Chapter 47 Chemotherapeutic Drugs & Biologic immune Modifiers

The nurse is conducting a class on drugs for malignant tumors for a group of new oncology staff members. Which best describes the action of interferons in the management of malignant tumors? A. Interferons increase the production of specific anticancer enzymes. B. Interferons have antiviral and antitumor properties and strengthen the immune system. C. Interferons stimulate the production and activation of T lymphocyes and cytotoxic T cells. D. Interferons help improve the cell-killing action of T cells because they are retrieved from healthy donors.

B. Interferons have antiviral and antitumor properties and strengthen the immune system.

Which statement regarding use of monoclonal antibodies in the treatment of cancer does the nurse identify as being true? Monoclonal antibodies A. are not as effective as other chemotherapy drugs. B. have few adverse effects. C. may cause flulike effects but do not cause the typical adverse effects associated with chemotherapy. D. are only used in cases of last resort when other chemotherapy drugs have failed.

C. Because these drugs only target cancer cells, they do not have the adverse effects that are typically associated with chemotherapy. However, they do cause acute symptoms that are similar to classic allergy or flulike symptoms. As a result, these symptoms are managed during therapy.

A patient's chemotherapy has ended at 1800 on a Tuesday afternoon. When is it appropriate to start therapy with filgrastim? A. 1800 on Tuesday B. 0600 on Wednesday C. 1800 on Wednesday D. 1 week later, 1800 the next Tuesday

C. Filgrastim and sargramostim have significant drug interactions when given with myelosuppressive antineoplastic drugs. Typically filgrastim and sargramostim are not given within 24 hours of administration of myelosuppressive antineoplastics.

Prior to administering methotrexate, it is most important for the nurse to assess the patient for A. allergy to eggs. B. congestive heart failure. C. latent tuberculosis. D. hypothyroidism.

C. Prior to administering DMARDs, it is important for the nurse to assess the patient for contraindications to the use of DMARDs such as active bacterial infections, active herpes, active/latent tuberculosis, and acute or chronic hepatitis B or C.

In caring for a patient recieving therapy with a myelosuppressive antineoplastic drug, the nurse notes an order to begin filgrastim after the chemotherapy is completed. Which statement correcty describes when the the nurse will begin the filgrastin therapy? A. It can be started during the chemotherapy. B. It will begin immediately after the chemotherapy is completed. C. It will be initiated 24 hours after the chemotherapy is completed. D. It will not be started until at least 72 hours after the chemotherapy is completed.

C. It will be initiated 24 hours after the chemotherapy is completed.

The patient improved within the first three months of treatment with methotrexate. Six months later, the patient experienced worsening of symptoms. The prescriber will most likely order which monoclonial antibody for the treatment of rheumatoid arthritis? A. adalimumab (Humira) B. trastuzumab (Herceptin) C. rituximab (Rituxan) D. cetuximab (Erbitux)

A. Adalimumab (Humira) is indicated for the treatment of severe, progressive RA for which other RA therapies have failed. Trastuzumab (Herceptin) is indicated for the treatment of breast cancer. Rituximab (Rituxan) is used for the treatment of non-Hodgkin's lymphoma, and cetuximab (Erbitux) is indicated for the treatment of metastatic colorectal cancer.

A 40-year-old female patient is seen in the clinic. She has been newly diagnosed with rheumatoid arthritis. Which medication does the nurse anticipate being ordered for the patient? A. methotrexate B. adalimumab C. infliximab D. etanercept

A. For the treatment of rheumatoid arthritis, the recommend therapy with nonbiologic DMARDs usually begins with methotrexate or leflunomide for most patients. Biologic DMARDs are generally reserved for those patients whose disease does not respond to methotrexate or leflunomide. The biologic DMARDs include etanercept, infliximab, adalimumab, abatacept, and rituximab.

While teaching a patient about the possible adverse effects of the interferons, the nurse should mention which effects? (Select all that apply) A. Myalgia. B. Fever. C. Diarrhea. D. Fatigue. E. Chills. F. Dizziness.

A. Myalgia. B. Fever. C. Diarrhea. D. Fatigue. E. Chills.

When planning care for a patient who is receiving interferon therapy, the nurse must keep in mind that the major dose-limiting factor is A. fatigue. B. bone marrow suppression. C. fever. D. nausea and vomiting.

A. fatigue