Question 1

A patient is receiving a third session of chemotherapy with daunorubicin (Cerubidine).The nurse will assess the patient for which signs of a potential severe toxic effect of this drug?&#10;A) Tinnitus and hearing loss&#10;B) Numbness and tingling in the fingers&#10;C) A weight gain of 2 pounds or more in 24 hours&#10;D) Decreased blood urea nitrogen and creatinine levels

Accepted Answer

Cardiac toxicity may occur, so frequent checking of heart and breath sounds is necessary and daily weights need to be recorded (with reporting of an increase of 2 pounds or more in 24 hours or 5 pounds or more in 1 week).

Question 2

When giving cisplatin (Platinol-AQ),the nurse is aware that the major dose-limiting effect of this drug is which condition?&#10;A) Alopecia&#10;B) Kidney damage&#10;C) Cardiotoxicity&#10;D) Stomatitis

Accepted Answer

The major dose-limiting effect of cisplatin is kidney damage. This drug is known to cause nephrotoxicity, which can lead to acute kidney injury, electrolyte imbalances, and renal failure. Other potential side effects of cisplatin include nausea, vomiting, neuropathy, ototoxicity, and myelosuppression. Alopecia and stomatitis may also occur, but they are not the major dose-limiting effects of this drug. Cardiotoxicity is not typically associated with cisplatin administration.

Question 3

A female patient is receiving palliative therapy with androgen hormones as part of treatment for inoperable breast cancer.The nurse will discuss with the patient which potential body image changes that may occur as adverse effects?

A) Hirsutism and acne
B) Weight gain
C) Flushing and hot flashes
D) Alopecia and body odor

Hirsutism and acne

Accepted Answer

Androgen hormones can cause hirsutism (excessive hair growth) and acne as adverse effects, which may affect the patient's body image. Weight gain, flushing, hot flashes, alopecia, and body odor are also potential adverse effects, but they are not directly related to changes in body image.

Question 4

Just before the second course of chemotherapy,the laboratory calls to report that the patient's neutrophil count is 450 cells/mm³.The nurse expects that the oncologist will follow which course of treatment?

A) Chemotherapy will continue as scheduled.
B) Chemotherapy will resume with a lowered dosage.
C) Chemotherapy will resume after a transfusion of neutrophils.
D) Chemotherapy will be withheld until the neutrophil count returns toward normal levels.

Accepted Answer

A neutrophil count of 450 cells/mm3 is considered severely low and puts the patient at high risk for infection. Chemotherapy is known to further suppress the bone marrow, which produces neutrophils, putting the patient at even higher risk for infection. Therefore, chemotherapy should be withheld until the neutrophil count returns towards normal levels to avoid potentially life-threatening infections.

Question 5

A patient is receiving doxorubicin (Adriamycin)as part of treatment for ovarian cancer.Which nursing diagnosis is related to this antineoplastic drug?&#10;A) Decreased cardiac output related to the adverse effect of cardiotoxicity&#10;B) Ineffective breathing pattern related to the adverse effect of pulmonary toxicity&#10;C) Risk for injury related to the effects of neurotoxicity (ataxia,numbness of hands and feet)&#10;D) Impaired urinary elimination pattern related to hyperuricemia

Accepted Answer

Doxorubicin is known for causing cardiotoxicity, which can lead to decreased cardiac output. It is important for the nurse to monitor the patient's cardiac function and manage any adverse effects accordingly. Option B and C may also be potential adverse effects of doxorubicin, but they are not as commonly associated with this medication. Option D is not directly related to the drug's mechanism of action or adverse effects.

Question 6

What is the nurse's priority action if extravasation of an antineoplastic drug occurs during intravenous (IV)administration?&#10;A) Reduce the infusion rate.&#10;B) Discontinue the IV,and apply warm compresses.&#10;C) Stop the infusion immediately,but leave the IV catheter in place.&#10;D) Change the infusion to normal saline,and inject the area with hydrocortisone.

Accepted Answer

When extravasation of an antineoplastic drug occurs, the nurse's priority action is to stop the infusion immediately but leave the IV catheter in place to allow for administration of an antidote or other medications. Discontinuing the IV and applying warm compresses or changing the infusion to normal saline and injecting the area with hydrocortisone are not appropriate actions for extravasation of antineoplastic drugs. Reducing the infusion rate is also not appropriate as the drug has already leaked into the surrounding tissue.

Question 7

The nurse is teaching a class about the various chemotherapy drugs.Which of these statements explains why alkylating drugs are also called &#34;cell cycle-nonspecific drugs&#34;?&#10;A) They are cytotoxic during a specific cell cycle.&#10;B) They are cytotoxic in any phase of the cell cycle.&#10;C) They are effective against several types of neoplasms.&#10;D) They are more highly differentiated than cell cycle-specific drugs.

Accepted Answer

Alkylating drugs are called cell cycle-nonspecific drugs because they are cytotoxic in any phase of the cell cycle, as they work by attaching an alkyl group to DNA and preventing it from replicating. This is in contrast to cell cycle-specific drugs, which target cells at specific phases of the cell cycle when they are most active.

Question 8

A patient will be receiving mitoxantrone (Novantrone),12 mg/m² every 3 weeks,as part of treatment for prostate cancer.Each dose is mixed into a 50-mL bag of D₅W and needs to infuse over 15 minutes.The infusion pump delivers the dose at milliliters per hour.Identify the nurse will set the pump to infuse at what rate._______

Accepted Answer

The answer of A patient will be receiving mitoxantrone (Novantrone),12...

Question 9

When hanging a new infusion bag of a chemotherapy drug,the nurse accidentally spills a small amount of the solution onto the floor.Which action by the nurse is appropriate?&#10;A) Let it dry,and then mop the floor.&#10;B) Wipe the area with a disposable paper towel.&#10;C) Use a spill kit to clean the area.&#10;D) Ask the housekeeping department to clean the floor.

Accepted Answer

Chemotherapy drugs are hazardous substances, and any spillages must be dealt with using appropriate precautions. Option C is the correct choice as it involves using a spill kit, which contains materials to safely and effectively clean up the spill and prevent further spread of the medication. Options A and B do not provide sufficient protection for staff or patients, and option D is not practical as waiting for housekeeping to clean the area may cause a delay in administering the medication.

Question 10

During chemotherapy,a patient develops severe diarrhea caused by a vasoactive intestinal peptide-secreting tumor (VIPoma).The nurse expects to administer which drug for this problem?&#10;A) Dexrazoxane (Zinecard)&#10;B) Allopurinol (Zyloprim)&#10;C) Octreotide (Sandostatin)&#10;D) Bismuth subsalicylate (Pepto-Bismol)

Accepted Answer

Octreotide is a synthetic form of somatostatin that inhibits the secretion of vasoactive intestinal peptide (VIP). Inhibition of VIP secretion can effectively treat diarrhea associated with VIPoma. Dexrazoxane is a cardioprotective agent used to reduce the risk of cardiotoxicity associated with certain chemotherapeutic agents, and is not indicated for diarrhea. Allopurinol is a xanthine oxidase inhibitor used to prevent hyperuricemia and gout, and is not indicated for diarrhea. Bismuth subsalicylate is an antidiarrheal agent that works by reducing inflammation and fluid secretion in the gastrointestinal tract, but is not specific for VIPoma-associated diarrhea.

Deck 46: Antineoplastic Drugs Part 2: Cell Cyclenonspecific Drugs and Miscellaneous Drugs