Deck 57: Pharmacotherapy of Neoplasia

Question 1

Many antineoplastic agents have characteristics of more than one class.Paclitaxel (Taxol)can be classified as a(n):
Select all that apply.

A)natural product.
B)taxane.
C)mitotic inhibitor.
D)cell cycle inhibitor.
E)alkylating agent.

Answer 1

natural product.
taxane.
mitotic inhibitor.
cell cycle inhibitor.

Question 2

Folic acid analogs can be toxic to normal cells as well as to cancer cells.Which drug will the nurse administer following the administration of methotrexate to "rescue" the normal cells,causing them to be able to continue replication and development?

A)Leucovorin
B)Iron therapy
C)Immunoglobulin
D)Vitamin B₁₂

Answer 2

Leucovorin

Question 3

The client receives cyclophosphamide (Cytoxan)as treatment for cancer and experiences oral irritation as an adverse effect.What does the best plan of the nurse include to promote oral comfort?

A)Ice fluids before drinking.
B)Teach good oral hygiene,including rinsing the mouth with plain water after eating.
C)Teach the client to drink tea to keep tissues moist.
D)Teach the client to use a firm toothbrush for brushing teeth.

Answer 3

Teach good oral hygiene,including rinsing the mouth with plain water after eating.

Question 4

The client receives tamoxifen for treatment of breast cancer.She asks the nurse why the medicine works.What is the best response by the nurse?

A)"Tamoxifen works by inhibiting the metabolism of breast cancer cells."
B)"Tamoxifen works by inhibiting the cellular mitosis of breast cancer."
C)"Tamoxifen works by blocking estrogen receptors on breast tissue."
D)"Tamoxifen works by binding to the DNA of breast cancer cells."

Question 5

The nurse is explaining the mechanisms of action for alkylating agents and states that alkylating agents kill cancer cells by:
Select all that apply.

A)altering the shape of the DNA double helix.
B)preventing the DNA from duplicating during cell division.
C)becoming incorporated into the DNA of cancer cells.
D)interfering with DNA replication and function.
E)an unknown mechanism of action.

Question 6

The nurse is teaching a client about anthracyclines.Which medications will the nurse include in the teaching session?
Select all that apply.

A)Doxorubicin
B)Daunorubicin
C)Epirubicin
D)Bleomycin
E)Dactinomycin

Question 7

Which statement is true regarding hormone antagonists?

A)They are cytotoxic.
B)They enhance substances essential for hormone growth.
C)They produce similar debilitating adverse effects that other antineoplastics produce.
D)They can produce debilitating adverse effects at high doses for prolonged periods.

Question 8

Unlike alkylating agents,antitumor antibiotics:

A)are not given orally.
B)have severe adverse effects.
C)have no dose-limiting toxicities.
D)are not mitotic inhibitors.

Question 9

The nurse is discussing the use of tamoxifen with a client who has a family history of breast cancer.The nurse states that a unique approved use for tamoxifen is:

A)treatment for advanced lung cancer.
B)for prophylaxis of breast cancer.
C)treatment for estrogen receptor-negative cancers.
D)for the cure of advanced breast cancer.

Question 10

The nurse states that bone marrow toxicity does not suppress which type of cells?

A)White blood cells
B)Platelets
C)T cells
D)Red blood cells

Question 11

The nurse is describing the mechanism of action of antimetabolites to a client with cancer.Which statement best describes how the antimetabolites kill cancer cells?

A)They use the body's immune system to kill tumor cells."
B)They disrupt metabolic pathways,slowing growth of cancer cells."
C)They contain bacterial substances that can kill cancer cells."
D)They change the shape of the DNA and prevent division of cancer cells."

Question 12

The client receives cisplatin (Platinol)as therapy for cancer.Which assessment finding would prompt the nurse to contact the client's health care provider immediately?

A)Nausea and projectile vomiting
B)A temperature greater than 101°F
C)An elevation in blood glucose
D)A complaint of painful leg cramps

Question 13

The nurse is reviewing medications that are similar to methotrexate.Which medications are closely related to methotrexate?
Select all that apply.

A)Pemetrexed
B)Pralatrexate
C)Idarubicin
D)Plicamycin
E)Doxorubicin

Question 14

When a client taking methotrexate notifies the nurse of a sudden onset of a rash,the nurse is alerted to what life-threatening adverse effect associated with methotrexate?

A)Peptic ulcer
B)Stevens-Johnson syndrome
C)Pancreatitis
D)Myocardial infarction

Question 15

Classification of antineoplastics is difficult because:

A)The drugs kill cancer cells by different mechanisms and have characteristics from more than one class.
B)The drugs cannot always kill the cancer cells.
C)The drugs only have characteristics from one class,even though they kill by different mechanisms.
D)The drugs have various adverse effects.

Question 16

The nurse tells the client that alkylating agents kill cancer cells by:

A)containing substances from bacteria that can kill cancer cells.
B)disrupting critical cellular pathways of cancer cells.
C)changing the shape of the DNA double helix and preventing DNA from duplicating during cell division.
D)blocking substances necessary for continued growth of tumors.

Question 17

A common theme among all the antineoplastic agents is:

A)their adverse effects.
B)their ability to kill cancer cells.
C)their drug interactions.
D)their mechanism of action.

Question 18

The nurse is describing the mechanism of action for antibiotic antineoplastics to a client who is being treated for cancer.Which description by the nurse is most appropriate?

A)They contain substances from bacteria that have the ability to kill cancer cells."
B)They contain substances from plants that have the ability to kill cancer cells."
C)They contain substances from viruses that have the ability to kill cancer cells."
D)They contain substances from hormones that have the ability to kill cancer cells."

Question 19

The nurse knows that client education on drug interactions with doxorubicin has been successful when the client states:

A)"I can take acetaminophen if I get a fever."
B)"I can take my Celebrex for my arthritis."
C)"I can take ibuprofen for my back pain."
D)"I can take an aspirin for a headache."

Question 20

Which statement regarding the adverse effects of antineoplastic drugs is the most accurate?

A)They produce the most,but a small range,of adverse effects.
B)They produce the same amount of adverse effects as any other medication.
C)They commonly produce serious adverse effects.
D)They produce the least amount of serious adverse effects of any medication.

Question 21

When administering vincristine,the nurse knows that its dose-limiting toxicity primarily affects what system?

A)Renal
B)Pulmonary
C)Cardiac
D)Central nervous system

Question 22

Agents with antineoplastic activity that have been isolated from a number of plants work in what way?

A)They aid in attachment to the receptor sites on the cancer cell.
B)They arrest cell division,or mitosis.
C)They contain substances that have the ability to kill the cancer cells.
D)They prevent conversion from DNA to RNA.

Question 23

The nurse anticipates administering which drug to stimulate neutrophil production in clients with myelosuppression?

A)Epoetin
B)Interferon alfa
C)Filgrastim
D)Oprelvekin

Question 24

A large number of antineoplastic medications are absorbed through what route?

A)Fecal/oral
B)Skin and mucous membranes
C)Respiratory
D)Hair follicles

Question 25

If the nurse is caring for a client taking Epogen and notices blood lab tests have dropped below normal,the best initial action would be to:

A)Tell the client to take her normal dose that day,but come in for some lab work.
B)Notify the health care provider.
C)Tell the client to stop the drug and notify her health care provider.
D)Tell the client to stop the drug for 3 days to give the body some time for the levels to rise back to normal.

Question 26

The nurse is teaching a client about the different plants that can be used in the treatment of cancer.Which plants does the nurse include in the teaching session?
Select all that apply.

A)Roses
B)Common periwinkle
C)Pacific yew
D)Mandrake
E)Tulips

Question 27

OSHA has established guidelines for the safe handling of chemotherapeutic medications.The nurse correctly states that safe handling includes:
Select all that apply.

A)safe medication storage.
B)safe medication disposal.
C)safe medication handling.
D)required days off.
E)appropriate charges for services.

Question 28

A client shows a proper understanding of the adverse effects of vincristine when he states:

A)"I need to let my doctor know immediately if I have any weakness in my hands or feet."
B)"If I have swelling in my legs,I should keep them elevated for a while."
C)"I can take ibuprofen if I have any pain."
D)"I need to let my doctor know immediately if I took two pills instead of one."

Question 29

Which statement best explains the mechanism of action of monoclonal antibodies?

A)They alter the DNA of the tumor cells.
B)They prevent replication of the tumor cells.
C)They stimulate immune cell function.
D)They attack antigens on the surface of specific tumor cells.

Question 30

Which statement is true regarding biological response modifiers?

A)They are used to treat transplant rejections.
B)Some are immunostimulants and,when given with other antineoplastic agents,help limit severe myelosuppression.
C)They alter the body's defense system to decrease the removal of foreign cancer cells.
D)They are less toxic than are most classes of antineoplastics.

Question 31

With administering cyclophosphamide (Cytoxan),which has the potential adverse effect of cardiotoxicity,what is the best action by the nurse during treatment?

A)Obtain baseline and periodic ECGs.
B)Stop the drug if abnormal heart sounds are auscultated.
C)Obtain baseline and periodic echocardiograms.
D)Obtain baseline and periodic cardiac enzymes.

Question 32

The nurse is teaching a client about medications that can be taken to treat the diarrhea that often accompanies chemotherapy.Which medications would be appropriate for the nurse to include in the teaching session?
Select all that apply.

A)Polyethylene glycol 3350 (MiraLAX)
B)Psyllium (Metamucil)
C)Atropine (Lomotil)
D)Loperamide (Imodium)
E)Bismuth salts (Pepto Bismol)

Question 33

The nurse is teaching a client about the use of hematopoietic growth factors to promote the formation of specific blood cells.Which medications will the nurse include in the teaching session?
Select all that apply.

A)Epoetin alfa
B)Filgrastim
C)Sargramostim
D)Aldesleukin
E)IFN alfa-2b

Question 34

The nurse is preparing to administer cyclophosphamide (Cytoxan),which can cause nausea and vomiting.The nurse can best manage this by:

A)giving the client bland foods during treatment.
B)administering antiemetic drugs as necessary.
C)withholding food during administration.
D)increasing fluids during administration.

Question 35

The nurse who has received special training to administer chemotherapy is called:

A)an antineoplastic administrator.
B)a chemotherapy nurse.
C)an oncology nurse.
D)an IV therapy nurse.

Question 36

Many chemotherapy agents cause nausea and vomiting.The type and dose of antiemetic prescribed are based on:

A)the potential of specific antineoplastics to cause nausea and vomiting.
B)how many other medications the client is taking.
C)the severity of the client's symptoms.
D)the dose of the antineoplastics.