Chapter 14 PrepU

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 rate

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.

A patient will soon begin targeted therapy as a component of her treatment plan for chronic leukemia. The nurse is conducting health education about this new aspect of the patient's drug regimen and the patient has asked about the potential side effects of treatment. How should the nurse best respond?

"Both classes of drugs have adverse effects, but targeted therapies tend to have less of an effect on healthy body cells."

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 will grow back, but the new hair may be a different color or texture."

Which agent would the nurse expect to be administered orally?

Methotrexate

A patient has chosen to be placed on hospice. Which is acceptable chemotherapy for a patient on hospice?

Palliative chemotherapy

An adverse effect of tamoxifen therapy involves menopausal symptoms.

True

A patient is diagnosed with a brain tumor. The patient is told that the cancer cells proliferate. The patient asks the nurse what this means. What is the nurse's best response?

"The proliferation is the growth of cancer cells and the rate of growth."

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?

"The reddish urine is harmless and an expected response to the drug."

The nurse may be asked to administer which medication to a patient to counteract the increase in uric acid and subsequent hyperuricemia resulting from the metabolic waste buildup from rapid tumor lysis?

Allopurinol (Zyloprim)

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

Cardiotoxicity

An oncology nurse is reviewing the pathophysiology of cancer and is discussing with a colleague the factors that contribute to the success or failure of a patient's chemotherapy. Which cancerous cell is most susceptible to the effects of chemotherapeutic drugs?

Cells that have a rapid mitotic rate

The nurse understands that when administering cisplatin, the drug has a high potential for causing severe nausea and vomiting. What term is used to describe this group of antineoplastic drug?

Emetogenic

No cancer cells have been identified that can remain dormant for more than 2 years.

False

A male client is diagnosed with prostate cancer. The treatment modality of choice includes both surgery and chemotherapy. What does the chemotherapeutic option include?

Hormonal therapies

A nurse is administering an antineoplastic extravasation occurs. How can the nurse best prevent tissue damage caused by extravasation?

Inspect the site frequently for redness or swelling

A patient is receiving carboplatin. The nurse would expect to administer this drug by which route?

Intravenous

Which would the nurse identify as an antineoplastic antibiotic?

Mitomycin

A male client is informed by his physician 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 physician to do?

Monitor the client closely and repeat LFTs routinely

An elderly man has been admitted to a residential care facility and the nurse has conducted a medication reconciliation. The man has taken numerous drugs in the past, including a course of bicalutamide (Casodex) several years earlier. The nurse recognizes this drug as being an antiandrogen and is consequently justified in presuming that the man has a history of what disease?

Prostate cancer

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?

Reassure the patient that it is a harmless and expected response to the drug.

A patient has just received the first dose of imatinib and the nurse on the oncology unit is amending the patient's care plan accordingly. What nursing diagnosis is most appropriate in light of this addition to the patient's drug regimen?

Risk for Infection related to bone marrow suppression

A patient with non-Hodgkin's lymphoma (NHL) will be starting a course of doxorubicin shortly. When planning this patient's care, what nursing diagnosis should the nurse prioritize?

Risk for Infection related to suppressed bone marrow function

When describing the various effects of antineoplastic agents, the nurse explains that antineoplastic drugs primarily affect human cells that are rapidly multiplying, going through the cell cycle quickly. The nurse would identify which cells as an example?

Skin

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?

Suggest the use of a wig or cap.

A postmenopausal woman with breast cancer will most likely be treated with which anti-estrogen drug?

Tamoxifen

A nurse educator who coordinates the staff education on an oncology unit is conducting an inservice on targeted therapies. What potential benefit of targeted therapies should the nurse highlight in this education session?

Targeted therapies have the potential to damage cancerous cells while leaving normal body cells less affected.

When describing the process of cancer cell growth to a client, the nurse addresses angiogenesis. Which description would the nurse include?

The process of creating new blood vessels to supply oxygen and nutrients to the cells

A patient is started on chemotherapy. The chemotherapy regimen includes three agents. What is the rationale for using three different antineoplastic agents?

The use of three agents decreases the development of cell resistance.

A female client age 25 years is prescribed methotrexate to treat rheumatoid arthritis (RA). The nurse should teach the client to:

Use an effective contraceptive.

A nurse is performing discharge teaching with a client who will soon return home. The client will continue taking imatinib for the foreseeable future, and the nurse is teaching the client about the safe administration of this drug. How should the nurse instruct the client to take imatinib?

With food and a large glass of water

An adult patient who has been diagnosed with a rectal tumor is scheduled to begin treatment with cisplatin. The nurse has conducted patient teaching about the possibility of nausea and vomiting. In order to reduce the patient's risk of severe nausea, the nurse should:

administer a combination of antiemetics prior to the administration of the drug.

Which agents would be considered cancer non-cell cycle specific agents?

alkylating agents

The oncology nurse understands that chemotherapeutic agents are most effective during a particular phase of the cell cycle. This means the agents are:

cell cycle-specific.

A patient with acute lymphoblastic leukemia (ALL) is receiving imatinib on an inpatient basis. When planning the care of this patient, what assessment should be specified in the patient's plan of nursing care?

daily weights

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.

A client is receiving tamoxifen. Which adverse effect would be most specific to the action of this drug?

menopausal effects

A 57-year-old male patient who has been prescribed doxorubicin for small-cell lung cancer is advised by the nurse to avoid taking aspirin or drugs that contain aspirin because it may:

promote bleeding.