Question 1

A patient is receiving irinotecan (Camptosar),along with other antineoplastic drugs,as treatment for ovarian cancer.The nurse will monitor for which potentially life-threatening adverse effect that is associated with this drug?

A) Severe stomatitis
B) Bone marrow suppression
C) Delayed-onset cholinergic diarrhea
D) Immediate and severe nausea and vomiting

Accepted Answer

Irinotecan is associated with delayed-onset cholinergic diarrhea, which can be life-threatening if not treated promptly. Other potential adverse effects of irinotecan include bone marrow suppression, nausea and vomiting, and stomatitis, but delayed-onset cholinergic diarrhea is the most concerning.

Question 2

A patient is to receive a daily dose of fludarabine (Fludara),25 mg/m²/day for 5 consecutive days.Each dose is diluted in a 125-mL bag of normal saline and is to infuse over 30 minutes.The nurse will set the infusion pump to what rate in milliliters per hour? _______

Accepted Answer

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Question 3

When giving chemotherapy as cancer treatment,the nurse recognizes that toxicity to rapidly growing normal cells also occurs.Which rapidly growing normal cells are also harmed by chemotherapy? (Select all that apply.)

A) Bone marrow cells
B) Retinal cells
C) Hair follicle cells
D) Nerve myelin cells
E) Gastrointestinal (GI)mucous membrane cells

Bone marrow cells
Hair follicle cells
Gastrointestinal (GI)mucous membrane cells

Accepted Answer

Chemotherapy targets rapidly dividing cells, which includes not only cancer cells but also normal cells in the body that divide quickly. Bone marrow cells, hair follicle cells, and gastrointestinal mucous membrane cells all divide rapidly and can be harmed by chemotherapy. Retinal cells and nerve myelin cells are not rapidly dividing cells and are typically not harmed by chemotherapy.

Question 4

The nurse is monitoring a patient who has severe bone marrow suppression following antineoplastic drug therapy.Which is considered a principal early sign of infection?&#10;A) Fever&#10;B) Diaphoresis&#10;C) Tachycardia&#10;D) Elevated white blood cell count

Accepted Answer

Fever is considered a principal early sign of infection in patients with severe bone marrow suppression. This is because their immune system is compromised and may not be able to mount a typical response to an infection, resulting in a delayed increase in white blood cells. Therefore, fever is often the earliest and only sign of infection in these patients. Diaphoresis (excessive sweating), tachycardia (rapid heartbeat), and elevated WBC count are not specific early signs of infection in this population.

Question 5

The nurse is developing a plan of care for a patient who is experiencing gastrointestinal adverse effects,including anorexia and nausea,after the first course of antineoplastic therapy.What is an appropriate outcome for this patient when dealing with this problem?

A) The patient will eat three balanced meals a day within 2 days.
B) The patient will return to normal eating pattern within 4 weeks.
C) The patient will maintain normal weight by consuming healthy snacks as tolerated.
D) The patient will maintain a diet of small,frequent feedings with nutrition supplements within 2 weeks.

Accepted Answer

The patient's anorexia and nausea are likely due to the antineoplastic therapy and may continue for several weeks. Therefore, the goal should be to maintain the patient's weight and prevent further weight loss through small, frequent feedings and nutrition supplements. A return to normal eating patterns within 2 days or even 4 weeks may not be feasible for this patient. Choosing healthy snacks as tolerated may not provide enough nutrition to prevent weight loss.

Question 6

During treatment of a patient who has brain cancer,the nurse hears the oncologist mention that the patient has reached the &#34;nadir.&#34; The nurse knows that this term means which of these?&#10;A) The lowest level of neutrophils reached during therapy.&#10;B) The highest level of neutrophils reached during therapy.&#10;C) The point at which the adverse effects of chemotherapy will stop.&#10;D) The point at which the cytotoxic action against cancer cells is the highest.

Accepted Answer

Nadir refers to the lowest point that a patient's blood counts will reach during chemotherapy or radiation treatment. Specifically, it typically refers to the lowest level of neutrophils, which are a type of white blood cells that play a key role in fighting infection. This is important because when a patient's neutrophil count is low, they are at increased risk for infections, so precautions must be taken to protect them.

Question 7

A patient is receiving her third course of 5-fluorouracil therapy and knows that stomatitis is a potential adverse effect of antineoplastic therapy.What will the nurse teach her about managing this problem?

A) "You can take aspirin to prevent stomatitis."
B) "Be sure to watch for and report black,tarry stools immediately."
C) "You need to increase your intake of foods containing fiber and citric acid."
D) "Be sure to examine your mouth daily for bleeding,painful areas,and ulcerations."

Accepted Answer

The nurse should teach the patient to examine her mouth daily for bleeding, painful areas, and ulcerations as this is the best way to manage stomatitis. Aspirin does not prevent stomatitis, black, tarry stools are a symptom of gastrointestinal bleeding, and increasing fiber and citric acid intake may irritate the mouth further.

Question 8

A patient,diagnosed with lymphoma,has an allergy to one of the proposed chemotherapy drugs.The tumor has not responded to other types of treatment.The nurse expects the oncologist to follow which course of treatment?

A) The physician will choose another drug to use.
B) The chemotherapy will be given along with supportive measures to treat a possible allergic reaction.
C) The patient will receive reduced doses of chemotherapy for a longer period of time.
D) The chemotherapy cannot be given because of the patient's allergy.

Accepted Answer

Even if a patient has a known allergic reaction to a given antineoplastic medication, the urgency of treating the patient's cancer may still necessitate administering the medication and then treating any allergic symptoms with supportive medications, such as antihistamines, corticosteroids, and acetaminophen.

Question 9

A patient is receiving high doses of methotrexate and is experiencing severe bone marrow suppression.The nurse expects which intervention to be ordered with this drug to reduce this problem?&#10;A) A transfusion of whole blood&#10;B) Leucovorin rescue&#10;C) Therapy with filgrastim (Neupogen)&#10;D) Administration of allopurinol (Zyloprim)

Accepted Answer

Leucovorin rescue is used to reduce bone marrow suppression caused by high doses of methotrexate. It is given as an antidote to rescue normal cells from toxic effects of methotrexate. This option is preferred over the other choices as it targets the problem directly. A transfusion of whole blood may be given if the patient develops severe anemia or bleeding as a complication of bone marrow suppression. Therapy with filgrastim may be used to increase white blood cell production in patients receiving chemotherapy but is not specific to bone marrow suppression. Allopurinol is not used in the treatment of bone marrow suppression caused by methotrexate.

Question 10

A patient who has been on methotrexate therapy is experiencing mild pain.The patient is asking for aspirin for the pain.The nurse recognizes that which of these is true in this situation?&#10;A) The aspirin will aggravate diarrhea.&#10;B) The aspirin will masks signs of infection.&#10;C) Aspirin can lead to methotrexate toxicity.&#10;D) The aspirin will cause no problems for the patient on methotrexate.

Accepted Answer

Aspirin can increase the risk of methotrexate toxicity, including bone marrow suppression, gastrointestinal toxicity, and renal toxicity. Therefore, it is not recommended for patients on methotrexate therapy to take aspirin for pain relief. The nurse should discuss alternative pain relief options with the patient's healthcare provider.

Question 11

The nurse is reviewing infection-prevention measures with a patient who is receiving antineoplastic drug therapy.Which statement by the patient indicates the need for further teaching?&#10;A) &#34;I will avoid those who have recently had a vaccination.&#34;&#10;B) &#34;I will eat only fresh fruits and vegetables.&#34;&#10;C) &#34;I will report a sore throat,cough,or low-grade temperature.&#34;&#10;D) &#34;It is important for both my family and me to practice good hand washing.&#34;

Accepted Answer

The answer of The nurse is reviewing infection-prevention measures with...

Question 12

The nurse is administering a combination of three different antineoplastic drugs to a patient who has metastatic breast cancer.Which statement best describes the rationale for combination therapy?&#10;A) There will be less nausea and vomiting.&#10;B) Increased cancer-cell killing will occur.&#10;C) The drugs will prevent metastasis.&#10;D) Combination therapy reduces the need for radiation therapy.

Accepted Answer

The answer of The nurse is administering a combination of...

Question 13

One patient has cancer of the bone; another has cancer in the connective tissues of the thigh muscles; a third patient has cancer in the vascular tissues.Which of these is the correct term for these tumors?

A) Sarcoma
B) Leukemia
C) Carcinoma
D) Lymphoma

Accepted Answer

The answer of One patient has cancer of the bone;...

Deck 45: Antineoplastic Drugs Part 1: Cancer Overview and Cell Cyclespecific Drugs