Chapter 45 ( Pharm )
A nurse is caring for a patient with cancer who has been prescribed dacarbazine 100 mg, which is highly emetic. Which is the most appropriate instruction given by the primary health care provider to the nurse?
"Administer antiemetic medications 30 minutes before administering dacarbazine."
A provider has prescribed asparaginase to a patient for cancer treatment. A nursing student asks the nurse, "What is the route of administration of asparaginase?" Which appropriate response does the nurse give to the nursing student?
"Asparaginase is administered via the intramuscular route."
A nursing student caring for a geriatric patient with benign nonmalignant adenoma asks the clinical instructor about the characteristics of this condition. Which response by the clinical instructor is appropriate?
"Benign tumors are a mass of new cells, which are of uniform size and shape."
A nurse is teaching care management to the caregiver of a patient who is on chemotherapy. Which instruction given by the nurse is appropriate?
"Ginger ale or ginger tea must be given to the patient to prevent nausea."
A nursing student asks the clinical instructor, "If antineoplastic drugs have teratogenic effects, then why are pregnant women with cancer prescribed antineoplastic drugs rather than radiation therapy?" What appropriate response does the clinical instructor give to the nurse?
"Radiation therapy can only be given during the postpartum period."
The nurse is reviewing a patient's mammogram report. The report reveals the presence of a well-defined encapsulated tumor in the left breast. After the provider reviews the results with the patient, what will the nurse say to the patient to reinforce this teaching?
"Removal of this breast lump will render you free from cancer."
A patient was administered pegaspargase for cancer treatment. During assessment the nurse finds that the patient is experiencing severe burning pain in the upper abdominal area that radiates to the back. The patient also has nausea, increased blood pressure, and vomiting. All of this is reported to the primary health care provider. What instruction does the primary health care provider give to the nurse?
"Stop administering pegaspargase."
A nurse is assessing a patient with cancer who has been prescribed methotrexate. On reviewing the patient's case history, the nurse finds that the patient has joint pain and is taking aspirin for pain relief. Which response given by the nurse is appropriate?
"Stop taking aspirin immediately."
Nausea and vomiting are common adverse effects associated with antineoplastic therapy. What should a nurse advise patients who are experiencing this unpleasant effect?
"Try to maintain hydration and nutrition, which are very important during treatment."
The nurse is assessing a patient with cancer who has been prescribed paclitaxel. The nurse is teaching dietary guidelines to the patient's relative. Which statement made by the nurse is appropriate? Select all that apply.
-"Avoid giving the patient dry or sticky foods like bread, cold meat, and chocolate." -"Provide the patient with small and frequent meals to prevent nutritional deficiency." -"Provide meals with plastic utensils if the patient complains of food having a metallic taste."
A nursing student asks a nurse, "Which factors are related to the prognosis of a patient with cancer?" What appropriate response does the senior nurse give to the nursing student? Select all that apply.
-"Efficacy of cancer treatments" -"Development of drug resistance" -"Classification of the stage of cancer at the time of diagnosis"
Alopecia is a side effect of most antineoplastic medications, often causing patients to feel depressed and not adhere to the medication regimen. What should the nurse tell patients who are experiencing depression because of hair loss? Select all that apply.
-"Wear scarves throughout the treatment." -"Purchase a wig for use during treatment." -"Hair loss will begin about a week after treatment."
A nurse is assessing a group of healthy adults to find their risks of cancer. Which patients have a higher probability of having cancer in the future? Select all that apply.
-A patient exposed to vinyl chloride -A patient exposed to ionizing radiation -A female patient who does not have any children
The nurse is assessing a patient who has neutropenia because of chemotherapy. Which are symptoms associated with neutropenia that the nurse may find in the patient? Select all that apply.
-Abnormal breath sounds -Elevated body temperature -Cough with purulent sputum
Which of these are general adverse effects of chemotherapy? Select all that apply.
-Alopecia -Thrombocytopenia
Which medications will the nurse administer as premedication to a patient who is to receive chemotherapy with mitotic inhibitors? Select all that apply.
-H 2-receptor antagonists -Antihistamines -Corticosteroids
What are the symptoms of antineoplastic toxicity? Select all that apply.
-Limb pain -Eye irritation -Excessive sweating
Which types of cancer are caused by exposure to ultraviolet radiation? Select all that apply.
-Melanoma -Squamous cell carcinoma
What are the symptoms of cytarabine syndrome? Select all that apply.
-Muscle pain -Conjunctivitis
Which drugs are classified as folate antagonists? Select all that apply.
-Pemetrexed -Pralatrexate -Methotrexate
A patient has undergone chemotherapy for the treatment of cancer. The patient reports dryness of the oral mucosa. What nursing advice is helpful for decreasing the dryness of the oral mucosa? Select all that apply.
-Perform oral hygiene regularly. -Use a soft-bristled toothbrush to clean your teeth. -Use diluted warm saline solution to rinse your mouth.
Combinations of chemotherapeutic drugs are commonly used for which purpose? Select all that apply.
-Preventing drug resistance -Providing a synergistic action -Decreasing the severity of adverse effects
Which patient is the most appropriate candidate to receive antineoplastic enzymes?
A patient with acute lymphocytic leukemia
Which paraneoplastic syndrome is associated with lymphoma?
Addison's syndrome
Which part of the body is the origin of Kaposi's sarcoma?
Blood vessel
Which cancer is caused by the Epstein-Barr virus?
Burkitt's lymphoma
Which type of tumor arises from the epithelial tissues?
Carcinomas
A nurse is caring for a patient who has lung cancer. The nurse identifies the patient as having symptoms of Cushing's syndrome. What is the probable reason for patient to have Cushing's syndrome?
Changes in the level of hormones
A patient's biopsy report indicates tumor growth at the shoulder cartilage. What diagnosis should the nurse suspect based on the patient's biopsy report?
Chondrosarcoma
Which antimetabolite is indicated for treating hairy cell leukemia?
Cladribine
A nurse is caring for a patient with meningeal leukemia who has been prescribed the drug cytarabine. After administering the medication, the nurse finds that the patient has a fever, a maculopapular rash, and malaise. What medication should be administered to the patient in this condition?
Corticosteroid medications
Which medication should be given before administering paclitaxel?
Dexamethasone
A primary health care provider has prescribed capecitabine to a patient to treat cancer. During the assessment the nurse finds that the patient is taking warfarin. The nurse should contact the provider to discuss which action?
Discontinuing administration of warfarin
Which medication is indicated for bladder cancer?
Gemcitabine
Which type of cells have the capacity for self-renewal and can transform into different types of blood and bone marrow cells?
Hematopoietic stem cells
Current research has led to discovery of cancer-causing viruses. Which virus that is linked to cancer can be prevented by vaccination in humans?
Human papillomavirus
A nurse is assessing a patient who had cervical cancer caused by a viral infection. Which viral infection did the patient have?
Human papillomavirus infection
Which clinical manifestation is observed in a patient using antineoplastic agents related to metabolic toxicity?
Hypokalemia
A nurse is caring for a patient with colon cancer who was prescribed radiation therapy and busulfan. What is the most appropriate nursing action in this situation?
Inform the patient that nausea is an adverse effect of radiation therapy.
A patient undergoing chemotherapy develops severe nausea and vomiting and is not able to retain oral food or fluids. Which treatment strategy is included in the treatment plan to prevent dehydration?
Intravenous fluids
What is a characteristic of a malignant tumor?
It has the potential to metastasize.
A nurse would anticipate administering which medication to patients receiving high-dose methotrexate?
Leucovorin
Which drug is the antidote of methotrexate?
Leucovorin
Which cancerous cells are referred to as circulating tumors?
Leukemia
Which is a characteristic of leukemia?
Leukemia is not a solid tumor.
Which type of cancer predominantly occurs in pediatric patients?
Lymphocytic leukemia
For which type of cancer is an individual at risk if exposed to asbestos?
Mesothelioma
Which medication is effective in killing cancer cells during the S phase?
Methotrexate
Which medication leads to hyperglycemia when coadministered with asparaginase?
Prednisone
A patient with breast cancer was prescribed paclitaxel. What precautions are implemented for the safe administration of paclitaxel to the patient?
Ranitidine must be administered to the patient before administering paclitaxel.
A nurse is caring for a patient with cancer who has been prescribed premetrexed. The nurse reports to the primary health care provider that the patient is showing signs of tumor lysis syndrome. What does the primary health care provider prescribe to the patient?
Rasburicase
Medication 'X' is found to be effective for the treatment of acquired immunodeficiency syndrome (AIDS), but during postmarketing surveillance, it was found that the drug has carcinogenic properties. What action does the Food and Drug Administration (FDA) take for such a medication?
Recommends recalling the medication from the market
A patient is taking an antineoplastic agent for the treatment of cancer. During assessment, the nurse finds that the patient has thrombocytopenia. Which is a symptom associated with thrombocytopenia that the nurse may have found in the patient?
Red or purple spots on body
Which type of tumor originates in the connective tissue?
Sarcomas
A nurse is caring for a patient with a brain tumor who has been prescribed vincristine. Which action should the nurse take while administering this medication to the patient?
The nurse administers the medication by diluting it with 25 mL of normal saline.
A patient is treated with asparaginase as part of chemotherapy. The nurse is advised to assess the patient's serum alkaline phosphatase and white blood cell (WBC) counts. What is the reason for this?
The patient may develop pancreatitis.
A patient who has cancer is prescribed antineoplastic agents and radiation therapy. Which prophylactic treatment can prevent nadir?
The patient must be administered intravenous antibiotics.
What is the mechanism of action of vinca alkaloids?
They dissolve important mitotic spindles.
