ALL PREPU CH 57
The nurse is caring for a patient taking tamoxifen (Nolvadex) for treatment of breast cancer. What instruction will help the patient control hot flashes? Select all that apply. Avoid caffeinated products. Use lubricant during intercourse. Eat a low-sodium diet. Wear absorbent cotton clothing. Perform regular aerobic exercise.
Perform regular aerobic exercise. Avoid caffeinated products. Wear absorbent cotton clothing.
The husband of a newly married couple has been diagnosed with acute leukemia and will be on high-dose cyclophosphamide. He states to the nurse, "We want so much to have children. I will have to have chemotherapy and won't ever be able to have children!" What is the best response by the nurse? "You can adopt children if you want them in the future." "Your wife could always have artificial insemination with another donor." "I understand how you feel. That is a terrible side effect of the chemotherapy." "It is very possible to bank sperm so that you and your wife will be able to have children in the future."
"It is very possible to bank sperm so that you and your wife will be able to have children in the future."
A patient received an injection of doxorubicin and is now observing a reddish urine. The patient states, "Do you think I am bleeding?" What is the best response by the nurse? "We need to notify the physician because this is a complication of the medication." "Let's get a urinalysis to confirm a urinary tract infection." "You may have hemorrhagic cystitis." "The reddish urine is harmless and an expected response to the drug."
"The reddish urine is harmless and an expected response to the drug."
A patient who will begin chemotherapy tells the nurse that the accompanying nausea and vomiting are going to be terrible. What is the best response by the nurse? "We can relieve your nausea and vomiting with antiemetic drug therapy. You should ask for these medications whenever you need them." "We can relieve your nausea and vomiting with drugs but you can have them only before and after the chemotherapy." "Nausea and vomiting are an unfortunate side effect of the chemotherapy. We will do what we can but you may have it anyway." "Not everyone has nausea and vomiting. Just wait to see how you will react to the chemotherapy."
"We can relieve your nausea and vomiting with antiemetic drug therapy. You should ask for these medications whenever you need them."
A patient having chemotherapy is losing her hair. She asks the nurse if her hair will come back as it originally was. What is the best response by the nurse? "Your hair may not grow back, but we can refer you to a wig specialist." "Your hair will grow back, but the new hair may be a different color or texture." "I think you have more to worry about than if you have hair. You can buy a wig." "Your hair will grow back, but it will be very thin and straight."
"Your hair will grow back, but the new hair may be a different color or texture."
In which of these patients would cyclophosphamide not likely be effective? A 47 year old with Hodgkin's lymphoma A 57 year old with endometrial cancer A 60 year old with a brain tumor A 62 year old with multiple myeloma
A 60 year old with a brain tumor
Which female breast cancer patient is experiencing the adverse effects characteristic of androgen therapy? A 27 year old with hot flashes and amenorrhea A 38 year old with weight gain and fluid retention A 49 year old with nausea, vaginal dryness, and constipation A 65 year old with alopecia, increased facial hair, and acne
A 65 year old with alopecia, increased facial hair, and acne
Malignant cells seem to be more susceptible than normal cells to the effects of which of the following class of antineoplastic drugs? (Choose one) Antineoplastic antibiotics Alkylating agents Antimetabolites Vinca alkaloids
Alkylating agents
A patient had severe nausea and vomiting with the first dose of a chemotherapeutic agent. The patient states to the nurse, "I just know I will have a problem again." When the patient has a learned response from the negative experience, what type of emesis is this considered? Breakthrough emesis Anticipatory emesis Acute emesis Delayed emesis
Anticipatory emesis
A patient has been prescribed melphalan, an alkylating agent, for the treatment of an ovarian tumor. The patient wants to know the action of the drug in treating the tumor. Which of the following should the nurse inform the patient? Neutralizes the alkalinity of the cell environment. Changes the cell to a more alkaline environment. Increases the acidity of the cell environment. Changes the cell to a neutral environment.
Changes the cell to a more alkaline environment.
A patient has been diagnosed with leukemia. Which alkylating agent is the only one that can be used for both acute and chronic leukemia? Streptozocin Carmustine Cyclophosphamide Chlorambucil
Cyclophosphamide
Which action by the nurse follows safety protocols when administering doxorubicin (Doxil)? Monitors for digoxin toxicity if given along with doxorubicin Administers doxorubicin, then flushes the line with heparin Uses a Y-site adaptor to infuse doxorubicin and furosemide together Frequently checks IV site for patency during doxorubicin infusion
Frequently checks IV site for patency during doxorubicin infusion
For what reasons is combination chemotherapy generally considered a more effective treatment regimen for cancer than treatment with just one medication? Select all that apply. Higher cost per cycle of patient therapy Higher rate of patient survival than monotherapy Maximum cell death within patient tolerance of toxicity Less development of resistant malignant cells Shorter duration of cancer remission
Higher rate of patient survival than monotherapy Maximum cell death within patient tolerance of toxicity Less development of resistant malignant cells
A 26-year-old man with testicular cancer is prescribed combination chemotherapy that involves using two drugs that are effective against testicular tumors. Combination drug therapy is superior to single-drug therapy because of: Higher tumor response rates Decreased duration of remissions Lower risk for secondary cancers Increased capillary permeability
Higher tumor response rates
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 methotrexate toxicity Increased risk of hypoglycemia Increased risk of nephrotoxicity Increased risk of bleeding
Increased risk of nephrotoxicity
A patient is receiving carboplatin. The nurse would expect to administer this drug by which route? Subcutaneous Intravenous Intramuscular Oral
Intravenous
Which nonpharmacological intervention may prevent cystitis caused by cyclophosphamide (Cytoxan)? Drinking cranberry juice Keeping well hydrated Wearing cotton underwear Drinking milk
Keeping well hydrated
Ms. Nolan is prescribed cyclophosphamide as part of her treatment for non-Hodgkin's lymphoma. Which symptoms would Ms. Nolan report to her physician immediately? Nasal congestion Alopecia Pain and burning with urination Nausea and vomiting
Pain and burning with urination
Which tissue type does not respond well to reproductive hormone therapy for cancer? Breast Lung Endometrial Prostate
Lung
What intervention will the nurse caring for a patient receiving cancer treatment with high doses of cyclophosphamide (Cytoxan) implement to prevent hemorrhagic cystitis? Provide increased protein intake. Monitor daily BUN. Maintain daily fluid intake of 2 to 3 L. Encourage moderate exercise.
Maintain daily fluid intake of 2 to 3 L.
The nurse is caring for a patient who has just been diagnosed with adenocarcinoma of the pancreas. What antineoplastic does the nurse suspect the patient will receive? Daunorubicin (DaunoXome) Mitomycin (Mutamycin) Bleomycin (Blenoxane) Idarubicin (Idamycin)
Mitomycin (Mutamycin)
A client has just started on an alkalating agent to treat their cancer. What is the most common side effect of most alkalating agents? Depression Myelosuppression Nephrotoxicity Confusion
Myelosuppression
A client has just started on an alkalating agent to treat their cancer. What is the most common side effect of most alkalating agents? Myelosuppression Nephrotoxicity Depression Confusion
Myelosuppression
For which chemotherapeutic medication should patients be monitored for abnormal liver function? Leuprolide (Lupron) Nilutamide (Nilandron) Estradiol (Estinyl) Femara (Letrozole)
Nilutamide (Nilandron) heavily metabolized in the liver
A patient with breast cancer being treated with tamoxifin is also taking the oral anticoagulant coumadin for chronic atrial fibrillation. What is important to monitor in this patient? Blood urea nitrogen and creatinine levels Liver enzymes White blood count Prothrombin time
Prothrombin time
A patient with acute myeloblastic leukemia is taking doxorubicin. What is an appropriate nursing intervention for this antineoplastic antibiotic agent? Plan for appropriate rest periods Provide frequent mouth care Use safety measures Report all other drugs and alternative therapies that they might be using
Provide frequent mouth care
Mike, a lymphoma patient, is administered bleomycin drug therapy according to the physician's instructions. Following the drug administration, he complains of fever, chills, nausea, and general weakness. What preventive measure would be helpful in his case? Administering a test dose of 3 units of acetaminophen before the first two treatments Providing premedication with acetaminophen and diphenhydramine Performing meticulous monitoring during drug administration Using bleomycin and dexrazoxane concurrently
Providing premedication with acetaminophen and diphenhydramine
A client is prescribed doxorubicin drug therapy for carcinoma of the breast. On the second day of drug therapy, she calls in to report reddish urine. What should the nurse do? Suggest some nonpharmacologic interventions. Reassure the patient that it is a harmless and expected response to the drug. Reassure the patient about adequate monitoring and follow-up in her home setting. Caution the patient against taking aspirin or caffeine.
Reassure the patient that it is a harmless and expected response to the drug.
A patient is receiving melphalin for the treatment of multiple myeloma. What does the nurse determine may be a problem for this patient in high doses? Diabetis insipidus Hemorrhagic cystitis Syndrome of inappropriate antidiuretic hormone Severe oral mucositis
Severe oral mucositis
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? Continue to go to church or to the mall just as she did before the diagnosis of cancer. Take special care when shaving or brushing her teeth. Stay in bed 2 days after each administration. Stay on a low-fat diet during the course of the drug therapy.
Take special care when shaving or brushing her teeth.
A postmenopausal woman with breast cancer will most likely be treated with which anti-estrogen drug? Bleomycin Cyclophosphamide Cisplatin Tamoxifen
Tamoxifen
The oncology nurse is discussing when the patient should administer oral doses of cyclophosphamide at home. What time is the patient instructed to take the medication? As long as the patient takes the medication by 9 AM, there will be a decrease in side effects. The medication should be taken before 4 or 5 PM daily. The patient should take the medication at 11 PM. The patient should take the medication by midnight.
The medication should be taken before 4 or 5 PM daily.
A patient who has been taking high doses of cyclophosphamide for the treatment of acute leukemia states that he is having pain and burning on urination and has noticed blood in the urine. What does the nurse identify has occurred? The patient has developed a urinary tract infection. The patient is having a complication from the leukemia that is causing bleeding. The patient has developed sterile hemorrhagic cystitis. The patient is having a hypersensitivity reaction to the cyclophosphamide.
The patient has developed sterile hemorrhagic cystitis.
A patient taking high doses of cyclophosphamide is exhibiting muscle cramps and confusion and reports headaches. The nurse assesses the laboratory tests and notices the sodium level is low. What does the nurse determine may be occurring with this patient? The patient is having a hypersensitivity reaction to the chemotherapy. The patient is exhibiting signs of diabetes insipidus caused by the high dose of cyclophosphamide. The patient is having a toxic reaction to the high level of cyclophosphamide. The patient is exhibiting signs of syndrome of inappropriate antidiuretic hormone caused by the high dose of cyclophosphamide.
The patient is exhibiting signs of syndrome of inappropriate antidiuretic hormone caused by the high dose of cyclophosphamide.
A patient receiving oxaliplatin (Eloxatin) requests a blanket because he is very cold. When the nurse comes back with the blanket, the patient becomes short of breath and reports difficulty swallowing. What does the nurse determine is happening with this patient? The patient is upset because he had to wait for the blanket to arrive. The patient is having a panic attack. The patient is having a hypersensitivity reaction to the medication. The patient is having acute syndrome of pharyngolaryngeal dysethesia.
The patient is having acute syndrome of pharyngolaryngeal dysethesia.
A patient receiving oxaliplatin (Eloxatin) requests a blanket because he is very cold. When the nurse comes back with the blanket, the patient becomes short of breath and reports difficulty swallowing. What does the nurse determine is happening with this patient? The patient is upset because he had to wait for the blanket to arrive. The patient is having a panic attack. The patient is having a hypersensitivity reaction to the medication. The patient is having acute syndrome of pharyngolaryngeal dysethesia.
The patient is having acute syndrome of pharyngolaryngeal dysethesia.
An adverse effect of tamoxifen therapy involves menopausal symptoms. False True
True
Which agents would be considered cancer non-cell cycle specific agents? antimetabolites protein tyrosine kinase inhibitors mitotic inhibitors alkylating agents
alkylating agents