Nclex purple book Antineplastic Meds

Tamoxifen citrate is prescribed for a client with metastatic breast carcinoma. The nurse administering the medication understands that which is the primary action of this medication? 1. It increases DNA and RNA synthesis 2. It promotes the biosynthesis of nucleic acids 3. It increases estrogen concentration and estrogen response 4. It competitively binds to estrogen receptors on tumors and other tissue targets

4. It competitively binds to estrogen receptors on tumors and other tissue targets

The nurse is reviewing the history and physical examination of a client who will be receiving asparaginase (Elspar), an antineoplastic agent. The nurse contacts the health care provider before administering the medication if which disorder is documented in the client's history? 1. Pancreatitis 2. Diabetes mellitus 3. Myocardial Infraction 4. Chronic obstructive pulmonary disease

1. Pancreatitis The medication impairs pancreatic function and pancreatic function tests should be performed before therapy begins and when a week or more has elapsed between dose administration.

The nurse is monitoring the intravenous (IV) infusion of an antineoplastic medication. During the infusion, the client complains of pain at the insertion site.On inspection of the site, the nurse notes redness and swelling and that the infusion of the medication has slowed in rate. The nurse suspects extravasation and should take which action? Select all that apply 1. Stop the infusion. 2. Notify the health care provider (HCP). 3. Prepare to apply ice or heat to the site. 4. Restart the IV at a distal part of the same vein. 5. Prepare to administer a prescribed antidote into the site. 6. Increase the flow rate of the solution to flush the skin and subcutaneous tissue.

1. Stop the infusion. 2. Notify the health care provider (HCP). 3. Prepare to apply ice or heat to the site. 5. Prepare to administer a prescribed antidote into the site. If a nurse suspects extravasation during the intravenous administration of an antineoplastic medication, the infusion is stoppped and the HCP is notified. Ice or Heat may be prescribed for application to the site and an antidote may be given to the site.

A client with metastatic breast cancer is receiving tamoxifen. The nurse specifically monitors which laboratory value while the client is taking this medication? 1. Glucose level 2. Calcium level 3. Potassium level 4. Prothrombin time

2. Calcium level Tamoxifen may increase calcium, cholesterol, and triglyceride levels.

The nurse is providing medication instructions to a client with breast cancer who is receiving cyclophosphamide. The nurse should tel the client to take which action? 1. Take medication with food 2. Increase fluid intake to 2000 to 3000mL daily 3. Decrease sodium intake while taking the medication 4. Increase potassium intake while taking the medication

2. Increase fluid intake to 2000 to 3000mL daily Hemorrhagic cystitis is an adverse effect that can occur with this medication. The patient must consume copious amounts of fluid.

A client with acute myelocytic leukemia is being treated with busulfan (Myleran, Busulfex). Which laboratory value would the nurse specifically monitor during treatment with this medication? 1. Clotting time 2. Uric acid level 3. Potassium level 4. Blood glucose level

2. Uric acid level Busulfan (Myleran, Busulfex) can cause an increase in the uric acid level. Hyperuricemia can produce uric acid nephropathy, renal stones, and acute kidney injury.

A clinic nurse prepares a teaching plan for a client receiving an antineoplastic medication. When implementing the plan, the nurse should make which statement to the client? 1. "You can take aspirin (acetylsalicylic acid) as needed for headache." 2. " You can drink alcoholic beverages in moderate amounts each evening." 3. "You need to consult with the health care provider (HCP) before receiving immunizations." 4. " It is fine to receive a flu vaccine at the local health fair without HCP approval because the flu is so contagious."

3. "You need to consult with the health care provider (HCP) before receiving immunizations." Because your immune system is already compromised you should not receive any vaccines without HCP approval.

The nurse is monitoring the laboratory results of a client receiving an antineoplastic medication by the intravenous route. The nurse plans to initiate bleeding precautions if which laboratory result is noted? 1. A clotting time of 10 minutes 2. An ammonia level of 20 mcg/dL 3. A platelet count of 50,000 cells/mm3 4. A white blood cell count of 5000 cells/mm3

3. A platelet count of 50,000 cells/mm3 The normal platelet count is 150,000 to 450,000 cells/mm3. When platelet count decreases, the client is at risk for bleeding.

The nurse is analyzing the laboratory results of a client with leukemia who has received a regimen of chemotherapy. Which laboratory value would the nurse specifically note as a result of the massive cell destruction that occurred from chemotherapy? 1. Anemia 2. Decreased platelets 3. Increased Uric acid level 4. Decreased leukocyte count

3. Increased Uric acid level Hyperuricemia is especially common following treatment for leukemias and lymphomas because chemotherapy results in massive cell kill.

Megestrol acetate (Megace), an antineoplastic medication, is perscribed for a client with mestastatic endometrial carcinoma. The nurse reviews the client's history and should contact the health care provider if which diagnosis is documented in the client's history? 1. Gout 2. Asthma 3. Thrombophlebitis 4. Myocardial infraction

3. Thrombophlebitis Megestrol acetate (Megace) suppresses the release of luteinizing hormone from the anterior pituitary by inhibiting pituitary function and regressing tumor size.

A client with non-Hodgkin's lymphoma is receiving daunorubicin (DaunoXome). Which finding would indicate to the nurse that the client is experiencing an adverse effect related to the medication? 1. Fever 2. Sores in the mouth and throat 3. Complaints of nausea and vomiting 4. Crackles on auscultation of the lungs

4. Crackles on auscultation of the lungs Cardiotoxicity noted by abnormal electrocardiographic findings or cardiomyopathy manifested as heart failure (lung crackles) is an adverse effect of daunorubicin.

Chemotherapy dosage is frequently based on total body surface area (BSA), so it is important for the nurse to perform which assessment before administering chemotherapy? 1. Measure the client's abdominal girth. 2. Calculate the client's body mass index. 3. Ask the client about his or her weight and height. 4. Measure the client's current weight and height.

4. Measure the client's current weight and height. To ensure that the client receives optimal doses of chemotherapy, dosing is usually based on the total body surface area (BSA), Obtain current weight and height rather than asking the patient.

A client with small cell lung cancer is being treated with etoposide (Toposar). The nurse monitors the client during administration, knowing that which adverse effect is specifically associated with this medication? 1. Alopecia 2. Chest pain 3. Pulmonary fibrosis 4. Orthostatic hypotension

4. Orthostatic hypotension Etoposide should be administered slowly over 30 to 60 minutes to avoid hypotension. The client's blood pressure is monitored during the infusion.

A client with ovarian cancer is being treated with vincristine (Vincasar). The nurse monitors the client, knowing that which manifestation indicates an adverse effect specific to this medication? 1. Diarrhea 2. Hair loss 3. Chest pain 4. Peripheral neuropathy

4. Peripheral neuropathy Peripheral neuropathy occurs in almost every client. Depression of the Achilles tendon reflex may be the first clinical sign indicating peripheral neuropathy.

A client with squamous cell carcinoma of the larynx is receiving bleomycin intravenously. The nurse caring for the client anticipates that which diagnostic study will be prescribed? 1. Echocardiography 2. Electrocardiography 3. Cervical radiography 4. Pulmonary function studies

4. Pulmonary function studies Bleomycin is an antineoplastic medication that can cause interstitial pneumontitis, which can progress pulmonary fibrosis. The medication needs to be discontinued immediately if pulmonary toxicity occurs.