CHP 57 PREP U
C
A 26-year-old man with testicular cancer is prescribed combination chemotherapy that involves using two drugs that are effective against testicular tumors. Combination drug therapy is superior to single-drug therapy because of: A) Decreased duration of remissions B) Lower risk for secondary cancers C) Higher tumor response rates D) Increased capillary permeability
B
A 42-year-old female with breast cancer has had a radical mastectomy. She will have radiation therapy and then begin chemotherapy. Drug therapy will consist of a combination of doxorubicin, cyclophosphamide, and paclitaxel. What will the nurse include in the teaching plan concerning the drug therapy? A) Stay on a low-fat diet during the course of the drug therapy. B) Take special care when shaving or brushing her teeth. C) Continue to go to church or to the mall just as she did before the diagnosis of cancer. D) Stay in bed 2 days after each administration.
A
A client has just started on an alkalating agent to treat their cancer. What is the most common side effect of most alkalating agents? A) Myelosuppression B) Nephrotoxicity C) Confusion D) Depression
B
A client is prescribed doxorubicin drug therapy for carcinoma of the breast. On the second day of drug therapy, she calls in to report reddish urine. What should the nurse do? A) Suggest some nonpharmacologic interventions. B) Reassure the patient about adequate monitoring and follow-up in her home setting. C) Caution the patient against taking aspirin or caffeine. D) Reassure the patient that it is a harmless and expected response to the drug.
A, D, E
A nurse should monitor a client closely for signs of worsening atrial fibrillation when which of the following antineoplastic drugs is used concomitantly with digoxin (Lanoxin)? Select all that apply: A) Mercaptopurine (Purinethol) B) Busulfan (Busulfex) C) Thiotepa (Thioplex) D) Doxorubicin (Doxil) E) Irinotecan (Camptosar)
B
A patient has been diagnosed with leukemia. Which alkylating agent is the only one that can be used for both acute and chronic leukemia? A) Carmustine B) Cyclophosphamide C) Streptozocin D) Chlorambucil
A
A patient has received a chemotherapy infusion and within 3 hours after the infusion begins to have severe nausea and vomiting. What type of emesis does the nurse determine this patient is having? A) Acute B) Delayed C) Breakthrough D) Anticipatory
B
A patient having chemotherapy is losing her hair. She asks the nurse if her hair will come back as it originally was. What is the best response by the nurse? A) "I think you have more to worry about than if you have hair. You can buy a wig." B) "Your hair will grow back, but the new hair may be a different color or texture." C) "Your hair will grow back, but it will be very thin and straight." D) "Your hair may not grow back, but we can refer you to a wig specialist."
D
A patient is receiving melphalin for the treatment of multiple myeloma. What does the nurse determine may be a problem for this patient in high doses? A) Syndrome of inappropriate antidiuretic hormone B) Diabetis insipidus C) Hemorrhagic cystitis D) Severe oral mucositis
A
A patient is to receive doxorubicin as treatment for leukemia. The nurse would instruct the patient that the typical cycle would be repeated at which frequency? A) Every 3 weeks B) Every week C) Every other week D) Every 4 weeks
A
A patient receiving doxorubicin (Doxil) has these laboratory results: K+ 5.2 mEq/L, WBC 2.1 thou/mm3, RBC 3.0 million/mm3, and platelets 19,000 cells/mm3. Which nursing focus is the highest priority for a potential risk? A) Injury B) Infection C) Decreased carbon dioxide D) Fatigue
B
A patient receiving oxaliplatin (Eloxatin) requests a blanket because he is very cold. When the nurse comes back with the blanket, the patient becomes short of breath and reports difficulty swallowing. What does the nurse determine is happening with this patient? A) The patient is having a panic attack. B) The patient is having acute syndrome of pharyngolaryngeal dysethesia. C) The patient is having a hypersensitivity reaction to the medication. D) The patient is upset because he had to wait for the blanket to arrive.
A
A patient taking high doses of cyclophosphamide is exhibiting muscle cramps and confusion and reports headaches. The nurse assesses the laboratory tests and notices the sodium level is low. What does the nurse determine may be occurring with this patient? A) The patient is exhibiting signs of syndrome of inappropriate antidiuretic hormone caused by the high dose of cyclophosphamide. B) The patient is exhibiting signs of diabetes insipidus caused by the high dose of cyclophosphamide. C) The patient is having a toxic reaction to the high level of cyclophosphamide. D) The patient is having a hypersensitivity reaction to the chemotherapy.
A
A patient undergoing antineoplastic drug therapy is administered an alkylating drug. The patient is also administered an aminoglycoside as an anti-infective agent. Which of the following interactions of the alkylating drug with the aminoglycoside should the nurse assess the patient for? A) Increased risk of nephrotoxicity B) Increased risk of bleeding C) Increased risk of hypoglycemia D) Increased risk of methotrexate toxicity
A
After teaching a group of students about antineoplastic antibiotics, the instructor determines that the teaching was successful when the students identify which drug as an example? A) Doxorubicin B) Vincristine C) Imatinib D) Methotrexate
B
Chlorambucil has been ordered for a patient with Hodgkin's disease. The patient's son asks the nurse what this drug does. What would be the nurse's best answer? A) "It is palliative chemotherapy used to prevent tumor growth." B) "It is palliative chemotherapy used to relieve pain associated with tumor." C) "It is palliative chemotherapy used to destroy tumor." D) "It is palliative chemotherapy used to prevent metastasis."
B
Ethan, age 11, is diagnosed with acute lymphocytic leukemia and is prescribed doxorubicin drug therapy. Why does a nutritional assessment play a part in anticipating the adverse effects of the medication? A) Because calcium-rich foods increase the body's requirements for the drug B) Because malnutrition may potentiate cardiotoxicity C) Because malnutrition may induce myelotoxic effects of the drug D) Because a diet high in magnesium helps offset losses from drug therapy
B
For which oncology patient is doxorubicin (Doxil) therapy contraindicated? A) A 17 year old with leukemia and polycystic ovaries B) A 29 year old with Kaposi's sarcoma and cardiomyopathy C) A 42 year old with breast cancer and peptic ulcer disease D) A 58 year old with ovarian cancer and osteoarthritis
A
In describing the action of alkylating agents, what would the nurse include? A) React chemically with portions of RNA, DNA, and other cellular proteins. B) Inhibit DNA production by replacing the natural substances for cell function. C) Block DNA synthesis to interfere with the cell's ability to divide. D) Insert itself between base pairs in the DNA chain to disrupt DNA synthesis.
D
In which of these patients would cyclophosphamide not likely be effective? A) A 47 year old with Hodgkin's lymphoma B) A 62 year old with multiple myeloma C) A 57 year old with endometrial cancer D) A 60 year old with a brain tumor
A
Mr. Zale is treated with carmustine drug therapy. During this hospital admission, you note increased shortness of breath and a chronic cough. Analysis of this finding indicates that the patient is exhibiting signs and symptoms of pulmonary toxicity in the form of irreversible pulmonary fibrosis. What factor is most likely to cause this adverse effect? A) Prolonged therapy and cumulative doses of more than 1,400 mg/m2 B) Cumulative doses of 770 mg/m2 and cranial irradiation C) Prolonged duration of administration D) Rapid infusion
B
Ms. Nolan is prescribed cyclophosphamide as part of her treatment for non-Hodgkin's lymphoma. Which symptoms would Ms. Nolan report to her physician immediately? A) Nausea and vomiting B) Pain and burning with urination C) Alopecia D) Nasal congestion
D
Nitrosoureas are alkylating agents that interfere with cell division and structuring of DNA during all phases of the malignant cell cycle. They are most effective in hematologic malignancies but are also used for others. After dosing, what needs monitoring and for what time period? A) Urinalysis weekly for at least 4 weeks B) Uric acid levels twice weekly for 6 weeks C) WBC level weekly for 6 weeks D) CBC weekly for at least 6 weeks
D
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? A) Bleomycin (Blenoxane) B) Daunorubicin (DaunoXome) C) Idarubicin (Idamycin) D) Mitomycin (Mutamycin)
A, C, E
The nurse should monitor a client receiving doxorubicin (Doxil) for signs of extravasation that include which of the following? Select all that apply: A) Swelling B) Petechiae C) Lack of blood return D) Urticaria E) Redness
A
What can the oncology nurse advise the patient taking oxaliplatin to do to minimize the risk of acute syndrome of pharyngolaryngeal dysethesia? A) Avoid cold drinks, cold air, or cold food for up to 1 week after receiving the drug. B) Be sure to drink a minimum of 2 L of fluid daily. C) Be sure to eat a low-protein, low-fat diet. D) Take an antiemetic as prescribed prior to receiving the drug.
A
What intervention will the nurse caring for a patient receiving cancer treatment with high doses of cyclophosphamide (Cytoxan) implement to prevent hemorrhagic cystitis? A) Maintain daily fluid intake of 2 to 3 L. B) Monitor daily BUN. C) Encourage moderate exercise. D) Provide increased protein intake.
B
Which action by the nurse follows safety protocols when administering doxorubicin (Doxil)? A) Administers doxorubicin, then flushes the line with heparin B) Frequently checks IV site for patency during doxorubicin infusion C) Uses a Y-site adaptor to infuse doxorubicin and furosemide together D) Monitors for digoxin toxicity if given along with doxorubicin
D
Which female breast cancer patient is experiencing the adverse effects characteristic of androgen therapy? A) A 27 year old with hot flashes and amenorrhea B) A 38 year old with weight gain and fluid retention C) A 49 year old with nausea, vaginal dryness, and constipation D) A 65 year old with alopecia, increased facial hair, and acne
B
Which medication is used as a cytoprotectant for patients receiving cisplatin (Platinol)? A) Amifostine(Ethyol) B) Dexamethasone (Decadron) C) Flutamide (Eulixin) D) Ondansetron (Zofran)
C
Which nonpharmacological intervention may prevent cystitis caused by cyclophosphamide (Cytoxan)? A) Drinking cranberry juice B) Drinking milk C) Keeping well hydrated D) Wearing cotton underwear
D
Which tissue type does not respond well to reproductive hormone therapy for cancer? A) Breast B) Prostate C) Endometrial D) Lung
B
x Mike, a lymphoma patient, is administered bleomycin drug therapy according to the physician's instructions. Following the drug administration, he complains of fever, chills, nausea, and general weakness. What preventive measure would be helpful in his case? A) Administering a test dose of 3 units of acetaminophen before the first two treatments B) Providing premedication with acetaminophen and diphenhydramine C) Performing meticulous monitoring during drug administration D) Using bleomycin and dexrazoxane concurrently
