NUR 521 Quiz 6 GI, Immune, & Chemo and Cancer Therapy Drugs

Which of the following medications is a classified as a class three drug under the Controlled Substance Act; it often used in cancer and AIDS patients, both for it's antiemetic effect and for stimulating appetite? o dronabinol (Marinol) o haloperidol (Haldol) o droperidol (Inapsine) o lorazepam (Ativan) o apreptitant (Emend)

dronabinol (Marinol)

Following kidney transplantation, cyclosporine (Sandimmune) is prescribed for a client. Which laboratory result would indicate an adverse effect from the use of this medication? o Decreased hemoglobin level o Decreased creatinine level o Decreased blood urea nitrogen level o Elevated blood urea nitrogen level

o Elevated blood urea nitrogen level The medication is a immunosuppressant. Nephrotoxicity can occur from the use of cyclosporine. Nephrotoxicity is evaluated by monitoring for elevated blood urea nitrogen levels and serum creatinine levels. Normal blood urea nitrogen is 10-20 mg/dl. Normal creatinine is 0.6-1.2 mg/dl for male and 0.5-1.1 for female. Cyclosporine does not effect blood glucose level.

A practitioner prescribes Maalox by mouth and ranitidine (Zantac) by IVPB for a client with burns and crushing injuries caused by a train accident. The client asks why these medications are being administered. The nurse's best response is: o "They decrease irritability of the bowel to prevent diarrhea." o "They're what your physician prescribed to increase your appetite and intake of protein for tissue healing o "They're ordered for clients with multiple injuries to prevent the development of gallstones." o "They decrease acidity in the GI tract to prevent stress ulcers."

"They decrease acidity in the GI tract to prevent stress ulcers."

A client is to receive chemotherapy for cancer of the colon. The practitioner prescribes an intravenous dose metoclopramide (Reglan) 30 minutes before the chemotherapy infusion.The nurse explains to the client that this medication will: o Increase absorption of the chemotherapeutic agents form the gastrointestinal system o Stimulate production & secretion of gastrointestinal secretions and pancreatic enzymes in the stomach & small intestine o Block serotonin & dopamine receptors in the CTZ of the brain & enhance motility of the upper gastrointestinal tract o Prolong excretion of the chemotherapeutic agents from the urinary & gastrointestinal systems.

Block serotonin & dopamine receptors in the CTZ of the brain & enhance motility of the upper gastrointestinal tract

______________ is the most toxic vesicant of all chemotherapeutic agents; it is a cell cycle _______________.agent that interrupts DNA synthesis must be monitored closely for adverse effects and extravasation. o Vincristine (Oncovin), Specific o Doxorubicin (Adriamycin), Non Specific o Carmustine (BCNU), Nonspecific o Etoposide (VP-16), Specific

Doxorubicin (Adriamycin), Non Specific

Cyclophoshamide (Cytoxan) is a cell cycle non-specific chemotherapy. The most important information in regards to adverse effects to include in patient teaching specific to this agent is: o Increase fluids to 2 liters or more daily o Take your temperature weekly o Take your BP every day o Decrease fluid intake to one liter daily

Increase fluids to 2 liters or more daily

Which of the following agents slows down tumor cell division, stimulates proliferation of natural killer cells, and inhibits expression of oncogenes? o Rituximab (Rituxan) o Interferon alpha o Doxorubicin (Adriamycin) o Etoposide (VP-16)

Interferon alpha

A practitioner prescribes docustae sodium (Colace) every day for a client. The nurse determines that this drug is prescribed specifically to: o Lubricate the feces and walls of the intestine in the GI tract to promote defecation o Create an osmotic effect in the GI tract to promote defecation o Stimulate motor activity (motility) of the GI tract to promote defecation o Lower the surface tension & low water to penetrate the feces to promote defecation

Lower the surface tension & low water to penetrate the feces to promote defecation

A client with a gastric ulcer has an order for sucralfate (Carafate), 1 gram orally four times a day. The nurse schedules the medication for which of the following times? o With meals and at bedtime o One hour after meals and at bedtime o Every 6 hours around the clock o One hour before meals and at bedtime

One hour before meals and at bedtime

A nurse has given instructions to the client who just received a prescription for diphenoxylate with atropine (Lomotil). The nurse determines that the client understands the use of the medication and its properties if the client states that he or she will: o Expect increased salivation while taking the medication o Take the medication with a bulk-forming laxative. o Stay within the prescribed dose because it can be habit-forming o Anticipate side effects related to central nervous system excitability

Stay within the prescribed dose because it can be habit forming

The client is prescribed omeprazole (Prilosec) a proton pump inhibitor. The nurse realizes which of the following is most essential when administering this medication? o Take medication with milk o Take medication before meals o Take medication after meals o Take medication with acidic beverage

Take medication before meals

The nurse teaches all patient's taking metoclopramide (Reglan) & phenothiazine anti-emetics such as prochlorperazine (Compazine) & promethazine (Pheneragan), particularly in long-term use, to discontinue the medication immediately and call the physician if which of the following occurs? o Fever. o Excessive drowsiness or excitability. o Uncontrolled rhythmic movements of the face or limbs. o Dry mouth not minimized by the use of sugar-free hard candy.

Uncontrolled rhythmic movements of the face or limbs

A nurse is plans to administer either scopolamine or dipenhydramine to a client to prevent nausea and vomiting. The nurse would monitor the client for which frequent side effect of this medication? o Diarrhea o Blurred vision o Drooling o Excessive lacrimation

blurred vision

Which of the following information should a nurse include in her teaching plan for a newly diagnosed cancer patient who is starting chemotherapy? (Select all that apply) o Keep all follow up appointments for monitoring & lab testing o Monitor temperature once or twice a daily o Saline mouth rinses at least every 2-4 hours while awake o Follow a neutropenic diet during and after chemotherapy for approximately 2 weeks o Use an electric razor

o Keep all follow up appointments for monitoring & lab testing o Monitor temperature once or twice a daily o Saline mouth rinses at least every 2-4 hours while awake o Follow a neutropenic diet during and after chemotherapy for approximately 2 weeks o Use an electric razor

Which of the following antiemetics block dopamine receptors in the CTZ of the brain, produce a sedative effect & CNS depression that could include both hypotension and respiratory depression and possible extrapyramidal effects? (Select all that apply) o droperidol (Inapsine) o Ondansteron (Zofran) o promethazine (Phenergan) o haloperidol (Haldol) o metoclopromide (Reglan)

o droperidol (Inapsine) o promethazine (Phenergan) o haloperidol (Haldol)

Which of the following are osmotic laxatives? (Select all that apply) o magnesium hydroxide (MOM) o bisacodyl (Dulcolax) o polyethylene glycol (Miralax) o Ducosate sodium (Colace) o Lactulose (Enulose)

o magnesium hydroxide (MOM) o polyethylene glycol (Miralax) o Lactulose (Enulose)

A client has begun medication therapy with pancrelipase (Pancrease). The nurse determines that the medication is having the optimal intended benefit is which effect is observed? o Absence of abdominal pain o Relief of heartburn o Reduction of steatorrhea o Weight loss

reduction of steatorrhea

Which of the following laxatives is contraindicated in patients with heart failure, hypertension, or edema and only used with great caution in patients with renal disease or on medications that effect renal function such as ACE inhibitors or diuretics? o sodium phosphate (Fleet Phospha-soda) o bisacodyl (Dulcolax) o psyllium (Metamucil) o lactulose (Constulose, Cronulac) o polyethylene glycol (Miralax, PEG)

sodium phosphate (Fleet Phospha-soda)