Chapter 50: Antineoplastic Drugs and Targeted Therapies PrepU, chapter 53, ch.54, ch 51, ch 52

The student nurse is assigned to a client who is to receive an 80 mEq/1000 mL infusion of potassium over 16 hours for a K+ level of 2.1. The student voices concern over the concentration. Which of the following statements by the nursing instructor would be the best response?

"80 mEq in 1000 mL of IV solution is the maximum recommended dose, although in an acute emergency situation a higher concentration of potassium may be required."

What health education should the nurse convey to the client prescribed trifluridine eye ointment before the initiation of treatment?

"It will take 1 or 2 weeks for the ointment to resolve the infection in your eye."

The nurse is educating a client newly diagnosed with necrotizing otitis externa of the left ear about the prescribed ciprofloxacin IVPB. Which statement made by the client establishes the need for further clarification?

"Once the symptoms decrease, otic drops will be used to treat the infection."

What administration instructions should the nurse provide to the parents of a 4-year-old child prescribed a neomycin-polymyxin B-hydrocortisone combination drug for otitis media in the right ear?

"Place three drops into the right ear four times a day."

7 See full question 22s A young man asks the nurse about the goal of the cancer therapy his mother is receiving. What would be the nurse's best response?

"The goal is to limit the cancer cells so the immune system can respond without causing too much toxicity to your mother." Explanation: The goal of cancer therapy, much like that of anti-infective therapy, is to limit the offending cells to the degree that the immune system can then respond without causing too much toxicity to the host. Therefore the other options are incorrect. Reference: Ford, Susan M., Roach's Introductory Clinical Pharmacology, 11th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Antineoplastic Drugs and Targeted Therapies, p. 598. Chapter 50: Antineoplastic Drugs and Targeted Therapies - Page 598 Add a Note

What explanation does the nurse provide when a client asks why an ophthalmic medication is needed during an assessment of the eye for the treatment of hyperopia?

"The medication is used to aid in prescribing corrective eyeglasses for your farsightedness."

12 See full question 53s An oncology nurse is performing patient teaching for a woman who is scheduled to begin treatment with a targeted therapy. The woman is unfamiliar with this class of drugs. How should the nurse best describe targeted therapies to this patient?

"These drugs are capable of controlling the signals that tell cancer cells to grow and divide." Explanation: By blocking the signals that tell cancer cells to grow and divide uncontrollably, targeted cancer therapies can help stop the growth and division of cancer cells. Targeted therapies do not enhance immune function or induce mutations in cancer cells. Reference: Ford, Susan M., Roach's Introductory Clinical Pharmacology, 11th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Antineoplastic Drugs and Targeted Therapies, p. 598. Chapter 50: Antineoplastic Drugs and Targeted Therapies - Page 598 Add a Note

A client prescribed tetracycline for acne vulgaris asks how long until the client can see results from the medication. What is the nurse's best response?

"We should see improvement in 6-8 weeks."

17 See full question 5s A client newly diagnosed with chronic myelocytic leukemia (CML) has been prescribed treatment with imatinib. What assessment question is most relevant to this client's care?

"Will paying for this medication be a problem for you and your family?" Explanation: Imatinib is expensive. It is estimated that 1 year of treatment with the drug (which needs to be taken continually) costs the patient between $30,000 and $35,000. For nearly all clients, this is a very significant consideration. The drug is not associated with a risk for depression and it is not contraindicated in clients with a shellfish allergy. Social support is always important, but financial concerns are likely to be paramount. Reference: Ford, Susan M., Roach's Introductory Clinical Pharmacology, 11th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Antineoplastic Drugs and Targeted Therapies, p. 600. Chapter 50: Antineoplastic Drugs and Targeted Therapies - Page 600 Add a Note

The nurse is administering colony-stimulating factors to an older adult client after chemotherapy. The nurse should explain to the client that this medication is being administered for which reason?

"Your body is going to have trouble fighting off infections on it's own. This medication will help with that."

Normal saline for intravenous (IV) infusion has been ordered for a client. The student nurse correctly chooses which intravenous fluid bag labeled with what for this client?

0.9% NaCl

A client should not use over-the-counter ear wax removal products for more than how long before consulting a health care provider?

4 days

What client would be most likely to benefit from the administration of epoetin alfa

A client with hemorrhage after abdominal surgery

A client has come into the emergency department after crashing on a bike. There is the "road rash" covering the client's legs. After cleansing the affected area with chlorhexidine, what type of drug would the nurse use topically on the "road rash" area?

A topical anti-infective

A boy 16 years of age is seen in the clinic for a progressed rash in his groin which begun shortly after he begun working full time as a lifeguard. The nurse knows that the provider would most likely order which type of medication?

A topical antifungal

The client reports taking niacin regularly to reduce triglyceride levels. What information related to niacin should the nurse include in the client's teaching plan?

After a dose of oral niacin, lie down for 30 minutes.

The nurse is providing health education for the parents of a child whose otitis media has warranted treatment with Cortisporin Otic. The nurse should explain that this medication contains which of the following components? Select all that apply.

An antibiotic A steroid

The nurse is caring for a client diagnosed with rheumatoid arthritis (RA) who recently underwent a liver transplant. What immunosuppressant could this client be prescribed that would treat both diagnoses?

Anakinra

The nurse is seeing a client in the emergency department who has not passed urine in four days. The client was diagnosed with anemia during a previous visit and was prescribed oral iron supplements. The nurse expects that which of the following types of anemia would be a priority part of the initial workup?

Anemia in chronic kidney disease

A client describes burning to the right eye along with itching and redness to the eyelid. Which ocular disorder does the nurse suspect?

Anterior blepharitis

What are factors that can increase systemic absorption of topical agents? Select all that apply.

Application to inflamed skin Application to the mucous membranes

18 See full question 51s An adult client has recently begun cancer treatment with methotrexate (MTX). When reviewing this client's laboratory work, the nurse should consequently prioritize assessment of which of the following?

BUN and creatinine Explanation: The antimetabolites may also be nephrotoxic. MTX use in clients with impaired renal function may lead to accumulation of toxic amounts or additional renal damage. Evaluation of the client's renal status should take place before and during MTX therapy. This adverse effect of MTX treatment supersedes the importance of electrolytes and ABGs, though these would also be considered. Reference: Ford, Susan M., Roach's Introductory Clinical Pharmacology, 11th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Antineoplastic Drugs and Targeted Therapies, p. 607. Chapter 50: Antineoplastic Drugs and Targeted Therapies - Page 607 Add a Note

Some eyedrops contain a preservative absorbed by soft contacts. The nurse recognizes that clients should be cautioned about instilling eyedrops containing what substance if they wear soft contacts?

Benzalkonium hydrochloride

The client is treated for chronic open-angle glaucoma. The nurse recognizes that which category of drugs is considered the first-line category of drugs to treat this?

Beta blockers

9 See full question 15s Your patient is taking ifosfamide as part of their cancer treatment. They are also taking Mesna to prevent cystitis induced by the ifosfamide. How does the Mesna work?

By combining with metabolites of ifosfamide Explanation: Amifostine and mesna are cytoprotective (cell-protecting) drugs that may be given to limit certain effects of cisplatin and ifosfamide, respectively. Mesnex does not work by increasing urine output, decreasing viral load, or increasing white blood cell production. Reference: Ford, Susan M., Roach's Introductory Clinical Pharmacology, 11th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Antineoplastic Drugs and Targeted Therapies, p. 597. Chapter 50: Antineoplastic Drugs and Targeted Therapies - Page 597 Add a Note

Which laboratory value is necessary for the nurse to monitor in a client receiving darbepoetin alfa?

CBC

4 See full question 9s A client is receiving idarubicin. What is the nurse's priority assessment?

Cardiac function Explanation: The client's cardiac function needs to be monitored closely because idarubicin is specifically toxic to the heart. The pancytopenia that accompanies antineoplastics can cause decreased red cell indices, but this does not address the particular threat to the cardiac system posed by idarubicin. Respiratory function is not commonly impacted by idarubicin. Electrolyte levels should be monitored in clients receiving any antineoplastic study due to adverse effects impacting nutrition and kidney function, but are not specific to idarubicin. Reference: Ford, Susan M., Roach's Introductory Clinical Pharmacology, 11th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Antineoplastic Drugs and Targeted Therapies, p. 610. Chapter 50: Antineoplastic Drugs and Targeted Therapies - Page 610 Add a Note

The client has just been diagnosed with psoriasis and has lesions around the right eye. What would be an important factor for the nurse to teach the client about the use of topical corticosteroid preparations repeatedly on the face and around the eyes?

Cataract development is possible

A nurse is caring for a 35-year-old client who is receiving magnesium sulfate intravenously. Which action would be most important for the nurse to do when caring for this client?

Check knee-jerk reflexes before each dose.

The nurse is admitted to the unit for intravenous (IV) fluids due to dehydration. During the infusion, the nurse knows to take which of the following nursing actions? Select all that apply.

Check the needle site every 15 to 30 minutes. Inspect the needle site for signs of extravasation. Inspect the needle site for signs of infiltration.

A pregnant woman is being prepped and draped for her C-section delivery. The client is allergic to povodine-iodine. What would be a good choice for the nurse to use?

Chlorhexidine

The pharmacology instructor asks a student to list the uses for topical enzymes. The student is correct when listing the following. (Select all that apply.)

Chronic dermal ulcers Severely burned areas

The nurse knows that which topical medication can be absorbed in sufficient amounts to cause systemic effects such as severe diarrhea, stomach cramps, or bloody stools?

Clindamycin

The client is reporting sharp shooting pains to the left eye and loss of peripheral vision. What does the nurse suspect?

Closed angle glaucoma

Which medications are effective treatments for tinea infections? Select all that apply.

Clotrimazole Ketoconazole Miconazole

A nurse is monitoring a client's laboratory values and notices that the sodium level is 120 meq/L. What are some side effects that this client may demonstrate? (Select all that apply.)

Cold, clammy skin Apprehension Hypotension Tachycardia

2 See full question 14s A patient who is receiving methotrexate is also receiving leucovorin. The nurse understands that this drug is being given for which reason?

Counteract effects of methotrexate Explanation: Leucovorin is administered with methotrexate to counteract the effects of methotrexate treatment. Reference: Ford, Susan M., Roach's Introductory Clinical Pharmacology, 11th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Antineoplastic Drugs and Targeted Therapies, p. 597. Chapter 50: Antineoplastic Drugs and Targeted Therapies - Page 597 Add a Note

A client is examined by an opthamologist and has been diagnosed with verneal conjunctivitis. Which medication is appropriate for this client?

Cromolyn

A client reports dry eyes and no tear production. Which ophthalmic medication does the nurse anticipate the prescriber to order for these symptoms?

Cyclosporine

14 See full question 1m 7s The nurse is reviewing the lab values for a client who has myelosuppression post chemotherapy treatment. The nurse is likely to see which abnormal values for this client?

Decreased thrombocytes Explanation: Many antineoplastic drugs interfere with the bone marrow's ability to make new cells. This interference is called bone marrow suppression or myelosuppression and is a potentially dangerous adverse reaction. Bone marrow suppression is manifested by abnormal laboratory test results and clinical evidence of leukopenia, thrombocytopenia, or anemia. For example, there is a decrease in the white blood cells or leukocytes (leukopenia), a decrease in the thrombocytes (thrombocytopenia), and a decrease in the red blood cells, resulting in anemia. Reference: Ford, Susan M., Roach's Introductory Clinical Pharmacology, 11th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Antineoplastic Drugs and Targeted Therapies, p. 603. Chapter 50: Antineoplastic Drugs and Targeted Therapies - Page 603 Add a Note

in what layer of the skin are the blood vessels and nerve endings found?

Dermis

The eyeball can exhibit refractory errors, which impair vision by interfering with the eye's ability to focus light rays on the retina. How are ophthalmic drugs used in these instances?

Diagnostically

The nurse is preparing a client for discharge after cataract surgery. The client is instructed to use anti-inflammatory eyedrops after the surgery for 2 weeks. Which of the following medications will the client be using?

Diclofenac (Voltaren)

The nurse is caring for a client admitted with a diagnosis of renal failure. When the nurse reviews the client's laboratory reports, the magnesium levels are high. What would be important for the nurse to assess?

Diminished deep tendon reflexes

The nurse is administering cyclosporine. The nurse should anticipate the client may report which adverse reaction?

Excessive hair growth

The nurse is caring for a client who is to receive IV daunorubicin. The nurse starts the infusion and checks the insertion site as per protocol. The nurse notes that the infusion has infiltrated. What is the nurse's main concern with the infiltration?

Extravasation of the medication

On assessment of a client receiving magnesium intravenously (IV), the nurse notes the client does not have deep tendon reflexes. The nurse anticipates the client's lab values for magnesium will show which serum level?

Greater than 10 mEq/L

A nurse is caring for a client with a nursing diagnosis of Imbalanced Nutrition: Less Than Body Requirements related to iron deficiency. Which instructions should the nurse offer the client when providing care?

Increase intake of lean red meats.

Which of the following has anti-infective action against bacteria, fungi, viruses, yeasts, and protozoa? (Choose one)

Iodine

A student nurse is preparing to administer an oral iron supplement to a client diagnosed with iron deficiency anemia. The supervising nurse should question the student regarding which interaction caused when iron and antibiotics are used together for treatment?

Iron causes a decreased gastrointestinal absorption of the antibiotic.

A nurse is attending a professional development class on hematopoietic drugs. The course would include which of the following types of anemia? Select all that apply.

Iron deficiency Anemia in chronic kidney disease Pernicious anemia Folic acid deficiency

A hospitalized client treated for intracellular fluid and electrolyte imbalance. The nurse knows that which two major electrolytes are normally found in intracellular body fluid?

Magnesium and potassium

A client is seen in the clinic due to seasonal allergies. His major complaint is his itchy eyes. The nurse knows that what type of medication could be used to treat his itchy eyes?

Mast cell stabilizer

The nurse is teaching a client about megakaryocytes. Which of the following information would the nurse include in the teaching plan?

Megakaryocytes are precursor cells to platelets.

The nurse is caring for a 65-year-old client admitted to the hospital unit 72 hours ago with pyloric stenosis. A nasogastric tube was placed upon admission has been on low intermittent suction. Lab values indicate the client's potassium is very low. What should the nurse be concerned that the client may be at risk for?

Metabolic alkalosis

A client is being treated for malignant melonoma and has been prescribed interferon alfa-2b. The client has complex medical history and the medication regimen includes aspirin, furosemide, bisoprolol and levothyroxine. When planning the client's care, what should the nurse prioritize?

Monitor the client's response to the medication and assess for adverse effects.

The nurse is caring for a client who is receiving a magnesium infusion but has renal impairment. How often will the nurse monitor the urinary output?

Monitor the urinary output to verify an output of at least 100 mL every four hours, and report less than 100 mL of urine every four hours to the primary care provider.

16 See full question 15s The client is taking ifosfamide as a component of cancer treatment and the client's oncologist has just added mesna to the client's medication regimen. How should the nurse best assess for the therapeutic effect of mesna?

Monitoring the client's urine output for signs of hematuria Explanation: Mesna combines with a urotoxic metabolite of ifosfamide to reduce the damaging effects of ifosfamide. It addresses the risk of hemorrhagic cystitis, so the absence of hematuria would suggest that it is having the intended effect. Mesna is not given to address diarrhea, pain or nausea. Reference: Ford, Susan M., Roach's Introductory Clinical Pharmacology, 11th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Antineoplastic Drugs and Targeted Therapies, p. 597. Chapter 50: Antineoplastic Drugs and Targeted Therapies - Page 597 Add a Note

The nurse is seeing a female client who states she needs to have her prescription for eye drops refilled. The nurse notes the client has brimonidine listed as a medication in her health records. The nurse knows the use of which drug is contraindicated for this client?

Monoamine oxidase (MAO) inhibitor

When administering medications through a feeding tube, what intervention should the nurse implement?

Obtain liquid forms of medications whenever possible.

A senior level nurse is teaching a new nurse about lifespan considerations. Which of the following information would the nurse include while teaching the subject?

Older adults are at increased risk for fluid overload because of an increased risk of cardiac and renal disease.

7 See full question 2s A client has chosen to be placed on hospice. Which is acceptable chemotherapy for a client on hospice?

Palliative chemotherapy Explanation: Palliative chemotherapy is used in advanced cancer to relieve symptoms and treat or prevent complications. Adjuvant chemotherapy is used after surgery or radiation to destroy or reduce microscopic metastasis. Radiation combined with chemotherapy is implemented to treat the cancer and not used in palliation. Neoadjuvant chemotherapy is used before surgery or radiation. Reference: Ford, Susan M., Roach's Introductory Clinical Pharmacology, 11th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Antineoplastic Drugs and Targeted Therapies, pp. 608-609. Chapter 50: Antineoplastic Drugs and Targeted Therapies - Page 608-609 Add a Note

A client is diagnosed with hypocalcemia. Which of the following conditions most commonly causes this condition?

Parathyroid hormone deficit

The nurse knows that a pediatric client is at greater risk for systemic adverse reactions from a topical medication. Why?

Pediatric clients have a greater skin surface area to body mass ratio.

Which medication does the nurse anticipate the prescriber to order for a pediatric client who has a high mercury level?

Penicillamine

The nurse knows to monitor the IV site for which of the following complications during parenteral management of body fluids?

Phlebitis and/or thrombosis

Burn clients have a difficult time maintaining adequate fluid balance due to their wounds. What role of the skin does a burn wound violate?

Physical barrier

Brimonidine, used to treat open-angle glaucoma, has which of the following actions? (Select all that apply.)

Reduce the production of aqueous humor Increase the outflow of aqueous humor

A client comes to the clinic for follow-up for a diagnosis of hypertension. During the intake history, the nurse finds that the client is scheduled for epoetin alfa therapy. Which action will the nurse take?

Report any rise in the blood pressure of 20 mm Hg or more in the systolic or diastolic to the primary care provider.

A nurse is writing a care plan for a client who is being treated for glaucoma. Which of the following nursing diagnoses would be appropriate for this client? Select all that apply.

Risk for Injury Related to Blurred Vision Risk for Body Image Disturbance related to eye discoloration Risk for Acute Pain related to increased intraocular pressure

The nurse is caring for a client with a secondary diagnosis of hypermagnesemia. For what should the nurse assess?

Shallow respirations

What is a major electrolyte in extracellular fluid that influences the distribution of water and maintains acid-base balance and nerve function?

Sodium

The nurse knows that which two major electrolytes are normally found in extracellular body fluid?

Sodium and Calcium

A nurse is caring for client with a serum potassium level of 7 mEq/L. Which treatments does the nurse anticipate the prescriber to order? Select all that apply.

Sodium bicarbonate Glucose and insulin Calcium gluconate

8 See full question 17s 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. Explanation: By focusing on molecular and cellular changes that are specific to cancer, targeted cancer therapies may be more effective than current treatments and less harmful to normal cells so that they may produce fewer adverse effects. However, adverse effects are not wholly absent. These drugs are not normally used as cancer prophylaxis and many are prohibitively expensive. Reference: Ford, Susan M., Roach's Introductory Clinical Pharmacology, 11th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Antineoplastic Drugs and Targeted Therapies, p. 599. Chapter 50: Antineoplastic Drugs and Targeted Therapies - Page 599 Add a Note

9 See full question 2s The oncology nurse is administering a chemotherapy agent that arrests mitosis by promoting the formation of abnormal spindle fibers and mitotic asters. What classification of drug is the nurse administering?

Taxane Explanation: Reference: Ford, Susan M., Roach's Introductory Clinical Pharmacology, 11th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Antineoplastic Drugs and Targeted Therapies, p. 596. Chapter 50: Antineoplastic Drugs and Targeted Therapies - Page 596 Add a Note

A cardiac surgery nurse is teaching novice nurses about alkalinizing agents. During the class, a nurse asks if Tham has any adverse reactions. The answer would include which of the following information?

Tham can cause fever, low blood sugar, high potassium, respiratory depression, hemorrhagic hepatic necrosis, venospasm, and vein necrosis.

A nurse is assigned to care for a client with iron deficiency anemia who is prescribed iron therapy. Which should the nurse confirm to ensure that iron compounds are not contraindicated in this client?

The client does not have hemochromatosis

A client has undergone bone marrow transplant for the treatment of multiple myeloma. The client has been prescribed filgrastim (Neupogen) 6 mcg/kg IV daily. What outcome should indicate successful medication therapy to the nurse?

The client remains free of infection

A client who presented with signs and symptoms characteristic of otitis externa is requesting prescription ear drops. The nurse would recognize that the safe and effective use of polymyxin B-neomycin-hydrocortisone suspension would be contraindicated by what variable?

The client's infection is thought to be caused by a virus.

A client is preparing for open heart surgery. The provider gave her a bottle of chlorhexidine and told her to scrub her chest the night before surgery. The nurse knows that this was done for what reason?

The health care provider wants to eliminate as many organisms from the skin as possible by prescrubbing the area the night before surgery.

The nursing instructor is discussing metabolic acidosis with senior nursing students. What would the instructor tell the students about the role of the kidneys in metabolic acidosis?

The kidneys excrete hydrogen ions and conserve bicarbonate ions to help restore balance

10 See full question 20s 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?

The use of dexrazoxane in conjunction with doxorubicin Explanation: Dexrazoxane, a cardioprotectant, is recommended to reduce the severity and incidence of cardiomyopathy associated with doxorubicin for women with metastatic breast cancer who received a cumulative dose of 300 mg/m2. Meticulous monitoring or multiplying daily doses would not reduce the severity and incidence of cardiomyopathy as effectively as using dexrazoxane, and reducing the dosage is not advisable. Reference: Ford, Susan M., Roach's Introductory Clinical Pharmacology, 11th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Antineoplastic Drugs and Targeted Therapies, p. 598. Chapter 50: Antineoplastic Drugs and Targeted Therapies - Page 598 Add a Note

A nursing student correctly identifies the action of a keratolytic when stating which of the following?

This drug removes excess growth of the epidermis.

A client is seeing the health care provider for itchy, flaky feet, particularly between the toes. The client will likely be diagnosed with which condition? (Choose one)

Tinea pedis

A client is seen daily for debridement of his second- and third-degree burns on his arm. The nurse expects that what type of medication will be used to help remove the dead skin from the burn?

Topical enzyme

6 See full question 2s What measure protects the nurse when preparing cytotoxic drugs?

Wearing protective equipment such as gloves, mask, and gown Explanation: Avoid direct skin or eye contact with the drug. Wear protective clothing and goggles while preparing and administering the drug to prevent toxic reaction to the drug. Washing hands prior to preparing the medication, mixing the medication in a 1-L bag, or administering the medication IM does not protect the nurse. Reference: Ford, Susan M., Roach's Introductory Clinical Pharmacology, 11th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Antineoplastic Drugs and Targeted Therapies, p. 601. Chapter 50: Antineoplastic Drugs and Targeted Therapies - Page 601 Add a Note

17 See full question 12s 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) Explanation: Insertion of an indwelling central venous catheter is often appropriate for clients who have poor peripheral venous access, who require many doses of chemotherapy, or who require continuous infusions. The antecubital IV insertion site would be unlikely unstainable for this chemotherapy regimen. Overall, a CVC is preferable to peripheral access. IM administration is uncommon. Reference: Ford, Susan M., Roach's Introductory Clinical Pharmacology, 11th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Antineoplastic Drugs and Targeted Therapies, p. 600. Chapter 50: Antineoplastic Drugs and Targeted Therapies - Page 600 Add a Note

A client asks what neutropenia is. Which is the nurse's best response?

a condition when the neutrophil level is very low

The nurse at the clinic should teach the client that the symptoms of psoriasis are attributable to what physiological process?

accelerated turnover of epidermal cells

A client underwent a solid organ transplant several years ago and has remained largely symptom free. The nurse should educate the client on long-term immunosuppressant therapy of what increased risk?

cancer

A nurse is caring for a client with metabolic acidosis who is prescribed sodium bicarbonate orally to alkalinize the urine. Which would be most important for the nurse to do when caring for this client?

check the urine pH two to three times a day

A client requiring frequent blood transfusions has developed iron overload. Which medication will be administered?

deferasirox

3 See full question 13s Based on the nurse's understanding of antineoplastic drugs, the nurse would anticipate administering which in conjunction with doxorubicin as a cardioprotective agent?

dexrazoxane Explanation: Dexrazoxane is administered concomitantly with doxorubicin as a cardioprotective agent. Leucovorin provides folic acid to cells after methotrexate administration. Mesna binds with metabolites of ifosfamide to protect the bladder from hemorrhagic cystitis. Amifostine binds with metabolites of cisplatin to protect the kidneys from nephrotoxic effects, reduces xerostomia. Reference: Ford, Susan M., Roach's Introductory Clinical Pharmacology, 11th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Antineoplastic Drugs and Targeted Therapies, p. 597. Chapter 50: Antineoplastic Drugs and Targeted Therapies - Page 597 Add a Note

Which way(s) is/are the correct way to maintain intravenous (IV) access ? (Select all that apply.)

direct IV push intermittent infusion continuous infusion

a college student is seen in the clinic for a cold sore on her upper lip. The nurse knows that what type of topical medication may be prescribed?

docosanol

Which oral antibiotics may be prescribed to treat acne vulgaris? Select all that apply.

minocycline tetracycline doxycycline erythromycin

19 See full question 10s In caring for clients undergoing chemotherapy, the nurse should monitor for what adverse effective triggered by the cytotoxic effect of the antineoplastic medication therapy? Select all that apply.

mucositis nausea diarrhea Explanation: Common adverse effects of chemotherapy include mucositis, diarrhea, and nausea. Peripheral neuropathy and increased urine output are not typical adverse effects. Reference: Ford, Susan M., Roach's Introductory Clinical Pharmacology, 11th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Antineoplastic Drugs and Targeted Therapies, pp. 596-597. Chapter 50: Antineoplastic Drugs and Targeted Therapies - Page 596-597 Add a Note

A client has been diagnosed with a fungal infection in the right eye. The ophthalmologist plans to order which drug to treat this infection?

natamycin

After teaching a group of nursing students about electrolytes, the instructor determines that the teaching was successful when the students identify which as a major intracellular fluid electrolyte?

potassium

The nurse understands that when instilling otic preparations into the external auditory canal, the drug is being used for which of the following reasons? (Select all that apply.)

relieve pain treat infection treat inflammation aid in the removal of cerumen

After being prescribed a keratolytic, a client has asked the nurse to clarify the purpose of the medication. The nurse's reply is based upon what information regarding the purpose of the classification of medications?

repair of sun-damaged skin

A client is to begin treatment for rheumatoid arthritis with infliximab. What potential risk should the nurse identify as being associated with this drug?

risk for infection

The eyeball is a spherical structure with several components. Which are components of the eyeball? Select all that apply

sclera retina choroid cornea

Which medication is most effective in treating rosacea?

topical metronidazole

Which of these conditions or lifestyle choices would put clients at risk for developing a B12 deficiency? Select all that apply

vegan lifestyle gastric cancer ulcerative colitis

A client asks the nurse what the cause of the primary form of open angle glaucoma is. What is the nurse's best response?

"Abnormality of the trabecular meshwork that controls the flow of aqueous humor into canal of Schlemm."

A client has been taking isotretinoin for 4 months. What question should the nurse ask to best assess for a serious adverse effects associated with this drug?

"Are you experiencing any signs of depression?"

A nurse is working in the emergency department and caring for a client who requires emergency dental care. The dentist uses viscous lidocaine as a topical anesthetic. What discharge instruction should the nurse give the client?

"Do not eat food for the next hour."

The nurse is educating a client diagnosed with bacterial conjunctivitis of the right eye in an outpatient clinic about the prescribed ophthalmic medication ciprofloxacin, 2 drops every 2 hours while awake for 2 days, then 2 drops every 4 hours while awake for 5 days. Which statement made by the client establishes the need for further clarification?

"I will continue to take the medication until the bottle is empty."

A nurse is teaching about filgrastim to a client. During the teach-back session, which statement by the client indicates a need for additional teaching?

"I will take this medication until it is all gone."

Which statement should be used in teaching a client prescribed isotretinoin about the US FDA black box warning?

"It can cause spontaneous abortion and congenital malformations."

Which adverse effects of ophthalmic medications should a nurse include when providing client education? Select all that apply.

"It is common to experience some irritation to the eye." "You should anticipate blurred vision and take caution when moving around." "It is likely you will have some redness of the eyes."

A client is prescribed natamycin. What statement should be included in the teaching about the medication?

"It is used for intraocular fungal infection."

What statement related to the action of timolol should be included in the teaching plan?

"It reduces aqueous humor production while increasing its outflow."

10 See full question 5s A client who is being treated with an antineoplastic medication for cancer is prescribed Kepivance. The client is refusing this medication, stating that "all these drugs are making everything worse," including the inside of her mouth. What would be an appropriate response from the nurse?

"Kepivance is used to protect the normal cells in your body from the chemotherapy." Explanation: While a client can refuse a medication, it is important that the client understand why the medication is being given prior to her refusal. Walking away from a client who is screaming may be appropriate, but the nurse will still need to come back to give the medication at a later time. Explaining to the client that cytoprotective agents protect the normal cells in her body from the chemotherapy, and that the Kepivance is used to help epithelial cells recover in the oral cavity, would help educate the client. She would then be more likely to allow the medication to be administered. Reference: Ford, Susan M., Roach's Introductory Clinical Pharmacology, 11th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Antineoplastic Drugs and Targeted Therapies, p. 597. Chapter 50: Antineoplastic Drugs and Targeted Therapies - Page 597 Add a Note

A client is undergoing chemotherapy for vulvar cancer. The client had a friend who died after treatment, which has caused severe anxiety and fear; the client is constantly tired and sees this as an indication she won't survive. The nurse knows that the client is scheduled for immunostimulant drug therapy to support the hematopoietic system.The nurse would include which statement to explain the action of drug?

"Taking immunostimulants to stimulate the production of blood cells will help you feel better."

The nurse is preparing to administer oprelvekin to a client diagnosed with a chemotherapy-induced bleeding disorder. The nurse is explaining to the client the reason for administering this drug? Which explanation is best?

"The drug is used to increase platelet count during chemotherapy."

The nurse is caring for a client in the immediate postoperative period following cardiac transplantation who is receiving mycophenolate IV. What should the nurse teach the client regarding drug therapy? Select all that apply.

"The drug will be given orally as soon as possible. "It's important to avoid people with contagious diseases." "Ask a pharmacist about drug-drug interactions before taking any over-the-counter (OTC) drug once you're discharged." "Never miss a dose of medication."

A client diagnosed with an infection is prescribed an antimicrobial. The client asks when antimicrobials are used. What is the nurse's best response?

"They are used to treat infections caused by bacteria, fungi, and viruses."

Which teaching instructions should a nurse include when a client is prescribed a topical medication? Select all that apply.

"Use a small amount of the medication and rub it in well." "Wash your hands before and after application." "Wash the skin and pat it dry."

A client is admitted to the hospital for a sudden onset of convulsions due to a low magnesium level. The provider orders a magnesium infusion, and the nurse knows that the client requires constant observation. The client must be transferred to the critical care transition unit due to the need for frequent observation. What would the nurse say to justify the transfer to a higher level of care?

"When a magnesium infusion is ordered to treat convulsions, the blood pressure, pulse, and respiratory rate need to be monitored every 5 to 10 minutes."

An elderly client postoperative hip replacement is experiencing signs of hyponatremia. The nurse checks the client's electrolyte levels. Which of the following serum sodium levels confirms this diagnosis?

130 mEq/L

The nurse may use Cerumenex to aid in the removal of wax cerumen from the client's ear canal; however, Cerumenex is not allowed to stay in the ear canal for more than how long before irrigation?

30 minutes

A nurse is administering two different types of eyedrops to a client. What is the minimal time the nurse should wait between the instillations?

5 minutes

The correct treatment regimen for oprelvekin is for injections to start within:

6 hours and continue until platelet count is at least 50,000/mcL.

The nurse is aware that concentrated potassium mixtures should always be diluted in intravenous (IV) fluids because undiluted forms can lead to sudden death. The maximum recommended concentration of potassium is which of the following?

80 meq/1000 ml

15 See full question 1m 15s A client is being treated for pancreatic cancer and has been prescribed streptozocin 500 mg/m2 IV for five consecutive days. The client's body surface area is 1.78 m2 and the client weighs 69.5 kg. The nurse should administer how many mg of this medication? Your Response: 890

890 Explanation: The is calculated by multiplying the ordered dose by the client's body surface area: 500 mg x 1.78 m2 = 890 mg. Weight is not included in this calculation. Reference: Ford, Susan M., Roach's Introductory Clinical Pharmacology, 11th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Antineoplastic Drugs and Targeted Therapies, p. 600. Chapter 50: Antineoplastic Drugs and Targeted Therapies - Page 600 Add a Note

What clients are likely to benefit from treatment with interferons? Select all that apply.

A 52 year-old female client with multiple sclerosis An adult client who has chronic hepatitis C

10 See full question 36s In which of these patients would cyclophosphamide not likely be effective?

A 60 year old with a brain tumor Explanation: Cyclophosphamide is the most widely used alkylating agent. It has a broad spectrum of antitumor activity and plays a major role in the treatment of hematologic malignancies such as Hodgkin's and non-Hodgkin's lymphoma and multiple myeloma. It is the only alkylating agent that is effective against acute as well as chronic leukemias. Cyclophosphamide is an important component of regimens used in stem cell transplantation. It is also effective against solid tumors, such as breast cancer, small cell lung cancer, endometrial cancer, and ovarian cancer. Cyclophosphamide is given intravenously or orally. Reference: Ford, Susan M., Roach's Introductory Clinical Pharmacology, 11th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Antineoplastic Drugs and Targeted Therapies, p. 608. Chapter 50: Antineoplastic Drugs and Targeted Therapies - Page 608 Add a Note

15 See full question 11s The nurse on an oncology unit is providing care for several clients with cancer, most of whom are receiving chemotherapy. What client should the nurse prioritize?

A client with hairy cell leukemia receiving pentostatin whose urine output is 35 mL over the past 12 hours Explanation: Oliguria is suggestive of renal failure and requires prompt intervention. It would be prioritized over nausea and mucositis, even though the nurse should address both of these problems. Similarly, the care team should address the client's drop in hemoglobin but it is not so precipitous that it would be more time-dependent than a client with possible acute renal failure. Reference: Ford, Susan M., Roach's Introductory Clinical Pharmacology, 11th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Antineoplastic Drugs and Targeted Therapies, p. 608. Chapter 50: Antineoplastic Drugs and Targeted Therapies - Page 608 Add a Note

An infant comes to the clinic with extreme diaper rash that has spread over the entire genitalia and begun to advance down both legs. The health care provider orders a topical ointment to treat this problem. What should the nurse include in teaching the parents about this ointment?

Apply the diaper loosely after applying this ointment.

A client has been diagnosed with herpes simplex keratitis. He has been prescribed vidarabine. What instructions will the nurse give the client about using this medication? Select all that apply.

Apply the ointment five times per day. Apply the ointment into the lower conjunctival sac.

A client is prescribed bimatoprost for chronic open angle glaucoma. What information should be included in the plan of care regarding the action of this medication?

Aqueous drainage is increased by increasing uvesclerol outflow.

A client is scheduled for renal transplantation. At what point in the client's care should the first dose of sirolimus be given?

As soon as possible after the transplant

A client is admitted to the clinic for management of body fluids. Before administering an IV solution, the nursing assessment should include which of the following? Select all that apply.

Assess the client's general status. Review recent laboratory test results. Weigh the client. Ask the client how he or she feels.

12 See full question 12s A client with acute myeloid leukemia has been receiving mitoxantrone IV as part of the chemotherapeutic regimen. When assessing the client for the effects of bone marrow suppression, the nurse should perform what assessment?

Assessment of the client's activity tolerance and energy level Explanation: The decrease in red cells that accompanies bone marrow suppression causes fatigue. Effects of bone marrow suppression on respiratory status, kidney function and electrolytes are not as common or direct, though many antineoplastics affect these domains. Reference: Ford, Susan M., Roach's Introductory Clinical Pharmacology, 11th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Antineoplastic Drugs and Targeted Therapies, p. 603. Chapter 50: Antineoplastic Drugs and Targeted Therapies - Page 603 Add a Note

What are important precautions a nurse should teach a client receiving an immunosuppressant? (Select all that apply.)

Avoid crowds. Take precautions to avoid getting pregnant. Keep follow-up appointments for laboratory assessments.

The nurse educator is teaching a class of students about the actions and uses of colony stimulating factor. The nurse should inform students CSF is indicated for what secondary problem related to cancer treatment?

Chemotherapy-induced neutropenia

The nurse is addressing with a nursing student the types of treatments to expect when caring for a client with chronic kidney disease. Which of the following would the nurse include in the lesson plan?

Colony stimulating factors are one type of immunostimulant that can boost the diminished cell count caused by chronic kidney failure

11 See full question 11s During ongoing assessment of a patient receiving 5-FU therapy, the nurse finds the patient's platelet count to be 92,000 cells/mm3. The nurse should do which of the following?

Consult the prescriber for discontinuation of the drug Explanation: The drug should be discontinued if the patient's platelet count is less than 1,00,000 cells/mm3 because it indicates that the patient has developed thrombocytopenia. Increasing the dosage or continuing the therapy with a decreased dosage is not appropriate. Reference: Ford, Susan M., Roach's Introductory Clinical Pharmacology, 11th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Antineoplastic Drugs and Targeted Therapies, p. 602. Chapter 50: Antineoplastic Drugs and Targeted Therapies - Page 602 Add a Note

The nurse is caring for a client who is receiving parenteral administration of an iron supplement. During administration, the nurse will monitor and report which of the following adverse reactions immediately?

Dyspnea, urticaria, rashes, itching, and fever

A nurse is caring for a client who is to receive IV potassium. Which action would be appropriate?

Ensure that potassium infuses in no less than 4 hours.

14 See full question 3s A client is experiencing intense nausea while being treated with chemotherapeutics. What actions should the nurse perform? Select all that apply.

Ensure that the client has had a dietician consult Administer antiemetics as prescribed Provide the client with small, frequent meals Explanation: A dietician should consult in the treatment of a client with nausea secondary to chemotherapy. Small, frequent meals and vigilant use of antiemetics are useful as well. There is no need for a low-residue diet and antacids do not normally prevent nausea. Reference: Ford, Susan M., Roach's Introductory Clinical Pharmacology, 11th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Antineoplastic Drugs and Targeted Therapies, p. 602. Chapter 50: Antineoplastic Drugs and Targeted Therapies - Page 602 Add a Note

5 See full question 16s The part of cell growth that entails RNA and protein synthesis preparing for division is known as which phase?

G2 phase Explanation: The part of cell growth that entails RNA and protein synthesis preparing for division is known as the G2 phase. During the G1 phase, RNA and proteins are built. During the S phase, DNA is made from the components of the G1 phase. Mitotic cell division occurs during the M phase. Reference: Ford, Susan M., Roach's Introductory Clinical Pharmacology, 11th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Antineoplastic Drugs and Targeted Therapies, p. 594. Chapter 50: Antineoplastic Drugs and Targeted Therapies - Page 594 Add a Note

A client is receiving omalizumab to treat allergic asthma, which is not relieved by inhaled corticosteroids. Which nursing intervention is appropriate with each dose administration of omalizumab?

Have epinephrine available during administration.

A client comes to the clinic asking what hematopoiesis means. How should the nurse explain this to the client?

Hematopoiesis means undifferentiated stem cells are stimulated to become specific blood cells.

The nurse educator is teaching students about various viral skin infections. Which types of infections should the nurse educator include in the teaching session? Select all that apply.

Herpes simplex, type 1 Herpes zoster Varicella

A nurse educator is teaching nursing students about the administration colony-stimulating factors. Teaching is effective when the students identify the need to assess for which adverse reaction related to this drug?

Hypertension

A nurse is caring for a 65-year-old female client who is in renal failure. During shift assessment, the client reports tingling in her lips and in her fingers whenever anyone takes her blood pressure. The client tells the nurse that she gets a spasm in her wrist and hand and that it is very painful. What would the nurse suspect?

Hypocalcemia

A client demonstrating electrocardiography (EKG) changes and dysthymias would be expected to have which electrolyte imbalance?

Hypokalemia

The nurse is reviewing the lab results for a client with congestive heart failure. The report is as follows: sodium, 142 mEq/L; potassium, 2.5 mEq/L; calcium, 5 mEq/L; and chloride, 98 mEq/L. Which electrolyte disturbances should the nurse report?

Hypokalemia

A client is experience muscle tremors and premature atrial contractions. Which electrolyte imbalance does the nurse suspect?

Hypomagnesia

A client is taking an oral beta-adrenergic blocker for his congestive heart failure. He has just been diagnosed with glaucoma and prescribed carteolol, an ophthalmic beta blocker. What potentially dangerous adverse reaction should the nurse warn the client about?

Hypotension

A 19-month-old infant is prescribed a topical corticosteroid for treatment of a rash in both axillae. The client's health care provider should monitor for which adverse effect of this medication?

Impaired adrenal function

15 See full question 3s The nurse is providing care for an older adult client who has stomatitis secondary to the administration of methotrexate. The nurse should assess for indications of what nursing diagnoses? Select all that apply.

Impaired skin integrity Risk for infection Imbalanced nutrition Risk for bleeding Explanation: Because of the common adverse effects of severe bone marrow suppression, fatigue, malaise, rashes, alopecia, ulcerative stomatitis, hepatic toxicity, interstitial pneumonitis, chills, fever, and anaphylaxis, priority nursing diagnosis would include impaired skin integrity related to rash, risk for infection, and risk for bleeding related to severe bone marrow suppression. Because the client has stomatitis, there is a risk for imbalanced nutrition less than body requirements because eating is uncomfortable and not feeling well will also reduce her appetite. Autonomic dysreflexia is limited to clients who have spinal cord injuries. Reference: Ford, Susan M., Roach's Introductory Clinical Pharmacology, 11th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Antineoplastic Drugs and Targeted Therapies, p. 600. Chapter 50: Antineoplastic Drugs and Targeted Therapies - Page 600 Add a Note

16 See full question 23s The nurse is preparing to administer a client's prescribed chemotherapy. The client has developed bone marrow suppression during treatment. What should the nurse include in the client's plan of care? Select all that apply.

Implement falls prevention measures Place the client on protective isolation Monitor the client's laboratory values closely Allow sufficient time for rest between scheduled activities Explanation: Decreased platelets create a risk for bleeding if the client experiences an injury; anemia causes fatigue and activity intolerance; neutropenia creates a serious risk for infection. It is important for the nurse to monitor the client's laboratory values as closely as possible. Anticoagulants would be likely to exacerbate the risks associated with thrombocytopenia. Reference: Ford, Susan M., Roach's Introductory Clinical Pharmacology, 11th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Antineoplastic Drugs and Targeted Therapies, pp. 600-601. Chapter 50: Antineoplastic Drugs and Targeted Therapies - Page 600-601 Add a Note

The nurse knows that hospitalized elderly clients receiving intravenous (IV) fluids are at increased risk for fluid volume overload for which reasons? (Select all that apply.)

Increased incidence of cardiac disease Decreased renal function

Which statement is true regarding iron dextran and iron sucrose?

Iron dextran is usually administered with a small test dose.

The nurse is in the process of creating test questions about immunostimulant drugs for nursing students in an online RN to BSN nursing program. Which of the following drugs would be included?

Iron dextran, filgrastim, and leucovorin

A client diagnosed with anemia asks what the cause of anemia is. Which is the nurse's best response?

It is caused by a decrease in the number of RBCs.

A nursing student learning about drug dosage calculations is confused about the term "drop factor" and asks the instructor for a further explanation. The instructor correctly clarifies what about "drop factor"?

It is the number of drops/mL given by the drip chamber.

A nurse is caring for a client prescribed warfarin for chronic atrial fibrillation. Which information should be included in this client's medication teaching plan?

Keep intake of vitamin K foods constant.

When applying a topical corticosteroid, the nurse avoids applying an occlusive dressing whenever possible. The rationale for this action is:

Localized adverse reactions are more likely when a dressing is applied

A wrestler is seen by the school nurse for a rash on his arms. This is the same type of rash that several of his teammates have had recently. The nurse recognizes the rash and tells the wrestler that he has ringworm. The nurse knows that which of the following medications is used to treat ringworm?

Lotrimin

The nurse educator is teaching students regarding different types of immunostimulant drugs. When discussing lab values associated with the administration of these drugs, which cell counts should the nurse tell the students to expect?

Low platelet and low white blood cell count.

11 See full question 8s A client is being treated with cyclophosphamide. The client's health care provider is monitoring the client for adverse reactions to the drug. What common adverse reaction would limit increasing of the dose?

Low white blood cells Explanation: The dose-limiting toxicity associated with cyclophosphamide (at high dosage) is leukopenia. Leukocytes reach nadir within 2 weeks, with recovery after 3 to 4 weeks. Reference: Ford, Susan M., Roach's Introductory Clinical Pharmacology, 11th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Antineoplastic Drugs and Targeted Therapies, p. 606. Chapter 50: Antineoplastic Drugs and Targeted Therapies - Page 606 Add a Note

4 See full question 20s 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?

Mitomycin Explanation: Mitomycin is used in the treatment of disseminated adenocarcinoma of the stomach and pancreas. Bleomycin is used for palliative treatment of squamous cell carcinomas, testicular cancers, and lymphomas. Daunorubicin is first-line treatment of advanced HIV infection and associated Kaposi's sarcoma. Idarubicin is used in combination therapy for treatment of acute myeloid leukemia in adults. Reference: Ford, Susan M., Roach's Introductory Clinical Pharmacology, 11th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Antineoplastic Drugs and Targeted Therapies, p. 610. Chapter 50: Antineoplastic Drugs and Targeted Therapies - Page 610 Add a Note

A 5-year-old is diagnosed with impetigo. Which medication does the nurse suspect the prescriber to order for this condition?

Mupirocin

Which characteristic does both atropine and phenylephrine share?

Mydriatic effects

6 See full question 10s 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 Explanation: Hematological effects include bone marrow suppression, with leukopenia, thrombocytopenia, anemia, and pancytopenia, secondary to the effects of the drugs on the rapidly multiplying cells of the bone marrow. Reference: Ford, Susan M., Roach's Introductory Clinical Pharmacology, 11th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Antineoplastic Drugs and Targeted Therapies, p. 603. Chapter 50: Antineoplastic Drugs and Targeted Therapies - Page 603 Add a Note

Health care providers use a combination drug to treat acute otitis externa. The nurse recognizes that AK-Spore is a combination of which of the following? Select all that apply

Neomycin Polymyxin hydrocortisone

A nurse is caring for client with a serum potassium level of 5.8 mEq/L. Which treatment does the nurse anticipate the prescriber to order?

Polystyrene sulfonate

A 69-year-old client, who has been prescribed a daily diuretic, is admitted to critical care with a cardiac arrhythmia. Which electrolyte should be monitored due to its' effect on heart rate and excretion or retention during diuretic therapy?

Potassium

The nurse is providing care for a client whose current medications include tacrolimus (Prograf). The nurse should anticipate that this client is likely to be taking what medication concurrently?

Prednisone

14 See full question 22s A client 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 client?

Prothrombin time Explanation: Clients taking oral anticoagulants and tamoxifin are at an increased risk for bleeding. Prothrombin times should be monitored. Reference: Ford, Susan M., Roach's Introductory Clinical Pharmacology, 11th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Antineoplastic Drugs and Targeted Therapies, p. 599. Chapter 50: Antineoplastic Drugs and Targeted Therapies - Page 599 Add a Note

20 See full question 10s A nurse is caring for a client who has received antineoplastic therapy. The client has developed inflammation of the oral mucous membrane, which is affecting his nutritional status. Which action by the nurse would be most appropriate? Select all that apply.

Provide mouth care with normal saline every 4 hours. Offer soft or liquid foods. Explanation: The nurse should suggest that the client provide mouth care with normal saline every 4 hours and offer soft or liquid foods. Use of toothpaste, lemon or glycerin swabs, or alcohol-based mouthwash for oral care is not suggested as they cause further irritation to the oral mucosa and complicate stomatitis.

A 2-year-old with an ear infection is seen in the clinic. The health care provider orders ear drops and asks the nurse to teach the mother the correct way to instill them. Which would be correct to tell the mother?

Pull the pinna down and back before instilling the drops.

A client with chronic lymphocytic leukemia has begun treatment with alemtuzumab, a monoclonal antibody. What assessment should the nurse prioritize when monitoring the client for adverse effects?

Pulmonary auscultation

The nurse is reviewing laboratory values of client who has a respiratory illness. Which cells supply oxygen to the tissues?

RBCs

3 See full question 41s In describing the action of alkylating agents, what would the nurse include?

React chemically with portions of RNA, DNA, and other cellular proteins. Explanation: Alkylating agents react chemically with portions of the RNA, DNA, or other cellular proteins. Antimetabolites inhibit DNA production in cells that depend on certain natural metabolites to produce DNA, replacing the needed metabolites, which prevents normal cellular function. Mitotic inhibitors interfere with the ability of a cell to divide, blocking or altering DNA synthesis. Antineoplastic antibiotics interfere with cellular DNA synthesis by inserting themselves between base pairs in the DNA chain. Reference: Ford, Susan M., Roach's Introductory Clinical Pharmacology, 11th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Antineoplastic Drugs and Targeted Therapies, p. 596. Chapter 50: Antineoplastic Drugs and Targeted Therapies - Page 596 Add a Note

In reviewing a client's record, the nurse observes that the health care provider suspects a Vitamin B12 deficiency. What test is used to diagnosis a vitamin B12 deficiency?

Schilling test

13 See full question 8s A client has been started on vincristine as part of treatment for cancer. What factor will the nurse need to assess with regard to interactions with this medication?

Sensory, motor, and perceptual functions Explanation: Before drug administration, the nurse must determine the patient's sensory, motor, and perceptual functions, because of the potential dysfunctions associated with vincristine. The nurse must also consider bowel elimination patterns and food and fluid intake to assess for risk for constipation. Because the drug does not cause photosensitivity, the patient's exposure to sunlight need not be assessed. The drug is not known to interact with alcohol or nicotine; therefore, alcohol intake and cigarette smoking also need not be assessed. Reference: Ford, Susan M., Roach's Introductory Clinical Pharmacology, 11th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Antineoplastic Drugs and Targeted Therapies, p. 606. Chapter 50: Antineoplastic Drugs and Targeted Therapies - Page 606 Add a Note

18 See full question 6s The nurse transfers from the adult oncology unit to the pediatric oncology unit. What will the nurse need to add to the client's plan of care that was not a part of the adult client's care plan?

Social, emotional, and intellectual stimulation Explanation: Children need to play and learn so meeting the child's social, emotional, and intellectual needs is a part of the care plan that was not as significant with adults. Administration of combination drugs, Double-checking dosage calculations and appropriateness of drug dosage, and Monitoring for hydration and nutritional status are all components of adult care as well as pediatric care. Reference: Ford, Susan M., Roach's Introductory Clinical Pharmacology, 11th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Antineoplastic Drugs and Targeted Therapies, p. 600. Chapter 50: Antineoplastic Drugs and Targeted Therapies - Page 600 Add a Note

The nurse should caution the client about potential common adverse effects of opthalamic antibiotics. What are some common adverse effects? Select all that apply

Stinging or burning Blurred vision

A client is receiving an IV immune stimulant and develops a cardiac arrhythmia. What is the nurse's priority action?

Stop the drug immediately.

9 See full question 16s 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 effective regardless of whether a cancerous cell is proliferating. Explanation: Cell cycle-nonspecific drugs act on cells in both the proliferative and the nonproliferative phases of the cell cycle. Cell cycle-nonspecific drugs can help recruit cells into a more actively dividing state, but they do not induce mutations. They are less able to distinguish between normal cells and malignant cells. Reference: Ford, Susan M., Roach's Introductory Clinical Pharmacology, 11th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Antineoplastic Drugs and Targeted Therapies, p. 596. Chapter 50: Antineoplastic Drugs and Targeted Therapies - Page 596 Add a Note

12 See full question 35s What should the oncology nurse understand when administering a cell cycle-nonspecific chemotherapeutic agent about its effect?

The drug will be effective through all phases of the cell cycle. Explanation: Drugs that are effective through all phases of the cell cycle and not limited to a specific phase are classified as cell cycle-nonspecific. Reference: Ford, Susan M., Roach's Introductory Clinical Pharmacology, 11th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Antineoplastic Drugs and Targeted Therapies, p. 594. Chapter 50: Antineoplastic Drugs and Targeted Therapies - Page 594 Add a Note

13 See full question 40s A patient treated with a left breast lumpectomy and radiation therapy 2 weeks ago has developed redness, blistering, and hyperpigmentaion on the left breast. What does the nurse determine the patient is experiencing?

The patient is a having radiation recall reaction. Explanation: Remind patients who have had radiation therapy that recall reactions, manifested by redness, blistering, and hyperpigmentation, can have a delayed onset and should be reported promptly. Reference: Ford, Susan M., Roach's Introductory Clinical Pharmacology, 11th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Antineoplastic Drugs and Targeted Therapies, p. 610. Chapter 50: Antineoplastic Drugs and Targeted Therapies - Page 610 Add a Note

8 See full question 6s A patient's current course of cancer treatment involves the administration of a conjugated monoclonal antibody. What characteristic of the drug is specified by the fact that it is classified as a conjugated drug?

The targeted therapy is combined with another substance that causes cell death. Explanation: Monoclonal antibodies can be conjugated, meaning that they are combined with another substance such as radiation or a toxic drug that then produces indirect cell destruction as the conjugate infiltrates the cell. A conjugated drug is not necessarily derived from nonhuman sources, and it does not possess the ability to modify pharmacokinetics. Reference: Ford, Susan M., Roach's Introductory Clinical Pharmacology, 11th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Antineoplastic Drugs and Targeted Therapies, p. 598. Chapter 50: Antineoplastic Drugs and Targeted Therapies - Page 598 Add a Note

20 See full question 47s What rationale should the nurse provide to the client when describing the necessity of recovery periods between treatment cycles of chemotherapy?

Time is needed to replace many of the healthy body cells killed by chemotherapy. Explanation: Cyclic administration involves taking the drugs for a specific period, with a recovery period following each treatment cycle. The recovery period allows time for the client to produce new, healthy cells to replace the normal rapidly dividing cells that have been affected by the drugs.

A client is diagnosed with keratoconjunctivitis. When treating keratoconjunctivitis, which medication would be prescribed for its antivial properties?

Trifluridine

An inflammatory response characterized by a raised edematous area with a pale center and red border, which itches intensely, is known as

Urticaria.

A client was prescribed an enzyme preparation for his pressure ulcer. Once the nurse applied it, the client started screaming that it hurt terribly and to please remove it. What should the nurse do?

Use povidone-iodine to wash the enzyme preparation off the client.

A client has been diagnosed with keratoconjunctivitis related to an exacerbation of herpes simplex virus. The nurse anticipates this client will need teaching regarding which of the following medications?

Viroptic

Which would the nurse include when teaching a client about instilling his prescribed otic drug?

Warm the solution to room temperature before using.

A client has been prescribed dapiprazole hydrochloride by the primary health care provider for reversing diagnostic mydriasis after an ophthalmic examination. The nurse should know that dapiprazole hydrochloride is contraindicated in which condition?

acute iritis

A client is diagnosed with an oral herpes simplex virus infection. Which would the nurse expect the primary health care provider to prescribe? Select all that apply.

acyclovir penciclovir

11 See full question 2s 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. Explanation: Like many antineoplastics, oxaliplatin causes nausea and the nurse should anticipate this by premedicating the client. There is no need to establish a new IV site for this particular drug and administration will not normally affect the client's pain. There is no reason to anticipate anxiety during administration unless this is the client's typical response. Reference: Ford, Susan M., Roach's Introductory Clinical Pharmacology, 11th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Antineoplastic Drugs and Targeted Therapies, p. 596. Chapter 50: Antineoplastic Drugs and Targeted Therapies - Page 596 Add a Note

Which topical drug exerts localized anti-inflammatory activity?

alclometasone

8 See full question 14s Malignant cells seem to be more susceptible than normal cells to the effects of which class of antineoplastic drugs?

alkylating agents Explanation: Malignant cells seem to be more susceptible than normal cells to the effects of the alkylating agents. Antineoplastic antibiotics appear to interfere with DNA and RNA synthesis, thereby delaying or inhibiting cell division and blocking the reproductive ability of malignant cells. The vinca alkaloids interfere with amino acid production in the S phase and formation of microtubules in the M phase. Antimetabolite drugs are substances that incorporate themselves into the cellular components during the S phase of cell division. This interferes with the synthesis of RNA and DNA, making it impossible for the cancerous cell to divide into two daughter cells. Reference: Ford, Susan M., Roach's Introductory Clinical Pharmacology, 11th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Antineoplastic Drugs and Targeted Therapies, p. 596. Chapter 50: Antineoplastic Drugs and Targeted Therapies - Page 596 Add a Note

A new graduate is taking an orientation at the local hospital and attends an in-service on antiseptics and germicides. The graduate correctly identifies what uses for both? Select all that apply.

all to reduce the number of bacteria on skin as a surgical scrub and preoperative skin cleanser for washing the hands before and after client care in the home to cleanse the skin on minor cuts and abrasions to prevent infection

A client asks the nurse if there is any herbal therapy that can be used to help soothe and heal his minor burn. Which would the nurse suggest?

aloe vera

A client with metabolic alkalosis is normally prescribed which drug to lower the blood pH?

ammonium chloride

A 10-year-old client is diagnosed with acute otitis media. What does the nurse anticipate the prescriber to order?

amoxicillin

An older adult client has been bedridden for several months and has developed a deep bedsore on her hip. The nurse knows that which of the following would be used in the treatment of this wound?

an enzyme combination

The nurse is explaining the physiological changes that lead to glaucoma to a client who is newly diagnosed with the condition. The nurse correctly includes that glaucoma results from:

an increase in intraocular pressure (IOP).

A client presents to the clinic with bright red patches that are covered with scales on her elbows. The client states her friend had the same symptoms and was prescribed a medication for psoriasis. The nurse knows that the client's friend likely was given which topical medication?

anthralin

A nursing student learns that various preparations are used to treat otic disorders. Such preparations fall into which of the following categories? (Select all that apply.)

antibiotics antibiotic and steroid combinations miscellaneous preparations

The nursing student is learning about topical anti-infectives and correctly identifies the following to be included in this class: (Select all that apply.)

antibiotics antifungals antivirals

A nurse is caring for a client who is receiving collagenase for the treatment of severe burns. The nurse should know that which other drugs can impair the enzymatic activity?

antiseptics

A client has a successful liver transplant. The nurse should advise the client prescribed oral cyclosporine to avoid mixing the drug with what form of liquid?

any type of grapefruit juice

When lidocaine is used to facilitate an ophthalmologic procedure, how long will the topical anesthetic action be effective?

approximately 15 minutes

A client with chronic renal failure is prescribed darbepoetin alfa. After administering the drug, the nurse would assess the client for which adverse reaction? Select all that apply.

arthralgia rashes hypertension

A client with iron deficiency is prescribed iron dextran. Based on the nurse's understanding of this drug, the nurse would expect to administer it cautiously to a client with which condition?

asthma

If a nurse needs to administer otic preparations in both of the client's ears, how long should the nurse wait to place drops in the second ear?

at least 5 minutes

5 See full question 12s 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:

avoid any skin, eye, or mucous membrane contact with the drug. Explanation: Special care needs to be taken when administering these drugs. The nurse should avoid any skin, eye, or mucous membrane contact with the drug. This type of contact can cause serious reactions and toxicity. The nurse should check for extravasation frequently during the infusion, a distal vein should be used, nausea and vomiting are adverse effects of these drugs, and encouraging a patient to eat while having the infusion may not be what is best for the patient. Reference: Ford, Susan M., Roach's Introductory Clinical Pharmacology, 11th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Antineoplastic Drugs and Targeted Therapies, p. 603. Chapter 50: Antineoplastic Drugs and Targeted Therapies - Page 603 Add a Note

The nurse is able to apply which antibiotics in the topical form? (Select all that apply.)

bacitracin gentamicin erythromycin

A nursing instructor is teaching a pharmacology class and informs the students that various preparations are used to treat ophthalmic disorders such as glaucoma. The instructor also states that other conditions of the eyes require treatment, including which of the following? (Select all that apply.)

bacterial infections viral infections inflammatory conditions symptoms of allergies related to the eyes

A client asks the nurse about herbs that might be beneficial in promoting eye health. Which herbal remedy would the nurse suggest? Select all that apply.

bilberry whortleberry huckleberry

When educating a group of older adults about glaucoma, the nurse should identify what classic characteristics of this disorder? Select all that apply.

blurred vision halos around lights loss of peripheral vision

5 See full question 2s The nurse should exercise caution when administering antimetabolites to a client with:

bone marrow suppression. Explanation: Bone marrow is often the index for dosing and re-dosing levels. Caution should be used and strict monitoring done for clients who have suppressed bone marrow and receiving an antimetabolite. Diabetes mellitus, hypertension, and seizure activity have not been identified as interfering with this drug therapy. Reference: Ford, Susan M., Roach's Introductory Clinical Pharmacology, 11th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Antineoplastic Drugs and Targeted Therapies, p. 593. Chapter 50: Antineoplastic Drugs and Targeted Therapies - Page 593 Add a Note

1 See full question 26s Which classes of antineoplastic drugs inhibit DNA synthesis during the S phase?

camptothecin analogs Explanation: Camptothecin analogs are the class of antineoplastic drugs that inhibit DNA synthesis during the S phase. Podophyllotoxins are the class of antineoplastic drugs that stop cells in the S and G2 phase, thereby causing cell division to cease. Taxanes also interfere in the M phase with microtubules. The vinca alkaloids, like vinblastine, are the class of antineoplastic drugs that interfere with amino acid production in the S phase and the formation of microtubules in the M phase. Reference: Ford, Susan M., Roach's Introductory Clinical Pharmacology, 11th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Antineoplastic Drugs and Targeted Therapies, p. 596. Chapter 50: Antineoplastic Drugs and Targeted Therapies - Page 596 Add a Note

2 See full question 9s After teaching a group of nursing students about antimetabolite drugs, the instructor determines that the teaching was successful when the students identify which as an example?

capecitabine Explanation: Capecitabine is an example of an antimetabolite drug. Topotecan is a camptothecin analog drug. Ixabepilone is a miscellaneous agent drug. Chlorambucil is a nitrogen mustard derivative drug. Reference: Ford, Susan M., Roach's Introductory Clinical Pharmacology, 11th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Antineoplastic Drugs and Targeted Therapies, pp. 601-602. Chapter 50: Antineoplastic Drugs and Targeted Therapies - Page 601-602 Add a Note

3 See full question 30s A nurse is preparing an antineoplastic agent for a 9-year-old cancer patient. Before administering an antineoplastic agent, the nurse's most important action should be to:

check indexes of bone marrow functioning. Explanation: The most important action of the nurse prior to administering the drug would be to check indexes of bone marrow functioning. An increase or decrease of the desired dosage could be harmful to the patient. The nurse should wash the hands prior to administration and correctly identify the patient. The nurse should also create a quiet environment for the patient during the administration of the drug. However, the incorrect dosage could cause toxic effects or be insufficient in treating the cancer. Reference: Ford, Susan M., Roach's Introductory Clinical Pharmacology, 11th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Antineoplastic Drugs and Targeted Therapies, p. 603. Chapter 50: Antineoplastic Drugs and Targeted Therapies - Page 603 Add a Note

A nurse is teaching a client about immunosuppressants. Which common adverse reactions of immunosuppressants should be included in the teaching? (Select all that apply.

chills fever headache

A client has onychomycosis. Which medication might the nurse expect to be prescribed?

ciclopirox

Clients receiving intravenous (IV) fluids are at risk for fluid volume overload resulting from the amount and rate of administration of that fluid. Fluid overload depends upon what factor(s)? (Select all that apply.)

client's cardiac status adequacy of the client's renal function the client's renal status

Which topical medication regimen is most usually prescribed when retinoid therapy is not an option?

clindamycin with benzoyl peroxide

19 See full question 3s A client with colorectal cancer is being treated with oxaliplatin. Which potential adverse effect should the nurse explain to the client?

cold-induced neurotoxicity Explanation: Cold-induced neurotoxicity is an adverse effect of oxaliplatin resulting from an effect on peripheral nerves, especially in the hands and feet. Dysuria, diarrhea, and insomnia are not closely associated with oxaliplatin as a result of its pharmacologic actions. Reference: Ford, Susan M., Roach's Introductory Clinical Pharmacology, 11th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Antineoplastic Drugs and Targeted Therapies, p. 599. Chapter 50: Antineoplastic Drugs and Targeted Therapies - Page 599 Add a Note

An older adult client with pneumonia has just been admitted from a nursing home to the medical floor with a stage 4 decubitus ulcer on the buttocks. The ulcer has approximately 80% necrtoci tissue in the wound bed. What topical agent should the nurse expect the health care to prescribe for this client?

collagenase

The nurse understands that when applying a corticosteroid to the skin, it varies in potency depending on the following characteristics: (Select all that apply.

concentration vehicle area of treatment

Tacrolimus belongs to what classification of medications?

conventional antirejection agents

A client with an earache visits the clinic. The primary care provider orders otobiotic otic 4 gtts instilled TID. The nurse knows that this drug belongs to which category?

corticosteroid and antibiotic combinations

what medication is prescribed for a severe reaction to poison ivy?

corticosteroids

A client has just undergone a complete eye examination with dilation of the pupils. What drug would the nurse expect this client to be given to reverse this dilation?

dapiprazole

which risk factor involved in development of decubitus ulcers should the nurse discuss with a group of caregivers?(select all that apply)

debilitation malnutrition incontinence

What characteristics are associated with psoriasis rather than those of acute lesions of atopic dermatitis? Select all that apply.

dryness scales

A nursing student correctly identifies the following as situations not to use drugs that aid in removing cerumen: (Select all that apply.)

ear drainage present ear pain present ear irritation present eardrum perforation present

A client suffering from anemia resulting from chronic kidney disease might be treated with which drugs?

epoetin alfa

Which are common adverse reactions that is included in teaching a client about epoetin? Select all that apply.

fatigue nausea headache

A client is prescribed which drug that acts on the hematopoietic cells to stimulate proliferation, differentiation, and maturation of white blood cells?

filgrastim

Which foods should a nurse encourage for a client diagnosed with megaloblastic anemia? Select all that apply.

fish whole grains leafy green vegetables

A client is ordered to receive cyclosporine intravenously, and the nurse has explained the need for frequent blood work. This blood work is required because cyclosporine:

has a narrow therapeutic range.

When educating a client, who is to minimize intraocular pressure (IOP), the nurse should encourage the client to avoid which activities? Select all that apply

heavy lifting coughing straining bending

Viral skin infections present a difficult clinical challenge to the nurse. Which skin conditions are associated with a viral infection? Select all that apply.

herpes simplex varicella

What client assessment finding will have the greatest effect on the half-life of methotrexate therapy?

history of chronic renal impairment

A nurse has just started total parenteral nutrition (TPN) for an older adultt. The nurse should monitor for which complication(s) of a too rapid infusion? (Select all that apply.)

hyperglycemia glycosuria mental confusion loss of consciousness

A client is admitted to a medical-surgical unit with a diagnosis of nausea, vomiting, and dehydration related to an antibiotic allergy. Which electrolyte-associated imbalance does the nurse expect with this diagnosis?

hypernatremia

A nurse administers calcium IV slowly based on the understanding that rapid IV administration of calcium can lead to which adverse effects?

hypotension

Filgrastim (Neupogen) should be used cautiously in clients with which medical conditions?

hypothyroidism

A client is taking oral potassium because of a mild case of hypokalemia. When providing client education, the nurse should inform the client the best time to take the drug is:

immediately after meals.

A client is admitted to the hospital with severe poison ivy over the entire body. It has even spread to the eyes and genitalia. The nurse correctly identifies these nursing diagnoses for this client. (Select all that apply.)

impaired skin integrity acute pain risk for infection disturbed body image

After receiving a prescription for a topical medication to treat a skin disorder, a client wonders to expect the medication to do. The nurse should indicate that the medication could:

improve barrier function.

A nurse instructs a female client who is worried about losing her vision because both of her parents have had problems with their eyesight. Evidence supports the theory that the herb bilberry can help promote healthy eyes. What other benefits have been reported for this herb? (Select all that apply.)

improved visual acuity improved night vision prevention of free radical damage promotion of capillary blood flow to the eyes, hands, and feet

A nurse is caring for a client who is prescribed fat emulsions. The nurse would be alert for the development of which adverse reaction? Select all that apply.

increase in body temperature slight pressure over eyes chest and back pain

16 See full question 9s 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 leukocytes Explanation: Severe neutropenia can be prevented or its extent and duration minimized by administering filgrastim or sargramostim to stimulate the bone marrow to produce leukocytes. Filgrastim does not address the risk of inflammation (mucositis), abnormal platelet production, or bleeding (hemorrhagic cystitis). Reference: Ford, Susan M., Roach's Introductory Clinical Pharmacology, 11th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Antineoplastic Drugs and Targeted Therapies, p. 603. Chapter 50: Antineoplastic Drugs and Targeted Therapies - Page 603 Add a Note

When planning client care, the nurse should ensure that the client has been informed of what risk associated with tacrolimus therapy?

increased risks of skin cancer and lymphoma

A client is receiving folic acid for the treatment of megaloblastic anemia. The client tells the nurse that he or she also takes hydantoins. The nurse would monitor the client for which effect due to an interaction with these two drugs?

increased seizure activity

A student demonstrates understanding of topical antiseptics and germicides by identifying which as having anti-infective action against bacteria, fungi, viruses, yeasts, and protozoa? Select all that apply.

iodine sodium hypochlorite

An infant comes to the clinic for his 6-month check-up. The nurse notices that the child is pulling at the ear and appears to be smiling at his mom. The nurse should suspect that the infant

is fine.

A client with warts is prescribed salicylic acid. The nurse understands that this topical drug is an example of which type of drug?

keratolytic

A client's medication history reveals the use of a prescribed nonsteroidal anti-inflammatory ophthalmic drop. The nurse identifies which medication?

ketorolac

A group of nursing students demonstrate understanding of blood cells when they identify which cell as responsible for controlling the bleeding from microscopic to major tears in our tissues?

megakaryocytes

The client has a blood pH of 7.29, is experiencing nausea and vomiting, and reports a headache. This client is demonstrating signs of:

metabolic acidosis.

A client comes to the dermatology clinic with redness on the cheeks and small, red, pus-filled bumps on the nose and cheeks. The nurse anticipates which medication to be ordered for this client?

metronidazole

1 See full question 16s 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?

nerve cell Explanation: The normal cells that line the oral cavity and GI tract and the cells of the gonads, bone marrow, hair follicles, and lymph tissues are rapidly dividing cells that are subject to the effects of antineoplastic drugs and are the cause of adverse effects of antineoplastic drugs. Nerve cells are slow reproducing. Reference: Ford, Susan M., Roach's Introductory Clinical Pharmacology, 11th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Antineoplastic Drugs and Targeted Therapies, p. 594. Chapter 50: Antineoplastic Drugs and Targeted Therapies - Page 594 Add a Note

A client has asked the nurse for the current recommendations surrounding sunscreen use, to avoid conflicting guidelines. What dermatologic guidelines concerning sunscreen protective factor (SPF) use should the nurse share with the client?

no less than 30

Sodium polystyrene sulfonate is administered to eliminate potassium from the body in cases of hyperkalemia. How is the medication administered? Select all that apply.

orally rectally

19 See full question 7s What is the defining characteristic of a sarcoma?

originates from connective tissue Explanation: Sarcomas are derived from connective tissue such as muscle, bone, cartilage, fibrous tissue, fat, or blood vessels. They are not sequestered within other tissues, and they are not the result of endogenous carcinogens. Sarcomas are not a congenital health problem. Reference: Ford, Susan M., Roach's Introductory Clinical Pharmacology, 11th ed., Philadelphia, Wolters Kluwer, 2018. Add a Note

Which medication will be administered to facilitate an ophthalmic examination?

phenylephrine

A nurse is caring for a client who is receiving an antiviral ophthalmic. The nurse suspects that the client is experiencing a systemic adverse reaction based on which assessment finding?

photophobia

7 See full question 13s Which classes of antineoplastic drugs stop cells in the S and G2 phase, thereby causing cell division to cease?

podophyllotoxins Explanation: Podophyllotoxins are the class of antineoplastic drugs that stop cells in the S and G2 phase, thereby causing cell division to cease. Taxanes also interfere in the M phase with microtubules. The vinca alkaloids, like vinblastine, are the class of antineoplastic drugs that interfere with amino acid production in the S phase and the formation of microtubules in the M phase. DNA synthesis during the S phase is inhibited by camptothecin analog drugs such as irinotecan. Reference: Ford, Susan M., Roach's Introductory Clinical Pharmacology, 11th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Antineoplastic Drugs and Targeted Therapies, p. 596. Chapter 50: Antineoplastic Drugs and Targeted Therapies - Page 596 Add a Note

When discussing dermatological medications with a group of teens, what factors associated with the increased systemic absorption of topical agents should be discussed? Select all that apply.

presence of skin inflammation size of application area potency of the medication

1 See full question 20s A client has returned to the outpatient treatment center for a regular IV chemotherapy session. The nurse understands that one of the goals of chemotherapy is to:

prevent or treat adverse drug effects. Explanation: Drugs used in oncologic disorders include those used to kill, damage, or slow the growth of cancer cells, and those used to prevent or treat adverse drug effects. Cancer cells demonstrate uncontrolled cell growth; normal cells grow in a controlled fashion. Biologic targeted therapies are a newer group of anticancer medications. Reference: Ford, Susan M., Roach's Introductory Clinical Pharmacology, 11th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Antineoplastic Drugs and Targeted Therapies, p. 596. Chapter 50: Antineoplastic Drugs and Targeted Therapies - Page 596 Add a Note

An older adult woman has experienced a sharp decline in her mobility and quality of life due to severe rheumatoid arthritis. As a result, her care provider has recently prescribed abatacept. This fusion protein inhibitor will achieve a therapeutic effect by what means?

preventing the activation of T cells

An 6 month old infant is brought to the clinic by his mother who suspects that he has an ear infection. Which of the following would indicate an ear infection? (Select all that apply.)

pulling at the ear crying irritability running a fever

13 See full question 3s A client has been prescribed cabazitaxel 25 mg/m2 PO every three weeks for the treatment of prostate cancer. What is the nurse's priority response to this prescription?

question the prescriber about the route Explanation: Cabazitaxel, like all mitotic inhibitors, is administer intravenously. Confirming the order with the prescriber would consequently be a priority. Reference: Ford, Susan M., Roach's Introductory Clinical Pharmacology, 11th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Antineoplastic Drugs and Targeted Therapies, p. 601. Chapter 50: Antineoplastic Drugs and Targeted Therapies - Page 601 Add a Note

A nursing student has been instructed that total parenteral nutrition (TPN) should never be stopped suddenly but instead the client should gradually be weaned from it. The rationale is that sudden withdrawal of TPN can cause

rebound hypoglycemia.

18 See full question 20s An oncology nurse is reviewing the medication administration record of a client being treated for advanced prostate cancer. In addition to two chemotherapeutic agents, the nurse reads that the client has been ordered a cytoprotective agent. The goal of this agent is to:

reduce the incidence or severity of adverse drug effects. Explanation: Cytoprotectant agents reduce the adverse effects of cytotoxic drugs, some of which can be severe, debilitating, or life threatening. Cytoprotectant drugs do not potentiate chemotherapy, protect the client from the effects of cancer, or buffer cytotoxins. Reference: Ford, Susan M., Roach's Introductory Clinical Pharmacology, 11th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Antineoplastic Drugs and Targeted Therapies, p. 597. Chapter 50: Antineoplastic Drugs and Targeted Therapies - Page 597 Add a Note

20 See full question 2s 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 Explanation: Because of the toxicity of chemotherapeutic agents, nurses who administer intravenous (IV) cytotoxic chemotherapy receive special training and are certified in handling and administering the chemotherapy drugs safely and accurately. Incorrect administration creates a serious risk for injury. Pain, contamination, and impaired health maintenance are not directly associated with incorrect administration.

Which conditions in a client's history should the nurse report to the health care provider who prescribed epoetin alfa? Select all that apply.

seizures hypertension congestive heart failure

A nurse is caring for a client who received IV calcium. Assessment of the client reveals elevated plasma calcium levels. The health care provider suspects hypercalcemic syndrome. Which finding would support this suspicion? Select all that apply.

severe vomiting lethargy weakness

A nursing student is learning the differences between intracellular and extracellular fluids. The student correctly identifies which are major electrolytes found in extracellular fluid? (Select all that apply.)

sodium calcium

A nurse, caring for a pediatric client who has a high lead level, should anticipate the prescriber to order which drug?

succimer

Which medication will be administered to decrease lead levels in a child who ingested lead-based paint chips?

succimer

2 See full question 9s A nurse is caring for an elderly client who is receiving vinblastine intravenously. The nurse suspects that the client is experiencing extravasation based on assessment of which finding?

swelling at the IV site or extremity Explanation: The most common sign of extravasation is swelling at the IV site or extremity; other signs include stinging, burning, or pain at the injection site; redness; and lack of blood return. Fever, sore throat, and chills are signs of infection. Reference: Ford, Susan M., Roach's Introductory Clinical Pharmacology, 11th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Antineoplastic Drugs and Targeted Therapies, p. 604. Chapter 50: Antineoplastic Drugs and Targeted Therapies - Page 604 Add a Note

17 See full question 55s A client has chosen to receive palliative care after lung cancer metastasized to the bones and liver. Which is the most appropriate during palliative cancer care?

the use of chemotherapy to reduce pain Explanation: Palliative chemotherapy is used in advanced cancer to prevent or treat pain and obstruction. Chemotherapy does not need to be stopped abruptly or replaced with CAM. Aggressive chemotherapy would not normally be administered in a palliative context. Reference: Ford, Susan M., Roach's Introductory Clinical Pharmacology, 11th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Antineoplastic Drugs and Targeted Therapies, p. 607. Chapter 50: Antineoplastic Drugs and Targeted Therapies - Page 607 Add a Note

A nursing instructor is teaching students the differences between whole blood and blood plasma. The nursing instructor should include that plasma is used in which situation(s)? (Select all that apply.)

to increase blood volume in cases of severe hemorrhage to replace plasma when plasma alone has been lost

The nurse is preparing to give a client morphine intravenously (IV) through a heparin lock. Prior to giving the drug, the nurse flushes the heparin lock with normal saline. This is done for which reason?

to prevent incompatibility of heparin with other drugs

What common adverse reactions of tacrolimus should the nurse teach the client? (Select all that apply.)

tremors hair growth gum hyperplasia

A college student is distraught that facial acne has become more serious over the past several months and is requesting a prescription for isotretinoin. What assessment is the priority before the initiation of this treatment?

two consecutive pregnancy testings

4 See full question 42s A nurse is caring for a client who is to undergo chemotherapy for leukemia. Which should be part of the initial assessment performed by the nurse? Select all that apply.

type and location of the neoplastic lesion previous or concurrent treatments presence of nonmalignant disease Explanation: The initial assessment performed by the nurse for a client who is to receive chemotherapy includes the type and location of the neoplastic lesion, previous or concurrent treatments, and the presence of nonmalignant disease. Results of kidney function tests and radiographic scans are observed as part of ongoing chemotherapy administration. Reference: Ford, Susan M., Roach's Introductory Clinical Pharmacology, 11th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Antineoplastic Drugs and Targeted Therapies, p. 600. Chapter 50: Antineoplastic Drugs and Targeted Therapies - Page 600 Add a Note

After reviewing information about the use of epoetin alfa (Epogen), the nurse demonstrates understanding of the information by identifying that this drug is contraindicated in clients with which medical conditions?

uncontrolled hypertension

What term is used to identify an inflammatory response characterized by a raised edematous area with a pale center and red border, which itches intensely?

urticaria

Localized adverse reactions to corticosteroids include burning, itching, irritation, redness, and dryness of the skin. Which is likely to increase the occurrence of these reactions?

used with occlusive dressings

6 See full question 13s Which is an example of an antineoplastic drug that interferes with amino acid production in the S phase and the formation of microtubules in the M phase?

vinblastine Explanation: The vinca alkaloids, like vinblastine, are the class of antineoplastic drugs that interfere with amino acid production in the S phase and the formation of microtubules in the M phase. Etoposide's main effect is at the G2 portion of the cell cycle in mammalian cells. Cells are stopped during the S and G2 phases by the podophyllotoxins such as teniposide and thus are unable to divide. DNA synthesis during the S phase is inhibited by camptothecin analog drugs such as irinotecan. Reference: Ford, Susan M., Roach's Introductory Clinical Pharmacology, 11th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 50: Antineoplastic Drugs and Targeted Therapies, p. 596. Chapter 50: Antineoplastic Drugs and Targeted Therapies - Page 596 Add a Note

The nurse should educate a client that drug-related reactions typically occur how long after the introduction of a new drug?

within the first 2 weeks of treatment