Saunders- Oncology Meds
A client admitted to the hospital is taking capecitabine (Xeloda). The nurse should monitor the client for which symptom that is an adverse effect of the medication?
1. Dyspnea 2. Dizziness 3. Headache 4. Constipation 1. Dyspnea
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
The nurse is monitoring a client with leukemia who is receiving doxorubicin (Adriamycin PFS) by intravenous infusion. The nurse should monitor for which assessment finding that would indicate toxicity to the medication?
1. Elevated creatinine 2. Red coloration in the urine 3. Elevated blood urea nitrogen 4. Electrocardiogram (ECG) changes 4. Electrocardiogram (ECG) changes
The nurse tells a client with leukemia who is receiving chemotherapy that allopurinol (Zyloprim) has been added to the medication list. When the client asks the purpose of the new medication, the nurse responds that the allopurinol is intended to prevent which problem?
1. Nausea 2. Diarrhea 3. Muscle spasms 4. Hyperuricemia 4. Hyperuricemia
The nurse is caring for a client on the oncology unit who has developed stomatitis during chemotherapy. The nurse should plan which measure to treat this complication?
1. Rinse the mouth with diluted baking soda or saline. 2. Use lemon and glycerin swabs liberally on painful oral lesions. 3. Place the client on NPO status for 12 hours, and then resume liquids. 4. Brush the teeth and use non-waxed dental floss at least twice a day. 1. Rinse the mouth with diluted baking soda or saline.
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 client with breast cancer has been given a prescription for cyclophosphamide. The nurse determines that the client understands the proper use of the medication if the client states that he or she will take which measure?
1. Increase dietary intake of potassium. 2. Increase fluid intake to 2 to 3 L/day. 3. Take the medication with large meals. 4. Decrease dietary intake of magnesium. 2. Increase fluid intake to 2 to 3 L/day.
A nurse is assigned to care for a client with metastatic breast cancer who is taking tamoxifen citrate. The nurse plans to monitor for which changes in laboratory values for this client? Select all that apply.
1. Increase in lipase level 2. Increase in blood glucose level 3. Increase in serum calcium level 4. Increase in serum potassium level 5. Decrease in low-density lipoprotein levels 3. Increase in serum calcium level 5. Decrease in low-density lipoprotein levels
A client with lung cancer is receiving a high dose of methotrexate (Trexall). Leucovorin (citrovorum factor, folic acid) is also prescribed. The nurse planning care for the client should understand that the purpose of administering the leucovorin is to promote which action?
1. Preserve normal cells. 2. Promote DNA synthesis. 3. Enable medication excretion. 4. Facilitate the synthesis of nucleic acids. 1. Preserve normal cells.
Capecitabine (Xeloda) has been prescribed for a client, and the client asks the nurse about the action of the medication. The nurse responds that this medication has which mechanism of action?
1. Promotes DNA synthesis 2. Interferes with protein synthesis 3. Assists with the processing of RNA 4. Processes enzymes needed for cellular growth 2. Interferes with protein synthesis
Capecitabine (Xeloda) has been prescribed, and the nurse provides instructions to the client about the medication. Which statement by the client indicates the need for further instruction?
1. "I need to monitor my temperature." 2. "I need to be sure to go to the clinic to receive my yearly flu vaccine." 3. "I may have some diarrhea, but if it becomes severe, I will call my health care provider." 4. "It's important for me to contact my health care provider if I have any fever or other signs of infection." 2. "I need to be sure to go to the clinic to receive my yearly flu vaccine."
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 beverages containing alcohol 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."
A female client with carcinoma of the breast is admitted to the hospital for treatment with intravenously administered doxorubicin (Adriamycin). The client tells the nurse she has been told by her friends that she is going to lose all her hair. What is the appropriate nursing response?
1. "Your friends are correct." 2. "You will not lose your hair." 3. "Hair loss may occur, but it will grow back just as it is now." 4. "Hair loss may occur, and it will grow back, but it may have a different color or texture." 4. "Hair loss may occur, and it will grow back, but it may have a different color or texture."
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
A client with cancer has received a course of chemotherapy and received fluorouracil (Adrucil). The nurse should tell the client to report which finding immediately?
1. Alopecia 2. Headache 3. Stomatitis and diarrhea 4. Changes in color vision 3. Stomatitis and diarrhea
A nurse is monitoring a client with acute lymphocytic leukemia for toxic effects of asparaginase (Elspar). The nurse should notify the health care provider if monitoring reveals which finding?
1. Alopecia 2. Oral ulcerations 3. Prolonged blood clotting times 4. Decreased white blood cell count 3. Prolonged blood clotting times
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 the chemotherapy?
1. Anemia 2. Decreased platelets 3. Increased uric acid level 4. Decreased leukocyte count 3. Increased uric acid level
The clinic nurse prepares instructions for a client who developed stomatitis after the administration of a course of antineoplastic medications. The nurse should provide the client with which instruction?
1. Avoid foods and fluids for the next 24 hours. 2. Swab the mouth daily with lemon and glycerin pads. 3. Brush the teeth and use waxed dental floss three times a day. 4. Rinse the mouth with a diluted solution of baking soda or saline. 4. Rinse the mouth with a diluted solution of baking soda or saline.
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
The nurse should be prepared to institute bleeding precautions in the client receiving antineoplastic medication if which result was reported from the laboratory?
1. Clotting time 12 seconds 2. Ammonia level 28 mcg/dL 3. Platelet count 50,000 cells/mm3 4. White blood cell count (WBC) 4500 cells/mm3 3. Platelet count 50,000 cells/mm3
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
Capecitabine (Xeloda) has been prescribed for a client, and the client asks the nurse about the side effects of the medication. The nurse responds that a frequent side effect of this medication is which finding?
1. Diarrhea 2. Weakness 3. Irritability 4. Increased appetite 1. Diarrhea
A client is receiving intravesical chemotherapy for cancer of the bladder. The nurse should plan to take which action after the completion of each treatment?
1. Encourage increased intake of oral fluids. 2. Provide increased doses of opioid analgesics. 3. Place the client on strict contact isolation for 24 hours. 4. Keep the client on nothing by mouth (nil per os [NPO]) status for 6 hours. 1. Encourage increased intake of oral fluids.
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
A client with cancer is about to be started on mitomycin (Mutamycin). The nurse should contact the health care provider after noting that the client is also taking which medication?
1. Furosemide (Lasix) 2. Ondansetron (Zofran) 3. Warfarin (Coumadin) 4. Allopurinol (Zyloprim) 3. Warfarin (Coumadin)
The nurse administering a combination chemotherapy regimen understands that it is important to implement which action?
1. Give two agents from the same medication class. 2. Give two agents with like nadirs at the same time. 3. Test the client's knowledge about each agent's nadir. 4. Avoid giving agents with the same nadirs and toxicities at the same time. 4. Avoid giving agents with the same nadirs and toxicities at the same time.
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
Megestrol acetate (Megace), an antineoplastic medication, is prescribed for a client with metastatic 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 infarction 3. Thrombophlebitis
The nurse is preparing a plan of care for a client who will be receiving intravenous bleomycin sulfate for the treatment of cancer. In developing the plan of care, the nurse includes monitoring of which option as the priority?
1. Heart rate 2. Lung sounds 3. Bowel sounds 4. Level of consciousness 2. Lung sounds
The nurse is reviewing the record of a client who arrives at the health care clinic. The nurse notes that the client is taking letrozole (Femara). The nurse should suspect that the client has which disorder?
1. Hypothyroidism 2. Diabetes mellitus 3. Chronic kidney disease 4. Advanced breast cancer 4. Advanced breast cancer
The nurse is collecting subjective and objective data from a client and notes that the client is taking capecitabine (Xeloda). The nurse determines that this medication has been prescribed to treat which condition?
1. Hypothyroidism 2. Kidney dysfunction 3. Cushing's syndrome 4. Metastatic breast cancer 4. Metastatic breast cancer
A client who has been diagnosed with cancer is to receive chemotherapy with both cisplatin (Platinol-AQ) and vincristine (Oncovin). The client asks the nurse why both medications must be given together. The nurse's response is based on the understanding that the purpose of using both medications is to promote which action?
1. Increase the destruction of tumor cells. 2. Prevent the destruction of normal cells. 3. Decrease the risk of the alopecia and stomatitis. 4. Increase the likelihood of erythrocyte and leukocyte recovery. 1. Increase the destruction of tumor cells.
Capecitabine (Xeloda) has been prescribed for a client. The nurse should tell the client that which blood test will be done periodically while the client is taking this medication?
1. Liver function tests 2. Bilirubin level assay 3. Triglyceride level determination 4. Complete blood cell count (CBC) 4. Complete blood cell count (CBC)
The nurse understands that which condition is an indication for the use of asparaginase (Elspar)?
1. Lung cancer 2. Breast cancer 3. Metastatic prostate cancer 4. Acute lymphocytic leukemia 4. Acute lymphocytic leukemia
A client with squamous cell carcinoma is receiving bleomycin. To determine whether adverse effects of this medication are occurring, the nurse should carefully assess which item?
1. Lung sounds 2. Platelet count 3. Blood pressure 4. White blood cell count 1. Lung sounds
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.
The health care provider (HCP) writes a prescription for capecitabine (Xeloda) for a client who was admitted to the hospital. The nurse should contact the HCP to verify the prescription if which condition is noted in the assessment data?
1. Myalgia 2. Psoriasis 3. Rheumatoid arthritis 4. Chronic kidney disease 4. Chronic kidney disease
The nurse caring for a client receiving vincristine (Oncovin) is monitoring the client for toxicity. The nurse interprets that the client is experiencing a toxic effect of this medication on the basis of which assessment finding?
1. Nausea and vomiting 2. Decreased platelet count 3. Decreased white blood cell count 4. Weakness and sensory loss in the legs 4. Weakness and sensory loss in the legs
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 infarction 4. Chronic obstructive pulmonary disease 1. Pancreatitis
The nurse transcribes a medication prescription for ifosfamide (Ifex) for a client with a diagnosis of germ cell cancer of the testes. The nurse reviews the client's history and looks for another prescription for which medication, which usually is administered with the antineoplastic medication?
1. Prednisone 2. Mesna (Mesnex) 3. Bleomycin sulfate 4. Melphalan (Alkeran) 2. Mesna (Mesnex)
The nurse reviewing a medical record notes that high concentrations of methotrexate followed by leucovorin (citrovorum factor, folic acid) are being given to the client with cancer. The nurse correctly interprets that which is the reason for therapy with leucovorin?
1. Preserve normal cells. 2. Promote protein synthesis. 3. Promote medication excretion. 4. Hasten the effect of the methotrexate. 1. Preserve normal cells.
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 actions? 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.
A female client with a diagnosis of breast cancer is taking cyclophosphamide. The client calls the health care clinic and tells the nurse that the medication is upsetting her stomach. Which instruction should the nurse provide to the client?
1. Take the medication with food. 2. Avoid drinking fluids while taking the medication. 3. Try to take the medication with a small amount of orange juice. 4. Continue to take the medication on an empty stomach, and lie down after taking the medication. 1. Take the medication with food.
The nurse is providing medication instructions to a client with breast cancer who is receiving cyclophosphamide. The nurse should tell the client to take which action?
1. Take the medication with food. 2. Increase fluid intake to 2000 to 3000 mL daily. 3. Decrease sodium intake while taking the medication. 4. Increase potassium intake while taking the medication. 2. Increase fluid intake to 2000 to 3000 mL daily.
A client with cancer is receiving a continuous intravenous infusion of morphine sulfate. The nurse monitoring the client for adverse effects would become most concerned about which vital sign?
1. Temperature of 99.1° F 2. Apical heart rate of 90 beats/min 3. Blood pressure of 110/70 mm Hg 4. Respirations of 10 breaths per minute 4. Respirations of 10 breaths per minute
A client with testicular cancer is receiving cisplatin. The nurse assesses for which finding as a toxic effect of this medication?
1. Tinnitus 2. Diarrhea 3. Nausea and vomiting 4. Elevated white blood cell (WBC) count 1. Tinnitus
The client with bladder cancer is receiving cisplatin and vincristine (Vincasar PFS). The nurse preparing to give the medication understands that which is the purpose of administering both of these medications?
1. To prevent alopecia 2. To decrease the destruction of cells 3. To increase the therapeutic response 4. To prevent gastrointestinal side effects 3. To increase the therapeutic response