B. Nausea and vomiting are common side effects and will abate over time. C. Nausea and vomiting are common and will be treated with antiemetics when they occur. D. Nausea and vomiting can be avoided by having a snack before chemotherapy.

A. The provider will order drugs to help prevent nausea nd vomiting before each dose.

A nurse is caring for an infant after a surgical procedure. After ensuring that the ordered dose is appropriate for the infant's age and weight, the nurse administers a narcotic analgesic IV. When assessing the infant 15 min later, the nurse notes respirations of 22 breaths per min. and a heart rate of 110 beats/min. The infant is asleep in the parent's arms and does not awaken when vital signs are assessed. The nurse understands that these findings are the results of: A. immaturity of the blood-brain barrier in the infant. B. Toxic effects of the narcotic, requiring naloxone as an antidote. C. An allergic reaction to the medication. D. Unexpected side effects of the medications in infants.

A. immaturity of the blood-brain barrier in the infant.

A nursing student asks about the differences between cell-cycle phase-specific chemotherapeutic agents and those that are cell-cycle phase nonspecific. What will the nurse explain? A. Neither type is toxic to cells in the resting g0 Phase. B. Cell-cycle phase-nonspecific drugs are less toxic. C. Cell-cycle phase-specific drugs do not harm resting cells. D. Cell-cycle phase-specific drugs should be given at specific intervals.

C. Cell-cycle phase-specific drugs do not harm resting cells.

A nursing student asks the nurse why more is not known about the teratogenic effects of maternal medication ingestion during pregnancy. Which response by the nurse is correct? A. More women are reluctant to admit taking medications while they are pregnant. B. It is safer to recommend that pregnant women avoid medications while pregnant. C. Clinical trials to assess the risk would put the fetus at risk. D. The relatively new MEPREP study will allow testing of medications during pregnancy in the future.

C. Clinical trials to assess the risk would put the fetus at risk.

A patient is receiving fluorouracil (Adrucil) as a continuous IV dose to treat a solid tumor. The patient reports soreness and blisters in the mouth, loose stools, and tingling of the hands and feet. What will the nurse do? A. Request an order for dexamethasone to treat these side effects. B. Contact the provider to discuss bolus doing instead of continuous dosing. C. Discontinue the medication and contact the provider to report these symptoms. D. Reassure the patient that these are expected, uncomfortable side effects.

C. Discontinue the medication and contact the provider to report these symptoms.

A nurse is teaching a group of nursing students about administering medications to older adult patients. Which statement by a student indicates a need for further teaching? A. Most adverse drug reactions in older adult patients are related to altered renal function. B. Most nonadherence among older adult patients is intentional. C. Changes in GI function in older adult patients lead to lower serum drug levels. D. Alteration in hepatic function requires more frequent drug dosing.

D. Alteration in hepatic function requires more frequent drug dosing.