NUR 232 Pharm EAQ - Chapter 101: Basic Principles of Cancer Chemotherapy

The nurse is caring for a patient who is prescribed imatinib for chronic myeloid leukemia. Which instructions does the nurse include in discharge teaching? Select all that apply.

1.) "You can take the drug with water and a meal." 2.) "You must avoid breastfeeding while on therapy." 3.) "You will have blood tests weekly during the first month of treatment."

Which statements should the nurse include when teaching a patient about use of abiraterone in the treatment of prostate cancer? Select all that apply.

1.) "You may develop hot flashes." 2.) "You may develop enlargement of your breast tissues." 3.) "Blood work will be obtained at regular intervals to assess the function of your liver."

Which interventions does the nurse implement when caring for a patient receiving pemetrexed? Select all that apply.

1.) Administer prophylactic glucocorticoids to reduce skin rash. 2.) Administer prophylactic doses of folic acid 1 week before dosing. 3.) Administer prophylactic doses of vitamin B12 1 week before dosing.

When administering anticancer drugs, the nurse identifies which interventions as effective in minimizing renal injury from hyperuricemia? Select all that apply.

1.) Administration of fluids. 2.) Administration of rasburicase. 3.) Prophylactic administration of allopurinol.

For which adverse effects will the nurse monitor in a patient receiving chemotherapy? Select all that apply.

1.) Alopecia 2.) Stomatitis 3.) Neutropenia

Chemotherapy is dose-limiting primarily because of its toxicity to the cells in which tissues ? Select all that apply.

1.) Bone marrow 2.) Sperm-forming cells 3.) Gastrointestinal lining

A patient receives a rituximab infusion. The nurse monitors which laboratory tests for signs of tumor lysis syndrome (TLS)? Select all that apply.

1.) Calcium 2.) Uric acid 3.) Potassium

The nurse is preparing to administer doxorubicin intravenously (IV) to a patient with breast cancer. Which actions does the nurse take? Select all that apply.

1.) Ensure the patency of the IV site. 2.) Tell the patient the urine will turn red. 3.) Place the patient on a cardiac monitor.

Starting with the resting phase, list the major phases of the cell cycle in order.

1.) G0 2.) G1 3.) S 4.) G2 5.) M

A nurse is describing the characteristics of neoplastic cells to a patient. Which information will the nurse include in the teaching session? Select all that apply.

1.) Immortality 2.) Persistent proliferation 3.) Formation of metastases

Which benefits of combination chemotherapy would be discussed with a patient making a decision about options to treat recently diagnosed breast cancer? Select all that apply.

1.) Increased cancer cell kill. 2.) Suppression of drug resistance. 3.) Reduce injury to normal cells.

The provider indicates she will prescribe a purine analog for a patient with cancer. The nurse anticipates administering which medication? Select all that apply.

1.) Pentostatin 2.) Thioguanine 3.) Mercaptopurine

The nurse recognizes that a high tissue growth fraction allows chemotherapeutic medications to be more toxic to tissues in which phases of the cell cycle? Select all that apply.

1.) S 2.) G1 3.) M 4.) G2

Which statements regarding treatment modalities for cancer does the nurse identify as true? Select all that apply.

1.) Surgery is the most common treatment for solid cancers. 2.) Drug therapy is the treatment of choice for disseminated cancers. 3.) Drug therapy is effective as an adjunct therapy in treating a patient who has had irradiation.

What are the primary benefits to a patient who is receiving glucocorticoids as part of a chemotherapy regimen? Select all that apply.

1.) They promote appetite and weight gain. 2.) They are cytotoxic to selective cancers. 3.) They reduce cerebral edema after radiation.

A nurse is caring for a patient who is receiving chemotherapy for breast cancer. The provider prescribes zoledronate. When administering this drug, the nurse provides which information to the patient? Select all that apply.

1.) This may help prolong life. 2.) This will help prevent fractures. 3.) This may help prevent metastases.

Which assessment findings, if present on the palms and soles of the patient receiving fluorouracil, would prompt the nurse to report palmar-plantar erythrodysesthesia to the provider? Select all that apply.

1.) Tingling 2.) Swelling 3.) Blistering

Which nursing action is a priority when a patient is taking anastrozole?

Instruct the patient to increase dietary vitamin D and calcium.

The nurse has received an order for an antitumor antibiotic for a patient with acute myelogenous leukemia. Which route would the nurse most likely use to administer this drug?

Intravenous

A nurse is administering subQ an immunostimulant that is approved for only melanoma. Which immunostimulant is the nurse administering to the patient?

Peginterferon alfa-2b

The nurse is caring for a patient who has mild thrombocytopenia after chemotherapy. Which action should the nurse take?

Use minimal cuff inflation when taking the blood pressure.

Before beginning treatment with trastuzumab, the nurse should check which screening?

HER2-positive breast cancer.

A patient with breast cancer is receiving trastuzumab in combination with doxorubicin. The nurse would monitor the patient for which complication?

Heart failure.

The nurse hydrates a patient with intravenous (IV) fluids before administering cyclophosphamide IV. Which adverse effect is the nurse trying to prevent in the patient?

Hemorrhagic cystitis.

The nurse will administer docetaxel to the patient with which type of cancer?

Hormone-refractory prostate cancer.

A cancer patient who is on chemotherapy reports severe nausea and vomiting. Which action would be most beneficial to the patient?

Administer ondansetron.

The nurse planning care for a patient taking filgrastim would list which outcome as a goal for treatment?

An increase in white blood cells.

A patient undergoing chemotherapy for acute lymphocytic leukemia experiences confusion and liver injury. The nurse attributes these adverse effects to which drug?

Asparaginase

Which action does the nurse take for a patient who is receiving bortezomib for multiple myeloma?

Assess the patient's peripheral sensation.

The nurse would identify which immunostimulant as most effective in the treatment of in situ bladder cancer?

Bacille Calmette-Guérin (BCG) vaccine

The nurse on the oncology floor is planning care for four patients. The patient taking which cytotoxic anticancer drug will require ondansetron least frequently?

Bleomycin

Which type of cancer will the nurse expect to find documented in the chart for a patient receiving tamoxifen?

Breast cancer.

The patient with a brain tumor informs the nurse that she had an anticancer wafer inserted into her brain in a previous procedure. The nurse lists which medication in the patient's medical history?

Carmustine

The nurse is caring for a patient who has been diagnosed with metastatic breast cancer. The nurse receives an order to administer dasatinib. Which action by the nurse is priority?

Contact the provider regarding the medication.

A patient is receiving cancer chemotherapy. Which type of drug is the nurse administering?

Cytotoxic agents.

The nurse identifies which class of anticancer drugs as used most often in the treatment of patients?

Cytotoxic drugs.

A patient with cancer who is neutropenic is hospitalized. Which action by the nursing assistant requires the supervising nurse to intervene?

Delivering a fresh fruit basket to the patient's room.

A patient with breast cancer has hypercalcemia due to bone metastases. The nurse would anticipate use of which drug for the treatment of hypercalcemia?

Denosumab

Before an infusion of paclitaxel, the nurse administers which medication to prevent a complication?

Diphenhydramine

Which would the nurse recognize as the rationale for using more than one chemotherapy drug simultaneously for a patient with breast cancer?

Drug resistance occurs less frequently.

The nurse is preparing to administer the first dose of intravenous cetuximab. To prevent a complication, the nurse should have which medication readily available?

Epinephrine

Before administering etoposide, the nurse mixes the drug in a sufficient amount of intravenous (IV) fluid. Which adverse effect is the nurse trying to prevent with the IV fluid?

Hypotension

When planning care for a patient who is receiving cyclophosphamide, the nurse finds which intervention most important to include to prevent complications of cyclophosphamide therapy?

Increase the intravenous and oral fluid intake.

The nurse will anticipate administering which medication to patients receiving high-dose methotrexate?

Leucovorin

The nurse is planning care for a patient who is scheduled to receive bevacizumab. The patient had colon surgery 3 weeks ago. Which outcome does the nurse establish on the care plan?

No evidence of wound dehiscence.

The nurse should identify which cytotoxic anticancer agent as most likely to cause pulmonary toxicity in the patient?

Nonanthracyclines

A patient is given intravenous (IV) atropine for an adverse effect caused by irinotecan. Which assessment finding would the nurse use to evaluate the effectiveness of this approach?

Number of loose stools.

A patient is receiving cisplatin. Which finding, if noted in the patient receiving cisplatin, would prompt the nurse to notify the provider immediately?

Numbness in the fingers and toes.

The nurse develops a plan of care for a patient receiving chemotherapy whose neutrophil count has reached its nadir. Which nursing action is the priority?

Obtain temperature frequently.

Which characteristic of cancer cells can be described as "unresponsiveness to feedback mechanisms that control cellular growth in healthy tissue?"

Persistent proliferation.

The nurse understands that which type of anticancer drugs can act during any phase of the cell cycle?

Phase-nonspecific.

A patient is receiving vincristine for cancer. Which assessment is the highest priority?

Presence of peripheral neuropathy.

The nurse is assessing a patient who is taking rituximab for non-Hodgkin's lymphoma. In the patient's medical history, the nurse finds that the patient had a high tumor burden at the start of therapy. Based on this finding, which assessment is priority?

Presence of tumor lysis syndrome.

After reviewing the chart, the nurse will find which information is a cause to notify the health care provider about a patient receiving bevacizumab?

Previous gastrointestinal (GI) bleed.

When administering phase-specific anticancer medications, which schedule does the nurse use to achieve maximum therapeutic effectiveness?

Short intervals over time.

A patient with prostate cancer is receiving a treatment custom made from the patient's own immune cells by leukapheresis. Which medication will the nurse observe documented in the chart?

Sipuleucel-T

Following periodic lab work, the nurse instructs the patient who is receiving cancer chemotherapy to use a soft-bristled toothbrush and to avoid activities that may increase risk of injury. What is the rationale for the nurse's instructions?

The patient has developed thrombocytopenia.

A patient with cancer asks the nurse why he must take multiple chemotherapy drugs. The nurse bases the response on which understanding of the rationale behind multidrug chemotherapy regimens?

This prevents drug resistance.

A nurse is administering leuprolide to a patient with prostate cancer. Which goal does the nurse document in the care plan for this treatment?

To provide palliation.