Chapter 14 PrepU

A 63-year-old male patient has just begun treatment with IV paclitaxel. About 10 minutes into the infusion, the nurse becomes concerned about a possible anaphylactic reaction to the drug because the patient is experiencing: dyspnea. bradycardia. hypertension. increased body temperature.

dyspnea

A nurse is preparing to administer etoposide to a client. Which assessment finding that could influence dosing should the nurse prioritize in the preadministration assessment? The emotional response Complete blood count Fluid intake and output Understanding of therapy

Complete blood count

A client has been diagnosed with cancer. The health care provider prescribes antineoplastic drug therapy to the client. How should the nurse explain the use of antineoplastic drugs? Leads to complete cure of cancer Destroys only cancerous cells Complete relief of symptoms of cancer Delays spread of cancer to other sites

Delays spread of cancer to other sites

What is the nurse's priority intervention to reduce the risk of renal damage caused by cyclophosphamide? Encourage the client to drink cranberry juice. Promote adequate rest and sleep. Encourage fluids to maintain hydration. Instruct the client to wear only cotton underwear.

Encourage fluids to maintain hydration.

The nursing instructor is teaching a class on the necessary precautions required when working around a chemotherapeutic drug. The instructor determines the session is successful when the students correctly don which piece(s) of equipment to clean a drug spill? Select all that apply. Gloves Safety goggles Gown Chemical spill boots NIOSH-approved respirator

Gloves Safety goggles Gown NIOSH-approved respirator

A patient undergoing antineoplastic drug therapy is administered an alkylating drug. The patient is also administered an aminoglycoside as an anti-infective agent. Which of the following interactions of the alkylating drug with the aminoglycoside should the nurse assess the patient for? Increased risk of nephrotoxicity Increased risk of bleeding Increased risk of hypoglycemia Increased risk of methotrexate toxicity

Increased risk of nephrotoxicity

A nurse is caring for a client who is undergoing chemotherapy. The client has experienced several episodes of vomiting. Which would be appropriate for the nurse to do for this client as part of the ongoing assessment? Measure and record client's temperature. Measure and record client's blood pressure. Observe the results of liver function tests Measure all fluid intake and output

Measure all fluid intake and output

Which agent would the nurse expect to be administered orally? Cytarabine Fluorouracil Gemcitabine Methotrexate

Methotrexate

A male client is informed that the latest tests indicate that his cancer has spread to his liver. The client receives capecitabine as part of his treatment regimen. What would the nurse expect the health care provider to do? Increase the dose of capecitabine. Discontinue the capecitabine. Add routine blood transfusions to the client's treatment regimen. Monitor the client closely and repeat LFTs routinely.

Monitor the client closely and repeat LFTs routinely.

A nurse in an outpatient treatment center is caring for a client who receives regular IV chemotherapy sessions. The nurse understands that one important goal of chemotherapy is what? Prevention or treatment of adverse drug effects decrease in biologic targeted therapies promotion of uncontrolled cell growth Inhibition of normal cell production

Prevention or treatment of adverse drug effects

A client, who is prescribed vinblastine, is also currently administered warfarin. The nurse will carefully monitor the client for which reaction? Seizures Ototoxicity CNS depression Prolonged bleeding

Prolonged bleeding

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

Provide mouth care frequently.

A 42-year-old female with breast cancer has had a radical mastectomy. She will have radiation therapy and then begin chemotherapy. Drug therapy will consist of a combination of doxorubicin, cyclophosphamide, and paclitaxel. What will the nurse include in the teaching plan concerning the drug therapy? Stay on a low-fat diet during the course of the drug therapy. Take special care when shaving or brushing her teeth. Continue to go to church or to the mall just as she did before the diagnosis of ca

Take special care when shaving or brushing her teeth.

A female client is prescribed methotrexate for meningeal leukemia. What health education should the nurse prioritize? Use reliable forms of barrier contraception. Discontinue oral contraceptives. Avoid grapefruit juice. Abstain from alcohol until 7 days after treatment.

Use reliable forms of barrier contraception.

A nurse is caring for a client during chemotherapeutic drug therapy and determines a nursing diagnosis of impaired tissue integrity is appropriate. Which action would be appropriate for the nurse to suggest during the teaching session? Scrub and clean skin often. Wear loose protective clothing. Ensure adequate sunlight. Have frequent baths.

Wear loose protective clothing.

Your new admission is a 53-year-old black woman, presenting after bilateral mastectomies. Earlier biopsy results indicated multiple malignancies in each breast. How long does it usually take for malignant cells to produce a clinically detectable neoplasm? Hours Days Months Years

Years

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

The nurse is assessing a client for adverse effects related to methotrexate therapy. What diagnostic finding should the nurse prioritize? serum osmolality creatinine clearance electrocardiogram (ECG) calcium and magnesium levels

creatinine clearance

Many times a combination of antineoplastic medications are used to: decrease the development of cell resistance. increase the length of treatment. increase the quantity of each medication used. decrease the side effects of each medication.

decrease the development of cell resistance.

A nurse educator is discussing the role of protooncogenes in the pathophysiology of cancer. What typically triggers protooncogenes to differentiate into oncogenes? ischemia exposure to a low-pH environment exposure to carcinogens exposure to chemotherapeutic agents

exposure to carcinogens

A client diagnosed with cancer is experiencing pain and the early signs of organ dysfunction. How should the nurse explain these signs and symptoms originate? overgrowth of tumor cells enzymes that generate blood vessels tumor cells invading healthy tissue the body's own misguided immune response

tumor cells invading healthy tissue

The dosages of the chemotherapy agents that will be administered are based primarily on what client variable? weight comorbidities body surface area (BSA) percentage of body water

weight

What best reflects the action of antimetabolites? Reacts chemically with portions of RNA, DNA, or other cellular proteins Inserts itself between base pairs in the DNA chain, disrupting DNA synthesis Inhibits DNA production via replacing the natural substances needed for it Interferes with the ability of the cell to divide by blocking DNA synthesis

Inhibits DNA production via replacing the natural substances needed for it

A nurse is presenting information at a health fair concerning cancer. When questioned about the use of green tea, the nurse would point out which potential effect of green tea? Dental caries Damage to heart Insomnia Damage to liver

Insomnia

How can a nurse best prevent tissue damage caused by an antineoplastic extravasation? Inspect the site frequently for redness or swelling Infuse into proximal veins whenever possible Administer through a hand vein, if possible Use an infusion pump

Inspect the site frequently for redness or swelling

The nurse is caring for a client who is receiving a combination of antimetabolite 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? Reassure the client that other people who are treated with cancer also experience this. Encourage the client to view the hair loss as something that indicates cancer is being eradicated. Reassure the client that the hair loss will be temporary rather than perma

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

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. limit fluid intake. take the medication at bedtime. increase the protein in her diet.

drink a lot of water.

A patient has been scheduled to begin treatment with rituximab for non-Hodgkin's lymphoma. The nurse who will administer this drug should understand that it targets the function of the complement system. specific antigens on the surface of malignant B cells. the DNA of mature plasma cells. the molecular structure of the cells making up the semipermeable membrane of cancerous cells.

specific antigens on the surface of malignant B cells.

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

Cardiotoxicity

A 39-year-old client has begun taking tamoxifen to reduce the risk of contralateral breast cancer. The client is now reporting hot flashes and dysmenorrhea. What is the nurse's best action? Tell the client to stop taking the drug immediately and contact the prescriber. Encourage the client to ask their provider about the possible use of dexrazoxane to relieve these effects. Encourage the client to speak with their care provider about hormone therapy. Inform the client that these are likely adv

Inform the client that these are likely adverse effects of drug therapy.

What is the first action by the oncology nurse when observing extravasation with the client receiving vincristine? Obtain a photograph of the site. Apply warm compresses. Consult the health care provider. Stop the infusion.

Stop the infusion.

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? Forewarn about hair loss. Explain it is not life-threatening. Suggest the use of a wig or cap. Explain that hair preserves body heat.

Suggest the use of a wig or cap.

The nurse is describing the necessity of recovery periods between treatment cycles to a client receiving chemotherapy. How should the nurse best explain the need? Time is needed to replace many of the healthy body cells killed by chemotherapy. There is a need to restore a physiologic reserve of energy before further chemotherapy. The restoration of fluid balance and nutrition is needed before continuing with chemotherapy. Time is required for the successful application of radiotherapy between cy

Time is needed to replace many of the healthy body cells killed by chemotherapy.

The community health nurse is planning care for a client who will be prescribed an oral chemotherapy drug for the next several months while recovering at home. What health education topic should the nurse emphasize? techniques for safely handling the drug techniques for self-monitoring of liver status ways to match the dose to the severity of the symptoms appropriate herbal substitutes for the chemotherapy agent

techniques for safely handling the drug