Nur 211 Module 7 - Management of Patients with Oral and Esophageal Disorders Pt 2

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The client is instructed to return to the clinic after calling and reporting various concerns. The nurse alerts the primary health care provider after noting which signs on the assessment? Select all that apply.

*Bleeding gums *Petechiae *Hematuria

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 patient will be having chemotherapy to reduce a colon tumor prior to having a colon resection. To what is this type of therapy referred? A) Adjuvant therapy B) Neoadjuvant therapy C) Palliative therap D) Consolidation therapy

A patient with rhabdomyosarcoma has been admitted for chemotherapy with Vincristine. While preparing a plan of care for this patient, what would be an appropriate nursing diagnosis to use? A) Altered body image due to severe fluid retention B) Risk for bleeding due to possible hemorrhagic cystitis C) Risk for injury D) Risk of infection related to possible nosocomial infection

A 49-year-old client is diagnosed with ovarian cancer. What is a characteristic of malignant cells that differentiates them from normal body cells? A. Cancerous cells are not responsive to the presence of drugs. B. Cancerous cells do not require an energy source in order to proliferate. C. Cancerous cells grow in an uncontrollable fashion. D. Cancerous cells have a theoretically infinite life span.

Cancerous cells grow in an uncontrollable fashion

Ensure that all staff and visitors adhere to infection control precautions.

A client's chemotherapeutic regimen includes procarbazine. What is the client's most likely diagnosis?

Hodgkin lymphoma

During which phase of the cell cycle would a nurse expect a mitotic inhibitor to act?

A male client is informed by his physician that the latest tests indicate that his cancer has spread to his liver. The client receives capecitabine as part of his treatment regimen. What would the nurse expect the physician to do?

Monitor the client closely and repeat LFTs routinely

A male client is informed that the latest tests indicate that his cancer has spread to his liver. The client receives capecitabine as part of his treatment regimen. What would the nurse expect the health care provider to do? A. Increase the dose of capecitabine. B. Monitor the client closely and repeat LFTs routinely. C. Add routine blood transfusions to the client's treatment regimen. D. Discontinue the capecitabine.

Monitor the client closely and repeat LFTs routinely -Capecitabine blood levels are significantly increased with hepatic impairment, and clients with liver metastases should be monitored closely.

Oral administration of imatinib in a home setting

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?

Reassure the patient that it is a harmless and expected response to the drug.

A patient receiving chemotherapy complains of a metallic taste in the mouth. What suggestions by the oncology nurse may help to minimize this problem? Use an antifungal troche. Use an astringent mouthwash. Brush teeth before and after chemotherapy. Suck on hard candy.

Suck on hard candy.

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:

drink a lot of water

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 nurse on the oncology unit is caring for a client with an astrocytoma. The client has just been told that the tumor is growing very fast. The client asks the nurse how these tumors grow. What would be the nurse's best response? "Brain tumors grow by invading the surrounding white matter." "Brain tumors infiltrate the surrounding tissue." "Brain tumors grow by invading the surrounding grey matter." "Brain tumors spread down the spinal cord."

"Brain tumors infiltrate the surrounding tissue."

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 kill the cancer cells so your mother will be well again." "The goal is to keep the cancer cells from spreading all over your mother's body." "The goal is to limit the cancer cells so the immune system can respond without causing too much toxicity to your mother." "The goal is to control the spread of the cancer."

"The goal is to limit the cancer cells so the immune system can respond without causing too much toxicity to your mother."

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 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."

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

What potential benefit is unique to biologic agent therapies? A. They may affect cancer cells while leaving normal body cells unaffected. B. Cytotoxic adverse effects are rarely experienced. C. Administration does not require a certified chemotherapeutic nurse. D. They may be administered long term without the need for regular blood work.

A. They may affect cancer cells while leaving normal body cells unaffected. Biologic agents target cellular differences between the malignant and normal cells. Consequently, they may kill cancer cells while leaving normal body cells unaffected. Like all drugs, they have adverse effects. They require exceedingly careful administration and necessitate close monitoring by specially trained staff.

The nurse may be asked to administer which medication to a patient to counteract the increase in uric acid and subsequent hyperuricemia resulting from the metabolic waste buildup from rapid tumor lysis?

Allopurinol (Zyloprim)

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)

The nurse is preparing a client who will begin chemotherapy in a few days. The nurse knows that which are the most common adverse effects encountered by most clients who receive chemotherapy? (Select all that apply.) Alopecia Neutrocytosis Anemia Thrombocytopenia Stomach ulcers

Alopecia Anemia Thrombocytopenia

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? A. Risk for acute pain related to chemotherapy B. Risk for injury related to chemotherapy C. Risk for ineffective health maintenance related to chemotherapy D. Risk for contamination related to chemotherapy

B. Risk for injury related to chemotherapy Because of the toxicity of chemotherapeutic agents, nurses who administer intravenous 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.

The community health nurse is planning care for a client who will be prescribed an oral chemotherapy drug for the next several months while recovering at home. What health education topic should the nurse emphasize? A. Ways to match the dose to the severity of the symptoms B. Techniques for safely handling the drug C. Appropriate herbal substitutes for the chemotherapy agent D. Techniques for self-monitoring of liver status

B. Techniques for safely handling the drug All cytotoxic drugs are hazardous substances and require special handling and disposal, per safety guidelines, in the home. It is not possible for the client to independently monitor liver status in the home. Herbal substitutes for chemotherapy drugs do not exist, and doses are not adjusted based on short-term symptoms.

What can the oncology nurse do to minimize the exposure risk to chemotherapeutic agents? Only administer chemotherapy agents that are not toxic. Be familiar with institution's policies and procedures and use them as precautionary measures. Attend in-service education. Recognize the dangers of administering chemotherapeutic agents.

Be familiar with institution's policies and procedures and use them as precautionary measures.

Bleeding gums Petechiae Hematuria

A patient is experiencing antineoplastic-induced nausea and vomiting. The health care provider prescribes ondansetron. The nurse understands that this agent acts in which way? Blocking serotonin receptors in the CTZ Calming the activity of the gastrointestinal tract Blocking human substance P/neurokinin 1 receptors Directly blocking the chemoreceptor trigger zone (CTZ)

Blocking serotonin receptors in the CTZ

A nurse educator is discussing the role of protooncogenes in the pathophysiology of cancer. What typically triggers protooncogenes to differentiate into oncogenes? A. Ischemia B. Exposure to chemotherapeutic agents C. Exposure to carcinogens D. Exposure to a low-pH environment

C. Exposure to carcinogens When normal growth-regulating genes (protooncogenes) are exposed to carcinogens, they may undergo genetic alteration and become oncogenes. This can stimulate continuous cell growth, allowing abnormal, disordered, and unregulated cell replication. Exposure to the other factors does not result in this alteration.

After the instillation of an intrapleural chemotherapeutic agent, what should the oncology nurse do for the medication to reach optimal absorption? Infuse the medication, allow it to dwell, and then drain the solution. Clamp the tube for 18 hours and then connect to suction. Clamp the tube and reposition the patient every 10 to 15 minutes for 2 hours. Clamp the tube for 1 hour and unclamp for 1 hour.

Clamp the tube and reposition the patient every 10 to 15 minutes for 2 hours. Following installation of the chemotherapeutic agent, clamp tubing and reposition the patient every 10 to 15 minutes for 2 hours. Attach tubing to suction for 18 hours. Assess the patient for pain, fever, or anxiety and provide analgesic, antipyretic, and emotional support.

A patient with acute lymphoblastic leukemia (ALL) is receiving imatinib on an inpatient basis. When planning the care of this patient, what assessment should be specified in the patient's plan of nursing care? daily weights assessment of deep tendon reflexes bilateral blood pressures pupillary response

Daily Weights Chapter 14: Antineoplastic Agents, p. 240,table 14.6.

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?

Doxorubicin

After teaching a group of students about antineoplastic agents and their effect on cancer and healthy cells, the instructor determines that the teaching was successful when the students identify which drug as having the least effect on healthy cells?

Getitinib Chapter 14: Antineoplastic Agents - Page 239

During which phase of the cell cycle would a nurse expect a mitotic inhibitor to act? A. S B. G1 C. G0 D. M

Mr. Melika is treated with high-dose chemotherapy after a radical prostatectomy. What term would best describe this type of therapy? A) Adjuvant therapy B) Induction therapy C) Consolidation therapy D) Maintenance therapy

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

No cancer cells have been identified that can remain dormant for more than 2 years. Rationale: No cancer cells have been identified that can remain dormant for more than 5 years.

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 which cells as an example?

Skin

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

The drug is effective regardless of whether a cancerous cell is proliferating.

A nurse is caring for a client being treated with antineoplastic drugs. The client reports recently experiencing bloody urine. What complication might this client be experiencing?

Thrombocytopenia

A nurse should understand which adverse effects of antineoplastic drugs are related to the death of rapidly growing cells? (choose all that apply)

Thrombocytopenia Alopecia Stomatitis Leukopenia

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:

drink a lot of water.

A client, diagnosed with chronic myelocytic leukemia (CML), has not been responding to chemotherapy and the provider changes the client to imatinib. The client asks the nurse, "Compared with my previous meds, what adverse effects am I going to have to deal with from this drug?" What is the nurse's best response?

"Adverse effects are much less likely or severe including GI upset, headache, and muscle pain."

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

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 parent hears the health care provider using the word extravasation. The parent asks the nurse what extravasation means. What would be a correct answer? A. "Extravasation is when blood vessels are severed." B. "Extravasation is when fluid is pooled in one part of the body." C. "Extravasation is a disease that causes shock." D. "Extravasation is when fluid escapes from a blood vessel into the surrounding tissue."

"Extravasation is when fluid escapes from a blood vessel into the surrounding tissue." -Extravasation is the escape of fluid from a blood vessel into surrounding tissues. Blood vessels are not cut for this to happen.

"It's important to discuss what herbs you'll be taking with your health care provider or the pharmacist to make sure there aren't any interactions."

A female client is receiving L-asparaginase. She is at the end of her chemotherapeutic course and is concerned because her liver function tests are abnormal. What is an appropriate response by the nurse?

"Liver impairment usually subsides when chemotherapy is complete."

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."

A client received an injection of doxorubicin and is now observing a reddish urine. The client reports blood in the urine to the nurse. How should the nurse respond?

"The reddish urine is an expected response to the drug."

A client received an injection of doxorubicin and is now observing a reddish urine. The client reports blood in the urine to the nurse. How should the nurse respond? A. "We need to notify the health care provider because this is a complication of the medication." B. "The reddish urine is an expected response to the drug." C. "Let's get a urinalysis to confirm a urinary tract infection." D. "You may have hemorrhagic cystitis."

"The reddish urine is an expected response to the drug." -Reassure clients that reddish urine after doxorubicin injection is a harmless and expected response to the drug. This reaction may happen within 1 to 2 days postinfusion.

A patient received an injection of doxorubicin and is now observing a reddish urine. The patient states, "Do you think I am bleeding?" What is the best response by the nurse?

"The reddish urine is harmless and an expected response to the drug."

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."

A client with advanced prostatic cancer has opted for palliative care. At a care conference, the decision is made to pursue histrelin (Vantas) treatment. What should the nurse teach the client about this medication?

"This will involve giving you an implant of the drug"

A patient who will begin chemotherapy voices concern to the nurse about the accompanying nausea and vomitting. What is the best response by the nurse?

"We can relieve your nausea and vomiting with antiemetic drug therapy. You should ask for these medications whenever you need them." **Reassure patients that nausea and vomiting can be relieved with antiemetic drug therapy and emphasize that they should request these agents when needed.

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?

"Your hair will grow back, but the new hair may be a different color or texture."

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

*Alopecia *Leukopenia *Stomatitis *Thrombocytopenia

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?

890

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

Which patient receiving 5-FU therapy has the potential for severe neurotoxicity? A 32 year old with psoriasis A 52-year-old male with myelosuppression A 29-year-old female with familial pyrimidinemia A 54 year old with a history of coronary artery disease

A 29-year-old female with familial pyrimidinemia

A client asks the nurse why he has to have several courses of a chemotherapy drug instead of just one dose. The nurse states that it is based on the cell kill theory. Which of the following statements describes the cell kill theory? A) The cell kill theory is based on the premise that one dose of a chemotherapy drug will kill all the cancer cells if enough of the medication is given to a client. B) The cell kill theory describes the ways that different chemotherapy medications work to kill both healthy and cancerous cells within the human body. C) The cell kill theory describes the process of giving multiple doses of chemotherapy with each dose, killing approximately 90% of the cancer cells. After several rounds of chemotherapy, nearly all of the cancer cells are killed and the body's immune system will kill the few cancer cells that are left. D) The cell kill theory describes the phenomenon that occurs during the life cycle of a cancer cell as it is treated with a chemotherapy medication.

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

A female patient prescribed methotrexate for meningeal leukemia is asking the nurse about adverse effects of the drug. What would the nurse tell this patient should be avoided while taking methotrexate? A) pregnancy B) aerobic exercise C) smoking D alcohol

A patient will be receiving floxuridine (FUDR) for treatment of colorectal cancer that has metastasized to the liver. What will the patient require prior to administration? A chest tube for instillation An intravenous central line An epidural catheter A hepatic arterial pump for instillation

A hepatic arterial pump for instillation

A nurse is administering an antineoplastic extravasation occurs. How can the nurse best prevent tissue damage caused by extravasation? A) Inspect the site frequently for redness or swelling B) Infuse into proximal veins whenever possible C) Administer through a hand vein, if possible D) Use an infusion pump

A nurse is caring for a patient who is prescribed velban, a vinca alkaloid. The patient wants to know the action of the drug on the cell cycle. Which of the following should the nurse inform the patient? A) Interferes with amino acid production in the S phase. B) Cells are stopped during the S and G2 phases. C) Inhibits DNA synthesis during the S phase. D) Prevents cell division during the S and G2 phases,

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

A patient is beginning a course of chemotherapy for the treatment of chronic lymphocytic leukemia. To what is the start of this therapy referred? A) Consolidation therapy B) Induction therapy C) Maintenance therapy D) Palliative therapy

A patient receiving chemotherapy complains of a metallic taste in the mouth. What suggestions by the oncology nurse may help to minimize this problem? A) Use an astringent mouthwash. B) Suck on hard candy. C) Use an antifungal troche. D) Brush teeth before and after chemotherapy.

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

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

The nurse is preparing an infusion of a monoclonal antibody for a client undergoing treatment for cancer. Before administering the infusion, the nurse confirms the order for premedication using what drug? A. Acetaminophen B. Acetylsalicylic acid C. Ibuprofen D. Naproxen sodium

A. Acetaminophen To prevent or decrease infusion reactions, infusion of monoclonal antibodies is frequently preceded by administration of premedication with diphenhydramine and acetaminophen. Acetylsalicylic acid, naproxen sodium, and ibuprofen are not indicated.

Which cytoprotective agents can be given along with antineoplastic drugs to help prevent or lessen certain adverse effects? (Select all that apply.) Allopurinol (Zyloprim) Amifostine (Ethyol) Leucovorin (Wellcovorin) Mesna (Mesnex) Dexrazoxane (Zinecard)

Allopurinol (Zyloprim) Amifostine (Ethyol) Leucovorin (Wellcovorin) Mesna (Mesnex) Dexrazoxane (Zinecard)

A nurse should understand which adverse effects of antineoplastic drugs are related to the death of rapidly growing cells? (Select all that apply.) Alopecia Leukopenia Stomatitis Cardiotoxicity Thrombocytopenia

Alopecia Leukopenia Stomatitis Thrombocytopenia

Alopecia Thrombocytopenia Anemia

Alopecia Thrombocytopenia Anemia Chapter 14: Antineoplastic Agents - Page 220

Which of the following instructions would be most appropriate for a patient who is receiving temsirolimus?

Avoiding grapefruit juice

Which of the following instructions would be most appropriate for a patient who is receiving temsirolimus? Maintaining adequate nutrition Drinking adequate fluids Promoting frequent rest periods Avoiding grapefruit juice

Avoiding grapefruit juice

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

Which antineoplastic drugs are classified as antineoplastic antibiotics? (Select all that apply.) Bleomycin (Blenoxane) Carboplatin (Paraplatin) Dactinomycin (Cosmegen) Daunorubicin (DaunoXome) Busulfan (Busulfex)

Bleomycin (Blenoxane) Dactinomycin (Cosmegen) Daunorubicin (DaunoXome)

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

A 49-year-old client is diagnosed with ovarian cancer. What is a characteristic of malignant cells that differentiates them from normal body cells?

Cancerous cells grow in an uncontrollable fashion.

A client is receiving idarubicin. What is the nurse's priority assessment?

Cardiac function

A client is receiving idarubicin. What is the nurse's priority assessment? Respiratory function Electrolyte levels Cardiac function Red cell indices

Cardiac function

A child is prescribed an anthracycline drug. The nurse would teach the parents to observe for signs and symptoms of what adverse effect?

Cardiotoxicity

The oncology nurse understands that chemotherapeutic agents are most effective during a particular phase of the cell cycle. This means the agents are: A. cell targeting. B. cell cycle-specific. C. growth fraction. D. cell cycle-nonspecific.

Cell cycle specific -Chemotherapeutic drugs that are most effective during a particular phase of the cycle are known as cell cycle-specific.

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 patient taking tamoxifen to reduce the risk of contralateral breast cancer asks the nurse about adverse effects of the drug. What is an adverse effect of tamoxifen?

Cerebrovascular accidents

The nurse is caring for a client with cancer whose treatment regimen presents a risk of severe-to-fatal interstitial lung disease. What antineoplastic agent is the nurse administering that carries this risk? Valrubicin Triptorelin pamoate Histrelin acetate Ceretinib

Ceretinib

When describing alkylating agents, the nurse would explain that this medication is seen as the prototype:

Chlorambucil

When describing alkylating agents, the nurse would explain that this medication is seen as the prototype: A. Chlorambucil B. Fluorouracil C. Methotrexate D. Vincristine

Chlorambucil -Chlorambucil is the prototype alkylating agent.

A client has been diagnosed with leukemia. Which alkylating agent is the only one that can be used for both acute and chronic leukemia?

Cyclophosphamide

Disturbed body image

A client on the oncology unit has begun chemotherapy with a regimen that includes bendamustine. The client has begun to experience alopecia. The nurse should prioritize assessments related to what potential nursing diagnosis? A. Disturbed body image B.Ineffective thermoregulation C. Impaired tissue integrity D. Hypothermia

Disturbed body image -Women of childbearing age should use an effective contraceptive during therapy with methotrexate. When taking methotrexate, the client should be instructed to notify the primary health care provider immediately at first sign of a rash or sore throat.

A client with breast cancer is receiving goserelin (Zoladex). What aspect of the client's most recent laboratory results would suggest an adverse effect of this particular drug?

Elevated serum calcium

The nurse understands that when administering cisplatin, the drug has a high potential for causing severe nausea and vomiting. What term is used to describe this group of antineoplastic drug?

Emetogenic

A male client is receiving parenteral cytotoxic medications in the home. Adjunct therapy may include what substance?

Erythropoietin

A male client is receiving parenteral cytotoxic medications in the home. Adjunct therapy may include what substance? A. Antidiuretic hormone B. Normal saline 0.9% intravenously C. Erythropoietin D. Heparin

Erythropoietin

A male client is receiving parenteral cytotoxic medications in the home. Adjunct therapy may include what substance? Heparin Erythropoietin Antidiuretic hormone Normal saline 0.9% intravenously

Erythropoietin

A nurse educator is discussing the role of protooncogenes in the pathophysiology of cancer. What typically triggers protooncogenes to differentiate into oncogenes? A. exposure to chemotherapeutic agents B. exposure to carcinogens C. exposure to a low-pH environment D. ischemia

Exposure to carcinogens

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

FALSE

Cancer cells can rapidly develop a resistance to alkylating agents.

False

Cancer cells can rapidly develop a resistance to alkylating agents. (True/False)

False

Fewer adverse effects are associated with monoclonal antibody therapy than those of cytotoxic drugs. However, some of the potential adverse effects of monoclonal antibodies can be life threatening, including which effect? A. heart failure and bleeding problems B. ischemic heart disease C. bronchoconstriction and pulmonary edema D. changes in cognition and personality changes

Heart failure and bleeding problems

Higher tumor response rate

Combination drug therapy is superior to single-drug therapy because of:

Higher tumor response rates

A client's chemotherapeutic regimen includes procarbazine. What is the client's most likely diagnosis? Hodgkin lymphoma Neuroblastoma Astrocytoma Pancreatic cancer

Hodgkin lymphoma Procarbazine (Matulane) is used in combination therapy for treatment of stages III and IV of Hodgkin disease.

A male client is diagnosed with prostate cancer. The treatment modality of choice includes both surgery and chemotherapy. What does the chemotherapeutic option include?

Hormonal therapies

While receiving etoposide IV, extravasation occurs. Which agent would the nurse expect to be used?

Hyaluronidase

Imbalanced nutrition: less than body requirements

A client's chemotherapy regimen has been deemed successful, but the client is experiencing debilitating nausea and vomiting. These adverse effects should signal the nurse to the possibility of what nursing diagnosis? A. Ineffective therapeutic regimen management B. Imbalanced nutrition: less than body requirements C. Adult failure to thrive D. Acute pain

Imbalanced nutrition: less than body requirements -Nausea and vomiting are major threats to the client's nutrition.

A patient has been administered methotrexate, which is a purine antagonist used to treat a rapidly growing tumor. The patient develops stomatitis. What is the priority nursing diagnosis for a patient suffering from stomatitis? High risk for infection Imbalanced nutrition Impaired skin integrity Increased bleed risk

Impaired skin integrity

What nursing diagnoses is a priority for 87-year-old Mrs. Quinn, who has stomatitis secondary to the administration of Methotrexate? Impaired skin integrity High risk for bleeding Imbalanced nutrition High risk for infection

Impaired skin integrity

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.

What best reflects the action of antimetabolites?

Inhibits DNA production via replacing the natural substances needed for it

A patient with bladder cancer is to have intravesicular instillation of a chemotherapeutic agent into the bladder. What is a priority intervention of the oncology nurse? Keep the catheter unclamped. Attache the tubing to suction. Insert a Foley catheter. Assist the physician to place a thoracotomy tube.

Insert a Foley catheter.

A nurse is administering an antineoplastic extravasation occurs. How can the nurse best prevent tissue damage caused by extravasation?

Inspect the site frequently for redness or swelling

A nurse is administering an antineoplastic extravasation occurs. How can the nurse best prevent tissue damage caused by extravasation? Administer through a hand vein, if possible Use an infusion pump Inspect the site frequently for redness or swelling Infuse into proximal veins whenever possible

Inspect the site frequently for redness or swelling

A patient is receiving carboplatin. The nurse would expect to administer this drug by which route?

Intravenous

A female client is ending an extensive chemotherapeutic regimen that included cytotoxic antineoplastic drugs. What does the nurse understand about bone marrow toxicity in this client?

It is a common adverse effect of her treatment.

A patient is diagnosed with ovarian cancer. Why is considered to be an aggressive form of cancer?

It is fed by the hormones produced by the ovaries.

A patient is diagnosed with ovarian cancer. Why is considered to be an aggressive form of cancer? It is fed by calcium in women who take estrogen. It is fed by the hormones produced by the ovaries. The younger the client, the more aggressive the form. The woman has a supply of testosterone from the ovaries.

It is fed by the hormones produced by the ovaries.

Which nonpharmacological intervention may prevent cystitis caused by cyclophosphamide (Cytoxan)?

Keeping well hydrated

The patient in remission is receiving a low-dose cytotoxic drug so that there will be a delay in the regrowth of residual cancer cells. What is this form of therapy called? Neoadjuvant Maintenance Intensification Palliative

Maintenance

Which antineoplastic drugs are classified as antimetabolites? (Select all that apply.)

Mercaptopurine (Purinethol) Capecitabine (Xeloda) Fluorouracil (Adrucil)

A male client is informed that the latest tests indicate that his cancer has spread to his liver. The client receives capecitabine as part of his treatment regimen. What would the nurse expect the health care provider to do? Increase the dose of capecitabine. Add routine blood transfusions to the client's treatment regimen. Monitor the client closely and repeat LFTs routinely. Discontinue the capecitabine.

Monitor the client closely and repeat LFTs routinely.

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

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

A client has chosen to be placed on hospice. Which is acceptable chemotherapy for a client on hospice?

Palliative chemotherapy

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? A. Lymphoma B. Skin cancer C. Prostate cancer D. Lung cancer

Prostate Cancer -In male patients, antiandrogens are used to treat prostate cancer.

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.

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

In describing the action of alkylating agents, what would the nurse include?

React chemically with portions of RNA, DNA, and other cellular proteins.

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?

Reassure the client that it is a harmless and expected response to the drug.

A nurse administers ondansetron to a client receiving chemotherapy for which reason?

Reduce vomiting

What can the oncology nurse do to minimize the exposure risk to chemotherapeutic agents?

Review institutional policies and procedures related to chemotherapy

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

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 Risk for Impaired Skin integrity related to cytotoxic effects of doxorubicin Risk for Imbalanced Nutrition: More Than Body Requirements related to metabolic effects of doxorubicin Risk for Ineffective Airway Clearance related to decreased neurological function

Risk for Infection related to suppressed bone marrow function Chapter 14: Antineoplastic Agents - Page 230

A nurse is providing client education to a 50-year-old woman who is taking methotrexate (MTX) for breast cancer. The nurse will instruct the client to avoid which drug? Furosemide Digoxin Acetaminophen Salicylates

Salicylates

A nurse is providing client education to a 50-year-old woman who is taking methotrexate (MTX) for breast cancer. The nurse will instruct the client to avoid which drug?

Salycilates

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

When preparing to administer ondansetron for a patient's nausea and vomiting, the nurse understands that this agent blocks: A. dopamine. B. norepinephrine. C. GABA. D. serotonin.

Seratonin

What is the first action by the oncology nurse when observing extravasation with the patient receiving vincristine? Consult the physician. Stop the infusion. Obtain a photograph of the site. Apply warm compresses.

Stop the infusion

The patient receiving a first infusion of paclitaxel complains of chills and dyspnea. The oncology nurse assesses the patient and observes facial flushing, wheezing, and extreme anxiety. What is the priority intervention by the nurse? Continue the infusion and administer diphenhydramine 50 mg, intravenously. Continue the infusion and administer epinenphrine 0.3 mg subcutaneously. Place the patient in supine position. Stop the infusion.

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

The nurse should monitor a client receiving doxorubicin (Doxil) for signs of extravasation that include which of the following? Select all that apply:

Swelling Lack of blood return Redness

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

TRUE

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

Tamoxifen

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

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 are significantly more cost-effective than traditional chemotherapeutic drugs. Targeted therapies have the potential to damage cancerous cells while leaving normal body cells less affected. Targeted therapies achieve the therapeutic benefits of traditional chemotherapy with no risk of adverse effects. Targeted therapies have the potential to provide prophylactic protection against neoplasia in high-risk individuals.

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

The client has just been started on an alkylating agent to treat testicular cancer. What assessment finding would suggest that the client is experiencing a common adverse effect of this medication? The client's most recent laboratory results indicate pancytopenia The client is oriented to person but not to place and time The client describes his mood as "bleak" and "dark" The client describes "bone pain" in his lumbar and thoracic spine

The client's most recent laboratory results indicate pancytopenia

A client is undergoing a cytotoxic chemotherapy regimen for the treatment of stage III lung cancer. What effect will this regimen likely have on the client's hemostatic function?

The client's platelet count will decline.

What should the oncology nurse understand when administering a cell cycle-nonspecific chemotherapeutic agent about its effect? The drug has intermittent effectiveness throughout the cell cycle. The drug will be effective through all phases of the cell cycle. The drug is ineffective throughout all phases of the cell cycle. The drug will be effective through specific areas of the cell cycle.

The drug will be effective through all phases of the cell cycle.

What should the oncology nurse understand when administering a cell cycle-nonspecific chemotherapeutic agent about its effect? The drug will be effective through specific areas of the cell cycle. The drug has intermittent effectiveness throughout the cell cycle. The drug is ineffective throughout all phases of the cell cycle. The drug will be effective through all phases of the cell cycle.

The drug will be effective through all phases of the cell cycle.

The nurse is caring for a patient who is receiving a combination of antineoplastic agents. The patient will most likely lose her hair. Why would the nurse suggest that she get a wig or use appropriate head cover? A) People may be uncomfortable seeing her bald head B) The hair will likely grow back if the head is covered at all times C) Her self-esteem will be better if the head is covered D) Most of the heat is lost through the head and it is important to cover it during extremes in temperature

The nurse reviews the plan of care for a patient receiving antineoplastic therapy. The nurse notes a nursing diagnosis of risk for infection. Which adverse effect would the nurse expect the patient to exhibit? A) pancytopenia B) gastrointestinal toxicity C) dehydration D) alopecia

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

The oncology nurse administers 5-fluorouricil to a patient. During administration, the patient complains of a headache. The nurse performs an assessment and observes nystagmus and disorientation. What does the nurse determine is occurring with this patient? A) Acute cerebellar syndrome B) Disequilibrium syndrome C) Cardiotoxicity D) Myelosuppression

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? A) Taxane B) Antimetabolite C) Hormone antagonist D) Antitumor antibiotic

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.

The patient in remission is receiving a low-dose cytotoxic drug so that there will be a delay in the regrowth of residual cancer cells. What is this form of therapy called? A) Maintenance B) Intensification C) Neoadjuvant D) Palliative

When describing the process of cancer cell growth to a client, the nurse addresses angiogenesis. Which description would the nurse include?

The process of creating new blood vessels to supply oxygen and nutrients to the cells

In recent years, there have been rapid advances in cancer care for children and high cure rates for many pediatric malignancies. What is the reason behind many of these advances?

The systematic enrollment of children in well-designed clinical trials

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? A. the use of chemotherapy to reduce pain B. aggressive chemotherapy to reduce malignant cell proliferation C. Abrupt cessation of chemotherapy immediately prior to entering palliative care D. the replacement of chemotherapy with complementary and alternative treatments

The use of chemotherapy to reduce pain

A 51-year-old female patient has been receiving doxorubicin (Adriamycin) 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

A 51-year-old female patient has been receiving doxorubicin (Adriamycin) for metastatic breast cancer. Her medical record indicates she has cardiomyopathy and a cumulative dose of 300 mg/m2of doxorubicin. Which measure would help limit the severity of the cardiomyopathy in this client?

The use of dexrazoxane in conjunction with doxorubicin

A client with a diagnosis of bladder cancer is started on a chemotherapeutic regimen that includes three agents. What is the rationale for using multiple antineoplastic agents?

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

A female client develops hepatotoxicity from the antineoplastic drugs that she is receiving. She has abnormal levels of AST, ALT, and bilirubin. The health care provider may not decrease the drugs for what reason?

These findings do not indicate decreased ability to metabolize drugs.

Prior to administering a dose of 5-FU to a patient with pancreatic cancer, the nurse is conducting the necessary drug research. The nurse is aware that 5-FU is a cell cycle-specific chemotherapeutic agent. Which statement best describes cell cycle-specific drugs?

They affect cancerous cells during a particular phase of cellular reproduction.

What potential benefit is unique to biologic agent therapies?

They may affect cancer cells while leaving normal body cells unaffected.

What rationale should the nurse provide to the client when describing the necessity of recovery periods between treatment cycles of chemotherapy? A. The restoration of fluid balance and nutrition is needed before continuing with chemotherapy. B. Time is required for the successful application of radiotherapy between cycles of chemotherapy. C. Time is needed to replace many of the healthy body cells killed by chemotherapy. D. There is a need to restore a physiologic reserve of energy before further chemotherapy.

Time is needed to replace many of the healthy body cells killed by chemotherapy -Cyclic administration involves taking the drugs for a specific period, with a recovery period following each treatment cycle.

A client with alopecia should cover the head if the client will be exposed to extremes of temperature. False True

True

A patient with alopecia should cover his or head if he or she will be exposed to extremes of temperature.

True

An adverse effect of tamoxifen therapy involves menopausal symptoms.

True

An adverse effect of tamoxifen therapy involves menopausal symptoms. True or False

True

Anemia from chemotherapy treatment is the result of bone marrow suppression.

True

Anemia from chemotherapy treatment is the result of bone marrow suppression. True or False

True

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

True

Cancer is considered the second leading cause of death in the United States. (True/False)

True

True or False: An adverse effect of tamoxifen therapy involves menopausal symptoms.

True

True or False: Cancer is considered the second leading cause of death in the United States.

True

True or False: Anemia from chemotherapy treatment is the result of bone marrow suppression.

True -Adverse reactions common to many of the antineoplastic drugs include bone marrow suppression which in turn causes anemia, leukopenia and thrombocytopenia.

A client with leukemia has been prescribed rasburicase to be administered before chemotherapy. What is the nurse's priority assessment after administration of this medication? Serum potassium levels Blood glucose levels Serum calcium levels Uric acid levels

Uric acid levels

Which drug would be classified as a mitotic inhibitor? Chlorambucil Fluorouracil Methotrexate Vincristine

Vincristine

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

A, B, C

Which antineoplastic drugs are classified as antimetabolites? (Select all that apply.) A) Mercaptopurine (Purinethol) B) Capecitabine (Xeloda) C) Fluorouracil (Adrucil) D) Etoposide (Toposar) E) Irinotecan (Camptosar)

Which medication is used as a cytoprotectant for patients receiving cisplatin (Platinol)? A) Amifostine(Ethyol) B) Dexamethasone (Decadron) C) Flutamide (Eulixin) D) Ondansetron (Zofran)

Which tissue type does not respond well to reproductive hormone therapy for cancer? A) Breast B) Prostate C) Endometrial D) Lung

With food and a large glass of water

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

An adult patient who has been diagnosed with a rectal tumor is scheduled to begin treatment with cisplatin. The nurse has conducted patient teaching about the possibility of nausea and vomiting. In order to reduce the patient's risk of severe nausea, the nurse should

administer a combination of antiemetics prior to the administration of the drug.

Malignant cells seem to be more susceptible than normal cells to the effects of which class of antineoplastic drugs?

alkylating agents

The nurse may be asked to administer which medications to a client to counteract the increase in uric acid and subsequent hyperuricemia resulting from the metabolic waste buildup from rapid tumor lysis?

allopurinol

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.

The nurse should exercise caution when administering antimetabolites to a patient with: bone marrow suppression. diabetes mellitus. hypertension. seizure activity.

bone marrow suppression.

The nurse should exercise caution when administering antimetabolites to a patient with: hypertension. seizure activity. diabetes mellitus. bone marrow suppression.

bone marrow suppression.

A 79-year-old woman has recently moved to a long-term care facility, and the nurse at the facility is conducting a medication reconciliation. The nurse notes that the woman has recently been taking tamoxifen. The nurse is justified in concluding that the woman has a history of what malignancy?

breast cancer

A client has been diagnosed with a brain tumor and is dealing with this diagnosis by seeking detailed information about cancer. The nurse would explain to the client that cancer is essentially a result of the disruption of the:

cell cycle

The oncology nurse understands that chemotherapeutic agents are most effective during a particular phase of the cell cycle. This means the agents are:

cell cycle-specific.

The oncology nurse understands that chemotherapeutic agents are most effective during a particular phase of the cell cycle. This means the agents are: cell cycle-specific. cell cycle-nonspecific. cell targeting. growth fraction.

cell cycle-specific.

The oncology nurse understands that chemotherapeutic agents are most effective during a particular phase of the cell cycle. This means the agents are: cell cycle-nonspecific. growth fraction. cell cycle-specific. cell targeting.

cell cycle-specific.

cell cycle.

Many times a combination of antineoplastic medications are used to:

decrease the development of cell resistance

Many times a combination of antineoplastic medications are used to: decrease the side effects of each medication. decrease the development of cell resistance. increase the length of treatment. increase the quantity of each medication used.

decrease the development of cell resistance

heart failure and bleeding problems

A 54-year-old male patient with small-cell lung cancer is receiving etoposide. The nurse will carefully monitor for:

hypotension.

A client is receiving tamoxifen. Which adverse effect would be most specific to the action of this drug?

menopausal effects

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

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

What is the defining characteristic of a sarcoma?

originate from connective tissue

The nurse reviews the plan of care for a patient receiving antineoplastic therapy. The nurse notes a nursing diagnosis of risk for infection. Which adverse effect would the nurse expect the patient to exhibit? alopecia dehydration pancytopenia gastrointestinal toxicity

pancytopenia

A female client prescribed methotrexate for meningeal leukemia is asking the nurse about adverse effects of the drug. What would the nurse tell this client should be avoided while taking methotrexate?

pregnancy

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.

A client asks the nurse what cancer cell growth is called. What would the nurse tell the client?

proliferation

techniques for safely handling the drug

The nurse should encourage the client to implement which intervention in order to minimize the risk of developing chemotherapy-triggered mucositis?

thoroughly rinse the mouth often, especially before and after meals

A client with a diagnosis of cancer is experiencing pain and the early signs of organ dysfunction. The nurse should explain that these signs and symptoms result from: overgrowth of tumor cells. tumor cells invading healthy tissue. enzymes that generate blood vessels. the body's own misguided immune response.

tumor cells invading healthy tissue.

A client with leukemia has been prescribed rasburicase to be administered before chemotherapy. Which assessment should the nurse complete after administration of this medication? uric acid levels serum calcium levels blood glucose levels serum potassium levels

uric acid levels

A 25-year-old female client is prescribed methotrexate to treat rheumatoid arthritis (RA). The nurse should teach the client to:

use an effective contraceptive.

A 25-year-old female client is prescribed methotrexate to treat rheumatoid arthritis (RA). The nurse should teach the client to: use an effective contraceptive. drink milk with the medication. expect a mild rash and itching. take a pain reliever for sore throat.

use an effective contraceptive.

A middle-aged patient has received a diagnosis of GI stromal tumor following an extensive diagnostic workup. Imatinib has been recommended as a component of the patient's drug regimen. What patient education should the nurse provide to this patient? A. "If you experience significant nausea after taking a dose, stop taking the drug and schedule an appointment at the clinic." B. "You'll likely experience a lot of dry mouth while you're taking this drug, so it's helpful to chew ice chips." C. "It's important that you let us know if you develop any significant swelling or puffiness." D. "Try to keep your PICC line dressing as dry as possible at all times."

"It's important that you let us know if you develop any significant swelling or puffiness."

A patient is diagnosed with a brain tumor. The patient is told that 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."

A patient is diagnosed with a brain tumor. The patient is told that the cancer cells proliferate. The patient asks the nurse what this means. What is the nurse's best response? A. "The proliferation of the cancer cells is the treatment with chemotherapy." B. "The proliferation is the growth of cancer cells and the rate of growth." C. "The proliferation of the cancer cells is the suppression of growth." D. "The proliferation of cancer cells is the metastasis of the tumor."

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

A patient who will begin chemotherapy voices concern to the nurse about the accompanying nausea and vomitting. What is the best response by the nurse?

"We can relieve your nausea and vomiting with antiemetic drug therapy. You should ask for these medications whenever you need them."

A client asks the nurse why the chemotherapy is often administered in cycles. Which response by the nurse would be most appropriate?

"We want to attack the cells that might be dormant or moving into a new phase."

A client asks the nurse why the chemotherapy is often administered in cycles. Which response by the nurse would be most appropriate? A. "The cycles are the only way to guarantee a cure for the cancer." B. "The cycles help to prevent the drugs from destroying the healthy cells." C. "We want to attack the cells that might be dormant or moving into a new phase." D. "The drugs are highly toxic, so the body needs time to recover."

"We want to attack the cells that might be dormant or moving into a new phase."

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."

"Your hair will grow back, but the new hair may be a different color or texture." -Reassure patients that hair regrowth will occur; however, advise them that the new hair may be a different color or texture.

The nurse is conducting an ongoing assessment on a client who has received an antineoplastic agent. Which signs should the nurse prioritize and alert the health care provider concerning? Select all that apply.

* Cough * Sore throat * White blood cell count of less than 3500/mm3

A client is experiencing intense nausea while being treated with chemotherapeutics. What actions should the nurse perform? Select all that apply. -Administer antacids as prescribed, 30 minutes before meals -Ensure that the client has had a dietician consult -Administer antiemetics as prescribed -Provide the client with a low-residue diet -Provide the client with small, frequent meals

-Ensure that the client has had a dietician consult -Administer antiemetics as prescribed -Provide the client with small, frequent meals

A client diagnosed with a malignancy is receiving an antimetabolite as part of medication therapy. What should the nurse teach this client about the use of antimetabolite medication? Select all that apply. -Use safety measures due to possible dizziness, headache, and drowsiness -Report all other drugs and alternative therapies currently being taken -Avoid the consumption of high-tyramine foods -Cover the head at extremes of temperature -Plan for an appropriate exercise regimen

-Use safety measures due to possible dizziness, headache, and drowsiness - Report all other drugs and alternative therapies currently being taken -Cover the head at extremes of temperature

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 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? A) Alcohol intake B) Sensory, motor, and perceptual functions C) Exposure to sunlight D) Cigarette smoking

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

A patient has come to the short-stay unit to receive their IV chemotherapy. What action by the nurse would be the least beneficial to the patient? A) Checking the IV line frequently B) Using an infusion pump to administer the medication C) Premedication the patient as ordered D) Starting the IV in a large, distal vein

A patient with bladder cancer is to have intravesicular instillation of a chemotherapeutic agent into the bladder. What is a priority intervention of the oncology nurse? A) Keep the catheter unclamped. B) Attache the tubing to suction. C) Insert a Foley catheter. D) Assist the physician to place a thoracotomy tube.

A client is being treated for cancer and dronabinol has been added to the client's current medication regimen. What assessment finding would indicate a therapeutic effect of this medication? Increased energy Decreased pain Stable white blood cell levels Absence of nausea

Absence of nausea

The nurse is caring for a client who current chemotherapy regimen includes mitomycin. The nurse should recognize that this client's most likely diagnosis is what? Neuroblastoma Non-Hodgkin's lymphoma Adenocarcinoma of the pancreas Metastatic lung cancer

Adenocarcinoma of the pancreas

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

The nurse may be asked to administer which medication to a client to counteract the increase in uric acid and subsequent hyperuricemia resulting from the metabolic waste buildup from rapid tumor lysis? Allopurinol (Zyloprim) Amifostine (Ethyol) Mesna (Mesnex) Leucovorin (Wellcovorin)

Allopurinol Chapter 14: Antineoplastic Agents - Page 220

Malignant neoplasms are classified according to the type of tissue involved and other characteristics. What are examples of hematologic malignancies? Select all that apply. A. Angiosarcoma B. Leukemias C. Multiple myeloma D. Osteogenic sarcoma E. Lymphomas

B. Leukemias C. Multiple myeloma E. Lymphomas Hematologic malignancies involve the bone marrow and lymphoid tissues; they include leukemias, lymphomas, and multiple myeloma. Carcinomas and sarcomas are solid neoplasms, which are composed of a mass of malignant cells and a supporting structure of connective tissue, blood vessels, and lymphatics.

The nurse is providing education to a client diagnosed with metastatic cancer. What treatment will the nurse indicate is likely necessary? A. Combination of surgery and radiation therapy B. Systemic chemotherapy C. Localized chemotherapy and concurrent radiation therapy D. Radiation

B. Systemic chemotherapy Localized tumors are often treatable with surgery, radiation, or chemotherapy combined with radiation (concurrent) therapy. Metastatic disease requires systemic chemotherapy.

A patient is experiencing antineoplastic-induced nausea and vomiting. The health care provider prescribes ondansetron. The nurse understands that this agent acts in which way?

Blocking serotonin receptors in the CTZ

The nurse is describing the necessity of recovery periods between treatment cycles to a client receiving chemotherapy. How should the nurse best explain the need? A. ''The restoration of fluid balance and nutrition is needed before continuing with chemotherapy.'' B. ''There is a need to restore a physiologic reserve of energy before further chemotherapy.'' C. ''Time is needed to replace many of the healthy body cells killed by chemotherapy.'' D. ''Time is required for the successful application of radiation therapy between cycles of chemotherapy.''

C. ''Time is needed to replace many of the healthy body cells killed by chemotherapy.'' 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. Recovery time is unrelated to energy reserves, fluid balance, and nutrition. Recovery time does not necessarily correspond to the schedule for radiation therapy; not every client who receives chemotherapy will receive radiation therapy.

The nurse is providing medication education to a client with breast cancer who has been prescribed tamoxifen. How should the nurse explain the action of the drug? A. Increases the viability of healthy cells that are adjacent to cancerous cells B. Causes mutations of cancer cells C. Slows the growth of cancer cells D. Induces apoptosis of cancer cells

C. Slows the growth of cancer cells Antineoplastic hormone inhibitors slow the growth of cancer cells. They do not treat cancer by causing apoptosis (cell repair) or mutations. They do not influence healthy body cells in the area of the tumor.

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 is administering 5-fluourouricil (5-FU) to the patient with colon cancer. What rare but severe adverse effect should the nurse monitor for 72 hours after administration? Skin rash Nephrotoxicity Cardiotoxicity Hepatotoxicity

Cardiotoxicity

Cell cycle

Cells that have a rapid mitotic rate

An oncology nurse is reviewing the pathophysiology of cancer and is discussing with a colleague the factors that contribute to the success or failure of a patient's chemotherapy. Which cancerous cell is most susceptible to the effects of chemotherapeutic drugs? Cells with a long generation time Cells that lack contact inhibition Cells that have a rapid mitotic rate Cells that lack a blood supply

Cells that have a rapid mitotic rate

A nurse is preparing an antineoplastic agent for a school-aged client who has leukemia. What action related to the administration of this drug should the nurse perform first? -Perform thorough hand hygiene. -Check laboratory studies to determine most recent measures of bone marrow function. -Ensure a quiet environment, so the client can rest during administration of the drug. - Identify the client by checking the arm band and asking him or her to state his or her name.

Check laboratory studies to determine most recent measures of bone marrow function.

A client is receiving bleomycin as part of a chemotherapy regimen. Which would be most important for the nurse to monitor?

Chest x-ray

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."

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

Dactinomycin (Cosmegen) Bleomycin (Blenoxane) Daunorubicin (DaunoXome)

A patient with acute lymphoblastic leukemia (ALL) is receiving imatinib on an inpatient basis. When planning the care of this patient, what assessment should be specified in the patient's plan of nursing care? A. bilateral blood pressures B. daily weights C. pupillary response D. assessment of deep tendon reflexes

Daily weights

A patient with leukemia receiving cytarabine (Ara-C) has developed a toxicity called chemical keratitis. What medication can the oncology nurse anticipate using for treating this? Prostaglandin analogs Dexamethasone eye drops Decongestant eye drops Neosporin ophthalmic solution

Dexamethasone eye drops

Disturbed body image ***The physiologic consequences of alopecia are usually inconsequential. This adverse effect does not have a major effect on thermoregulation or tissue integrity. However, many clients find it distressing and experience a disturbance to their body image due to the significant and unwanted change in their appearance. The nurse should choose assessments and interventions accordingly.

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. Vincristine B. Imatinib C. Doxorubicin D. Methotrexate

Doxorubicin

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

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: A. increase the protein in her diet. B. take the medication at bedtime. C. drink a lot of water. D. limit fluid intake.

Drink a lot of water -An adverse effect of this drug is the incidence of hemorrhagic cystitis. The nurse should encourage the patient to drink at least 2 liters of fluid a day and, in high-dose therapy, administer the uroprotectant agent mesna.

A client with breast cancer is receiving goserelin. What aspect of the client's most recent laboratory results would suggest an adverse effect of this particular drug? Increased blood urea nitrogen and creatinine Elevated serum calcium Decreased hemoglobin and hematocrit Increased international normalized ratio

Elevated serum calcium

The nurse understands that when administering cisplatin, the drug has a high potential for causing severe nausea and vomiting. What term is used to describe this group of antineoplastic drug? Emetogenic Alkylating drug Estrogen Androgen

Emetogenic

A client with leukemia is being treated with a combination of antineoplastics, including methotrexate. The client's most recent laboratory results indicate the client is experiencing bone marrow suppression. What is the nurse's priority action? A. Provide small quantities of food several times per day, as tolerated. B. Encourage the client to limit physical activity in order to reduce the risk of bleeding. C. Ensure that all staff and visitors adhere to infection control precautions. D. Space out the client's care to preserve energy and prevent fatigue.

Ensure that all staff and visitors adhere to infection control precautions -The client's combination of cancer and bone marrow suppression creates an acute risk for infection. As a result, infection control is vital to maintaining the client's health and safety.

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?

Every 3 weeks

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? Every 4 weeks Every other week Every week Every 3 weeks

Every 3 weeks

When planning the care for a client receiving imatinib, the nurse would identify which nursing diagnosis as most likely?

Excess fluid volume related to fluid retention

Biologic targeted antineoplastics are being used more frequently to increase anticancer efficacy and decrease the adverse effects of traditional cytotoxic chemotherapy. They address which mechanisms of action in cancer development? Select all that apply.

Failure of the immune system to eliminate mutant, premalignant, and malignant cells. Failure of the growth-regulating mechanisms to control the proliferation of mutant, premalignant, and malignant cells.

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

False

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

False

No cancer cells have been identified that can remain dormant for more than 2 years. (True/False)

False

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

False -No cells have been identified that can remain dormant for more than 5 years.

Higher tumor response rates

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. Increased capillary permeability B. Higher tumor response rates C. Lower risk for secondary cancers D. Decreased duration of remissions

Higher tumor response rates

A client's chemotherapeutic regimen includes procarbazine. What is the client's most likely diagnosis? A. Neuroblastoma B. Pancreatic cancer C. Astrocytoma D. Hodgkin lymphoma

Hodgkin Lymphoma -Procarbazine (Matulane) is used in combination therapy for treatment of stages III and IV of Hodgkin disease.

Which drug would have the least effect on healthy human cells?

Imatinib

Which drug would have the least effect on healthy human cells? Etoposide Vincristine Imatinib Doxorubicin

Imatinib

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

Increased risk of nephrotoxicity

A nurse is caring for a patient undergoing treatment with plant alkaloids for cancer. The patient is also administered warfarin for a history of atrial fibrillation. Which of the following is an interactive effect of the two drugs which the nurse should monitor the patient for?

Increased risk of prolonged bleeding

A patient is receiving carboplatin. The nurse would expect to administer this drug by which route? Intravenous Oral

Intravenous

A patient is receiving carboplatin. The nurse would expect to administer this drug by which route? A. Intramuscular B. Intravenous C. Subcutaneous D. Oral

Intravenous -Carboplatin is administered IV on day 1 every 4 weeks.

A female client is ending an extensive chemotherapeutic regimen that included cytotoxic antineoplastic drugs. What does the nurse understand about bone marrow toxicity in this client? A. It is a rare side effect of the chemotherapy. B. It is a common adverse effect of her treatment. C. It will ultimately lead to death. D. It will cause the health care provider to increase the dose of chemotherapeutic medications.

It is a common adverse effect of her treatment -Traditional cytotoxic antineoplastic drugs are nonselective in their effect on proliferating cells; therefore, bone marrow toxicity is a common adverse effect of many cytotoxic drugs.

The oncology nurse is preparing to administer 5-fluorouracil to a patient with colon cancer. To potentiate the action of the 5-fluorouracil, what other medication may be administered with the drug? Paclitaxel Etoposide Hydroxyurea Leucovorin

Leucovorin

Which would the nurse expect to administer to counteract the effects of methotrexate?

Leucovorin

A male patient has been on long-term bicalutamide (Casodex) therapy. In order to assess adverse effects of the drug therapy, the nurse will closely monitor:

Liver function

A male patient has been on long-term bicalutamide (Casodex) therapy. In order to assess adverse effects of the drug therapy, the nurse will closely monitor: A. Visual function B. Pap test results C. Blood counts D. Liver function

Liver function

Which agent would the nurse expect to be administered orally?

Methotrexate

Which agent would the nurse expect to be administered orally? Cytarabine Fluorouracil Gemcitabine Methotrexate

Methotrexate Chapter 14: Antineoplastic Agents - Page 225

Which of the following would the nurse identify as an antineoplastic antibiotic?

Mitomycin

Which would the nurse identify as an antineoplastic antibiotic?

Mitomycin

Monitor the client closely and repeat LFTs routinely.

The nurse is caring for a client receiving cyclophosphamide. What is the priority nursing action for this client? Monitor urinalysis results Administer an antiemetic when needed Provide small, frequent meals Provide vigilant oral care

Monitor urinalysis results

Mr. Mass has been diagnosed with lung cancer. The health care provider orders chemotherapy prior to the surgery to reduce the tumor burden. What strategy relates to chemotherapy administered to reduce the tumor burden before surgery or radiation to improve the outcomes of these methods?

Neoadjuvant therapy

FALSE

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

A patient with a pancreatic tumor will be starting on chemotherapy to decrease the size of the tumor, give the patient a better quality of life, and reduce the discomfort. What is this form of therapy called? Adjuvant therapy Consolidation therapy Palliative therapy Neoadjuvant therapy

Palliative therapy

Which of the following classes of antineoplastic drugs are considered cell cycle-specific? Select all that apply: Akylating agents Plant alkaloids Antimetabolites Retinoids Antineoplastic antibiotics

Plant alkaloids Antimetabolites

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

A client who is taking chemotherapeutic medications has developed stomatitis. What intervention should the nurse include in the client's plan of care? Encourage the client's family to bring in mouthwash Provide mouth care frequently Provide a minced or pureed diet Administer antifungal mouthwash as prescribed

Provide mouth care frequently

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 Ineffective Airway Clearance related to decreased neurological function

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 has just received the 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 Risk for Acute Confusion related to adverse neurological effects of imatinib Risk for Impaired Skin Integrity related to exaggerated inflammatory response Risk for Deficient Fluid Volume related to changes in osmotic pressure

Risk for Infection related to bone marrow suppression Chapter 14: Antineoplastic Agents - Page 245

A client develops leukopenia after receiving chemotherapy. Which nursing diagnosis would be most appropriate?

Risk for infection

A client develops leukopenia after receiving chemotherapy. Which nursing diagnosis would be mostappropriate?

Risk for infection

A patient has just received the 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? A.Risk for Deficient Fluid Volume related to changes in osmotic pressure B. Risk for Infection related to bone marrow suppression C. Risk for Impaired Skin Integrity related to exaggerated inflammatory response D. Risk for Acute Confusion related to adverse neurological effects of imatinib

Risk for infections related to bone marrow suppression -Like many cancer treatments, imatinib causes bone marrow suppression that creates a consequent risk of infection.

A patient with rhabdomyosarcoma has been admitted for chemotherapy with Vincristine. While preparing a plan of care for this patient, what would be an appropriate nursing diagnosis to use?

Risk for injury

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? Alcohol intake Sensory, motor, and perceptual functions Exposure to sunlight Cigarette smoking

Sensory, motor, and perceptual functions Chapter 14: Antineoplastic Agents - Page 232 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.

The nurse is administering vincristine to a patient, and the container that the medication is in breaks open, resulting in the medication spraying over the patient and the nurse. The nurse follows the proper hospital procedures for cleaning up a chemotherapy spill. Afterward, what should the nurse be monitoring the patient for closely? Motor, sensory, and autonomic neuropathies Skin rash Severe eye irritation GI distress

Severe eye irritation

A nurse on an oncology unit is aware of the need to assess for adverse effects in patients who are being treated with rituximab. The risks of adverse effects are highest at what point during the course of treatment?

Shortly after the initiation of the first infusion of rituximab

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? A. Bleomycin B. Cisplatin C. Cyclophosphamide D. Tamoxifen

Tamoxifen -Anti-estrogens are first-line therapy for treating breast cancer in postmenopausal women. Tamoxifin is the most widely recognized anti-estrogen.

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

The cell cycle consists of 5 phases. Each cell goes through these phases. How would cell phase G1 be defined? Protein synthesis occurs. Mitosis occurs. The resting phase of the cell The cell increases in size and synthesis of RNA.

The cell increases in size and synthesis of RNA.

A client is undergoing a cytotoxic chemotherapy regimen for the treatment of stage III lung cancer. What effect will this regimen likely have on the client's hemostatic function? A. The client will require prophylactic heparin. B. The client will be at increased risk of deep vein thrombosis (DVT). C. The client will likely experience thrombocytosis. D. The client's platelet count will decline.

The client's platelet count will decline

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 capable of inducing cell division and subsequent mutations of cancerous cells. The drug is readily able to distinguish between normal body cells and malignant cells. The drug induces an abnormal cell cycle that results in cancerous cell death. The drug is effective regardless of whether a cancerous cell is proliferating.

The drug is effective regardless of whether a cancerous cell is proliferating.

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.

A patient is administered mesna (Mesnex) to prevent cystitis induced by ifosfamide. How will this medication combination prevent cystitis?

The medication combines with the metabolite of ifosfamide.

The nurse is caring for a client newly diagnosed with a primary brain tumor. The client asks the nurse where the tumor came from. What would be the nurse's best response? A) "Your tumor originated from somewhere outside the CNS from a cell just like other cells." B) "Your tumor is pituitary in origin." C) "Your tumor originated from a single cell that is genetically different from other cells in the surrounding tissue." D) "Your tumor is from nerve tissue somewhere in your body."

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)

The nurse should exercise caution when administering antimetabolites to a patient with: A) bone marrow suppression. B) diabetes mellitus. C) hypertension. D) seizure activity.

B, C, D, E

The oncology nurse is discussing with the staff ways chemotherapeutic ingestion can occur through hand-to-mouth contact. Which of the following methods will the nurse need to include? (Select all that apply.) A) Toilet seats B) Food (including gum and mints) C) Cosmetics D) Cigarettes E) Equipment contaminated with chemotherapy agents

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? A single large dose instead of multiple doses The use of dexrazoxane in conjunction with doxorubicin A reduced dose Meticulous monitoring during drug administration

The use of dexrazoxane in conjunction with doxorubicin

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.

What potential benefit is unique to biologic agent therapies? A. They may affect cancer cells while leaving normal body cells unaffected. B. Cytotoxic adverse effects are rarely experienced. C. They may be administered long term without the need for regular blood work. D. Administered does not require a certified chemotherapeutic nurse.

They may affect cancer cells while leaving normal body cells unaffected -Biologic agents target cellular differences between the malignant and normal cells. Consequently, they may kill cancer cells while leaving normal body cells unaffected.

Anemia from chemotherapy treatment is the result of bone marrow suppression. (True/False)

True

A patient has come to the short-stay unit to receive their IV chemotherapy. What action by the nurse would be the least beneficial to the patient? Using an infusion pump to administer the medication Premedication the patient as ordered Starting the IV in a large, distal vein Checking the IV line frequently

Using an infusion pump to administer the medication

The dosages of the chemotherapy agents that will be administered are based primarily on what client variable?

Weight

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 nurse is performing discharge teaching with a client who will soon return home. The client will continue taking imatinib for the foreseeable future, and the nurse is teaching the client about the safe administration of this drug. How should the nurse instruct the client to take imatinib? On an empty stomach With food and a large glass of water With a glass of grapefruit or cranberry juice Thirty minutes before breakfast and in the early evening, at least 2 hours after dinner

With food and a large glass of water

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. establish a new peripheral intravenous site. administer benzodiazepines as prescribed to prevent anxiety during chemotherapy. assess the client's baseline paint level to provide a comparison post-administration.

administer antiemetics and dexamethasone as prescribed.

Which agents would be considered cancer non-cell cycle specific agents?

alkylating agents

Which agents would be considered cancer non-cell cycle specific agents? mitotic inhibitors antimetabolites alkylating agents protein tyrosine kinase inhibitors

alkylating agents

allopurinol The nurse may be asked to administer allopurinol to a client to counteract the increase in uric acid and subsequent hyperuricemia resulting from the metabolic waste buildup from rapid tumor lysis. Amifostine binds with metabolites of cisplatin to protect the kidneys from nephrotoxic effects, reduces xerostomia. Mesna binds with metabolites of ifosfamide to protect the bladder from hemorrhagic cystitis. Leucovorin provides folic acid to cells after methotrexate administration.

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: encourage the patient to eat 6 small meals a day. avoid any skin, eye, or mucous membrane contact with the drug. check for extravasation when the infusion is over. avoid using a proximal vein.

avoid any skin, eye, or mucous membrane contact with the drug

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.

When assessing a client for adverse effects related to methotrexate (MTX) therapy, the nurse should prioritize what diagnostic findings? creatinine clearance electrocardiogram (ECG) calcium and magnesium levels serum osmolality

creatinine clearance

When assessing a client for adverse effects related to methotrexate (MTX) therapy, the nurse should prioritize what laboratory findings?

creatinine clearance

daily weights

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

dyspnea.

A 54-year-old male patient with small-cell lung cancer is receiving etoposide. The nurse will carefully monitor for: hypertension. hypoglycemia. hypotension. tachycardia.

hypotension.

increase leukocytes

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 platelet levels prevention of hemorrhagic cystitis increased leukocytes resolution of mucositis

increased leukocytes

The pathophysiology instructor is discussing neoplasms with the pre-nursing students. The instructor explains that the effects of neoplasms are caused by:

invading healthy tissue.

A nurse is caring for a 46-year-old female patient who is taking paclitaxel for ovarian cancer. Two or three days after the infusion of the drug, the nurse must closely monitor for:

neurotoxicity.

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.

When preparing to administer ondansetron for a patient's nausea and vomiting, the nurse understands that this agent blocks: serotonin. dopamine. norepinephrine. GABA.

serotonin Chapter 14: Antineoplastic Agents - Page 223

Tamoxifen achieves a therapeutic effect by which means?

slowing the growth of cancer cells

The dosages of the chemotherapy agents that will be administered are based primarily on what client variable?

weight

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

Getitinib

Mr. Mass has been diagnosed with lung cancer. The physician orders chemotherapy prior to the surgery to reduce the tumor burden. What strategy relates to chemotherapy administered to reduce the tumor burden before surgery or radiation, to improve the outcomes of these methods? A) Induction therapy B) Consolidation therapy C) Neoadjuvant therapy D) Palliative therapy

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. Risk for infection Risk for bleeding Imbalanced nutrition Impaired skin integrity Autonomic dysreflexia

Risk for infection Risk for bleeding Imbalanced nutrition Impaired skin integrity

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? Forewarn about hair loss. Explain it is not life-threatening. Suggest the use of a wig or cap. Explain that hair preserves body heat.

Suggest the use of a wig or cap.

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

Tamoxifen

The effect of cytotoxic chemotherapy regimen for the treatment of stage III lung cancer

The client's platelet count will decline.

B, C

The oncology nurse will be administering a cell cycle-specific drug. What drugs are considered cell cycle-specific? (Select all that apply.) A) Nitrosoureas B) Antimetabolites C) Mitotic inhibitors D) Alkylating agents E) Hormone antagonists

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

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

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

risk for injury related to chemotherapy

The nurse is caring for a client newly diagnosed with a primary brain tumor. The client asks the nurse where the tumor came from. What would be the nurse's best response? "Your tumor originated from somewhere outside the CNS from a cell just like other cells." "Your tumor is pituitary in origin." "Your tumor is from nerve tissue somewhere in your body." "Your tumor originated from a single cell that is genetically different from other cells in the surrounding tissue."

"Your tumor originated from a single cell that is genetically different from other cells in the surrounding tissue."

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 -Administer anticoagulants as prescribed -Place the client on protective isolation -Monitor the client's laboratory values closely -Allow sufficient time for rest between scheduled activities

- 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

A child is prescribed an anthracycline drug. The nurse would teach the parents to observe for signs and symptoms of what adverse effect? A. Esophageal varices B. Gallbladder disease C. Dehydration D. Cardiotoxicity

Cardiotoxicity

Cough Sore throat White blood cell count of less than 3500/mm3

A male patient has been on long-term bicalutamide therapy. In order to assess adverse effects of the drug therapy, the nurse will closely monitor: Pap test results Blood counts Liver function Visual function

Liver function

Which would the nurse identify as an antineoplastic antibiotic? A. Mitomycin B. Docetaxel C. Teniposide D. Vinblastine

Mitomycin -Mitomycin is an example of an antineoplastic antibiotic.

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? Assessing the client for nausea and vomiting Monitoring the client's urine output for signs of hematuria Monitoring the client's bowel movements for frequency and character

Monitoring the client's urine output for signs of hematuria

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

A patient with a diagnosis of chronic myeloid leukemia has met with the oncologist, who has recommended treatment with the kinase inhibitor imatinib. What route of administration will the client receive? Daily intramuscular injections throughout the course of treatment Peripheral IV administration three times a day for 7 to 10 days Oral administration of imatinib in a home setting Weekly IV infusions over 6 to 8 hours through a central line

Oral administration of imatinib in a home setting

A client is prescribed cyclophosphamide as part of her treatment for non-Hodgkin's lymphoma. Which symptoms should the client be instructted to report to her health care provider immediately?

Pain and burning with urination

A patient has chosen to be placed on hospice. Which is acceptable chemotherapy for a patient on hospice?

Palliative chemotherapy

A client with a pancreatic tumor will be starting on chemotherapy to decrease the size of the tumor, give the client a better quality of life, and reduce discomfort. What is this form of therapy called?

Palliative therapy

Prostate cancer

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? A. Risk for Ineffective Airway Clearance related to decreased neurological function B. Risk for Infection related to suppressed bone marrow function C. Risk for Imbalanced Nutrition: More Than Body Requirements related to metabolic effects of doxorubicin D. Risk for Impaired Skin integrity related to cytotoxic effects of doxorubicin

Risk for infection related to suppressed bone marrow function -Because doxorubicin suppresses bone marrow function, the patient is at risk of leukopenia and subsequent infection.

Skin

A client with breast cancer will have radiation therapy and then begin chemotherapy. Drug therapy will consist of a combination of doxorubicin, cyclophosphamide, and paclitaxel. What should the nurse include in the client's teaching plan concerning the drug therapy? Select all that apply. -Stay in bed 2 days after each administration -Avoid the use of antiemetics unless absolutely necessary -Take special care when shaving or when brushing her teeth - Stay on a low-fat diet during the course of the drug therapy -Avoid large crowds and public places whenever possible

Take special care when shaving or when brushing her teeth Avoid large crowds and public places whenever possible

The nurse is caring for a client receiving a combination of antineoplastic medications. The client asks the nurse why so many different medications are being used instead of just one medication. The nurse should explain what characteristics of combination therapy? Select all that apply. Increases the quantity of each medication used Targets different phases of the cell cycle Decreases the development of cell resistance Decreases the adverse effects of each medication Prolongs the length of treatment

Targets different phases of the cell cycle Decreases the development of cell resistance

Taxane

An antineoplastic extravasates, and the antidote is administered. The nurse would apply warmth to the site if extravasation involved which drug?

Teniposide

The nurse is caring for a client who has leukemia. What aspect of this client's health status should the nurse prioritize when confirming the appropriateness and dosing of antimetabolites? The client currently has bone marrow suppression. The client has a long-standing diagnosis of type 2 diabetes mellitus. The client has had seizure activity in recent months. The client's blood pressure is usually in the range of 140/90 mm Hg.

The client currently has bone marrow suppression.

lung cancer. What effect will this regimen likely have on the client's hemostatic function?

The client's platelet count will decline.

A patient is administered mesna (Mesnex) to prevent cystitis induced by ifosfamide. How will this medication combination prevent cystitis? The medications increase urine output related to ifosfamide. The medications decrease viral load related to ifosfamide. The medications increase white blood cells related to ifosfamide. The medication combines with the metabolite of ifosfamide.

The medication combines with the metabolite of ifosfamide Chapter 14: Antineoplastic Agents, box 14.3, p. 221. Mesna is used with ifosfamide, which produces a metabolite that causes hemorrhagic cystitis. Mesna combines with and inactivates the metabolite, thereby decreasing cystitis.

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.

the necessity of recovery periods between treatment cycles of chemotherapy?

Time is needed to replace many of the healthy body cells killed by chemotherapy.

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

Which of the following classes of antineoplastic drugs inhibits DNA synthesis during the S phase? (Choose one) A) Camptothecin analogs B) Podophyllotoxins C) Taxanes D) Vinca alkaloids

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

Many times a combination of antineoplastic medications are used to

decrease the development of cell resistance.

Many times a combination of antineoplastic medications are used to:

decrease the development of cell resistance.

Based on the nurse's understanding of antineoplastic drugs, the nurse would anticipate administering which in conjunction with doxorubicin (Doxil) as a cardioprotective agent?

dexrazoxane

Based on the nurse's understanding of antineoplastic drugs, the nurse would anticipate administering which in conjunction with doxorubicin as a cardioprotective agent? mesna dexrazoxane leucovorin amifostine

dexrazoxane

A nurse is caring for a 46-year-old female patient who is taking paclitaxel for ovarian cancer. Two or three days after the infusion of the drug, the nurse must closely monitor for: cardiotoxicity. constipation. neurotoxicity. asthma.

neurotoxicity Chapter 14: Antineoplastic Agents - Page 232 Neurotoxicity is a major problem associated with paclitaxel therapy, and close monitoring is needed. Neurotoxicity generally begins 2 to 3 days after the infusion. Cardiotoxicity is observed in less than 1% of patients. The drug is not known to cause constipation or asthma.

A client asks the nurse what cancer cell growth is called. What would the nurse tell the client? pleomorphism neoplasm anaplasia proliferation

proliferation

A 57-year-old male patient who has been prescribed doxorubicin for small-cell lung cancer is advised by the nurse to avoid taking aspirin or drugs that contain aspirin because it may:

promote bleeding.

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 risk for ineffective health maintenance related to chemotherapy risk for acute pain related to chemotherapy risk for contamination related to chemotherapy

risk for injury related to chemotherapy

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.

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? Alcohol intake Sensory, motor, and perceptual functions Exposure to sunlight Cigarette smoking

sensory, motor, and perceptual functions

When preparing to administer ondansetron for a patient's nausea and vomiting, the nurse understands that this agent blocks:

serotonin.

skin

A patient who will begin chemotherapy voices concern to the nurse about the accompanying nausea and vomitting. What is the best response by the nurse? A. "Not everyone has nausea and vomiting. Just wait to see how you will react to the chemotherapy." B. "Nausea and vomiting are an unfortunate side effect of the chemotherapy. We will do what we can but you may have it anyway." C. "We can relieve your nausea and vomiting with antiemetic drug therapy. You should ask for these medications whenever you need them." D. "We can relieve your nausea and vomiting with drugs but you can have them only before and after the chemotherapy."

"We can relieve your nausea and vomiting with antiemetic drug therapy. You should ask for these medications whenever you need them."

A nurse in an outpatient treatment center is caring for a client who receives regular IV chemotherapy sessions. The nurse understands that one important goal of chemotherapy is what? A. Prevention or treatment of adverse drug effects B. Promotion of uncontrolled cell growth C. Decrease in biologic targeted therapies D. Inhibition of normal cell production

A. Prevention or treatment of adverse drug effects 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.

A 49-year-old client is diagnosed with ovarian cancer. What is a characteristic of malignant cells that differentiates them from normal body cells? A .Cancerous cells do not require an energy source in order to proliferate. B. Cancerous cells grow in an uncontrollable fashion. C. Cancerous cells have a theoretically infinite life span. D. Cancerous cells are not responsive to the presence of drugs.

Cancerous cells grow in an uncontrollable fashion -Malignant cells have lost the normal genetic regulation that controls cell growth, invading normal tissues and taking blood and nutrients away from these tissues. They grow in an uncontrolled fashion without regard to growth regulation signals (e.g., contact with other cells) that stop the growth of normal cells.

Which antineoplastic drugs are classified as alkylating agents? (Select all that apply.) Bleomycin (Blenoxane) Chlorambucil (Leukeran) Vinblastine (Velban) Cyclophosphamide (Cytoxan) Ifosfamide (Ifex)

Chlorambucil (Leukeran) Cyclophosphamide (Cytoxan) Ifosfamide (Ifex)

Mutation in what gene results in more than 90% of small cell lung cancers and more than 50% of breast and colon cancers? A. a42 B. c42 C. a53 D. p53

D. p53 Mutations of the p53 gene, a common genetic change in cancer, are associated with more than 90% of small cell lung cancers and more than 50% of breast and colon cancers. All other choices are incorrect.

Getitinib

A nurse is administering an antineoplastic extravasation occurs. How can the nurse best prevent tissue damage caused by extravasation? Inspect the site frequently for redness or swelling Infuse into proximal veins whenever possible Administer through a hand vein, if possible Use an infusion pump

Inspect the site frequently for redness or swelling

A nurse is administering an antineoplastic extravasation occurs. How can the nurse best prevent tissue damage caused by extravasation? A. Infuse into proximal veins whenever possible B. Use an infusion pump C. Inspect the site frequently for redness or swelling D. Administer through a hand vein, if possible

Inspect the site frequently for redness or swelling -Site inspection is a major intervention for preventing extravasation. Distal veins should be used.

During which phase of the cell cycle would a nurse expect a mitotic inhibitor to act? M G1 S G0

During which phase of the cell cycle would a nurse expect a mitotic inhibitor to act? M G0 G1 S

M Mitotic Inhibitors act in M phase (mitosis)

The patient taking hydroxyurea states that she is having difficulty swallowing the pills. What suggestions by the oncology nurse can help minimize this problem? Mix the capsules with applesauce, water, or juice and swallow in liquid form. Administer the medication at the outpatient clinic intravenously. Switch the treatment regimen to one that the patient can tolerate. Suck on an ice cube to numb the pharynx prior to swallowing the medication.

Mix the capsules with applesauce, water, or juice and swallow in liquid form.

A nurse is preparing to administer imatinib to a client. The nurse expects to administer this drug by which route?

Oral

The nurse is caring for a client whose current antineoplastic regimen includes bicalutamide. The nurse should most likely foresee what additional aspect of this client's cancer treatment? Total mastectomy Prostatectomy Hemicolectomy Thyroidectomy

Prostatectomy

Skin -Skin cells proceed very rapidly through the cell cycle.

Tamoxifen achieves a therapeutic effect by which means? A. inducing apoptosis of cancer cells B. slowing the growth of cancer cells C. causing mutations of cancer cells D. increasing the viability of healthy cells that are adjacent to cancerous cells

Slowing the growth of cancer cells -Antineoplastic hormone inhibitors slow the growth of cancer cells.

A client with Hodgkin's disease has been prescribed vincristine. What nursing consideration should the nurse prioritize when administering this drug? - The nurse should avoid using a distal vein. - The nurse should encourage the client to eat six small meals a day. - The nurse should check for extravasation when the infusion is over. - The nurse should avoid any skin, eye, or mucous membrane contact with the drug.

The nurse should avoid any skin, eye, or mucous membrane contact with the drug.

A pediatric patient with leukemia is being followed by a nurse. Prior to the administration of chemotherapy, the patient receives rasburicase (Elitek). The nurse's follow-up care after administration of the drug will involve monitoring what?

Uric acid levels

The nurse is caring for a client who is receiving a combination of antineoplastic agents. The client has been told that alopecia is likely to occur, and the client is tearful and distraught about this. What is the nurse's best response? -Validate the client's sense of impending loss and offer guidance for getting a wig -Encourage the client to view the hair loss as something that indicates cancer is being eradicated -Reassure the client that other people who are treated with cancer also experience this -Reassure the client that the hair loss will be temporary rather than permanent

Validate the client's sense of impending loss and offer guidance for getting a wig

The nurse is preparing to administer doxorubicin for a client who has a diagnosis of neuroblastoma. What action should the nurse perform?

Wear personal protective equipment

The nurse is preparing to administer doxorubicin for a client who has a diagnosis of neuroblastoma. What action should the nurse perform? Assess the integrity of the client's deltoid sites Perform hand hygiene before administration to protect against cytotoxic effects Wear personal protective equipment Assess the integrity of the client's mucous membranes

Wear personal protective equipment

The dosages of the chemotherapy agents that will be administered are based primarily on what client variable? A. weight B. body surface area (BSA) C. percentage of body water D. comorbidities

Weight

What can the oncology nurse do to minimize the exposure risk to chemotherapeutic agents? A) Only administer chemotherapy agents that are not toxic. B) Attend in-service education. C) Recognize the dangers of administering chemotherapeutic agents. D) Be familiar with institution's policies and procedures and use them as precautionary measures.

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.

An adult client who has been diagnosed with a rectal tumor is scheduled to begin treatment with cisplatin.The nurse has conducted client teaching about the possibility of nausea and vomiting. In order to reduce the client's risk of severe nausea, the nurse should: place the client on a low-residue diet. ensure that the client is NPO from midnight prior to receiving the drug. administer a combination of antiemetics prior to the administration of the drug. encourage the client to request antiemetics if the nausea becomes unbearable.

administer a combination of antiemetics prior to the administration of the drug. Chapter 14: Antineoplastic Agents - Page 223 Antiemetics should be administered proactively rather than waiting until the client's nausea becomes unbearable. A combination approach is often effective. A low-residue diet is unnecessary, and withholding food does not necessarily reduce nausea.

Many times a combination of antineoplastic medications are used to: decrease the development of cell resistance. increase the length of treatment. increase the quantity of each medication used. decrease the side effects of each medication.

decrease the development of cell resistance.

When preparing to administer ondansetron for a patient's nausea and vomiting, the nurse understands that this agent blocks:

serotonin

A 25-year-old female client is prescribed methotrexate to treat rheumatoid arthritis (RA). The nurse should teach the client to: A. use an effective contraceptive. B. drink milk with the medication. C. expect a mild rash and itching. D. take a pain reliever for sore throat.

use an effective contraception -Women of childbearing age should use an effective contraceptive during therapy with methotrexate. When taking methotrexate, the client should be instructed to notify the primary health care provider immediately at first sign of a rash or sore throat.

A client with a diagnosis of non-small-cell lung cancer is currently undergoing chemotherapy. At the encouragement of a family member, the client has announced to the nurse the intention to complement this treatment with a regimen of herbal remedies. How should the nurse respond to this client's statement? A. "It's likely best to begin taking herbal remedies after you've completed this round of chemotherapy." B. "Unfortunately, your current chemotherapy program will likely preclude the use of herbs." C. "It's important to discuss what herbs you'll be taking with your health care provider or the pharmacist to make sure there aren't any interactions." D. "If that's something in which you and your family see potential benefit, I'd encourage you to pursue it."

"It's important to discuss what herbs you'll be taking with your health care provider or the pharmacist to make sure there aren't any interactions."

A client being treated with an antineoplastic medication is being discharged from the hospital. Which of the following teaching instructions is appropriate for this client? A) "Your cancer will never be gone; however, if you eat only natural foods the likelihood of it getting worse is lessened." B) "You will be excreting the antineoplastic medications in your stool and urine. As a precaution, double-flush the toilet with the lid closed so the chances of contact with the drug will be lessened." C) "Your hair will never come back, so you should look into a wig or hair plugs." D) "If your mouth gets sores inside of it, eat lots of salty and spicy food to burn the sores off."

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.

An adult client who has been diagnosed with a rectal tumor is scheduled to begin treatment with cisplatin.The nurse has conducted client teaching about the possibility of nausea and vomiting. In order to reduce the client's risk of severe nausea, the nurse should: A. encourage the client to request antiemetics if the nausea becomes unbearable. B. ensure that the client is NPO from midnight prior to receiving the drug. C. place the client on a low-residue diet. D. administer a combination of antiemetics prior to the administration of the drug.

Administer a combination of antiemetics prior to the administration of the drug -Antiemetics should be administered proactively rather than waiting until the client's nausea becomes unbearable. A combination approach is often effective.

The dosages of the chemotherapy agents that will be administered are based primarily on what client variable? A. Body surface area (BSA) B. Percentage of body water C. Weight D. Comorbidities

C. Weight It is important to use weight-based dosing to individualize dosing of all cytotoxic drugs to minimize toxicity of normal cells. Considerations such as comorbidities, BSA, and percentage of body water may be relevant for certain clients, but weight-based dosing is the norm.

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

The nurse is caring for a patient who is receiving a combination of antineoplastic agents. The patient will most likely lose her hair. Why would the nurse suggest that she get a wig or use appropriate head cover? People may be uncomfortable seeing her bald head The hair will likely grow back if the head is covered at all times Most of the heat is lost through the head and it is important to cover it during extremes in temperature Her self-esteem will be better if the head is covered

Most of the heat is lost through the head and it is important to cover it during extremes in temperature

A Hispanic client has just been diagnosed with cancer. The nurse notes that the client does not speak English very well, and no matter what the nurse says the client simply shakes his head and says "okay." How can the nurse best respond to this client? Continue to speak English to the client regarding the client's diagnosis. Give the client lots of literature regarding the client's diagnosis so that the client can read it at his leisure. Speak English very slowly and loudly so that the client can understand better what the nurse is saying. Obtain the services of an interpreter to translate the information to the client and obtain literature that is written in Spanish.

Obtain the services of an interpreter to translate the information to the client and obtain literature that is written in Spanish.

A nurse is providing client education to a 50-year-old woman who is taking methotrexate (MTX) for breast cancer. The nurse will instruct the client to avoid which drug?

Salicylates

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: A) encourage the patient to eat 6 small meals a day. B) avoid any skin, eye, or mucous membrane contact with the drug. C) avoid using a proximal vein. D) check for extravasation when the infusion is over.

The nurse is administering vincristine to a patient, and the container that the medication is in breaks open, resulting in the medication spraying over the patient and the nurse. The nurse follows the proper hospital procedures for cleaning up a chemotherapy spill. Afterward, what should the nurse be monitoring the patient for closely? A) GI distress B) Skin rash C) Severe eye irritation D) Motor, sensory, and autonomic neuropathies

When describing the process of cancer cell growth to a client, the nurse addresses angiogenesis. Which description would the nurse include? A. A process that involves the cells traveling to other areas of the body to develop new tumors B. A process in which the cells lose their ability to differentiate and organize C. The process of creating new blood vessels to supply oxygen and nutrients to the cells D. The process of growing without the usual homeostatic restrictions that regulate cells

The process of creating new blood vessels to supply oxygen and nutrients to the cells

Which of the following 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? Etoposide (Toposar) Irinotecan (Camptosar) Teniposide (Vumon) Vinblastine (Velban)

Vinblastine (Velban)

Which drug would be classified as a mitotic inhibitor?

Vincristine

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

see a wig specialist.

Cancer cells can rapidly develop a resistance to alkylating agents. True False

False Neoplastic cells can rapidly develop resistance to antimetabolites.

A patient is beginning a course of chemotherapy for the treatment of chronic lymphocytic leukemia. To what is the start of this therapy referred? Palliative therapy Induction therapy Consolidation therapy Maintenance therapy

Induction therapy

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

A male client is receiving parenteral cytotoxic medications in the home. Adjunct therapy may include what substance? Erythropoietin Heparin Normal saline 0.9% intravenously Antidiuretic hormone

Erythropoietin Chapter 14: Antineoplastic Agents - Page 223

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

A male client is diagnosed with prostate cancer. The treatment modality of choice includes both surgery and chemotherapy. What does the chemotherapeutic option include? A. Antidiuretic hormone B. Diuretics C. Hormonal therapies D. Hemoglobin replacement therapy

Hormonal therapies -Hormonal therapies that block the effects of estrogen (in an estrogen-responsive tumor) and androgen (in an androgen-responsive tumor), respectively, are essential in the treatment of breast and prostate cancers.

What health education topic should the community health nurse emphasize when planning care for a client who will be prescribed an oral chemotherapy drug for the next several months while recovering at home? A. ways to match the dose to the severity of the symptoms B. appropriate herbal substitutes for the chemotherapy agent C. techniques for safely handling the drug D. techniques for self-monitoring of liver status

Techniques for safely handling the drug -All cytotoxic drugs are hazardous substances and require special handling and disposal, per safety guidelines, in the home. It is not possible for the client to independently monitor liver status in the home.

A nurse is caring for a 46-year-old female patient who is taking paclitaxel for ovarian cancer. Two or three days after the infusion of the drug, the nurse must closely monitor for: asthma. cardiotoxicity. neurotoxicity. constipation.

neurotoxicity

A female client 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 client's drug regimen and the client has asked about the potential side effects of treatment. How should the nurse best respond? A. "Both classes of drugs have adverse effects, but targeted therapies tend to have less of an effect on healthy body cells." B. "Targeted therapies are often more effective than traditional chemotherapy, but the downside of this effectiveness is that adverse effects are more common and severe." C. "The adverse effects to targeted therapies are most often a result of the client's cancer, not the drugs themselves." D. "Chemotherapy causes a lot of unpleasant side effects, and the advantage of targeted therapies is that these are all avoided."

"Both classes of drugs have adverse effects, but targeted therapies tend to have less of an effect on healthy body cells." -Targeted therapies are generally considered to be less toxic than traditional chemotherapy drugs. However, adverse reactions to targeted therapies can occur such as severe skin reactions, GI toxicities, skin reactions, and thrombosis.

What is the defining characteristic of a sarcoma? A. Congenital in nature B. Originates from connective tissue C. Attributable to endogenous carcinogens D. Sequestered within bone or muscle tissue

B. Originates from connective tissue 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.

A patient is experiencing antineoplastic-induced nausea and vomiting. The health care provider prescribes ondansetron. The nurse understands that this agent acts in which way? Blocking serotonin receptors in the CTZ Blocking human substance P/neurokinin 1 receptors Directly blocking the chemoreceptor trigger zone (CTZ) Calming the activity of the gastrointestinal tract

Blocking serotonin receptors in the CTZ Chapter 14: Antineoplastic Agents - Page 223 Ondansetron blocks serotonin receptors in the CTZ. Aprepitant blocks human substance P/neurokinin 1 receptors in the central nervous system. Benzodiazepines directly block the CTZ. Metoclopramide calms the activity of the GI tract. Ondansetron blocks serotonin receptors in the chemoreceptor trigger zone (CTZ) and is one of the most effective antiemetics. Antihistamines help to reduce the risk of hypersensitivity reactions and decrease secretions ; corticosteroids help to relieve inflammation and may aid in reducing possible hypersensitivity.

A medical-surgical registered nurse (RN) is requested to go to the oncology unit, which is short staffed. When the RN arrives to the unit, the oncology nurse states, "We are so short today that you are going to have to administer chemotherapy to some of the clinic patients." According to the Oncology Nurses Society (ONS), of what should the oncology nurse be aware? Because there is a critical shortage of oncology nurses in the unit, it is within the scope of practice for the RN to administer the chemotherapy. The oncology nurse should be aware that he or she must watch the RN administer the chemotherapy. The oncology nurse should be aware that he or she may delegate chemotherapy to another nurse as long as the oncology nurse is in the department. Chemotherapy should be administered by RNs who have successfully completed a course in chemotherapy administration.

Chemotherapy should be administered by RNs who have successfully completed a course in chemotherapy administration.

When planning the care for a client receiving imatinib, the nurse would identify which nursing diagnosis as most likely? Excess fluid volume related to fluid retention Imbalanced nutrition, less than body requirements, related to severe nausea and vomiting Risk for infection related to bone marrow suppression Disturbed body image related to hair loss An older adult woman has been diagnosed with acute lymphoblastic leukemia (ALL) and her care team has identified potential benefits of imatinib. Which characteristic of this patient's current health status may preclude the use of imatinib? The patient has type 2 diabetes mellitus that is controlled using diet and oral antihyperglycemics. The patient has chronic heart failure resulting in significant peripheral edema. The patient experienced a mild ischemic stroke several years ago and had transient ischemic attacks last year. The patient had a total knee arthroplasty several months earlier.

Excess fluid volume related to fluid retention Chapter 14: Antineoplastic Agents - Page 240 The adverse effects associated with imatinib include GI upset, muscle cramps, heart failure, fluid retention, and skin rash. Thus a nursing diagnosis of excess fluid volume would be most likely. The severe bone marrow suppression, alopecia, and severe GI effects associated with the more traditional antineoplastic therapy do not occur. The patient has chronic heart failure resulting in significant peripheral edema. Imatinib may be associated with edema. Patients should be weighed regularly and assessed for signs of fluid retention that could be severe. The risk of edema increases with higher doses of imatinib and age greater than 65 years. Previous strokes, orthopedic surgery, or well-controlled diabetes may not contraindicate the use of imatinib.

The oncology nurse is preparing a chemotherapy agent and not wearing goggles. Some medication splashes in the eyes. What is the priority action for the eye exposure? Have a co-worker take the nurse to the emergency department. Place drops in the eyes for the discomfort and then irrigate with water. Cover the eyes with sterile gauze. Rinse with copious amounts of water for no fewer than 15 minutes.

Rinse with copious amounts of water for no fewer than 15 minutes.

A client with a diagnosis of bladder cancer is started on a chemotherapeutic regimen that includes three agents. What is the rationale for using multiple antineoplastic agents? The use of three agents decreases the development of cell resistance. The use of three agents increases the length of treatment. The use of three agents increases the quantity of one of the agents. The use of three agents decreases the adverse effects.

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

A female client age 25 years is prescribed methotrexate to treat rheumatoid arthritis (RA). The nurse should teach the client to:

Use an effective contraceptive.

A nurse is performing discharge teaching with a client who will soon return home. The client will continue taking imatinib for the foreseeable future, and the nurse is teaching the client about the safe administration of this drug. How should the nurse instruct the client to take imatinib? A. With a glass of grapefruit or cranberry juice B. Thirty minutes before breakfast and in the early evening, at least 2 hours after dinner C. With food and a large glass of water D. On an empty stomach

With food and a large glass of water

The nurse is assessing a client for adverse effects related to methotrexate therapy. What diagnostic finding should the nurse prioritize? A. Electrocardiogram (ECG) B. Calcium and magnesium levels C. Serum osmolality D. Creatinine clearance

D. Creatinine clearance Methotrexate is nephrotoxic. Consequently, the nurse must carefully follow indicators of the client's renal function. Electrolyte and water disturbances and cardiac conduction disorders are much less likely adverse effects.

What is the first priority action of the oncology nurse when there is a spill of a chemotherapeutic agent? Pick up glass fragments with a scoop. Wear an approved respirator. Post a sign to warn people away from the exposed area. Rinse the absorbed spill area with clean water. Repeat the washing and rinsing.

Post a sign to warn people away from the exposed area.

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) a peripheral IV in the nondominant forearm peripheral intravenous access in the antecubital fossa an intramuscular depot

a central venous catheter (CVC)

administer a combination of antiemetics prior to the administration of the drug.

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: drink a lot of water. limit fluid intake. take the medication at bedtime. increase the protein in her diet.

drink a lot of water. An adverse effect of this drug is the incidence of hemorrhagic cystitis. The nurse should encourage the patient to drink at least 2 liters of fluid a day and, in high-dose therapy, administer the uroprotectant agent mesna. Therapy should include prehydrating the patient orally and intravenously with at least 2 liters of normal saline solution. Potassium and magnesium additives may be indicated. The nurse will monitor urine output vigilantly to ensure an output of at least half of the intake. Taking the medication at bedtime and increasing protein in her diet are not associated with limiting the possible adverse effects of the drug.

nerve cell

A patient is receiving irinotecan (CPT-11) for colorectal cancer and begins having diarrhea, sweating, flushing, and abdominal cramping. What can the oncology nurse give to relieve these symptoms? A) Dexamethasone 4 mg IV B) Diphenhydramine 25 mg IV C) Epinephrine 0.3 mg subcutaneous (SC) D) Atropine 0.5 mg intravenous (IV)

A patient will be receiving floxuridine (FUDR) for treatment of colorectal cancer that has metastasized to the liver. What will the patient require prior to administration? A) An epidural catheter B) An intravenous central line C) A hepatic arterial pump for instillation D) A chest tube for instillation

Question 8 See full question 4m 52s When describing the use of the various agents for combating chemotherapy-induced nausea and vomiting, the nurse understands that the majority of these agents block:

Chemoreceptor trigger zone The majority of agents used to control nausea and vomiting secondary to chemotherapy directly block the CTZ. They do not affect neurotransmitters, gastric acidity, or the gag reflex.

A patient is having an intrapleural instillation of a chemotherapeutic agent. What does the oncology nurse need to monitor prior to instillation of the medication? Monitor for signs and symptoms of bleeding. Assess the patient for a headache. Monitor for signs and symptoms of infection. Monitor for complete drainage from the pleural cavity before instillation of the drug.

Monitor for complete drainage from the pleural cavity before instillation of the drug.

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

A mother has just been told that her child has cancer and will need chemotherapy. The mother is worried about side effects. What is the nurse's best response? "An immediate side effect of many chemotherapy agents is nausea and vomiting. There are medications that can be given prior to chemotherapy to lessen these side effects." "There are no long-term side effects from chemotherapy. Infertility and organ failure issues seen in clients after chemotherapy are coincidental." "During the treatment cycle, bone marrow suppression is a common side effect, so it is important that the child goes back to school and is involved in all activities, such as football." "Children do not have side effects of chemotherapy because their immune systems are not fully developed until after 12 years of life."

"An immediate side effect of many chemotherapy agents is nausea and vomiting. There are medications that can be given prior to chemotherapy to lessen these side effects."

The nurse is caring for a client newly diagnosed with a primary brain tumor. The client asks the nurse where the tumor came from. What is the nurse's best response? "Your tumor originated from a single cell that is genetically different from nearby cells." "Your tumor originated from changes in the structure of nerve tissue somewhere in your body." "Your tumor originated from somewhere outside the central nervous system from a cell just like other cells." "Your tumor most likely originated with a mutation in the pituitary gland that released pathologic hormones."

"Your tumor originated from a single cell that is genetically different from nearby cells."

A nurse on the oncology unit is caring for a client with an astrocytoma. The client has just been told that the tumor is growing very fast. The client asks the nurse how these tumors grow. What would be the nurse's best response? A) "Brain tumors infiltrate the surrounding tissue." B) "Brain tumors grow by invading the surrounding grey matter." C) "Brain tumors grow by invading the surrounding white matter." D) "Brain tumors spread down the spinal cord."

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)

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 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 patient with a pancreatic tumor will be starting on chemotherapy to decrease the size of the tumor, give the patient a better quality of life, and reduce the discomfort. What is this form of therapy called? A) Neoadjuvant therapy B) Adjuvant therapy C) Palliative therapy D) Consolidation therapy

A nurse is providing education to a client who is preparing to begin chemotherapy for the treatment of cancer. What action should the nurse encourage the client to implement to minimize the effects of chemotherapy-triggered mucositis? A. ''Self-administer 650 mg of acetaminophen 4 times daily.'' B. ''Thoroughly rinse your mouth often, especially before and after meals.'' C. ''Limit fluid intake to prevent overhydration of mucous membranes.'' D. ''Gargle with a commercial mouthwash 3 to 4 times daily.''

B. ''Thoroughly rinse your mouth often, especially before and after meals.'' A client who is experiencing mucositis should rinse the mouth several times daily, especially before meals (to decrease unpleasant taste and increase appetite) and after meals (to remove food particles that promote growth of microorganisms). Fluid intake should be increased, and commercial mouthwashes should be avoided. Analgesia therapy is usually topical, rather than oral.

The nurse is caring for a client who is undergoing chemotherapy for the treatment of leukemia. The nurse should monitor the client for what potential adverse effects? Select all that apply. A. Increased urine output B. Mucositis C. Hypouricemia D. Unusual fatigue E. Tetany

B. Mucositis D. Unusual fatigue E. Tetany Common adverse effects of cytotoxic drug administration include mucositis and fatigue. With treatment of leukemias and lymphomas, an adverse effect called tumor lysis syndrome may occur; effects of this disorder include paresthesias, tetany, decreased urine output, and hyperuricemia.

A client is receiving idarubicin. What is the nurse's priority assessment? Cardiac function Respiratory function Red cell indices Electrolyte levels

Cardiac function Chapter 14: Antineoplastic Agents - Page 229 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.

After the instillation of an intrapleural chemotherapeutic agent, what should the oncology nurse do for the medication to reach optimal absorption? Clamp the tube for 18 hours and then connect to suction. Clamp the tube for 1 hour and unclamp for 1 hour. Infuse the medication, allow it to dwell, and then drain the solution. Clamp the tube and reposition the patient every 10 to 15 minutes for 2 hours.

Clamp the tube and reposition the patient every 10 to 15 minutes for 2 hours.

A client 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 client with respect to the depressing effect of the bone marrow?

Complete blood count

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

The normal growth-regulating genes that are present in all cells are referred to by what name? A. Neoplastic transformations B. Carcinogens C. Oncogenes D. Protooncogenes

D. Protooncogenes Abnormal genes, called oncogenes, are mutations of normal growth-regulating genes called protooncogenes, which are present in all body cells. Carcinogens are cancer-causing agents. Neoplastic transformation is a process in which replication of abnormal cells occurs without normal immune destruction.

A client with breast cancer is receiving goserelin (Zoladex). What aspect of the client's most recent laboratory results would suggest an adverse effect of this particular drug? Elevated serum calcium Decreased hemoglobin and hematocrit Increased international normalized ratio Increased blood urea nitrogen and creatinine

Elevated serum calcium Chapter 14: Antineoplastic Agents - Page 235 Goserelin is associated with a risk of hypercalcemia. Renal dysfunction is important to dosage management of almost all antineoplastic drugs and is not specific to goserelin. Changes in INR or red cell indices would not be directly associated with goserelin treatment.

Mark, 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 for what reason?

Higher tumor response rate

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 Administer anticoagulants as prescribed Place the client on protective isolation Monitor the client's laboratory values closely Allow sufficient time for rest between scheduled activities

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 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.

Which antineoplastic drugs are classified as antimetabolites? (Select all that apply.) Mercaptopurine (Purinethol) Capecitabine (Xeloda) Fluorouracil (Adrucil) Etoposide (Toposar) Irinotecan (Camptosar)

Mercaptopurine (Purinethol) Capecitabine (Xeloda) Fluorouracil (Adrucil)

The oncology nurse is aware that skin and mucous membrane absorption and inhalation of chemotherapeutic agents can occur during which of the following activities? (Select all that apply.) Disposing of the body excreta of patients who have received these drugs within the past 48 hours Disposing of intravenous bags, bottles, syringes, and tubing used in administration of chemotherapeutic agents Eliminating air from a syringe filled with a chemotherapy agent Disposing of linens that a patient that received chemotherapy was laying on Opening a chemotherapy vial or ampule

Opening a chemotherapy vial or ampule Eliminating air from a syringe filled with a chemotherapy agent Disposing of intravenous bags, bottles, syringes, and tubing used in administration of chemotherapeutic agents Disposing of the body excreta of patients who have received these drugs within the past 48 hours

Prostate cancer

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

Stop the infusion.

A client asks the nurse why he has to have several courses of a chemotherapy drug instead of just one dose. The nurse states that it is based on the cell kill theory. Which of the following statements describes the cell kill theory? The cell kill theory is based on the premise that one dose of a chemotherapy drug will kill all the cancer cells if enough of the medication is given to a client. The cell kill theory describes the ways that different chemotherapy medications work to kill both healthy and cancerous cells within the human body. The cell kill theory describes the phenomenon that occurs during the life cycle of a cancer cell as it is treated with a chemotherapy medication. The cell kill theory describes the process of giving multiple doses of chemotherapy with each dose, killing approximately 90% of the cancer cells. After several rounds of chemotherapy, nearly all of the cancer cells are killed and the body's immune system will kill the few cancer cells that are left.

The cell kill theory describes the process of giving multiple doses of chemotherapy with each dose, killing approximately 90% of the cancer cells. After several rounds of chemotherapy, nearly all of the cancer cells are killed and the body's immune system will kill the few cancer cells that are left.

The patient is exhibiting signs of syndrome of inappropriate antidiuretic hormone caused by the high dose of cyclophosphamide.

The patient taking hydroxyurea states that she is having difficulty swallowing the pills. What suggestions by the oncology nurse can help minimize this problem? A) Administer the medication at the outpatient clinic intravenously. B) Mix the capsules with applesauce, water, or juice and swallow in liquid form. C) Suck on an ice cube to numb the pharynx prior to swallowing the medication. D) Switch the treatment regimen to one that the patient can tolerate.

A client with a diagnosis of bladder cancer is started on a chemotherapeutic regimen that includes three agents. What is the rationale for using multiple antineoplastic agents? A. The use of three agents decreases the development of cell resistance. B. The use of three agents increases the length of treatment. C. The use of three agents increases the quantity of one of the agents. D. The use of three agents decreases the adverse effects.

The use of three agents decrease the development of cell resistance -Most chemotherapy regimens involve a combination of drugs with different actions at the cellular level, which destroys a greater number of cancer cells and reduces the risk of the cancer developing drug resistance.

What is the first priority action of the oncology nurse when there is a spill of a chemotherapeutic agent? A) Rinse the absorbed spill area with clean water. Repeat the washing and rinsing. B) Post a sign to warn people away from the exposed area. C) Pick up glass fragments with a scoop. D) Wear an approved respirator.

What measure protects the nurse when preparing cytotoxic drugs? A) Washing hands before preparation B) Wearing protective equipment such as gloves, mask, and gown C) Mixing medication in a 1-L bag D) Administering medication IM

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

A patient who is receiving methotrexate is also receiving leucovorin. The nurse understands that this drug is being given for which reason? A. Counteract effects of methotrexate B. Synergistic effect on the cancer cells C. Relief of nausea and vomiting D. Reduction of renal toxicity risk

Counteract effects of methotrexat -Leucovorin is administered with methotrexate to counteract the effects of methotrexate treatment.

Which antineoplastic drugs are classified as antimetabolites? (Select all that apply.) A. Mercaptopurine (Purinethol) B. Irinotecan (Camptosar) C. Etoposide (Toposar) D. Capecitabine (Xeloda) E. Fluorouracil (Adrucil)

Mercaptopurine, Capecitabine, Fluorouracil -Antimetabolite drugs are substances that incorporate themselves into the cellular components during the S phase of cell division .

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. Caution the client against taking aspirin or caffeine. C. Reassure the client about adequate monitoring and follow-up in her home setting. D. Reassure the client that it is a harmless and expected response to the drug.

Reassure the patient that it is a harmless and expected response to the drug -Reddish urine is observed within a day or two after doxorubicin injection. The client should be reassured that it is a harmless and expected response to the drug.

allopurinol -The nurse may be asked to administer allopurinol to a client to counteract the increase in uric acid and subsequent hyperuricemia resulting from the metabolic waste buildup from rapid tumor lysis.

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