Prep you chapter 14
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.
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
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.
Tamoxifen achieves a therapeutic effect by which means?
slowing the growth of cancer cells
A client is receiving bleomycin as part of a chemotherapy regimen. Which would be most important for the nurse to monitor?
Chest-x ray
A client's chemotherapeutic regimen includes procarbazine. What is the client's most likely diagnosis?
Hodgkin lymphoma
Cancer is considered the second leading cause of death in the United States. T/F
TRUE
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 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 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.
A patient is receiving carboplatin. The nurse would expect to administer this drug by which route?
Intravenous
Which would the nurse expect to administer to counteract the effects of methotrexate?
Leucovorin
Which would the nurse identify as an antineoplastic antibiotic?
Mitomycin
A patient with non-Hodgkin's lymphoma (NHL) will be starting a course of doxorubicin shortly. When planning this patient's care, what nursing diagnosis should the nurse prioritize?
Risk for Infection related to suppressed bone marrow function
What 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.
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:
administer a combination of antiemetics prior to the administration of the drug.
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
When preparing to administer ondansetron for a patient's nausea and vomiting, the nurse understands that this agent blocks:
serotonin
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."
Which agent would the nurse expect to be administered orally?
Methotrexate
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 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?
Monitor the client closely and repeat LFTs routinely.
A client has chosen to be placed on hospice. Which is acceptable chemotherapy for a client on hospice?
Palliative chemotherapy
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 drug would be classified as a mitotic inhibitor?
Vincristine
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 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 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?
"Both classes of drugs have adverse effects, but targeted therapies tend to have less of an effect on healthy body cells."
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 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 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 postmenopausal woman with breast cancer will most likely be treated with which anti-estrogen drug?
Tamoxifen
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 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 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.
What potential benefit is unique to biologic agent therapies?
They may affect cancer cells while leaving normal body cells unaffected.
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.
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 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?
Imbalanced nutrition: less than body requirements
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
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
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?
techniques for safely handling the drug
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 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."
No cancer cells have been identified that can remain dormant for more than 2 years. T/F
FALSE
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
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
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
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.
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.
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
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
