CHP 56 PREP U
C
A client asks the nurse why he has to have several courses of a chemotherapy drug instead of just one dose. The nurse states that it is based on the cell kill theory. Which of the following statements describes the cell kill theory? A) The cell kill theory is based on the premise that one dose of a chemotherapy drug will kill all the cancer cells if enough of the medication is given to a client. B) The cell kill theory describes the ways that different chemotherapy medications work to kill both healthy and cancerous cells within the human body. C) The cell kill theory describes the process of giving multiple doses of chemotherapy with each dose, killing approximately 90% of the cancer cells. After several rounds of chemotherapy, nearly all of the cancer cells are killed and the body's immune system will kill the few cancer cells that are left. D) The cell kill theory describes the phenomenon that occurs during the life cycle of a cancer cell as it is treated with a chemotherapy medication.
B
A client being treated with an antineoplastic medication is being discharged from the hospital. Which of the following teaching instructions is appropriate for this client? A) "Your cancer will never be gone; however, if you eat only natural foods the likelihood of it getting worse is lessened." B) "You will be excreting the antineoplastic medications in your stool and urine. As a precaution, double-flush the toilet with the lid closed so the chances of contact with the drug will be lessened." C) "Your hair will never come back, so you should look into a wig or hair plugs." D) "If your mouth gets sores inside of it, eat lots of salty and spicy food to burn the sores off."
B
A client has been started on vincristine as part of treatment for cancer. What factor will the nurse need to assess with regard to interactions with this medication? A) Alcohol intake B) Sensory, motor, and perceptual functions C) Exposure to sunlight D) Cigarette smoking
A
A female patient prescribed methotrexate for meningeal leukemia is asking the nurse about adverse effects of the drug. What would the nurse tell this patient should be avoided while taking methotrexate? A) pregnancy B) aerobic exercise C) smoking D alcohol
A
A nurse is administering an antineoplastic extravasation occurs. How can the nurse best prevent tissue damage caused by extravasation? A) Inspect the site frequently for redness or swelling B) Infuse into proximal veins whenever possible C) Administer through a hand vein, if possible D) Use an infusion pump
A
A nurse is caring for a patient who is prescribed velban, a vinca alkaloid. The patient wants to know the action of the drug on the cell cycle. Which of the following should the nurse inform the patient? A) Interferes with amino acid production in the S phase. B) Cells are stopped during the S and G2 phases. C) Inhibits DNA synthesis during the S phase. D) Prevents cell division during the S and G2 phases,
A
A nurse on the oncology unit is caring for a client with an astrocytoma. The client has just been told that the tumor is growing very fast. The client asks the nurse how these tumors grow. What would be the nurse's best response? A) "Brain tumors infiltrate the surrounding tissue." B) "Brain tumors grow by invading the surrounding grey matter." C) "Brain tumors grow by invading the surrounding white matter." D) "Brain tumors spread down the spinal cord."
B
A patient has come to the short-stay unit to receive their IV chemotherapy. What action by the nurse would be the least beneficial to the patient? A) Checking the IV line frequently B) Using an infusion pump to administer the medication C) Premedication the patient as ordered D) Starting the IV in a large, distal vein
B
A patient is beginning a course of chemotherapy for the treatment of chronic lymphocytic leukemia. To what is the start of this therapy referred? A) Consolidation therapy B) Induction therapy C) Maintenance therapy D) Palliative therapy
D
A patient is receiving irinotecan (CPT-11) for colorectal cancer and begins having diarrhea, sweating, flushing, and abdominal cramping. What can the oncology nurse give to relieve these symptoms? A) Dexamethasone 4 mg IV B) Diphenhydramine 25 mg IV C) Epinephrine 0.3 mg subcutaneous (SC) D) Atropine 0.5 mg intravenous (IV)
B
A patient receiving chemotherapy complains of a metallic taste in the mouth. What suggestions by the oncology nurse may help to minimize this problem? A) Use an astringent mouthwash. B) Suck on hard candy. C) Use an antifungal troche. D) Brush teeth before and after chemotherapy.
B
A patient will be having chemotherapy to reduce a colon tumor prior to having a colon resection. To what is this type of therapy referred? A) Adjuvant therapy B) Neoadjuvant therapy C) Palliative therap D) Consolidation therapy
C
A patient will be receiving floxuridine (FUDR) for treatment of colorectal cancer that has metastasized to the liver. What will the patient require prior to administration? A) An epidural catheter B) An intravenous central line C) A hepatic arterial pump for instillation D) A chest tube for instillation
C
A patient with a pancreatic tumor will be starting on chemotherapy to decrease the size of the tumor, give the patient a better quality of life, and reduce the discomfort. What is this form of therapy called? A) Neoadjuvant therapy B) Adjuvant therapy C) Palliative therapy D) Consolidation therapy
C
A patient with bladder cancer is to have intravesicular instillation of a chemotherapeutic agent into the bladder. What is a priority intervention of the oncology nurse? A) Keep the catheter unclamped. B) Attache the tubing to suction. C) Insert a Foley catheter. D) Assist the physician to place a thoracotomy tube.
C
A patient with rhabdomyosarcoma has been admitted for chemotherapy with Vincristine. While preparing a plan of care for this patient, what would be an appropriate nursing diagnosis to use? A) Altered body image due to severe fluid retention B) Risk for bleeding due to possible hemorrhagic cystitis C) Risk for injury D) Risk of infection related to possible nosocomial infection
C
Mr. Mass has been diagnosed with lung cancer. The physician orders chemotherapy prior to the surgery to reduce the tumor burden. What strategy relates to chemotherapy administered to reduce the tumor burden before surgery or radiation, to improve the outcomes of these methods? A) Induction therapy B) Consolidation therapy C) Neoadjuvant therapy D) Palliative therapy
A
Mr. Melika is treated with high-dose chemotherapy after a radical prostatectomy. What term would best describe this type of therapy? A) Adjuvant therapy B) Induction therapy C) Consolidation therapy D) Maintenance therapy
FALSE
No cancer cells have been identified that can remain dormant for more than 2 years. True False
B
The mitotic inhibitors interfere with the ability of a cell to divide, and they block or alter DNA synthesis, thus causing cell death. For clients taking these drugs, the nurse should: A) encourage the patient to eat 6 small meals a day. B) avoid any skin, eye, or mucous membrane contact with the drug. C) avoid using a proximal vein. D) check for extravasation when the infusion is over.
C
The nurse is administering vincristine to a patient, and the container that the medication is in breaks open, resulting in the medication spraying over the patient and the nurse. The nurse follows the proper hospital procedures for cleaning up a chemotherapy spill. Afterward, what should the nurse be monitoring the patient for closely? A) GI distress B) Skin rash C) Severe eye irritation D) Motor, sensory, and autonomic neuropathies
C
The nurse is caring for a client newly diagnosed with a primary brain tumor. The client asks the nurse where the tumor came from. What would be the nurse's best response? A) "Your tumor originated from somewhere outside the CNS from a cell just like other cells." B) "Your tumor is pituitary in origin." C) "Your tumor originated from a single cell that is genetically different from other cells in the surrounding tissue." D) "Your tumor is from nerve tissue somewhere in your body."
D
The nurse is caring for a patient who is receiving a combination of antineoplastic agents. The patient will most likely lose her hair. Why would the nurse suggest that she get a wig or use appropriate head cover? A) People may be uncomfortable seeing her bald head B) The hair will likely grow back if the head is covered at all times C) Her self-esteem will be better if the head is covered D) Most of the heat is lost through the head and it is important to cover it during extremes in temperature
A
The nurse reviews the plan of care for a patient receiving antineoplastic therapy. The nurse notes a nursing diagnosis of risk for infection. Which adverse effect would the nurse expect the patient to exhibit? A) pancytopenia B) gastrointestinal toxicity C) dehydration D) alopecia
A
The nurse should exercise caution when administering antimetabolites to a patient with: A) bone marrow suppression. B) diabetes mellitus. C) hypertension. D) seizure activity.
A
The oncology nurse administers 5-fluorouricil to a patient. During administration, the patient complains of a headache. The nurse performs an assessment and observes nystagmus and disorientation. What does the nurse determine is occurring with this patient? A) Acute cerebellar syndrome B) Disequilibrium syndrome C) Cardiotoxicity D) Myelosuppression
A
The oncology nurse is administering a chemotherapy agent that arrests mitosis by promoting the formation of abnormal spindle fibers and mitotic asters. What classification of drug is the nurse administering? A) Taxane B) Antimetabolite C) Hormone antagonist D) Antitumor antibiotic
B, C, D, E
The oncology nurse is discussing with the staff ways chemotherapeutic ingestion can occur through hand-to-mouth contact. Which of the following methods will the nurse need to include? (Select all that apply.) A) Toilet seats B) Food (including gum and mints) C) Cosmetics D) Cigarettes E) Equipment contaminated with chemotherapy agents
C
The oncology nurse is preparing to administer 5-fluorouracil to a patient with colon cancer. To potentiate the action of the 5-fluorouracil, what other medication may be administered with the drug? A) Etoposide B) Paclitaxel C) Leucovorin D) Hydroxyurea
B, C
The oncology nurse will be administering a cell cycle-specific drug. What drugs are considered cell cycle-specific? (Select all that apply.) A) Nitrosoureas B) Antimetabolites C) Mitotic inhibitors D) Alkylating agents E) Hormone antagonists
A
The patient in remission is receiving a low-dose cytotoxic drug so that there will be a delay in the regrowth of residual cancer cells. What is this form of therapy called? A) Maintenance B) Intensification C) Neoadjuvant D) Palliative
B
The patient taking hydroxyurea states that she is having difficulty swallowing the pills. What suggestions by the oncology nurse can help minimize this problem? A) Administer the medication at the outpatient clinic intravenously. B) Mix the capsules with applesauce, water, or juice and swallow in liquid form. C) Suck on an ice cube to numb the pharynx prior to swallowing the medication. D) Switch the treatment regimen to one that the patient can tolerate.
D
What can the oncology nurse do to minimize the exposure risk to chemotherapeutic agents? A) Only administer chemotherapy agents that are not toxic. B) Attend in-service education. C) Recognize the dangers of administering chemotherapeutic agents. D) Be familiar with institution's policies and procedures and use them as precautionary measures.
B
What is the first priority action of the oncology nurse when there is a spill of a chemotherapeutic agent? A) Rinse the absorbed spill area with clean water. Repeat the washing and rinsing. B) Post a sign to warn people away from the exposed area. C) Pick up glass fragments with a scoop. D) Wear an approved respirator.
B
What measure protects the nurse when preparing cytotoxic drugs? A) Washing hands before preparation B) Wearing protective equipment such as gloves, mask, and gown C) Mixing medication in a 1-L bag D) Administering medication IM
A, B, C
Which antineoplastic drugs are classified as antimetabolites? (Select all that apply.) A) Mercaptopurine (Purinethol) B) Capecitabine (Xeloda) C) Fluorouracil (Adrucil) D) Etoposide (Toposar) E) Irinotecan (Camptosar)
A
Which of the following classes of antineoplastic drugs inhibits DNA synthesis during the S phase? (Choose one) A) Camptothecin analogs B) Podophyllotoxins C) Taxanes D) Vinca alkaloids