Ch 14

A patient will soon begin targeted therapy as a component of her treatment plan for chronic leukemia. The nurse is conducting health education about this new aspect of the patient's drug regimen and the patient has asked about the potential side effects of treatment. How should the nurse best respond?

"Both classes of drugs have adverse effects, but targeted therapies tend to have less of an effect on healthy body cells."

A patient is diagnosed with a brain tumor. He is told the cancer cells proliferate. The patient asks the nurse what this means. What is the nurse's best response?

"The proliferation is the growth of cancer cells and the rate of growth."

The nurse may be asked to administer which of the following medications to a patient to counteract the increase in uric acid and subsequent hyperuricemia resulting from the metabolic waste buildup from rapid tumor lysis? (Choose one)

Allopurinol (Zyloprim)

Antimetabolite drugs are substances that incorporate themselves into the cellular components during the S phase of cell division interfering with RNA and DNA synthesis. Which of the following is an example of an antimetabolite drug? (Choose one)

Capecitabine (Xeloda)

The oncology nurse understands that he or she is administering chemotherapeutic agents that are most effective during a particular phase of the cell cycle. To what is this referred?

Cell cycle-specific

A female patient is taking oral cyclophosphamide therapy for breast cancer. Because of possible adverse effects of the drug, the nurse will instruct the patient to do which of the following?

Drink a lot of water

No cancer cells have been identified that can remain dormant for more than 2 years.

False

A nurse is administering an antineoplastic that can cause necrosis and cellulitis if extravasation occurs. Which intervention would be most appropriate to prevent this from occurring?

Inspecting site for redness or swelling

An elderly man has been admitted to a residential care facility and the nurse has conducted a medication reconciliation. The man has taken numerous drugs in the past, including a course of bicalutamide (Casodex) several years earlier. The nurse recognizes this drug as being an antiandrogen and is consequently justified in presuming that the man has a history of what disease?

Prostate cancer

A patient has just received her first dose of imatinib and the nurse on the oncology unit is amending the patient's care plan accordingly. What nursing diagnosis is most appropriate in light of this addition to the patient's drug regimen?

Risk for Infection related to bone marrow suppression

A patient with non-Hodgkin's lymphoma (NHL) will be starting a course of doxorubicin shortly. When planning this patient's care, what nursing diagnosis should the nurse prioritize?

Risk for Infection related to suppressed bone marrow function

What is the first action by the oncology nurse when observing extravasation with the patient receiving vincristine?

Stop the infusion.

A patient is to start with chemotherapy. The patient is worried about going bald in the course of the treatment. How can the nurse assist the patient in being comfortable with his or her body image?

Suggest the use of a wig or cap.

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

Tamoxifen

A nurse educator who coordinates the staff education on an oncology unit is conducting an inservice on targeted therapies. What potential benefit of targeted therapies should the nurse highlight in this education session?

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

An older adult woman has been diagnosed with acute lymphoblastic leukemia (ALL) and her care team has identified potential benefits of imatinib. Which of the following characteristics of this patient's current health status may preclude the use of imatinib?

The patient has chronic heart failure resulting in significant peripheral edema.

A patient is started on chemotherapy. The chemotherapy regimen includes three agents. What is the rationale for using three different antineoplastic agents?

The use of three agents decreases the development of cell resistance.

An adverse effect of tamoxifen therapy involves menopausal symptoms.

True

Cancer is considered the second leading cause of death in the United States.

True

The chemotherapy nurse is preparing to administer cytotoxic chemotherapy medications for administration. Which of the following measures protects the nurse from harm related to the chemotherapy?

Wearing protective equipment

A nurse is performing discharge teaching with a patient who will soon return home. The patient will continue taking imatinib for the foreseeable future, and the nurse is teaching the patient about the safe administration of this drug. How should the nurse instruct the patient to take imatinib?

With food and a large glass of water

A 63-year-old male patient has just begun treatment with IV paclitaxel. About 10 minutes into the infusion, the nurse becomes concerned about a possible anaphylactic reaction to the drug because the patient is experiencing

dyspnea.

A nurse is providing patient education to a 35-year-old woman who has been prescribed cyclophosphamide therapy. When discussing possible hair loss, the nurse will advise the patient to

see a wig specialist.

When describing the various effects of antineoplastic agents, the nurse explains that antineoplastic drugs primarily affect human cells that are rapidly multiplying, going through the cell cycle quickly. The nurse would identify the cells of which of the following as an example?

skin

A nurse should understand which of the following adverse effects of antineoplastic drugs are related to the death of rapidly growing cells? Select all that apply:

• Leukopenia • Thrombocytopenia • Alopecia • Stomatitis

Which of the following should be included in the nurse's pre-administration assessment before the administration of the first dose of an antineoplastic drug? Select all that apply:

• Weight • Blood pressure • Temperature

A patient has been prescribed treatment with antineoplastic drugs, which have a depressing effect on the bone marrow. What pre-administration assessment should the nurse perform for this patient with respect to the depressing effect of the bone marrow?

Complete blood count