Ch 14 - Antineoplastic Agents

The purpose of antineoplastic drugs is to affect cells that rapidly divide and reproduce; however, the adverse effects produced by antineoplastic drugs result from their systemic use, which exposes nonmalignant cells in the body that are rapidly dividing and reproducing. Which is not an example of a rapidly dividing and reproducing cell in the body? bone marrow cell hair follicle cell oral mucosal cell nerve cell

nerve cell

A nurse is caring for a 46-year-old female patient who is taking paclitaxel for ovarian cancer. Two or three days after the infusion of the drug, the nurse must closely monitor for: asthma. cardiotoxicity. neurotoxicity. constipation.

neurotoxicity

A male patient has been on long-term bicalutamide therapy. In order to assess adverse effects of the drug therapy, the nurse will closely monitor: Pap test results Blood counts Liver function Visual function

Liver function

What should the oncology nurse understand when administering a cell cycle-nonspecific chemotherapeutic agent about its effect? The drug will be effective through specific areas of the cell cycle. The drug has intermittent effectiveness throughout the cell cycle. The drug is ineffective throughout all phases of the cell cycle. The drug will be effective through all phases of the cell cycle.

The drug will be effective through all phases of the cell cycle.

A recent nursing graduate is receiving special training to become certified in handling and administering chemotherapy drugs. This special training is necessary because of what nursing diagnosis among clients receiving chemotherapy? risk for injury related to chemotherapy risk for ineffective health maintenance related to chemotherapy risk for acute pain related to chemotherapy risk for contamination related to chemotherapy

risk for injury related to chemotherapy

A client is being treated for cancer and dronabinol has been added to the client's current medication regimen. What assessment finding would indicate a therapeutic effect of this medication? Increased energy Decreased pain Stable white blood cell levels Absence of nausea

Absence of nausea

The nurse is preparing a client who will begin chemotherapy in a few days. The nurse knows that which are the most common adverse effects encountered by most clients who receive chemotherapy? (Select all that apply.) Alopecia Neutrocytosis Anemia Thrombocytopenia Stomach ulcers

Alopecia Anemia Thrombocytopenia

Which of the following instructions would be most appropriate for a patient who is receiving temsirolimus? Maintaining adequate nutrition Drinking adequate fluids Promoting frequent rest periods Avoiding grapefruit juice

Avoiding grapefruit juice

The client is instructed to return to the clinic after calling and reporting various concerns. The nurse alerts the primary health care provider after noting which signs on the assessment? Select all that apply. Petechiae Bleeding gums Bright green emesis Hematuria Greenish-yellow stools

Bleeding gums Petechiae Hematuria

A patient is experiencing antineoplastic-induced nausea and vomiting. The health care provider prescribes ondansetron. The nurse understands that this agent acts in which way? Blocking serotonin receptors in the CTZ Calming the activity of the gastrointestinal tract Blocking human substance P/neurokinin 1 receptors Directly blocking the chemoreceptor trigger zone (CTZ)

Blocking serotonin receptors in the CTZ

A client is receiving idarubicin. What is the nurse's priority assessment? Respiratory function Electrolyte levels Cardiac function Red cell indices

Cardiac function

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 with a long generation time Cells that lack contact inhibition Cells that have a rapid mitotic rate Cells that lack a blood supply

Cells that have a rapid mitotic rate

After teaching a group of students about antineoplastic antibiotics, the instructor determines that the teaching was successful when the students identify which drug as an example? Vincristine Methotrexate Doxorubicin Imatinib

Doxorubicin

A client with breast cancer is receiving goserelin. What aspect of the client's most recent laboratory results would suggest an adverse effect of this particular drug? Increased blood urea nitrogen and creatinine Elevated serum calcium Decreased hemoglobin and hematocrit Increased international normalized ratio

Elevated serum calcium

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 Alkylating drug Estrogen Androgen

Emetogenic

A male client is receiving parenteral cytotoxic medications in the home. Adjunct therapy may include what substance? Heparin Erythropoietin Antidiuretic hormone Normal saline 0.9% intravenously

Erythropoietin

A patient is to receive doxorubicin as treatment for leukemia. The nurse would instruct the patient that the typical cycle would be repeated at which frequency? Every 4 weeks Every other week Every week Every 3 weeks

Every 3 weeks

After teaching a group of students about antineoplastic agents and their effect on cancer and healthy cells, the instructor determines that the teaching was successful when the students identify which drug as having the least effect on healthy cells? Vinblastine Paclitaxel Docetaxel Getitinib

Getitinib

Which drug would have the least effect on healthy human cells? Etoposide Vincristine Imatinib Doxorubicin

Imatinib

During which phase of the cell cycle would a nurse expect a mitotic inhibitor to act? M G1 S G0

M

A male client is informed 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 health care provider to do? Increase the dose of capecitabine. Add routine blood transfusions to the client's treatment regimen. Monitor the client closely and repeat LFTs routinely. Discontinue the capecitabine.

Monitor the client closely and repeat LFTs routinely.

A patient with a diagnosis of chronic myeloid leukemia has met with the oncologist, who has recommended treatment with the kinase inhibitor imatinib. What route of administration will the client receive? Daily intramuscular injections throughout the course of treatment Peripheral IV administration three times a day for 7 to 10 days Oral administration of imatinib in a home setting Weekly IV infusions over 6 to 8 hours through a central line

Oral administration of imatinib in a home setting

A nurse is providing client education to a 50-year-old woman who is taking methotrexate (MTX) for breast cancer. The nurse will instruct the client to avoid which drug? Furosemide Digoxin Acetaminophen Salicylates

Salicylates

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

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 are significantly more cost-effective than traditional chemotherapeutic drugs. Targeted therapies have the potential to damage cancerous cells while leaving normal body cells less affected. Targeted therapies achieve the therapeutic benefits of traditional chemotherapy with no risk of adverse effects. Targeted therapies have the potential to provide prophylactic protection against neoplasia in high-risk individuals.

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

What should the oncology nurse understand when administering a cell cycle-nonspecific chemotherapeutic agent about its effect? The drug has intermittent effectiveness throughout the cell cycle. The drug will be effective through all phases of the cell cycle. The drug is ineffective throughout all phases of the cell cycle. The drug will be effective through specific areas of the cell cycle.

The drug will be effective through all phases of the cell cycle.

A 51-year-old female patient has been receiving doxorubicin for metastatic breast cancer. Her medical record indicates she has cardiomyopathy and a cumulative dose of 300 mg/m2 of doxorubicin. Which measure would help limit the severity of the cardiomyopathy in this client? A single large dose instead of multiple doses The use of dexrazoxane in conjunction with doxorubicin A reduced dose Meticulous monitoring during drug administration

The use of dexrazoxane in conjunction with doxorubicin

Which drug would be classified as a mitotic inhibitor? Chlorambucil Fluorouracil Methotrexate Vincristine

Vincristine

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? On an empty stomach With food and a large glass of water With a glass of grapefruit or cranberry juice Thirty minutes before breakfast and in the early evening, at least 2 hours after dinner

With food and a large glass of water

A client has just been diagnosed with liver cancer, and the care team is finalizing the extensive chemotherapy regimen that will begin imminently. Administration of chemotherapeutic drugs is best achieved through which route? a central venous catheter (CVC) a peripheral IV in the nondominant forearm peripheral intravenous access in the antecubital fossa an intramuscular depot

a central venous catheter (CVC)

A client is undergoing treatment for metastatic colorectal cancer. The client's chemotherapeutic regimen includes oxaliplatin IV. The nurse is preparing to administer a scheduled dose, and should: administer antiemetics and dexamethasone as prescribed. establish a new peripheral intravenous site. administer benzodiazepines as prescribed to prevent anxiety during chemotherapy. assess the client's baseline paint level to provide a comparison post-administration.

administer antiemetics and dexamethasone as prescribed.

Which agents would be considered cancer non-cell cycle specific agents? mitotic inhibitors antimetabolites alkylating agents protein tyrosine kinase inhibitors

alkylating agents

The nurse may be asked to administer which medications to a client to counteract the increase in uric acid and subsequent hyperuricemia resulting from the metabolic waste buildup from rapid tumor lysis? amifostine leucovorin mesna allopurinol

allopurinol

The mitotic inhibitors interfere with the ability of a cell to divide, and they block or alter DNA synthesis, thus causing cell death. For clients taking these drugs, the nurse should: encourage the patient to eat 6 small meals a day. avoid any skin, eye, or mucous membrane contact with the drug. check for extravasation when the infusion is over. avoid using a proximal vein.

avoid any skin, eye, or mucous membrane contact with the drug

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-nonspecific. growth fraction. cell cycle-specific. cell targeting.

cell cycle-specific.

When assessing a client for adverse effects related to methotrexate (MTX) therapy, the nurse should prioritize what diagnostic findings? creatinine clearance electrocardiogram (ECG) calcium and magnesium levels serum osmolality

creatinine clearance

Many times a combination of antineoplastic medications are used to: decrease the side effects of each medication. decrease the development of cell resistance. increase the length of treatment. increase the quantity of each medication used.

decrease the development of cell resistance

Based on the nurse's understanding of antineoplastic drugs, the nurse would anticipate administering which in conjunction with doxorubicin as a cardioprotective agent? mesna dexrazoxane leucovorin amifostine

dexrazoxane

A 54-year-old male patient with small-cell lung cancer is receiving etoposide. The nurse will carefully monitor for: hypertension. hypoglycemia. hypotension. tachycardia.

hypotension.

A client is being treated on the oncology unit and has developed worsening adverse effects over the past several days of chemotherapy. Administration of filgrastim may aid in achieving what desired outcome? increased platelet levels prevention of hemorrhagic cystitis increased leukocytes resolution of mucositis

increased leukocytes

A client with leukemia has been prescribed rasburicase to be administered before chemotherapy. Which assessment should the nurse complete after administration of this medication? uric acid levels serum calcium levels blood glucose levels serum potassium levels

uric acid levels

A 54-year-old received a diagnosis of breast cancer several weeks ago and her current treatment regimen includes tamoxifen, a cell cycle-nonspecific antineoplastic drug. What is a characteristic of a cell cycle-nonspecific drug? The drug is capable of inducing cell division and subsequent mutations of cancerous cells. The drug is readily able to distinguish between normal body cells and malignant cells. The drug induces an abnormal cell cycle that results in cancerous cell death. The drug is effective regardless of whether a cancerous cell is proliferating.

The drug is effective regardless of whether a cancerous cell is proliferating.