Pharm Test 5 Chp 14, 57-59, Ap. A & B)
Carter, age 2, is diagnosed with cystic fibrosis; the physician places him on pancrelipase. What would be the most appropriate diagnosis for Carter related to his medication regimen?
Imbalanced nutrition: less than body requirements, related to impaired digestion secondary to insufficient pancreatic enzymes
A nurse is teaching a client about his prescribed lansoprazole. The nurse instructs the client to take the drug at which time?
1 hour before eating
A client is prescribed a proton pump inhibitor to treat erosive gastritis. How soon will the client's symptoms be resolved?
1-2 weeks
A client is in the intensive care unit and being administered ranitidine parenterally. How long will it take for ranitidine to reach peak blood levels?
15 minutes
A client is receiving sucralfate. The nurse understands that this drug would begin to act within which time frame?
30 minutes
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-- 590*1.78
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.
The client has a magnesium-based antacid prescribed for administration before meals. The nurse knows to withhold the medication if the client exhibits what?
Renal dysfunction
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
A nurse is planning care for a 59-year-old woman who is on ranitidine therapy. The nurse is concerned for the client's safety. What would be an appropriate nursing diagnosis?
Risk for Injury related to drug-induced somnolence, dizziness, confusion, or hallucinations
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 what?
cell cycle
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?
central venous catheter
A nurse is caring for an elderly patient who has been administered cimetidine. Which intervention should the nurse perform?
closely monitor the patient for confusion and dizziness
A client with colorectal cancer is being treated with oxaliplatin. Which potential adverse effect should the nurse explain to the client?
cold induced neurotocity
The nurse should warn a client taking aluminum- and calcium-containing antacids about which adverse effects?
constipation
The nurse is assessing a client for adverse effects related to methotrexate therapy. What diagnostic finding should the nurse prioritize?
creatinine clearance
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
Ranitidine and cimetidine are both H2RAs used in the treatment of peptic ulcer disease. Of the two, ranitidine is preferred in critically ill clients because it is less likely to:
interfere with the metabolism of other drugs
Which medication reduces the secretion of gastric acid by inhibition of the hydrogen-potassium adenosine triphosphate (ATPase) enzyme system of the gastric parietal cells? Select all that apply.
lansoprazole esomeprazole
Which is a common cause of diarrhea in older adults?
laxative overuse
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:
liver function
A client is receiving tamoxifen. Which adverse effect would be most specific to the action of this drug?
menopausal effects
A male client tells the nurse that he takes antacid tablets several times each day. Knowing that the brand of antacid he uses contains calcium carbonate, the nurse cautions the client that overuse could place him at risk for:
metabolic alkalosis
Which would the nurse identify as an antineoplastic antibiotic?
mitomycin
Defecation is normally stimulated by what physiologic trigger?
movements and reflexes in the GI tract
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
After teaching a group of students about proton pump inhibitors, the instructor determines that the students have understood the information when they identify which agent as the prototype proton pump inhibitor?
omeprazole
Which of the following would a nurse expect as most likely to be used in combination with antibiotics for treatment of Helicobacter pylori infection?
omeprazole
A nurse is preparing to administer imatinib to a client. The nurse expects to administer this drug by which route?
oral
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?
pancytopenia
A client who takes aluminum hydroxide with magnesium hydroxide (Mylanta) frequently for upset stomach, heartburn, and sour stomach is seen regularly in the clinic. The nurse should assess:
phosphate level
A client needing to evacuate the colon for endoscopy would likely be prescribed which medication?
polyethylene glycol electrolyte solution
A 52-year-old man is suffering from a deficiency of exocrine pancreatic secretions and is prescribed pancrelipase (Pancrease MT). Before the medication therapy begins, the nurse will assess for allergies related to
pork
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 asks the nurse what cancer cell growth is called. What would the nurse tell the client?
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
An elderly man has been admitted to a residential care facility and the nurse has conducted a medication reconciliation. The man has taken numerous drugs in the past, including a course of bicalutamide (Casodex) several years earlier. The nurse recognizes this drug as being an antiandrogen and is consequently justified in presuming that the man has a history of what disease?
prostate cancer
A female client presents to the health care provider's office with increasing stomach acidity. She self-administers calcium antacids. She notes that she seems to be having more issues with stomach acid, so she has been taking the calcium antacids more frequently. The nurse suspects that this may have caused what to occur in this client?
rebound acidity
The following data identified during a nursing assessment and interview. When considering risks for the development of a peptic ulcer, which situation should the nurse discuss with the client?
self medicates with a NSAID daily
A 75-year-old client is treating an ulcer with antacids. Based on the client's age, the nurse expects the health care provider to prescribe a dose of antacid that compares with the average prescribed dose in what way?
smaller than the avg prescribed dose
A client, with recent abdominal pain and a 40-pack per year smoking history, is prescribed a treatment regimen for a diagnosis of duodenal ulcer. What important teaching would the nurse include in relation to treatment?
smoking effects on the healing of ulcers
Client teaching should include what instruction about antacids?
take antacid 1 hour before other medications
The nurse is scheduled to administer sucralfate 1 gram po four times daily to a pregnant client admitted with gastroesophageal reflux disease (GERD). What is the priority teaching that would be provided regarding this medication?
take one hour before meals and at bedtime
Which would be most important to include when teaching a patient about using psyllium?
taking the agent with a large amount of water
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?
techniques for safely handling the drug
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 platelet count will decline
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?
thoroughly rinse the mouth often, especially before and after meals
Pancrelipase would most likely be used to treat a patient with cystic fibrosis.
true
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
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 nurse is providing education to a 23-year-old female client who has been prescribed misoprostol. What instruction should the nurse include in the teaching?
use of effective contraceptive measures
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?
with food and a large glass of water
A male client is taking cimetidine. Which adverse effect is more likely to occur with cimetidine than with other histamine2 receptor antagonists?
Gynecomastia
A client develops Clostridium difficile after receiving antibiotic therapy. The client asks the nurse how this occurs. Which is the nurse's best response?
"By suppressing normal flora, antibiotics allow proliferation of the organism."
A caregiver of a 1-year-old asks the nurse if they can give the diphenoxylate that was prescribed for an older sibling to the child. Which is the nurse's best response?
"Children younger than 1 year of age should not be given this medication."
A nurse is teaching a client about omeprazole, which has been prescribed as part of a regimen to treat an H. pylori infection. What statement, made by the client, suggests that the client understands proper use of the drug?
"I need to swallow whole"
A patient newly diagnosed with CML has been prescribed treatment with imatinib. The patient asks the nurse how imatinib works. What would be the nurse's best response?
"Imatinib inhibits the enzyme created by the Philadelphia chromosome abnormality in CML."
After teaching a client who is receiving sucralfate about the drug, which statement indicates that the teaching has been successful?
"i should eat a high-fiber diet"
The nurse is caring for a patient who has been prescribed a saliva substitute . The patient asks why this medication is necessary. What would be the most appropriate response?
"This medication helps people that have a condition that creates a lack of saliva."
A female client has GERD and is taking cimetidine. She continues to have gastric discomfort and asks whether she can take an antacid. Which is an appropriate response by the nurse?
"Yes, but be sure to wait at least 2 hours to take the antacid after you take the cimetidine."
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."
Which antineoplastic drugs are classified as antineoplastic antibiotics? (Select all that apply.)
Bleomycin (Blenoxane) Dactinomycin (Cosmegen) Daunorubicin (DaunoXome)
A child is prescribed an anthracycline drug. The nurse would teach the parents to observe for signs and symptoms of what adverse effect?
Cardiotoxity
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
When describing the drugs used to treat traveler's diarrhea, which would the nurse identify as the most common cause?
E. Coli
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?
Ensure that all staff and visitors adhere to infection control precautions.
No cancer cells have been identified that can remain dormant for more than 2 years.
False
How can a nurse best prevent tissue damage caused by an antineoplastic extravasation?
Inspect the site frequently for redness or swelling
A prescriber adds psyllium to the medication administration record for a client experiencing diarrhea. Which is the best rationale for the addition of psyllium?
It absorbs toxins and water, decreasing fluidity of stools.
A patient is diagnosed with ovarian cancer. Why is this considered to be an aggressive form of cancer?
It is fed by the hormones produced by the ovaries.
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?
Take special care when shaving or brushing her teeth
A nurse educator who coordinates the staff education on an oncology unit is conducting an inservice on targeted therapies. What potential benefit of targeted therapies should the nurse highlight in this education session?
Targeted therapies have the potential to damage cancerous cells while leaving normal body cells less affected.
A client is administered mesna to prevent cystitis induced by ifosfamide. How will this medication combination prevent cystitis?
The medication combines with the metabolite of ifosfamide.
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.
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
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.
What potential benefit is unique to biologic agent therapies?
They may affect cancer cells while leaving normal body cells unaffected.
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?
Time is needed to replace many of the healthy body cells killed by chemotherapy.
The nurse is seeing a 69-year-old client who is highly physically active and consumes a balanced diet that includes adequate fluid intake. Despite this, the client states experiencing occasional constipation in recent months. What remedy should be the nurse's first suggestion?
a bulk forming (fiber) laxative
Which agents would be considered cancer non-cell cycle specific agents?
alkylating agents
The nurse is caring for four clients. Which client would benefit most from misoprostol, a synthetic prostaglandin E analog?
an 83 year old male with RA
A critical care nurse is preparing to administer an intragastric drip of an antacid to a client through a nasogastric tube. How should the nurse most accurately titrate the dose and frequency?
aspirating stomach contents and measuring the pH
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 health care provider has recommended that an older adult client take a psyllium laxative. When providing client teaching, what potential effects should the nurse explain? Select all that apply.
bloating gas
A nurse is caring for a client who has developed diarrhea after antibiotic administration. The client has a BUN of 35 and creatinine of 1.8. The provider has ordered diphenoxylate with atropine for the client. What action should the nurse implement?
call the prescriber about the laboratory tests
When teaching a client about an antacid containing aluminum, what would the nurse include?
decreased risk for acid rebound
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?
disturbed body image
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 63-year-old male patient has just begun treatment with IV paclitaxel. About 10 minutes into the infusion, the nurse becomes concerned about a possible anaphylactic reaction to the drug because the patient is experiencing:
dyspnea
A 42-year-old man is being treated for a peptic ulcer with ranitidine (Zantac) taken PO at bedtime. Even though few adverse effects are associated with this drug, one common adverse effect that can be severe is:
headache
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:
higher tumor response rates
A 75-year-old client is diagnosed with type 2 diabetes mellitus, hypertension, osteoporosis, and gastric ulcer disease. She is prescribed PPIs. The nurse is aware that long-term (greater than 1 year) administration of PPIs may increase the risk for which problem for this client?
hip fractures
A client's chemotherapeutic regimen includes procarbazine. What is the client's most likely diagnosis?
hodgkin lymphoma
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
Mineral oil can be used as a laxative. The nurse knows that which statement regarding mineral oil is correct?
if aspirated, mineral oil can cause pneumonia
Which drug would have the least effect on healthy human cells?
imantinib
Which adverse reaction of proton pump inhibitors is specific to menopausal women with osteoporosis?
increased fracture risk
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 leukocytes
A client arrives at the walk-in clinic reporting vomiting and a burning sensation in the mid-epigastric region. The nurse suspects that the client has peptic ulcer disease. Which is a potential cause of peptic ulcer disease?
infection with H. pylori
The nurse should be aware that ranitidine achieves a therapeutic effect by which means?
inhibitingtthe secrection of gastric acid
